Local Methotrexate Injection as the First-line Treatment for Cesarean Scar Pregnancy: Review of the Literature.

PubMed

Cheung, Vincent Y T

2015-01-01

The objective of this study was to determine the outcome of using ultrasound-guided local methotrexate injection as the first-line treatment of cesarean scar pregnancy (CSP). A literature review was performed on all eligible reports using this modality as the first-line treatment of CSP. Relevant publications were obtained from the PubMed electronic database from inception to December 2014. Ninety-six cases from 95 women reported in 17 articles were reviewed. The success rate was 73.9% after a single local methotrexate injection. An accumulated success rate of 88.5% could be achieved after additional local or intramuscular methotrexate administration. Eleven cases (11.5%) failed methotrexate treatment and required surgical interventions. Except for women with serum human chorionic gonadotropin levels higher than 100 000 IU/L, ultrasound-guided local methotrexate injection could be considered as a first-line treatment modality for CSP. Copyright © 2015 AAGL. Published by Elsevier Inc. All rights reserved.

Monitoring of Serum DNA Methylation as an Early Independent Marker of Response and Survival in Metastatic Breast Cancer: TBCRC 005 Prospective Biomarker Study

PubMed Central

Fackler, MaryJo S.; Zhang, Zhe; Lopez-Bujanda, Zoila A.; Jeter, Stacie C.; Sokoll, Lori J.; Garrett-Mayer, Elizabeth; Cope, Leslie M.; Umbricht, Christopher B.; Euhus, David M.; Forero, Andres; Storniolo, Anna M.; Nanda, Rita; Lin, Nancy U.; Carey, Lisa A.; Ingle, James N.; Sukumar, Saraswati; Wolff, Antonio C.

2017-01-01

Purpose Epigenetic alterations measured in blood may help guide breast cancer treatment. The multisite prospective study TBCRC 005 was conducted to examine the ability of a novel panel of cell-free DNA methylation markers to predict survival outcomes in metastatic breast cancer (MBC) using a new quantitative multiplex assay (cMethDNA). Patients and Methods Ten genes were tested in duplicate serum samples from 141 women at baseline, at week 4, and at first restaging. A cumulative methylation index (CMI) was generated on the basis of six of the 10 genes tested. Methylation cut points were selected to maximize the log-rank statistic, and cross-validation was used to obtain unbiased point estimates. Logistic regression or Cox proportional hazard models were used to test associations between the CMI and progression-free survival (PFS), overall survival (OS), and disease status at first restaging. The added value of the CMI in predicting survival outcomes was evaluated and compared with circulating tumor cells (CellSearch). Results Median PFS and OS were significantly shorter in women with a high CMI (PFS, 2.1 months; OS, 12.3 months) versus a low CMI (PFS, 5.8 months; OS, 21.7 months). In multivariable models, among women with MBC, a high versus low CMI at week 4 was independently associated with worse PFS (hazard ratio, 1.79; 95% CI, 1.23 to 2.60; P = .002) and OS (hazard ratio, 1.75; 95% CI, 1.21 to 2.54; P = .003). An increase in the CMI from baseline to week 4 was associated with worse PFS (P < .001) and progressive disease at first restaging (P < .001). Week 4 CMI was a strong predictor of PFS, even in the presence of circulating tumor cells (P = .004). Conclusion Methylation of this gene panel is a strong predictor of survival outcomes in MBC and may have clinical usefulness in risk stratification and disease monitoring. PMID:27870562

Clinical importance of [18F]fluorodeoxyglucose positron emission tomography/computed tomography in the management of patients with bronchoalveolar carcinoma: Role in the detection of recurrence.

PubMed

Skoura, Evangelia; Datseris, Ioannis E; Exarhos, Dimitrios; Chatziioannou, Sophia; Oikonomopoulos, Georgios; Samartzis, Alexandros; Giannopoulou, Chariklia; Syrigos, Konstantinos N

2013-05-01

[ 18 F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) has been reported to have a low sensitivity in the initial diagnosis of bronchoalveolar carcinoma (BAC) due to BAC's low metabolic activity. The aim of this study was to assess the value of [ 18 F]FDG-PET/CT in the detection of BAC recurrence. Between February 2007 and September 2011, the [ 18 F]FDG-PET/CT scans that were performed on patients with known, histologically proven BAC were studied. A total of 24 [ 18 F]FDG-PET/CT scans were performed in 22 patients, including 16 males and 6 females, with a mean age of 65±9 years. Among the scans, 15 were performed to assess for possible recurrence with equivocal findings in conventional imaging methods and 9 for restaging post-therapy. In all cases conventional imaging studies (CT and MRI) were performed 5-30 days prior to PET/CT. Among the 24 [ 18 F]FDG-PET/CT scans, 18 were positive and 6 negative. Among the 15 [ 18 F]FDG-PET/CT scans performed for suspected recurrence, 34 lesions were detected and the mean maximum standardized uptake value (SUVmax) was 6.8±3.26. In nine scans, upstaging was observed, while two were in agreement with the findings of the conventional modalities. A greater number of lesions were detected in two scans and fewer lesions were detected in one, with no change in staging. Only one scan was negative. By contrast, in patients examined for restaging, there were only five lesions with a mean SUVmax of 4.86±3.18. Agreement between the findings of [ 18 F]FDG-PET/CT and the conventional modalities was observed in 8 out of 9 cases. Although [ 18 F]FDG-PET/CT has been reported to have a low sensitivity in the initial diagnosis of BAC, the present results indicate that when there is recurrence, the lesions become [ 18 F]FDG avid. [ 18 F]FDG-PET/CT may provide further information in patients evaluated for recurrence and thus improve patient management.

Implications of the Index Cholecystectomy and Timing of Referral for Radical Resection of Advanced Incidental Gallbladder Cancer

PubMed Central

Ausania, F; White, SA; French, JJ; Jaques, BC; Charnley, RM; Manas, DM

2015-01-01

Introduction Advanced (pT2/T3) incidental gallbladder cancer is often deemed unresectable after restaging. This study assesses the impact of the primary operation, tumour characteristics and timing of management on re-resection. Methods The records of 60 consecutive referrals for incidental gallbladder cancer in a single tertiary centre from 2003 to 2011 were reviewed retrospectively. Decision on re-resection of incidental gallbladder cancer was based on delayed interval restaging at three months following cholecystectomy. Demographics, index cholecystectomy data, primary pathology, CA19–9 tumour marker levels at referral and time from cholecystectomy to referral as well as from referral to restaging were analysed. Results Thirty-seven patients with pT2 and twelve patients with pT3 incidental gallbladder cancer were candidates for radical re-resection. Following interval restaging, 24 patients (49%) underwent radical resection and 25 (51%) were deemed inoperable. The inoperable group had significantly more patients with positive resection margins at cholecystectomy (p=0.002), significantly higher median CA19–9 levels at referral (p=0.018) and were referred significantly earlier (p=0.004) than the patients who had resectable tumours. On multivariate analysis, urgent referral (p=0.036) and incomplete cholecystectomy (p=0.048) were associated significantly with inoperable disease following restaging. Conclusions In patients with incidental, potentially resectable, pT2/T3 gallbladder cancer, inappropriate index cholecystectomy may have a significant impact on tumour dissemination. Early referral of breached tumours is not associated with resectability. PMID:25723690

Bleomycin-Induced Pulmonary Changes on Restaging Computed Tomography Scans in Two Thirds of Testicular Cancer Patients Show No Correlation With Fibrosis Markers.

PubMed

den Hollander, Martha W; Westerink, Nico-Derk L; Lubberts, Sjoukje; Bongaerts, Alfons H H; Wolf, Rienhart F E; Altena, Renska; Nuver, Janine; Oosting, Sjoukje F; de Vries, Elisabeth G E; Walenkamp, Anna M E; Meijer, Coby; Gietema, Jourik A

2016-08-01

In metastatic testicular cancer patients treated with bleomycin, etoposide, and cisplatin (BEP) chemotherapy, bleomycin-induced pneumonitis is a well-known and potentially fatal side effect. We sought to determine the prevalence of lesions as signs of bleomycin-induced pulmonary changes on restaging computed tomography (CT) scans after treatment and to ascertain whether fibrosis markers were predictive of these changes. This prospective nonrandomized cohort study included metastatic testicular cancer patients, 18-50 years of age, treated with BEP chemotherapy. Restaging CT scans were examined for lesions as signs of bleomycin-induced pulmonary changes by two independent radiologists and graded as minor, moderate, or severe. Plasma samples were collected before, during, and after treatment and were quantified for transforming growth factor-β1 (TGF-β1), growth differentiation factor-15 (GDF-15), and high-sensitivity C-reactive protein (hs-CRP). In total, 66 patients were included: forty-five (68%) showed signs of bleomycin-induced pulmonary changes on the restaging CT scan, 37 of which were classified as minor and 8 as moderate. No differences in TGF-β1, GDF-15, or hs-CRP plasma levels were found between these groups. Bleomycin-induced pulmonary changes are common on restaging CT scans after BEP chemotherapy for metastatic testicular cancer. Changes in TGF-β1, GDF-15, and hs-CRP plasma levels do not differ between patients with and without radiological lesions as signs of bleomycin-induced pulmonary changes and are therefore not helpful as predictive biomarkers. Bleomycin-induced pneumonitis (BIP) is a well-known and potentially fatal side effect in metastatic testicular cancer patients treated with bleomycin, etoposide, and cisplatin chemotherapy. Currently, the decision to discontinue bleomycin administration is made during treatment and is based on clinical signs. An upfront or early marker or biomarker that identifies patients likely to develop BIP would be preferable. This study found that bleomycin-induced pulmonary changes are common on restaging computed tomography scans and mostly resolve. No correlation was seen between these changes and fibrosis or inflammation markers (transforming growth factor-β1, growth differentiation factor-15, and high-sensitivity C-reactive protein). ©AlphaMed Press.

How effective is ureteroscopy in the treatment of pediatric stone disease?

PubMed

Thomas, John C

2010-08-01

Pediatric ureteroscopy has been increasingly used to manage both ureteral and renal stones. Unfortunately, there are no current standardized recommendations when treating pediatric stone disease so the modality chosen is left to the treating surgeon. A review of the current literature on pediatric ureteroscopy was used to compile this article. For the purposes of this review, the majority of series include stones < or =1 cm. Ureteroscopy is considered to be first-line therapy in treating mid- to distal ureteral stones and is rapidly evolving as an acceptable first-line therapy for renal stones as well. Limitations do exist and include stone composition, location, size, as well as the unique anatomic challenges faced by pediatric urologists in terms of anomalous kidneys and/or reconstructed urinary tracts. In conclusion, ureteroscopy can be considered first-line therapy for mid- or distal ureteral stones, however, it shares a similar efficacy rate as extracorporeal shock wave lithotripsy for the treatment of renal calculi. There is a need for direct comparison in the literature of all modalities treating pediatric stone disease to facilitate guidelines that help treating surgeons choose the most efficacious modality offering the highest success rates with the lowest morbidity.

Dose mapping: validation in 4D dosimetry with measurements and application in radiotherapy follow-up evaluation.

PubMed

Zhang, Geoffrey G; Huang, Tzung-Chi; Forster, Ken M; Lin, Kang-Ping; Stevens, Craig; Harris, Eleanor; Guerrero, Thomas

2008-04-01

The purpose of this paper is to validate a dose mapping program using optical flow method (OFM), and to demonstrate application of the program in radiotherapy follow-up evaluation. For the purpose of validation, the deformation matrices between four-dimensional (4D) CT data of different simulated respiration phases of a phantom were calculated using OFM. The matrices were then used to map doses of all phases to a single-phase image, and summed in equal time weighting. The calculated dose should closely represent the dose delivered to the moving phantom if the deformation matrices are accurately calculated. The measured point doses agreed with the OFM calculations better than 2% at isocenters, and dose distributions better than 1mm for the 50% isodose line. To demonstrate proof-of-concept for the use of deformable image registration in dose mapping for treatment evaluation, the treatment-planning CT was registered with the post-treatment CT image from the positron emission tomography (PET)/CT resulting in a deformation matrix. The dose distribution from the treatment plan was then mapped onto the restaging PET/CT using the deformation matrix. Two cases in which patients had thoracic malignancies are presented. Each patient had CT-based treatment planning for radiotherapy and restaging fluorodeoxy glucose (FDG)-PET/CT imaging 4-6 weeks after completion of treatments. Areas of pneumonitis and recurrence were identified radiographically on both PET and CT restaging images. Local dose and standard uptake values for pneumonitis and recurrence were studied as a demonstration of this method. By comparing the deformable mapped dose to measurement, the treatment evaluation method which is introduced in this manuscript proved to be accurate. It thus provides a more accurate analysis than other rigid or linear dose-image registration when used in studying treatment outcome versus dose.

Continuous ambulatory peritoneal dialysis is better than automated peritoneal dialysis as first-line treatment in renal replacement therapy.

PubMed

Li, Philip Kam-Tao; Chung, Kwok Yi; Chow, Kai Ming

2007-06-01

This article examines the roles of continuous ambulatory peritoneal dialysis (CAPD) versus automated peritoneal dialysis (APD) as first-line renal replacement therapy. To date, no high-quality large-scale randomized controlled studies have compared CAPD with APD as first-line therapy. However, a discussion on this issue is important so that nephrologists can decide and patients can have a choice of modality on which to start dialysis, especially in the context of health care economics. We review the literature and present Hong Kong as the model of a "CAPD first" policy, an appealing, cost-effective approach for any country. An ideal renal replacement therapy should provide optimal survival, lowest possible risk for comorbidity, highest level of quality of life, and equally important, acceptable cost to society. When we consider this subject in the context that all patients should be started on one first-line modality, the data suggest that a "CAPD first" policy has all these advantages, with APD probably having the edge only with regard to patient preference. The present review highlights preservation of residual renal function, removal and balancing of sodium, incidence of peritonitis, peritoneal membrane transport status, patient rehabilitation, and financial issues in demonstrating that a "CAPD first" policy is the model that should be adopted.

Diagnostic Performance of 11C-choline PET/CT and FDG PET/CT in Prostate Cancer.

PubMed

Kitajima, Kazuhiro; Yamamoto, Shingo; Odawara, Soichi; Kobayashi, Kaoru; Fujiwara, Masayuki; Kamikonya, Norihiko; Fukushima, Kazuhito; Nakanishi, Yukako; Hashimoto, Takahiko; Yamada, Yusuke; Suzuki, Toru; Kanematsu, Akihiro; Nojima, Michio; Yamakado, Koichiro

2018-06-01

We compared 11C-choline and FDG PET/CT scan findings for the staging and restaging of prostate cancer. Twenty Japanese prostate cancer patients underwent 11C-choline and FDG PET/CT before (n=5) or after (n=15) treatment. Using a five-point scale, we compared these scanning modalities regarding patient- and lesion-based diagnostic performance for local recurrence, untreated primary tumor, and lymph node and bony metastases. Of the 20 patients, documented local lesions, and node and bony metastases were present in 11 (55.0%), 9 (45.0%), and 13 (65.0%), respectively. The patient-based sensitivity/specificity/accuracy/area under the receiver-operating-characteristic curve (AUC) values for 11C-choline-PET/CT for diagnosing local lesions were 90.9% /100%/ 95.0% / 1.0, whereas those for FDG-PET/CT were 45.5% /100%/ 75.0% / 0.773. Those for 11C-choline-PET/CT for node metastasis were 88.9% /100%/ 95.0% / 0.944, and those for FDG-PET/CT were 44.4%/100%/75.0%/0.722. Those for 11C-choline-PET/CT for bone metastasis were 84.6%/100%/90.0%/0.951, and those for FDG-PET/CT were 76.9% /100%/ 85.0% / 0.962. The AUCs for local lesion and node metastasis differed significantly (p=0.0039, p=0.011, respectively). The lesion-based detection rates of 11C-choline compared to FDG PET/CT for local lesion, and node and bone metastases were 91.7% vs. 41.7%, 92.0% vs. 32.0%, and 94.8% vs. 83.0% (p=0.041, p=0.0030, p<0.0001), respectively. 11C-choline-PET/CT is more useful for the staging and restaging of prostate cancer than FDG-PET/CT in Japanese men.

Retrospective Evaluation of Hairy Cell Leukemia Patients Treated with Three Different First-Line Treatment Modalities in the Last Two Decades: A Single-Center Experience.

PubMed

Öngören, Şeniz; Eşkazan, Ahmet Emre; Berk, Selin; Elverdi, Tuğrul; Salihoğlu, Ayşe; Ar, Muhlis Cem; Başlar, Zafer; Aydın, Yıldız; Tüzüner, Nükhet; Soysal, Teoman

2017-12-01

In this study, we retrospectively analyzed the clinical outcome, treatment responses, infectious complications, and survival rates of 71 hairy cell leukemia (HCL) cases. Sixty-seven patients received a first-line treatment and 2-chlorodeoxyadenosine (cladribine-2-CdA) was administered in 31 cases, 19 patients received interferon-alpha (INF-α), splenectomy was performed in 16 cases, and rituximab was used in one. Although the highest overall response rate (ORR) was observed in patients receiving 2-CdA upfront, ORRs were comparable in the 2-CdA, INF-α, and splenectomy subgroups. Relapse rates were significantly lower in patients who received first-line 2-CdA. The progression-free survival (PFS) rate with 2-CdA was significantly higher than in patients with INF-α and splenectomy, but we found similar overall survival rates with all three upfront treatment modalities. Infections including tuberculosis were a major problem. Although purine analogues have improved the ORRs and PFS, there is still much progress to make with regard to overall survival and relapsed/refractory disease in patients with HCL.

The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma.

PubMed

Quartuccio, Natale; Treglia, Giorgio; Salsano, Marco; Mattoli, Maria Vittoria; Muoio, Barbara; Piccardo, Arnoldo; Lopci, Egesta; Cistaro, Angelina

2013-06-01

The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS). A comprehensive literature search of published studies through October 10(th), 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OS. Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning.

Diagnostic Value of Software-Based Image Fusion of Computed Tomography and F18-FDG PET Scans in Patients with Malignant Lymphoma

PubMed Central

Henninger, B.; Putzer, D.; Kendler, D.; Uprimny, C.; Virgolini, I.; Gunsilius, E.; Bale, R.

2012-01-01

Aim. The purpose of this study was to evaluate the accuracy of 2-deoxy-2-[fluorine-18]fluoro-D-glucose (FDG) positron emission tomography (PET), computed tomography (CT), and software-based image fusion of both modalities in the imaging of non-Hodgkin's lymphoma (NHL) and Hodgkin's disease (HD). Methods. 77 patients with NHL (n = 58) or HD (n = 19) underwent a FDG PET scan, a contrast-enhanced CT, and a subsequent digital image fusion during initial staging or followup. 109 examinations of each modality were evaluated and compared to each other. Conventional staging procedures, other imaging techniques, laboratory screening, and follow-up data constituted the reference standard for comparison with image fusion. Sensitivity and specificity were calculated for CT and PET separately. Results. Sensitivity and specificity for detecting malignant lymphoma were 90% and 76% for CT and 94% and 91% for PET, respectively. A lymph node region-based analysis (comprising 14 defined anatomical regions) revealed a sensitivity of 81% and a specificity of 97% for CT and 96% and 99% for FDG PET, respectively. Only three of 109 image fusion findings needed further evaluation (false positive). Conclusion. Digital fusion of PET and CT improves the accuracy of staging, restaging, and therapy monitoring in patients with malignant lymphoma and may reduce the need for invasive diagnostic procedures. PMID:22654631

PET/CT and contrast enhanced CT in single vs. two separate sessions: a cost analysis study.

PubMed

Picchio, M; Mansueto, M; Crivellaro, C; Guerra, L; Marcelli, S; Arosio, M; Sironi, S; Gianolli, L; Grimaldi, A; Messa, C

2012-06-01

Aim of the study was to quantify the economic impact of PET/CT and contrast enhanced (c.e.) CT performed in a single session examination vs. stand-alone modalities in oncological patients. One-hundred-forty-five cancer patients referred to both PET/CT and c.e. CT, to either stage (N.=46) or re-stage (N.=99) the disease, were included. Seventy-two/145 performed both studies in a single session (innovative method) and 73/145 in two different sessions (traditional method). The cost-minimization analysis was performed by evaluating: 1) institutional costs, data obtained by hospital accountability (staff, medical materials, equipment maintenance and depreciation, departments utilities); 2) patients costs, data obtained by a specific survey provided to patients (travel, food, accommodation costs, productivity loss). Economic data analysis showed that the costs for innovative method was lower than those of traditional method, both for Institution (106 € less per test) and for patient (21 € less per patient). The loss of productivity for patient and caregivers resulted lower for the innovative method than the traditional method (3 work-hour less per person). PET/CT and c.e. CT performed in a single session is more cost-effective than stand-alone modalities, by reducing both Institutional and patients costs. These advantages are mainly due to lower Institutional cost (single procedure) and to lower cost related to travel and housing.

Combined Modality Treatment for PET-Positive Non-Hodgkin Lymphoma: Favorable Outcomes of Combined Modality Treatment for Patients With Non-Hodgkin Lymphoma and Positive Interim or Postchemotherapy FDG-PET

DOE Office of Scientific and Technical Information (OSTI.GOV)

Halasz, Lia M.; Jacene, Heather A.; Catalano, Paul J.

2012-08-01

Purpose: To evaluate outcomes of patients treated for aggressive non-Hodgkin lymphoma (NHL) with combined modality therapy based on [{sup 18}F]fluoro-2-deoxy-2-D-glucose positron emission tomography (FDG-PET) response. Methods and Materials: We studied 59 patients with aggressive NHL, who received chemotherapy and radiation therapy (RT) from 2001 to 2008. Among them, 83% of patients had stage I/II disease. Patients with B-cell lymphoma received R-CHOP (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone)-based chemotherapy, and 1 patient with anaplastic lymphoma kinase-negative anaplastic T-cell lymphoma received CHOP therapy. Interim and postchemotherapy FDG-PET or FDG-PET/computed tomography (CT) scans were performed for restaging. All patients received consolidated involved-field RT.more » Median RT dose was 36 Gy (range, 28.8-50 Gy). Progression-free survival (PFS) and local control (LC) rates were calculated with and without a negative interim or postchemotherapy FDG-PET scan. Results: Median follow-up was 46.5 months. Thirty-nine patients had negative FDG-PET results by the end of chemotherapy, including 12 patients who had a negative interim FDG-PET scan and no postchemotherapy PET. Twenty patients were FDG-PET-positive, including 7 patients with positive interim FDG-PET and no postchemotherapy FDG-PET scans. The 3-year actuarial PFS rates for patients with negative versus positive FDG-PET scans were 97% and 90%, respectively. The 3-year actuarial LC rates for patients with negative versus positive FDG-PET scans were 100% and 90%, respectively. Conclusions: Patients who had a positive interim or postchemotherapy FDG-PET had a PFS rate of 90% at 3 years after combined modality treatment, suggesting that a large proportion of these patients can be cured with consolidated RT.« less

Position of nuclear medicine techniques in the diagnostic work-up of neuroendocrine tumors.

PubMed

Bombardieri, E; Seregni, E; Villano, C; Chiti, A; Bajetta, E

2004-06-01

In recent years nuclear medicine has contributed to the impressive development of the knowledge of neuroendocrine tumors in terms of biology (receptor scintigraphy), pharmacology (development of new tracers), and therapy (radiometabolic therapy). At present, it is impossible to plan the management of a patient affected by a neuroendocrine tumor without performing nuclear medicine examinations. The contribution of nuclear medicine had affected and improved the management of these patients by offering various important options that are part of the modern diagnosis and treatment protocols. The clinical experience and the literature confirm that, among the wide variety of tracers and nuclear medicine modalities available today, metaiodobenzylguanidine (MIBG) and DTPA-D-Phe-octreotide (pentetreotide) are the radiopharmaceuticals of current clinical use. Several new somatostatin analogues are under investigation. Positron emission tomography (PET) supplies a range of labelled compounds to be used for the visualization of tumor biochemistry. In addition to the first routinely used PET tracer in oncology, 18F-labelled deoxyglucose (FDG), a number of radiopharmaceuticals based on different precursors such as fluorodopamine and 5-hydroxytryptophan (5-HTP) are going to gain a clinical role. Of course, the diagnosis of neuroendocrine tumors has to be based on integrated information derived from different examinations including nuclear medicine studies. The clinical presentation of neuroendocrine tumors is highly variable: sometimes they manifest typical or atypical symptoms but they may also be detected by chance during an X-ray or ultrasound examination carried out for other reasons. At disease presentation nuclear medicine modalities are sometimes able to direct physicians towards the clinical diagnosis thanks to the specificity of their imaging mechanisms. They also play a role in disease staging and restaging, patient follow-up and treatment monitoring. In addition, the biological characterisation of neuroendocrine tissues (receptor status, glucose metabolism, differentiation, etc.) allows the interpretation of radiopharmaceutical uptake as a prognostic parameter and sometimes as a predictor of the response to treatment.

The role of Fluorine-18-Fluorodeoxyglucose positron emission tomography in staging and restaging of patients with osteosarcoma

PubMed Central

Quartuccio, Natale; Treglia, Giorgio; Salsano, Marco; Mattoli, Maria Vittoria; Muoio, Barbara; Piccardo, Arnoldo; Lopci, Egesta; Cistaro, Angelina

2013-01-01

Background The objective of this study is to systematically review the role of positron emission tomography (PET) and PET/computed tomography (PET/CT) with Fluorine-18-Fluorodeoxyglucose (FDG) in patients with osteosarcoma (OS). Methods A comprehensive literature search of published studies through October 10th, 2012 in PubMed/MEDLINE, Embase and Scopus databases regarding whole-body FDG-PET and FDG-PET/CT in patients with OS was performed. Results We identified 13 studies including 289 patients with OS. With regard to the staging and restaging of OS, the diagnostic performance of FDG-PET and PET/CT seem to be high; FDG-PET and PET/CT seem to be superior to bone scintigraphy and conventional imaging methods in detecting bone metastases; conversely, spiral CT seems to be superior to FDG-PET in detecting pulmonary metastases from OS Conclusions Metabolic imaging may provide additional information in the evaluation of OS patients. The combination of FDG-PET or FDG-PET/CT with conventional imaging methods seems to be a valuable tool in the staging and restaging of OS and may have a relevant impact on the treatment planning. PMID:23801904

The tell-tale heart: A case of recurrent vulvar carcinoma with cardiac metastasis and review of literature.

PubMed

Jafri, Syed Imran Mustafa; Ali, Naveed; Farhat, Salman; Malik, Faizan; Shahin, Mark

2017-08-01

A 50-year-old female was diagnosed with vulvar cancer treated with left partial vulvectomy and bilateral lymphadenectomy. Ten months after her surgery, she presented with increased labial swelling, pain and discharge. Biopsy confirmed recurrence of squamous cell vulvar carcinoma. Incidentally, on restaging radiographic scans, she was found to have a large right ventricular mass which, after surgical debulking, was shown to be a squamous cell cancer of vulvar origin. She was commenced on chemotherapy with carboplatin and paclitaxel along with concurrent radiation therapy. Restaging PET scan showed persistent metastatic disease. She was switched to Cisplatin/Taxol after having hypersensitivity reaction to Carboplatin. She received 5 cycles with progression of disease in the follow up scans. She then received Nivolumab for 2 cycles. The patient then opted for comfort directed care given worsening functional status and progression of disease on repeat imaging. Secondary cardiac tumors are very rare and not extensively studied in oncology. Therefore, optimal management is not entirely clear. It is extremely rare for vulvar cancer to metastasize to the heart and only two cases have been reported in the literature. However, vulvar cancer metastasizing to the right ventricular cavity and endocardium has not been described before. We believe that this is the first ever such reported case.

Virtual gastrointestinal colonoscopy in combination with large bowel endoscopy: Clinical application

PubMed Central

He, Qing; Rao, Ting; Guan, Yong-Song

2014-01-01

Although colorectal cancer (CRC) has no longer been the leading cancer killer worldwide for years with the exponential development in computed tomography (CT) or magnetic resonance imaging, and positron emission tomography/CT as well as virtual colonoscopy for early detection, the CRC related mortality is still high. The objective of CRC screening is to reduce the burden of CRC and thereby the morbidity and mortality rates of the disease. It is believed that this goal can be achieved by regularly screening the average-risk population, enabling the detection of cancer at early, curable stages, and polyps before they become cancerous. Large-scale screening with multimodality imaging approaches plays an important role in reaching that goal to detect polyps, Crohn’s disease, ulcerative colitis and CRC in early stage. This article reviews kinds of presentative imaging procedures for various screening options and updates detecting, staging and re-staging of CRC patients for determining the optimal therapeutic method and forecasting the risk of CRC recurrence and the overall prognosis. The combination use of virtual colonoscopy and conventional endoscopy, advantages and limitations of these modalities are also discussed. PMID:25320519

Prediction of Response to Neoadjuvant Chemotherapy and Radiation Therapy with Baseline and Restaging 18F-FDG PET Imaging Biomarkers in Patients with Esophageal Cancer.

PubMed

Beukinga, Roelof J; Hulshoff, Jan Binne; Mul, Véronique E M; Noordzij, Walter; Kats-Ugurlu, Gursah; Slart, Riemer H J A; Plukker, John T M

2018-06-01

Purpose To assess the value of baseline and restaging fluorine 18 ( 18 F) fluorodeoxyglucose (FDG) positron emission tomography (PET) radiomics in predicting pathologic complete response to neoadjuvant chemotherapy and radiation therapy (NCRT) in patients with locally advanced esophageal cancer. Materials and Methods In this retrospective study, 73 patients with histologic analysis-confirmed T1/N1-3/M0 or T2-4a/N0-3/M0 esophageal cancer were treated with NCRT followed by surgery (Chemoradiotherapy for Esophageal Cancer followed by Surgery Study regimen) between October 2014 and August 2017. Clinical variables and radiomic features from baseline and restaging 18 F-FDG PET were selected by univariable logistic regression and least absolute shrinkage and selection operator. The selected variables were used to fit a multivariable logistic regression model, which was internally validated by using bootstrap resampling with 20 000 replicates. The performance of this model was compared with reference prediction models composed of maximum standardized uptake value metrics, clinical variables, and maximum standardized uptake value at baseline NCRT radiomic features. Outcome was defined as complete versus incomplete pathologic response (tumor regression grade 1 vs 2-5 according to the Mandard classification). Results Pathologic response was complete in 16 patients (21.9%) and incomplete in 57 patients (78.1%). A prediction model combining clinical T-stage and restaging NCRT (post-NCRT) joint maximum (quantifying image orderliness) yielded an optimism-corrected area under the receiver operating characteristics curve of 0.81. Post-NCRT joint maximum was replaceable with five other redundant post-NCRT radiomic features that provided equal model performance. All reference prediction models exhibited substantially lower discriminatory accuracy. Conclusion The combination of clinical T-staging and quantitative assessment of post-NCRT 18 F-FDG PET orderliness (joint maximum) provided high discriminatory accuracy in predicting pathologic complete response in patients with esophageal cancer. © RSNA, 2018 Online supplemental material is available for this article.

The Role of Dual-Time Combined 18-Fluorideoxyglucose Positron Emission Tomography and Computed Tomography in the Staging and Restaging Workup of Locally Advanced Rectal Cancer, Treated With Preoperative Chemoradiation Therapy and Radical Surgery

DOE Office of Scientific and Technical Information (OSTI.GOV)

Capirci, Carlo; Rubello, Domenico; Pasini, Felice

2009-08-01

Purpose: In patients with locally advanced rectal cancer (LARC) staging and, after preoperative chemo-radiation therapy (CRT), restaging workup could be useful to tailor therapeutic approaches. Fluorine-18-fluorodeoxyglucose positron emission tomography ([{sup 18}F]FDG-PET) is a promising tool for monitoring the effect of antitumor therapy. This study was aimed to evaluate the possible role of dual time sequential FDG-PET scans in the staging and restaging workup of LARC. Methods and Materials: Eighty-seven consecutive patients with LARC were enrolled. CRT consisted of external-beam intensified radiotherapy (concurrent boost), with concomitant chemotherapy PVI 5-FU (300mg/m{sup 2}/day) followed 8-10 weeks later by surgery. All patients underwent [{supmore » 18}F]FDG-PET/CT before and 5-6 weeks later after the completion of CRT. Measurements of FDG uptake (SUV{sub max}), and percentage of SUV{sub max} difference (Response Index = RI) between pre- and post-CRT [{sup 18}F]FDG-PET scans were evaluated. Results: Six of 87 patients were excluded due to protocol deviation. Following CRT, 40/81 patients (49%) were classified as responders according to Mandard's criteria (TRG1-2). The mean pre-CRT SUV{sub max} was significantly higher than post-CRT (15.8, vs 5.9; p < 0.001). The mean RI was significantly higher in responders than in nonresponder patients (71.3% vs 38%; p = 0.0038). Using a RI cut-off of 65% for defining response to therapy, the following parameters have been obtained: 84.5% sensitivity, 80% specificity, 81.4% positive predictive value, 84.2% negative predictive value, and 81% overall accuracy. Conclusion: These results suggest the potential role of [{sup 18}F]FDG-PET in the restaging workup after preoperative CRT in LARC. RI seems the best predictor to identify CRT response.« less

Right Upper Quadrant Pain: Ultrasound First!

PubMed

Revzin, Margarita V; Scoutt, Leslie M; Garner, Joseph G; Moore, Christopher L

2017-10-01

Acute right upper quadrant (RUQ) pain is a common presenting symptom in emergency departments and outpatient medical practices, and is most commonly attributable to biliary and hepatic pathology. Ultrasound should be used as a first-line imaging modality for the diagnosis of gallstones and cholecystitis, as it allows the differentiation of medical and surgical causes of upper abdominal pathology, and in many circumstances is sufficient to guide patient management. Knowledge of strengths and limitations of ultrasound in the evaluation of RUQ is paramount in correct diagnosis. A spectrum of RUQ pathology for which a RUQ ultrasound examination should reasonably be considered as the initial imaging modality of choice will be reviewed. © 2017 by the American Institute of Ultrasound in Medicine.

Isolated, broad-based apical diverticulum: cardiac magnetic resonance is a "terminator" of cardiac imaging modality for the evaluation of cardiac apex.

PubMed

Ahn, Hyo-Suk; Kim, Hyung-Kwan; Park, Eun-Ah; Lee, Whal; Park, Jae-Hyung; Sohn, Dae-Won

2013-10-01

In spite of the frequent involvement of many cardiac diseases, it is difficult to evaluate the left ventricular apex in detail with transthoracic echocardiography, a first-line imaging modality in cardiovascular diseases, because the apex is very closely located at the echocardiographic probe. Cardiac magnetic resonance enables us to evaluate the cardiac apex without any limitation to the image acquisition. We here present a case regarding a broad-based apical diverticulum, which was initially confused with apical aneurysm.

68Ga-DOTA-TATE PET/CT for Molecular Imaging of Somatostatin Receptor Expression in Extra-adrenal Paraganglioma in a Case of Complete Carney Triad.

PubMed

Derlin, Thorsten; Hartung, Dagmar; Hueper, Katja

2017-12-01

Carney triad is a very rare syndrome characterized by the synchronous or metachronous occurrence of gastrointestinal stromal tumors, pulmonary chondroma, and extra-adrenal paraganglioma. We present the case of a 36-year-old woman with complete Carney triad who underwent a Ga-DOTA-TATE PET/CT scan for restaging of metastasizing extra-adrenal paraganglioma and for evaluation of targeted radionuclide therapy potential. On the Ga-DOTA-TATE PET scan, increased tracer accumulation was observed in paraganglioma metastases. This case highlights the usefulness of Ga-DOTA-TATE PET/CT for restaging of metastasizing paraganglioma in Carney triad and the option of targeted radionuclide therapy in this entity.

Alopecia areata: a new treatment plan

PubMed Central

Alsantali, Adel

2011-01-01

Many therapeutic modalities have been used to treat alopecia areata, with variable efficacy and safety profiles. Unfortunately, none of these agents is curative or preventive. Also, many of these therapeutic agents have not been subjected to randomized, controlled trials, and, except for topical immunotherapy, there are few published studies on long-term outcomes. The treatment plan is designed according to the patient’s age and extent of disease. In this paper, the therapeutic agents are organized according to their efficacy and safety profiles into first-line, second-line, and third-line options. PMID:21833161

Teaching Beginning Chess Skills to Students with Disabilities.

ERIC Educational Resources Information Center

Storey, Keith

2000-01-01

This article discusses teaching higher-level thinking skills and concentration to students with disabilities through chess instruction. Guidelines for chess instruction are provided, including: teaching ideas and strategy first rather than specific lines of play, using a variety of instructional modalities, and building in reinforcement for…

Modal characterization of the ASCIE segmented optics testbed: New algorithms and experimental results

NASA Technical Reports Server (NTRS)

Carrier, Alain C.; Aubrun, Jean-Noel

1993-01-01

New frequency response measurement procedures, on-line modal tuning techniques, and off-line modal identification algorithms are developed and applied to the modal identification of the Advanced Structures/Controls Integrated Experiment (ASCIE), a generic segmented optics telescope test-bed representative of future complex space structures. The frequency response measurement procedure uses all the actuators simultaneously to excite the structure and all the sensors to measure the structural response so that all the transfer functions are measured simultaneously. Structural responses to sinusoidal excitations are measured and analyzed to calculate spectral responses. The spectral responses in turn are analyzed as the spectral data become available and, which is new, the results are used to maintain high quality measurements. Data acquisition, processing, and checking procedures are fully automated. As the acquisition of the frequency response progresses, an on-line algorithm keeps track of the actuator force distribution that maximizes the structural response to automatically tune to a structural mode when approaching a resonant frequency. This tuning is insensitive to delays, ill-conditioning, and nonproportional damping. Experimental results show that is useful for modal surveys even in high modal density regions. For thorough modeling, a constructive procedure is proposed to identify the dynamics of a complex system from its frequency response with the minimization of a least-squares cost function as a desirable objective. This procedure relies on off-line modal separation algorithms to extract modal information and on least-squares parameter subset optimization to combine the modal results and globally fit the modal parameters to the measured data. The modal separation algorithms resolved modal density of 5 modes/Hz in the ASCIE experiment. They promise to be useful in many challenging applications.

Comparison of (68)Ga-DOTA-Tyr(3)-octreotide and (18)F-fluoro-L-dihydroxyphenylalanine positron emission tomography in neuroendocrine tumor patients.

PubMed

Putzer, D; Gabriel, M; Kendler, D; Henninger, B; Knoflach, M; Kroiss, A; Vonguggenberg, E; Warwitz, B; Virgolini, I J

2010-02-01

(68)Ga-DOTA-Tyr3-octreotide positron emission tomography ((68)Ga-DOTA-TOC PET) and (18)F-fluoro-L-dihydroxyphenylalanine PET ((18)F-DOPA PET) are emerging modalities for imaging of neuroendocrine tumors. This study reports our initial experiences with these two PET modalities on initial diagnosis, staging and restaging in NET patients. Fifteen patients with NET underwent both (68)Ga-DOTA-TOC and (18)F-DOPA PET as well as computed tomography (CT). Image findings were compared on a patient-basis (pathological uptake: yes/no) as well as on a lesion-basis. Contrast-enhanced CT and histological follow-up served as gold standard. Furthermore, imaging results were matched with tumor marker levels and quantitative tracer uptake by the tumor lesions. When comparing (68)Ga-DOTA-TOC and (18)F-DOPA PET, each modality showed a sensitivity of 64% and a specificity of 100% on a patient-based analysis. (68)Ga-DOTA-TOC PET and (18)F-DOPA PET showed equal findings in 7 out of 15 patients and disagreement in 8 patients. (68)Ga-DOTA-TOC revealed more metastases than (18)F-DOPA PET in 6 patients, while (18)F-DOPA PET detected more metastases than (68)Ga-DOTA-TOC in 4 patients. By (68)Ga-DOTA-TOC PET, 208 malignant lesions were detected, while by (18)F-DOPA only 86 lesions were found, and in CT 124, respectively. (68)Ga-DOTA-TOC and (18)F-DOPA PET are useful tools in the detection and staging of NET lesions. Our initial results allow the conclusion that (68)Ga-DOTA-TOC PET may have a stronger clinical impact in NET patients, as it does not only offer diagnostic information, but is decisive for the further treatment management, i. e. PRRT, as well.

Distributed flow estimation and closed-loop control of an underwater vehicle with a multi-modal artificial lateral line.

PubMed

DeVries, Levi; Lagor, Francis D; Lei, Hong; Tan, Xiaobo; Paley, Derek A

2015-03-25

Bio-inspired sensing modalities enhance the ability of autonomous vehicles to characterize and respond to their environment. This paper concerns the lateral line of cartilaginous and bony fish, which is sensitive to fluid motion and allows fish to sense oncoming flow and the presence of walls or obstacles. The lateral line consists of two types of sensing modalities: canal neuromasts measure approximate pressure gradients, whereas superficial neuromasts measure local flow velocities. By employing an artificial lateral line, the performance of underwater sensing and navigation strategies is improved in dark, cluttered, or murky environments where traditional sensing modalities may be hindered. This paper presents estimation and control strategies enabling an airfoil-shaped unmanned underwater vehicle to assimilate measurements from a bio-inspired, multi-modal artificial lateral line and estimate flow properties for feedback control. We utilize potential flow theory to model the fluid flow past a foil in a uniform flow and in the presence of an upstream obstacle. We derive theoretically justified nonlinear estimation strategies to estimate the free stream flowspeed, angle of attack, and the relative position of an upstream obstacle. The feedback control strategy uses the estimated flow properties to execute bio-inspired behaviors including rheotaxis (the tendency of fish to orient upstream) and station-holding (the tendency of fish to position behind an upstream obstacle). A robotic prototype outfitted with a multi-modal artificial lateral line composed of ionic polymer metal composite and embedded pressure sensors experimentally demonstrates the distributed flow sensing and closed-loop control strategies.

Positron Emission Tomography in Breast Cancer

PubMed Central

Vercher-Conejero, Jose Luis; Pelegrí-Martinez, Laura; Lopez-Aznar, Diego; Cózar-Santiago, María del Puig

2015-01-01

Gradually, FDG-PET/CT has been strengthening within the diagnostic algorithms of oncological diseases. In many of these, PET/CT has shown to be useful at different stages of the disease: diagnosis, staging or re-staging, treatment response assessment, and recurrence. Some of the advantages of this imaging modality versus CT, MRI, bone scan, mammography, or ultrasound, are based on its great diagnostic capacity since, according to the radiopharmaceutical used, it reflects metabolic changes that often occur before morphological changes and therefore allows us to stage at diagnosis. Moreover, another advantage of this technique is that it allows us to evaluate the whole body so it can be very useful for the detection of distant disease. With regard to breast cancer, FDG-PET/CT has proven to be important when recurrence is suspected or in the evaluation of treatment response. The technological advancement of PET equipment through the development of new detectors and equipment designed specifically for breast imaging, and the development of more specific radiopharmaceuticals for the study of the different biological processes of breast cancer, will allow progress not only in making the diagnosis of the disease at an early stage but also in enabling personalized therapy for patients with breast cancer. PMID:26854143

A Comparison between 18F-FDG PET/CT Imaging and Biological and Radiological Findings in Restaging of Hepatoblastoma Patients

PubMed Central

Treglia, Giorgio; Pagano, Manuela; Fania, Piercarlo; Basso, Maria Eleonora; Fagioli, Franca; Ficola, Umberto

2013-01-01

Background. In this study we retrospectively evaluated if 18F-FDG-PET/CT provided incremental diagnostic information over CI in a group of hepatoblastoma patients performing restaging. Procedure. Nine patients (mean age: 5.9 years; range: 3.1–12 years) surgically treated for hepatoblastoma were followed up by clinical examination, serum α-FP monitoring, and US. CI (CT or MRI) and PET/CT were performed in case of suspicion of relapse. Fine-needle aspiration biopsies (FNAB) were carried out for final confirmation if the results of CI, PET/CT, and/or α-FP levels were suggestive of relapse. PET/CT and CI findings were analyzed for comparison purposes, using FNAB as reference standard. Results. α-FP level was suggestive of disease recurrence in 8/9 patients. Biopsy was performed in 8/9 cases. CI and PET/CT resulted to be concordant in 5/9 patients (CI identified recurrence of disease, but 18F-FDG-PET/CT provided a better definition of disease extent); in 4/9 cases, CI diagnostic information resulted in negative findings, whereas PET/CT correctly detected recurrence of disease. 18F-FDG-PET/CT showed an agreement of 100% (8/8) with FNAB results. Conclusions. 18F-FDG-PET/CT scan seems to better assess HB patients with respect to CI and may provide incremental diagnostic value in the restaging of this group of patients. PMID:24063012

Neonatal Restriction of Tactile Inputs Leads to Long-Lasting Impairments of Cross-Modal Processing

PubMed Central

Röder, Brigitte; Hanganu-Opatz, Ileana L.

2015-01-01

Optimal behavior relies on the combination of inputs from multiple senses through complex interactions within neocortical networks. The ontogeny of this multisensory interplay is still unknown. Here, we identify critical factors that control the development of visual-tactile processing by combining in vivo electrophysiology with anatomical/functional assessment of cortico-cortical communication and behavioral investigation of pigmented rats. We demonstrate that the transient reduction of unimodal (tactile) inputs during a short period of neonatal development prior to the first cross-modal experience affects feed-forward subcortico-cortical interactions by attenuating the cross-modal enhancement of evoked responses in the adult primary somatosensory cortex. Moreover, the neonatal manipulation alters cortico-cortical interactions by decreasing the cross-modal synchrony and directionality in line with the sparsification of direct projections between primary somatosensory and visual cortices. At the behavioral level, these functional and structural deficits resulted in lower cross-modal matching abilities. Thus, neonatal unimodal experience during defined developmental stages is necessary for setting up the neuronal networks of multisensory processing. PMID:26600123

Diagnosis and management of olecranon bursitis.

PubMed

Del Buono, Angelo; Franceschi, Francesco; Palumbo, Alessio; Denaro, Vincenzo; Maffulli, Nicola

2012-10-01

We aim to review the current knowledge on diagnosis, clinical features and main management modalities of olecranon bursitis. We underline that the first treatment line is conservative, including ice, rest, anti-inflammatory and analgesic drugs and, occasionally, bursal fluid aspiration. In unresponsive patients, although open excisional procedures allow to completely remove the pathological bursal tissue, arthroscopy is increasingly being considered as a suitable new modality of management. These minimally invasive procedures, although not free from complications, avoid the wound problems often occurring following open excision. Copyright © 2012 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Determination of the Global-Average Charge Moment of a Lightning Flash Using Schumann Resonances and the LIS/OTD Lightning Data

NASA Astrophysics Data System (ADS)

Boldi, Robert; Williams, Earle; Guha, Anirban

2018-01-01

In this paper, we use (1) the 20 year record of Schumann resonance (SR) signals measured at West Greenwich Rhode Island, USA, (2) the 19 year Lightning Imaging Sensor (LIS)/Optical Transient Detector (OTD) lightning data, and (3) the normal mode equations for a uniform cavity model to quantify the relationship between the observed Schumann resonance modal intensity and the global-average vertical charge moment change M (C km) per lightning flash. This work, by integrating SR measurements with satellite-based optical measurements of global flash rate, accomplishes this quantification for the first time. To do this, we first fit the intensity spectra of the observed SR signals to an eight-mode, three parameter per mode, (symmetric) Lorentzian line shape model. Next, using the LIS/OTD lightning data and the normal mode equations for a uniform cavity model, we computed the expected climatological-daily-average intensity spectra. We then regressed the observed modal intensity values against the expected modal intensity values to find the best fit value of the global-average vertical charge moment change of a lightning flash (M) to be 41 C km per flash with a 99% confidence interval of ±3.9 C km per flash, independent of mode. Mode independence argues that the model adequately captured the modal intensity, the most important fit parameter herein considered. We also tested this relationship for the presence of residual modal intensity at zero lightning flashes per second and found no evidence that modal intensity is significantly different than zero at zero lightning flashes per second, setting an upper limit to the amount of nonlightning contributions to the observed modal intensity.

Cardiac and pericardial tumors: A potential application of positron emission tomography-magnetic resonance imaging.

PubMed

Fathala, Ahmed; Abouzied, Mohei; AlSugair, Abdul-Aziz

2017-07-26

Cardiac and pericardial masses may be neoplastic, benign and malignant, non-neoplastic such as thrombus or simple pericardial cysts, or normal variants cardiac structure can also be a diagnostic challenge. Currently, there are several imaging modalities for diagnosis of cardiac masses; each technique has its inherent advantages and disadvantages. Echocardiography, is typically the initial test utilizes in such cases, Echocardiography is considered the test of choice for evaluation and detection of cardiac mass, it is widely available, portable, with no ionizing radiation and provides comprehensive evaluation of cardiac function and valves, however, echocardiography is not very helpful in many cases such as evaluation of extracardiac extension of mass, poor tissue characterization, and it is non diagnostic in some cases. Cross sectional imaging with cardiac computed tomography provides a three dimensional data set with excellent spatial resolution but utilizes ionizing radiation, intravenous iodinated contrast and relatively limited functional evaluation of the heart. Cardiac magnetic resonance imaging (CMR) has excellent contrast resolution that allows superior soft tissue characterization. CMR offers comprehensive evaluation of morphology, function, tissue characterization. The great benefits of CMR make CMR a highly useful tool in the assessment of cardiac masses. (Fluorine 18) fluorodeoxygluocse (FDG) positron emission tomography (PET) has become a corner stone in several oncological application such as tumor staging, restaging, treatment efficiency, FDG is a very useful imaging modality in evaluation of cardiac masses. A recent advance in the imaging technology has been the development of integrated PET-MRI system that utilizes the advantages of PET and MRI in a single examination. FDG PET-MRI provides complementary information on evaluation of cardiac masses. The purpose of this review is to provide several clinical scenarios on the incremental value of PET and MRI in the evaluation of cardiac masses.

Fluorine-18-fluoroethylcholine PET/CT in the detection of prostate cancer: a South African experience.

PubMed

Vorster, Mariza; Modiselle, Moshe; Ebenhan, Thomas; Wagener, Carl; Sello, That; Zeevaart, Jan Rijn; Moshokwa, Evelyn; Sathekge, Mike Machaba

2015-01-01

Imaging with fluorine-18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has, until recently provided disappointing results with low sensitivity ranging from 31%-64% in patients with well-differentiated prostate cancer (PC) at all prostatic specific antigen (PSA) levels while fluorine-18-fluoroethylcholine ((18)F-FECh) PET/CT showed about 85% sensitivity in restaging patients after relapse. We present our experience of the sensitivity of (18)F-FECh PET/CT in the early stages of PC. Fifty patients were prospectively recruited and imaged, of which 40 fulfilled all inclusion criteria. Our patients had an average age of 65.5 years. Fifteen patients were referred for initial staging, with the remaining 25 referred for restaging and all patients had histologically confirmed adenocarcinoma. Patients were imaged by (18)F-FECh PET/CT. Findings were evaluated qualitatively and quantitatively and compared to the results of histology, PSA, Gleason score and bone scintigraphy. The prostate SUVmax was also used. Thirty-one patients demonstrated abnormal pelvic- and or extra- pelvic findings on (18)F-FECh PET/CT, which was consistent with malignant or metastatic involvement. The prostate SUVmax could not be used to predict the presence or absence of metastatic disease. Findings of this paper suggest that (18)F-FECh PET/CT in 30/40 cases (estimated as 75%) was helpful in the initial staging, restaging and lymph node detection of patients with PC. The SUVmax was not helpful. We diagnosed more PC cases in our African-American patients as compared to the Caucasian patients.

Multi-Modality Imaging in the Evaluation and Treatment of Mitral Regurgitation.

PubMed

Bouchard, Marc-André; Côté-Laroche, Claudia; Beaudoin, Jonathan

2017-10-13

Mitral regurgitation (MR) is frequent and associated with increased mortality and morbidity when severe. It may be caused by intrinsic valvular disease (primary MR) or ventricular deformation (secondary MR). Imaging has a critical role to document the severity, mechanism, and impact of MR on heart function as selected patients with MR may benefit from surgery whereas other will not. In patients planned for a surgical intervention, imaging is also important to select candidates for mitral valve (MV) repair over replacement and to predict surgical success. Although standard transthoracic echocardiography is the first-line modality to evaluate MR, newer imaging modalities like three-dimensional (3D) transesophageal echocardiography, stress echocardiography, cardiac magnetic resonance (CMR), and computed tomography (CT) are emerging and complementary tools for MR assessment. While some of these modalities can provide insight into MR severity, others will help to determine its mechanism. Understanding the advantages and limitations of each imaging modality is important to appreciate their respective role for MR assessment and help to resolve eventual discrepancies between different diagnostic methods. With the increasing use of transcatheter mitral procedures (repair or replacement) for high-surgical-risk patients, multimodality imaging has now become even more important to determine eligibility, preinterventional planning, and periprocedural guidance.

Prospective evaluation of 68 Ga-DOTATATE PET/CT in limited disease neuroendocrine tumors and/or elevated serum neuroendocrine biomarkers.

PubMed

Gabriel, Sophie; Garrigue, Philippe; Dahan, Laetitia; Castinetti, Frédéric; Sebag, Frédéric; Baumstark, Karine; Archange, Cendrine; Abhishek, Jha; Pacak, Karel; Guillet, Benjamin; Taïeb, David

2018-05-22

The 68 Ga-labelled somatostatin analogues ( 68 Ga-DOTA-SSAs) is becoming popular as an important diagnostic tool in neuroendocrine tumors as evidenced by a growing number of reports detailing institutional experience with various DOTA peptides. However, only few prospective studies have compared 68 Ga-DOTA-SSAs and somatostatin receptor scintigraphy (SRS) in gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and pulmonary neuroendocrine tumors. The aim of our prospective study was to perform head-to-head comparison between 68 Ga-DOTATATE PET/CT and standard imaging work-up (SI) that included multiphasic CT, liver MRI, and SRS using single photon emission computed tomography. In this prospective study, the patients were enrolled only if they met any of the following inclusion criteria were: i- initial staging of a NETs without distant metastases on SI or neuroendocrine tumor with unknown primary on SI; ii-restaging of NETs that could be treated by focused therapeutic interventions; iii- elevated serum neuroendocrine hormones or peptides. The exclusion criteria was grade 3 GEP-NETs. Thirty-two patients were enrolled in the study. Eleven patients (6 pancreas, 4 ileum, 1 duodenal) were included for initial evaluation and staging of NETs, 8 patients (5 pancreas, 1 ileal, 1 lung, 1 duodenal gastrinoma) for restaging, and 13 patients for elevated serum neuroendocrine biomarkers (5 ectopic Cushing's syndrome, 5 organic hypoglycemia, 1 patient each with elevated vasoactive inhibitory peptide, chromogranin A, and neuron-specific enolase). 68 Ga-DOTATATE PET/CT detected more primary tumors than SRS (15/18 vs 10/18: p=0.074). The missed tumors on 68 Ga-DOTATATE PET/CT were located in the lung in 2 cases and duodenum in 1 case. For other anatomical regions (nodal and distant metastasis), no statistical difference was observed between imaging modalities using 68 Ga-DOTATATE PET/CT and SRS. Overall, 68 Ga-DOTATATE PET/CT+CT+MRI detected 31/33 of the involved regions (including primaries) (29 and 22 for 68 Ga-DOTATATE and SRS, respectively). Our study shows that 68 Ga-DOTATATE PET/CT detected similar number of sites than combination of SRS, liver MRI and thoraco-abdominopelvic CT region-based analysis. 68 Ga-DOTATATE PET/CT missed half of primary lung carcinoids with ectopic Cushing's syndrome. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Surgical Scar Site Recurrence in Patients With Cervical Cancer on 18F-FDG PET-CT: A Case-Control Study.

PubMed

Dhull, Varun S; Khangembam, Bangkim C; Sharma, Punit; Rana, Neelima; Verma, Satyavrat; Sharma, Dayanand; Shamim, Shamim A; Kumar, Sunesh; Kumar, Rakesh

2016-02-01

The purpose of this study was to assess the role of fluorine 18 ((18)F)-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in evaluating various parameters in patients with surgical scar site recurrence in cervical carcinoma. Data of all patients with cervical cancer (n = 329) who underwent PET-CT at our institute between 2005 and 2013 was reviewed. Of these 329 patients, 132 patients who were surgically treated and underwent restaging/follow-up PET-CT were included in the present study for final analysis. Tumor recurrence at the abdominal surgical scar site was looked for. Abnormal uptakes suggestive of active disease at other sites were also noted. Maximum standardized uptake value was measured for all the lesions. Patients with scar site recurrence were taken as cases (n = 6), whereas the remaining patients served as controls (n = 126). Comparison with conventional imaging modalities was made wherever available. Histopathological examination was always sought for. The incidence of scar site recurrence after surgery was found to be 4.5% (6/117). A total of 56 of 132 patients had recurrent disease, including 6 patients with scar site recurrence. All of the patients with scar site recurrence also had recurrent disease at other sites (local, nodal, or distant). Conventional imaging modalities were available in 4 of these 6 patients and detected scar site recurrence in 3 of those 4 patients. In patients with scar site recurrence, the mean ± SD time to scar site recurrence was 14.0 ± 10.9 months (median, 10 months; range, 7-36 months). Significant difference was seen between cases and control for International Federation of Genecology and Oncology stage (P = 0.001) and nodal recurrence (P = 0.007). Additionally, age, nodal recurrence, distant recurrence, and scar site recurrence were significantly associated with death. Scar site recurrence carries a poor prognosis, and the incidence is much higher than previously known when PET-CT is used as a modality for its detection.

18F-FDG PET/CT and PET/MRI Perform Equally Well in Cancer: Evidence from Studies on More Than 2,300 Patients

PubMed Central

Spick, Claudio; Herrmann, Ken; Czernin, Johannes

2016-01-01

18F-FDG PET/CT has become the reference standard in oncologic imaging against which the performance of other imaging modalities is measured. The promise of PET/MRI includes multiparametric imaging to further improve diagnosis and phenotyping of cancer. Rather than focusing on these capabilities, many investigators have examined whether 18F-FDG PET combined with mostly anatomic MRI improves cancer staging and restaging. After a description of PET/MRI scanner designs and a discussion of technical and operational issues, we review the available literature to determine whether cancer assessments are improved with PET/MRI. The available data show that PET/MRI is feasible and performs as well as PET/CT in most types of cancer. Diagnostic advantages may be achievable in prostate cancer and in bone metastases, whereas disadvantages exist in lung nodule assessments. We conclude that 18F-FDG PET/MRI and PET/CT provide comparable diagnostic information when MRI is used simply to provide the anatomic framework. Thus, PET/MRI could be used in lieu of PET/CT if this approach becomes economically viable and if reasonable workflows can be established. Future studies should explore the multiparametric potential of MRI. PMID:26742709

Clinical activity of sunitinib rechallenge in metastatic renal cell carcinoma-Results of the REchallenge with SUnitinib in MEtastatic RCC (RESUME) Study.

PubMed

Oudard, Stéphane; Geoffrois, Lionnel; Guillot, Aline; Chevreau, Christine; Deville, Jean-Laurent; Falkowski, Sabrina; Boyle, Helen; Baciuchka, Marjorie; Gimel, Pierre; Laguerre, Brigitte; Laramas, Mathieu; Pfister, Christian; Topart, Delphine; Rolland, Frédéric; Legouffe, Eric; Denechere, Gwénaël; Amela, Eric Yaovi; Abadie-Lacourtoisie, Sophie; Gross-Goupil, Marine

2016-07-01

To assess the efficacy and tolerability of sunitinib rechallenge in the third-line or later setting in patients with metastatic renal cell carcinoma (mRCC). This observational study comprised 61 mRCC patients at 19 centres in France who received sunitinib rechallenge between January 2006 and May 2013. Patients received first-line sunitinib, ≥1 different targeted therapies, and then sunitinib rechallenge. Patient/disease characteristics, tolerability, treatment modalities, and outcomes of therapeutic lines were recorded. The primary end-point was progression-free survival (PFS) in sunitinib rechallenge. Analyses included 52 patients; median age was 59 years, 75% were male, and 98% had clear-cell mRCC and prior nephrectomy. At sunitinib rechallenge versus first-line, patients had poorer performance (Karnofsky performance status 90-100: 30% versus 81%) and Memorial Sloan Kettering Cancer Centre prognostic risk (poor risk: 18% versus 3%). Overall, 20%, 65%, 12%, and 4% received sunitinib rechallenge as third-, fourth-, fifth-, and sixth-line therapy, respectively, at 14.6 months (median) after stopping initial treatment. With first-line sunitinib and rechallenge, median PFS was 18.4 and 7.9 months, respectively; objective response rate was 54% and 15%. Two of eight rechallenge responders had not achieved first-line response. Median overall survival was 55.9 months. The sunitinib rechallenge safety profile was as expected, with no new adverse events reported. Sunitinib rechallenge is a feasible treatment option with potential clinical benefit for mRCC patients. Disease progression with first-line sunitinib may not be associated with complete or irreversible resistance to therapy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Automatic Omega Station and LOP (Line of Position) Selection,

DTIC Science & Technology

1987-09-01

LL- jAj C) LJ b- I- I LL I-0 a- 5~52 3.2.2 SOLAR EFFECTS The sun effects Omega modal interference in several significant ways. Firstly the effect...nx(n+l) TD and F are 2x(n+l) -67- %..T C ..4 . (43). a -Je MT Therefore to form BTH requires 4n multiplies and (H TH)- 1 requires 6 multiplies and

Refractory Gastrointestinal Bleeding: Role of Angiographic Intervention

PubMed Central

2013-01-01

Although endoscopic hemostasis remains initial treatment modality for nonvariceal gastrointestinal (GI) bleeding, severe bleeding despite endoscopic management occurs in 5% to 10% of the patients, requiring surgery or transcatheter arterial embolization (TAE). TAE is now considered the first-line therapy for massive GI bleeding refractory to endoscopic management. GI endoscopists need to be familiar with indications, principles, outcomes, and complications of TAE, as well as embolic materials available. PMID:24143308

Music-to-Color Associations of Single-Line Piano Melodies in Non-synesthetes.

PubMed

Palmer, Stephen E; Langlois, Thomas A; Schloss, Karen B

2016-01-01

Prior research has shown that non-synesthetes' color associations to classical orchestral music are strongly mediated by emotion. The present study examines similar cross-modal music-to-color associations for much better controlled musical stimuli: 64 single-line piano melodies that were generated from four basic melodies by Mozart, whose global musical parameters were manipulated in tempo(slow/fast), note-density (sparse/dense), mode (major/minor) and pitch-height (low/high). Participants first chose the three colors (from 37) that they judged to be most consistent with (and, later, the three that were most inconsistent with) the music they were hearing. They later rated each melody and each color for the strength of its association along four emotional dimensions: happy/sad, agitated/calm, angry/not-angry and strong/weak. The cross-modal choices showed that faster music in the major mode was associated with lighter, more saturated, yellower (warmer) colors than slower music in the minor mode. These results replicate and extend those of Palmer et al. (2013, Proc. Natl Acad. Sci. 110, 8836-8841) with more precisely controlled musical stimuli. Further results replicated strong evidence for emotional mediation of these cross-modal associations, in that the emotional ratings of the melodies were very highly correlated with the emotional associations of the colors chosen as going best/worst with the melodies (r = 0.92, 0.85, 0.82 and 0.70 for happy/sad, strong/weak,angry/not-angry and agitated/calm, respectively). The results are discussed in terms of common emotional associations forming a cross-modal bridge between highly disparate sensory inputs.

A Retrospective Survival Analysis of Anatomic and Prognostic Stage Group Based on the American Joint Committee on Cancer 8th Edition Cancer Staging Manual in Luminal B Human Epidermal Growth Factor Receptor 2-negative Breast Cancer.

PubMed

Xu, Ling; Li, Jiang-Hong; Ye, Jing-Ming; Duan, Xue-Ning; Cheng, Yuan-Jia; Xin, Ling; Liu, Qian; Zhou, Bin; Liu, Yin-Hua

2017-08-20

Current understanding of tumor biology suggests that breast cancer is a group of diseases with different intrinsic molecular subtypes. Anatomic staging system alone is insufficient to provide future outcome information. The American Joint Committee on Cancer (AJCC) expert panel updated the 8th edition of the staging manual with prognostic stage groups by incorporating biomarkers into the anatomic stage groups. In this study, we retrospectively analyzed the data from our center in China using the anatomic and prognostic staging system based on the AJCC 8th edition staging manual. We reviewed the data from January 2008 to December 2014 for cases with Luminal B Human Epidermal Growth Factor Receptor 2 (HER2)-negative breast cancer in our center. All cases were restaged using the AJCC 8th edition anatomic and prognostic staging system. The Kaplan-Meier method and log-rank test were used to compare the survival differences between different subgroups. SPSS software version 19.0 (IBM Corp., Armonk, NY, USA) was used for the statistical analyses. This study consisted of 796 patients with Luminal B HER-negative breast cancer. The 5-year disease-free survival (DFS) of 769 Stage I-III patients was 89.7%, and the 5-year overall survival (OS) of all 796 patients was 91.7%. Both 5-year DFS and 5-year OS were significantly different in the different anatomic and prognostic stage groups. There were 372 cases (46.7%) assigned to a different group. The prognostic Stage II and III patients restaged from anatomic Stage III had significant differences in 5-year DFS (χ2 = 11.319, P= 0.001) and 5-year OS (χ2 = 5.225, P= 0.022). In addition, cases restaged as prognostic Stage I, II, or III from the anatomic Stage II group had statistically significant differences in 5-year DFS (χ2 = 6.510, P= 0.039) but no significant differences in 5-year OS (χ2 = 5.087, P= 0.079). However, the restaged prognostic Stage I and II cases from anatomic Stage I had no statistically significant differences in either 5-year DFS (χ2 = 0.440, P= 0.507) or 5-year OS (χ2 = 1.530, P= 0.216). The prognostic staging system proposed in the AJCC 8th edition refines the anatomic stage group in Luminal B HER2-negative breast cancer and will lead to a more personalized approach to breast cancer treatment.

Modal analysis of untransposed bilateral three-phase lines -- a perturbation approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Faria, J.A.B.; Mendes, J.H.B.

1997-01-01

Model analysis of three-phase power lines exhibiting bilateral symmetry leads to modal transformation matrices that closely resemble Clarke`s transformation. The authors develop a perturbation theory approach to justify, interpret, and gain understanding of this well known fact. Further, the authors show how to find new frequency dependent correction terms that once added to Clarke`s transformation lead to improved accuracy.

Imaging assessment of penetrating injury of the neck and face.

PubMed

Offiah, Curtis; Hall, Edward

2012-10-01

Penetrating trauma of the neck and face is a frequent presentation to acute emergency, trauma and critical care units. There remains a steady incidence of both gunshot penetrating injury to the neck and face as well as non-missile penetrating injury-largely, but not solely, knife-related. Optimal imaging assessment of such injuries therefore remains an on-going requirement of the general and specialised radiologist. The anatomy of the neck and face-in particular, vascular, pharyngo-oesophageal, laryngo-tracheal and neural anatomy-demands a more specialised and selective management plan which incorporates specific imaging techniques. The current treatment protocol of injuries of the neck and face has seen a radical shift away from expectant surgical exploration in the management of such injuries, largely as a result of advances in the diagnostic capabilities of multi-detector computed tomography angiography (MDCTA), which is now the first-line imaging modality of choice in such cases. This review aims to highlight ballistic considerations, differing imaging modalities, including MDCTA, that might be utilised to assist in the accurate assessment of these injuries as well as the specific radiological features and patterns of specific organ-system injuries that should be considered and communicated to surgical and critical care teams. TEACHING POINTS : • MDCTA is the first-line imaging modality in penetrating trauma of the neck and, often, of the face • The inherent deformability of a bullet is a significant factor in its tissue-damaging capabilities • MDCTA can provide accurate assessment of visceral injury of the neck as well as vascular injury • Penetrating facial trauma warrants radiological assessment of key adjacent anatomical structures • In-driven fragments of native bone potentiate tissue damage in projectile penetrating facial trauma.

Drama: Transforming the Pathology of Compulsive Repetition.

ERIC Educational Resources Information Center

Bennett, Toni L.

1998-01-01

Highlights aspects of Freud's discussions on the "fort-da" game and the process of transference and countertransference in their connection to psychological aspects of dramatic activity. Concludes that from the pathological need to repeat can come therapeutic possibilities in the human tendency for people to restage and reobserve their…

Early dynamic imaging in 68Ga- PSMA-11 PET/CT allows discrimination of urinary bladder activity and prostate cancer lesions.

PubMed

Uprimny, Christian; Kroiss, Alexander Stephan; Decristoforo, Clemens; Fritz, Josef; Warwitz, Boris; Scarpa, Lorenza; Roig, Llanos Geraldo; Kendler, Dorota; von Guggenberg, Elisabeth; Bektic, Jasmin; Horninger, Wolfgang; Virgolini, Irene Johanna

2017-05-01

PET/CT with 68 Ga-labelled prostate-specific membrane antigen (PSMA)-ligands has been proven to establish a promising imaging modality in the work-up of prostate cancer (PC) patients with biochemical relapse. Despite a high overall detection rate, the visualisation of local recurrence may be hampered by high physiologic tracer accumulation in the urinary bladder on whole body imaging, usually starting 60 min after injection. This study sought to verify whether early dynamic 68 Ga-PSMA-11 (HBED-CC)PET/CT can differentiate pathologic PC-related tracer uptake from physiologic tracer accumulation in the urinary bladder. Eighty consecutive PC patients referred to 68 Ga -PSMA-11 PET/CT were included in this retrospective analysis (biochemical relapse: n = 64; primary staging: n = 8; evaluation of therapy response/restaging: n = 8). In addition to whole-body PET/CT acquisition 60 min post injection early dynamic imaging of the pelvis in the first 8 min after tracer injection was performed. SUV max of pathologic lesions was calculated and time-activity curves were generated and compared to those of urinary bladder and areas of physiologic tracer uptake. A total of 55 lesions consistent with malignancy on 60 min whole body imaging exhibited also pathologic 68 Ga-PSMA-11 uptake during early dynamic imaging (prostatic bed/prostate gland: n = 27; lymph nodes: n = 12; bone: n = 16). All pathologic lesions showed tracer uptake within the first 3 min, whereas urinary bladder activity was absent within the first 3 min of dynamic imaging in all patients. Suv max was significantly higher in PC lesions in the first 6 min compared to urinary bladder accumulation (p < 0.001). In the subgroup of PC patients with biochemical relapse the detection rate of local recurrence could be increased from 20.3 to 29.7%. Early dynamic imaging in 68 Ga-PSMA-11 PET/CT reliably enables the differentiation of pathologic tracer uptake in PC lesions from physiologic bladder accumulation. Performance of early dynamic imaging in addition to whole body imaging 60 min after tracer injection might improve the detection rate of local recurrence in PC patients with biochemical relapse referred for 68 Ga-PSMA-11 PET/CT.

On-Line Modal State Monitoring of Slowly Time-Varying Structures

NASA Technical Reports Server (NTRS)

Johnson, Erik A.; Bergman, Lawrence A.; Voulgaris, Petros G.

1997-01-01

Monitoring the dynamic response of structures is often performed for a variety of reasons. These reasons include condition-based maintenance, health monitoring, performance improvements, and control. In many cases the data analysis that is performed is part of a repetitive decision-making process, and in these cases the development of effective on-line monitoring schemes help to speed the decision-making process and reduce the risk of erroneous decisions. This report investigates the use of spatial modal filters for tracking the dynamics of slowly time-varying linear structures. The report includes an overview of modal filter theory followed by an overview of several structural system identification methods. Included in this discussion and comparison are H-infinity, eigensystem realization, and several time-domain least squares approaches. Finally, a two-stage adaptive on-line monitoring scheme is developed and evaluated.

Ultrasonography in diagnosing chronic pancreatitis: New aspects

PubMed Central

Dimcevski, Georg; Erchinger, Friedemann G; Havre, Roald; Gilja, Odd Helge

2013-01-01

The course and outcome is poor for most patients with pancreatic diseases. Advances in pancreatic imaging are important in the detection of pancreatic diseases at early stages. Ultrasonography as a diagnostic tool has made, virtually speaking a technical revolution in medical imaging in the new millennium. It has not only become the preferred method for first line imaging, but also, increasingly to clarify the interpretation of other imaging modalities to obtain efficient clinical decision. We review ultrasonography modalities, focusing on advanced pancreatic imaging and its potential to substantially improve diagnosis of pancreatic diseases at earlier stages. In the first section, we describe scanning techniques and examination protocols. Their consequences for image quality and the ability to obtain complete and detailed visualization of the pancreas are discussed. In the second section we outline ultrasonographic characteristics of pancreatic diseases with emphasis on chronic pancreatitis. Finally, new developments in ultrasonography of the pancreas such as contrast enhanced ultrasound and elastography are enlightened. PMID:24259955

Children's On-Line Processing of Epistemic Modals

ERIC Educational Resources Information Center

Moscati, Vincenzo; Zhan, Likan; Zhou, Peng

2017-01-01

In this paper we investigated the real-time processing of epistemic modals in five-year-olds. In a simple reasoning scenario, we monitored children's eye-movements while processing a sentence with modal expressions of different force ("might/must"). Children were also asked to judge the truth-value of the target sentences at the end of…

Comparable Efficacy of Abatacept Used as First-line or Second-line Biological Agent for Severe Juvenile Idiopathic Arthritis-related Uveitis.

PubMed

Birolo, Carolina; Zannin, Maria Elisabetta; Arsenyeva, Svetlana; Cimaz, Rolando; Miserocchi, Elisabetta; Dubko, Margarita; Deslandre, Chantal Job; Falcini, Fernanda; Alessio, Maria; La Torre, Francesco; Denisova, Ekaterina; Martini, Giorgia; Nikishina, Irina; Zulian, Francesco

2016-11-01

Abatacept (ABA) has recently been proposed as second-line treatment in patients with juvenile idiopathic arthritis (JIA)-associated uveitis refractory to anti-tumor necrosis factor-α (anti-TNF) agents, but little is known about its efficacy as a first-line approach. The aim of the present study was to compare the safety and efficacy of ABA as a first-line biological agent (ABA-1) with that of ABA as a second-line treatment after 1 or more anti-TNF agents (ABA-2), in patients with severe JIA-related uveitis. In this multicenter study, we collected data on patients with severe JIA-related uveitis treated with ABA as a first-line or second-line biological agent. Changes in frequency of uveitis flares/year and ocular complications before and after ABA treatment, clinical remission, and side effects were recorded. Thirty-five patients with a mean age of 10.8 years were treated with ABA for a mean period of 19.6 months. In 4 patients, ABA administration was discontinued, owing to inefficacy on arthritis in 3 cases and allergic reaction in 1. Thirty-one patients, 14 in the ABA-1 group and 17 in the ABA-2 group, completed the 12-month followup period; of these, 17 (54.8%) had clinical remission. The mean frequency of uveitis flares decreased from 4.1 to 1.2 in the ABA-1 group (p = 0.002) and from 3.7 to 1.2 in the ABA-2 group (p = 0.004). Preexisting ocular complications improved or remained stable in all but 5 patients, all in the ABA-2 group. No significant difference was found between the efficacy of the 2 treatment modalities. ABA confirmed its good safety profile. ABA, used as first-line biological treatment or after 1 or more anti-TNF agents, induces a comparable improvement in severe refractory JIA-related uveitis.

76 FR 52652 - National Fuel Gas Supply Corporation; Tennessee Gas Pipeline Company; Notice of Availability of...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-23

... gas-fired turbines for compressor units A2 and A3 and restaging of centrifugal compressors for units.... CP11-133-000] National Fuel Gas Supply Corporation; Tennessee Gas Pipeline Company; Notice of... assessment (EA) for National Fuel Gas Supply Corporation's (National Fuel) proposed Northern Access Project...

Clinical Significance of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography/computed Tomography in the Follow-up of Colorectal Cancer: Searching off Approaches Increasing Specificity for Detection of Recurrence

PubMed Central

Okuyucu, Kursat; Hancerliogulları, Oguz; Alagoz, Engin; San, Huseyin; Arslan, Nuri

2017-01-01

Abstract Background Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose (l8F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC. Patients and methods We examined the SUVmax value of lesions on control or restaging 18F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]). Results Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease. Conclusions Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18F-FDG-PET/CT. PMID:29333115

Clinical Significance of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography/computed Tomography in the Follow-up of Colorectal Cancer: Searching off Approaches Increasing Specificity for Detection of Recurrence.

PubMed

Ince, Semra; Okuyucu, Kursat; Hancerliogulları, Oguz; Alagoz, Engin; San, Huseyin; Arslan, Nuri

2017-12-01

Nearly 40% of colorectal cancer (CRC) recurs within 2 years after resection of primary tumor. Imaging with fluorine-18-fluorodeoxyglucose ( l8 F-FDG) positron emission tomography/computed tomography (PET/CT) is the most recent modality and often applied for the evaluation of metastatic spread during the follow-up period. Our goal was to study the diagnostic importance of 18 F-FDG-PET/CT data of maximum standardized uptake value (SUVmax), total lesion glycolysis (TLG) and the difference of SUVmax on dual-time imaging in CRC. We examined the SUVmax value of lesions on control or restaging 18 F-FDG-PET/CT of 53 CRC patients. All lesions with increased SUVmax values were confirmed by colonoscopy or histopathology. We compared PET/CT results with conventional imaging modalities (CT, MRI) and tumor markers (carbohydrate antigen 19-9 [Ca 19-9], carcinoembryonic antigen [CEA]). Mean SUVmax was 6.9 ± 5.6 in benign group, 12.7 ± 6.1 in malignant group. Mean TLG values of malignant group and benign group were 401 and 148, respectively. 18 F-FDG-PET/CT was truely positive in 48% of patients with normal Ca 19-9 or CEA levels and truely negative in 10% of cases with elevated Ca 19-9 or CEA. CT or MRI detected suspicious malignancy in 32% of the patients and 18 F-FDG-PET/CT was truely negative in 35% of these cases. We found the most important and striking statistical difference of TLG value between the groups with benign and recurrent disease. Although SUVmax is a strong metabolic parameter (p = 0.008), TLG seems to be the best predictor in recurrence of CRC (p = 0.001); both are increasing the specificity of 18 F-FDG-PET/CT.

Advances in organ preserving strategies in rectal cancer patients.

PubMed

Stijns, Rutger C H; Tromp, Mike-Stephen R; Hugen, Niek; de Wilt, Johannes H W

2018-02-01

Treatment of rectal cancer patients has been subjected to change over the past thirty years. Total mesorectal excision is considered the cornerstone of rectal cancer treatment, but is also associated with significant morbidity resulting in an impaired quality of life. The addition of neoadjuvant chemoradiotherapy to surgery has shown to improve survival and local control and may lead to a partial or even complete response (CR). This raises questions regarding the necessity for subsequent radical surgery. After careful patient selection local excision and wait-and-see approaches are explored, aiming to improve quality of life without compromising oncological outcome. A multimodality diagnostic approach for optimal staging is crucial in determining the appropriate neoadjuvant treatment regimen. Adequate endoscopic restaging of rectal tumours after multimodality treatment will aid in selecting patients who are eligible for an organ preserving approach. The role and accuracy of imaging in the detection of the primary tumour, residual rectal cancer or local recurrence seems vital. Alternative neoadjuvant regimens are currently explored to increase the rate of clinical CRs, which may support organ preserving approaches. This review aims to generate insight into the advances in diagnostics and treatment modalities in all stages of rectal cancer and will highlight future studies that may support further implementation of organ preservation treatment in rectal cancer. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Correlation between quantitative and semiquantitative parameters in DCE-MRI with a blood pool agent in rectal cancer: can semiquantitative parameters be used as a surrogate for quantitative parameters?

PubMed

Dijkhoff, Rebecca A P; Maas, Monique; Martens, Milou H; Papanikolaou, Nikolaos; Lambregts, Doenja M J; Beets, Geerard L; Beets-Tan, Regina G H

2017-05-01

The aim of this study was to assess correlation between quantitative and semiquantitative parameters in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) in rectal cancer patients, both in a primary staging and restaging setting. Nineteen patients were included with DCE-MRI before and/or after neoadjuvant therapy. DCE-MRI was performed with gadofosveset trisodium (Ablavar ® , Lantheus Medical Imaging, North Billerica, Massachusetts, USA). Regions of interest were placed in the tumor and quantitative parameters were extracted with Olea Sphere 2.2 software permeability module using the extended Tofts model. Semiquantitative parameters were calculated on a pixel-by-pixel basis. Spearman rank correlation tests were used for assessment of correlation between parameters. A p value ≤0.05 was considered statistically significant. Strong positive correlations were found between mean peak enhancement and mean K trans : 0.79 (all patients, p<0.0001), 0.83 (primary staging, p = 0.003), and 0.81 (restaging, p = 0.054). Mean wash-in correlated significantly with mean V p and K ep (0.79 and 0.58, respectively, p<0.0001 and p = 0.009) in all patients. Mean wash-in showed a significant correlation with mean K ep (0.67, p = 0.033) in the primary staging group. On the restaging MRI, mean wash-in only strongly correlated with mean V p (0.81, p = 0.054). This study shows a strong correlation between quantitative and semiquantitative parameters in DCE-MRI for rectal cancer. Peak enhancement correlates strongly with K trans and wash-in showed strong correlation with V p and K ep . These parameters have been reported to predict tumor aggressiveness and response in rectal cancer. Therefore, semiquantitative analyses might be a surrogate for quantitative analyses.

Comparison Between 64Cu-PSMA-617 PET/CT and 18F-Choline PET/CT Imaging in Early Diagnosis of Prostate Cancer Biochemical Recurrence.

PubMed

Cantiello, Francesco; Crocerossa, Fabio; Russo, Giorgio Ivan; Gangemi, Vincenzo; Ferro, Matteo; Vartolomei, Mihai Dorin; Lucarelli, Giuseppe; Mirabelli, Maria; Scafuro, Chiara; Ucciero, Giuseppe; De Cobelli, Ottavio; Morgia, Giuseppe; Damiano, Rocco; Cascini, Giuseppe Lucio

2018-06-04

To evaluate the diagnostic performance of 64 Cu-PSMA-617 positron emission tomography (PET) with computed tomography (CT) for restaging prostate cancer after biochemical recurrence (BCR) and to compare it with 18 F-choline PET/CT in a per-patient analysis. An observational study was performed of 43 patients with BCR after laparoscopic radical prostatectomy who underwent 64 Cu-PSMA-617 PET/CT and subsequently 18 F-choline PET/CT for restaging. The detection rates (DR) of 64 Cu-PSMA-617 PET/CT and of 18 F-choline PET/CT were calculated by standardized maximum uptake value (SUV max ) at 4 hours and SUV max at 1 hour as reference, respectively. Furthermore, univariate logistic regression analysis was carried out to identify independent predictive factors of positivity with 64 Cu-PSMA-617 PET/CT. An overall positivity with 64 Cu-PSMA-617 PET/CT was found in 32 patients (74.4%) versus 19 (44.2%) with 18 F-choline PET/CT. Specifically, after stratifying for prostate-specific antigen (PSA) values, we found a good performance of 64 Cu-PSMA-617 PET/CT at low PSA levels compared to 18 F-choline PET/CT, with a DR of 57.1% versus 14.3% for PSA 0.2-0.5 ng/mL (P = .031), and of 60% versus 30% with PSA 0.5-1 ng/mL. At univariate binary logistic regression analysis, PSA level was the only independent predictor of 64 Cu-PSMA-617 PET/CT positivity. No significant difference in terms of DR for both 64 Cu-PSMA-617 PET/CT and 18 F-choline PET/CT was found according to different Gleason score subgroups. In our study cohort, a better performance was observed for 64 Cu-PSMA-617 PET/CT compared to 18 F-choline PET/CT in restaging after BCR, especially in patients with low PSA values. Copyright © 2018 Elsevier Inc. All rights reserved.

Percutaneous Cholecystostomy as a First-Line Therapy in Chronic Hemodialysis Patients with Acute Cholecystitis with Midterm Follow-up

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gumus, Burcak, E-mail: burcakgumus73@yahoo.com

Purpose: The purpose of this article was to share midterm results of percutaneous cholecystostomy (PC) as a first-line therapy in chronic hemodialysis patients with acute cholecystitis. Methods: Fourteen chronic hemodialysis patients with acute cholecystitis underwent PC between March 2007 and May 2009 at our institute. On preoperative assessment, the patients were classified into the ASA score by the anesthesiology team. All patients were class IV because of severe underlying comorbidities. The patients were referred to interventional radiology unit for PC by consensus of the multidisciplinary team. Results: The PC was technically successful in all the patients without minor or majormore » complications related to the procedure. Clinical symptoms in three patients who presented with sepsis and multiorgan failure did not resolve after PC, and these patients died following urgent surgery, including open cholecystectomy and common bile duct exploration. A new cholecystitis attack was detected in one patient in the acalculous group at the sixth month of the follow-up period. The mean catheterization time was 31.7 (range, 28-41) days. The mean follow-up time was 13.3 (range 4-21) months. Conclusions: The PC may come into consideration as a first-line treatment modality in the management of acute cholecystitis in poor surgical candidate chronic hemodialysis patients. This is the first report focusing on the midterm results of PC as a first-line therapy in hemodialysis patients with acute cholecystitis who could be operated on.« less

New perspectives in the treatment of body dysmorphic disorder

PubMed Central

Hong, Kevin; Nezgovorova, Vera; Hollander, Eric

2018-01-01

Body dysmorphic disorder (BDD) is a disabling illness with a high worldwide prevalence. Patients demonstrate a debilitating preoccupation with one or more perceived defects, often marked by poor insight or delusional convictions. Multiple studies have suggested that selective serotonin reuptake inhibitors and various cognitive behavioral therapy modalities are effective first-line treatments in decreasing BDD severity, relieving depressive symptoms, restoring insight, and increasing quality of life. Selective serotonin reuptake inhibitors have also recently been shown to be effective for relapse prevention. This review provides a comprehensive summary of the current understanding of BDD, including its clinical features, epidemiology, genetics, and current treatment modalities. Additional research is needed to fully elucidate the relationship between BDD and comorbid illnesses such as obsessive–compulsive-related disorders and depression and to develop therapies for refractory patients and those who have contraindications for pharmacological intervention. PMID:29636904

[Current Status of Endoscopic Resection of Early Gastric Cancer in Korea].

PubMed

Jung, Hwoon Yong

2017-09-25

Endoscopic resection (Endoscopic mucosal resection [EMR] and endoscopic submucosal dissection [ESD]) is already established as a first-line treatment modality for selected early gastric cancer (EGC). In Korea, the number of endoscopic resection of EGC was explosively increased because of a National Cancer Screening Program and development of devices and techniques. There were many reports on the short-term and long-term outcomes after endoscopic resection in patients with EGC. Long-term outcome in terms of recurrence and death is excellent in both absolute and selected expanded criteria. Furthermore, endoscopic resection might be positioned as primary treatment modality replacing surgical gastrectomy. To obtain these results, selection of patients, perfect en bloc procedure, thorough pathological examination of resected specimen, accurate interpretation of whole process of endoscopic resection, and rational strategy for follow-up is necessary.

Monte Carlo simulations of medical imaging modalities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Estes, G.P.

Because continuous-energy Monte Carlo radiation transport calculations can be nearly exact simulations of physical reality (within data limitations, geometric approximations, transport algorithms, etc.), it follows that one should be able to closely approximate the results of many experiments from first-principles computations. This line of reasoning has led to various MCNP studies that involve simulations of medical imaging modalities and other visualization methods such as radiography, Anger camera, computerized tomography (CT) scans, and SABRINA particle track visualization. It is the intent of this paper to summarize some of these imaging simulations in the hope of stimulating further work, especially as computermore » power increases. Improved interpretation and prediction of medical images should ultimately lead to enhanced medical treatments. It is also reasonable to assume that such computations could be used to design new or more effective imaging instruments.« less

Clinical effectiveness in the diagnosis and acute management of pediatric nephrolithiasis.

PubMed

Van Batavia, Jason P; Tasian, Gregory E

2016-12-01

The incidence of pediatric nephrolithiasis has risen over the past few decades leading to a growing public health burden. Children and adolescents represent a unique patient population secondary to their higher risks from radiation exposure as compared to adults, high risk of recurrence, and longer follow up time given their longer life expectancies. Ultrasound imaging is the first-line modality for diagnosing suspected nephrolithiasis in children. Although data is limited, the best evidence based medicine supports the use of alpha-blockers as first-line MET in children, especially when stones are small and in a more distal ureteral location. Surgical management of pediatric nephrolithiasis is similar to that in adults with ESWL and URS first-line for smaller stones and PCNL reserved for larger renal stone burden. Clinical effectiveness in minimizing risks in children and adolescents with nephrolithiasis centers around ED pathways that limit CT imaging, strict guidance to ALARA principles or use of US during surgical procedures, and education of both patients and families on the risks of repeat ionizing radiation exposures during follow up and acute colic events. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

Stents for colorectal obstruction: Past, present, and future

PubMed Central

Kim, Eui Joo; Kim, Yoon Jae

2016-01-01

Since the development of uncovered self-expanding metal stents (SEMS) in the 1990s, endoscopic stents have evolved dramatically. Application of new materials and new designs has expanded the indications for enteral SEMS. At present, enteral stents are considered the first-line modality for palliative care, and numerous types of enteral stents are under development for extended clinical usage, beyond a merely palliative purpose. Herein, we will discuss the current status and the future development of lower enteral stents. PMID:26811630

Nuclear-coupled thermal-hydraulic stability analysis of boiling water reactors

NASA Astrophysics Data System (ADS)

Karve, Atul A.

We have studied the nuclear-coupled thermal-hydraulic stability of boiling water reactors (BWRs) using a model we developed from: the space-time modal neutron kinetics equations based on spatial omega-modes, the equations for two-phase flow in parallel boiling channels, the fuel rod heat conduction equations, and a simple model for the recirculation loop. The model is represented as a dynamical system comprised of time-dependent nonlinear ordinary differential equations, and it is studied using stability analysis, modern bifurcation theory, and numerical simulations. We first determine the stability boundary (SB) in the most relevant parameter plane, the inlet-subcooling-number/external-pressure-drop plane, for a fixed control rod induced external reactivity equal to the 100% rod line value and then transform the SB to the practical power-flow map. Using this SB, we show that the normal operating point at 100% power is very stable, stability of points on the 100% rod line decreases as the flow rate is reduced, and that points are least stable in the low-flow/high-power region. We also determine the SB when the modal kinetics is replaced by simple point reactor kinetics and show that the first harmonic mode has no significant effect on the SB. Later we carry out the relevant numerical simulations where we first show that the Hopf bifurcation, that occurs as a parameter is varied across the SB is subcritical, and that, in the important low-flow/high-power region, growing oscillations can result following small finite perturbations of stable steady-states on the 100% rod line. Hence, a point on the 100% rod line in the low-flow/high-power region, although stable, may nevertheless be a point at which a BWR should not be operated. Numerical simulations are then done to calculate the decay ratios (DRs) and frequencies of oscillations for various points on the 100% rod line. It is determined that the NRC requirement of DR < 0.75-0.8 is not rigorously satisfied in the low-flow/high-power region and hence these points should be avoided during normal startup and shutdown operations. The frequency of oscillation is shown to decrease as the flow rate is reduced and the frequency of 0.5Hz observed in the low-flow/high-power region is consistent with those observed during actual instability incidents. Additional numerical simulations show that in the low-flow/high-power region, for the same initial conditions, the use of point kinetics leads to damped oscillations, whereas the model that includes the modal kinetics equations results in growing nonlinear oscillations. Thus, we show that side-by-side out-of-phase growing power oscillations result due to the very important first harmonic mode effect and that the use of point kinetics, which fails to predict these growing oscillations, leads to dramatically nonconservative results. Finally, the effect of a simple recirculation loop model that we develop is studied by carrying out additional stability analyses and additional numerical simulations. It is shown that the loop has a stabilizing effect on certain points on the 100% rod line for time delays equal to integer multiples of the natural period of oscillation, whereas it has a destabilizing effect for half-integer multiples. However, for more practical time delays, it is determined that the overall effect generally is destabilizing.

Modal Ring Method for the Scattering of Electromagnetic Waves

NASA Technical Reports Server (NTRS)

Baumeister, Kenneth J.; Kreider, Kevin L.

1993-01-01

The modal ring method for electromagnetic scattering from perfectly electric conducting (PEC) symmetrical bodies is presented. The scattering body is represented by a line of finite elements (triangular) on its outer surface. The infinite computational region surrounding the body is represented analytically by an eigenfunction expansion. The modal ring method effectively reduces the two dimensional scattering problem to a one-dimensional problem similar to the method of moments. The modal element method is capable of handling very high frequency scattering because it has a highly banded solution matrix.

Suppression of fiber modal noise induced radial velocity errors for bright emission-line calibration sources

DOE Office of Scientific and Technical Information (OSTI.GOV)

Mahadevan, Suvrath; Halverson, Samuel; Ramsey, Lawrence

2014-05-01

Modal noise in optical fibers imposes limits on the signal-to-noise ratio (S/N) and velocity precision achievable with the next generation of astronomical spectrographs. This is an increasingly pressing problem for precision radial velocity spectrographs in the near-infrared (NIR) and optical that require both high stability of the observed line profiles and high S/N. Many of these spectrographs plan to use highly coherent emission-line calibration sources like laser frequency combs and Fabry-Perot etalons to achieve precision sufficient to detect terrestrial-mass planets. These high-precision calibration sources often use single-mode fibers or highly coherent sources. Coupling light from single-mode fibers to multi-mode fibersmore » leads to only a very low number of modes being excited, thereby exacerbating the modal noise measured by the spectrograph. We present a commercial off-the-shelf solution that significantly mitigates modal noise at all optical and NIR wavelengths, and which can be applied to spectrograph calibration systems. Our solution uses an integrating sphere in conjunction with a diffuser that is moved rapidly using electrostrictive polymers, and is generally superior to most tested forms of mechanical fiber agitation. We demonstrate a high level of modal noise reduction with a narrow bandwidth 1550 nm laser. Our relatively inexpensive solution immediately enables spectrographs to take advantage of the innate precision of bright state-of-the art calibration sources by removing a major source of systematic noise.« less

Monitoring proton radiation therapy with in-room PET imaging

NASA Astrophysics Data System (ADS)

Zhu, Xuping; España, Samuel; Daartz, Juliane; Liebsch, Norbert; Ouyang, Jinsong; Paganetti, Harald; Bortfeld, Thomas R.; El Fakhri, Georges

2011-07-01

We used a mobile positron emission tomography (PET) scanner positioned within the proton therapy treatment room to study the feasibility of proton range verification with an in-room, stand-alone PET system, and compared with off-line equivalent studies. Two subjects with adenoid cystic carcinoma were enrolled into a pilot study in which in-room PET scans were acquired in list-mode after a routine fractionated treatment session. The list-mode PET data were reconstructed with different time schemes to generate in-room short, in-room long and off-line equivalent (by skipping coincidences from the first 15 min during the list-mode reconstruction) PET images for comparison in activity distribution patterns. A phantom study was followed to evaluate the accuracy of range verification for different reconstruction time schemes quantitatively. The in-room PET has a higher sensitivity compared to the off-line modality so that the PET acquisition time can be greatly reduced from 30 to <5 min. Features in deep-site, soft-tissue regions were better retained with in-room short PET acquisitions because of the collection of 15O component and lower biological washout. For soft tissue-equivalent material, the distal fall-off edge of an in-room short acquisition is deeper compared to an off-line equivalent scan, indicating a better coverage of the high-dose end of the beam. In-room PET is a promising low cost, high sensitivity modality for the in vivo verification of proton therapy. Better accuracy in Monte Carlo predictions, especially for biological decay modeling, is necessary.

Primary lumbar extradural hemangiosarcoma in a dog.

PubMed

Paek, Matthew; Glass, Eric; Kent, Marc; Clifford, Craig A; De Lahunta, Alexander

2015-01-01

A 9 yr old castrated male golden retriever weighing 36 kg was presented for evaluation of progressive left pelvic limb paresis and fecal and urinary incontinence. MRI demonstrated an extradural, ovoid mass compressing the lumbar spinal cord. Surgical excision of the mass was performed. Histologically, the mass was consistent with hemangiosarcoma with no involvement of the adjacent vertebrae. The dog underwent a doxorubicin-based chemotherapy protocol with the addition of oral cyclophosphamide. After completion of chemotherapy, the dog was evaluated q 4 mo for restaging. Clinicopathological evidence of primary tumor recurrence or metastatic disease was not detected for 15 mo after initial diagnosis and treatment. To the authors' knowledge, this is the first report of a primary extradural hemangiosarcoma in the lumbar vertebral column in a dog. The clinical presentation, diagnosis, treatment, and outcome are also discussed.

[Atezolizumab (Tecentriq®): Activity, indication and modality of use in advanced or metastatic urinary bladder carcinoma].

PubMed

Bernard-Tessier, Alice; Bonnet, Clément; Lavaud, Pernelle; Gizzi, Marco; Loriot, Yohann; Massard, Christophe

2018-02-01

Treatments for patients with metastatic or advanced urothelial carcinomas on progression after first line chemotherapy or unfit for cisplatin are currently limited. Atezolizumab (Tecentriq ® ) is a monoclonal antibody targeting PD-L1. The first of IMVIGOR 210 phase II trial (NCT02951767) investigated atezolizumab as front line treatment among 119 patients with metastatic urothelial cancer unfit for cisplatin. Response rate was 23% and median overall survival 15.9 months. The second cohort (NCT02108652) included 310 patients whose tumors were progressing after first line platinum-based chemotherapy. Response rate was 15% and median overall survival 7.9 months. Among patients with high PD-L1 expression on infiltrating immune cells (ICs), response rate was 26% and median overall survival 11 months. Atezolizumab was well-tolerated in both cohorts with 66% of treatment-related toxicities including 12% (cohort 1) and 7% (cohort 2) of grade 3-4 adverse events. These results led to an approval by the FDA in United States and the EMA in Europe. In France, atezolizumab was available through an early access agreement by the French National Agency for Medicines and Health Products (ANSM) for patients with metastatic or advanced urothelial carcinomas on progression after first line chemotherapy or unfit for cisplatin. So far, its avaibility in France within the EMA approval is pending its pricing. Copyright © 2017 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Long-term results of positron emission tomography-directed management of the neck in node-positive head and neck cancer after organ preservation therapy.

PubMed

Sjövall, Johanna; Chua, Benjamin; Pryor, David; Burmeister, Elizabeth; Foote, Matthew C; Panizza, Benedict; Burmeister, Bryan H; Porceddu, Sandro V

2015-03-01

The current study presents the long-term results from a study designed to evaluate a restaging positron emission tomography (PET) directed policy whereby neck dissections were omitted in all node positive head and neck squamous cell carcinoma (N+HNSCC) patients with PET-negative lymph nodes after definitive radiotherapy (RT), with or without chemotherapy. A post-therapy nodal response assessment with PET and computed tomography (CT) was performed in patients who achieved a complete response at the primary site after definitive radiotherapy. Patients with PET-negative lymph nodes were observed regardless of residual CT abnormalities. One hundred and twelve patients, the majority of whom (83 patients, 74%) had oropharyngeal primaries, were treated on protocol. Median follow-up was 62months. Negative and positive predictive values for the restaging PET was 97.1% and 77.8% respectively, with only one patient who was PET-negative after treatment experiencing an isolated nodal relapse. PET-guided management of the neck following organ preservation therapy effectively spares neck dissections in patients with N+HNSCC without compromising isolated nodal control or overall survival. Crown Copyright © 2014. Published by Elsevier Ltd. All rights reserved.

Discrimination of chemical vapor and temperature using an in-line modal interferometer based on an exterior hole-assisted polarization-maintaining photonic crystal fiber

NASA Astrophysics Data System (ADS)

Yoon, Min-Seok; Jun, Naram; Lee, Sang Bae; Han, Young-Geun

2014-05-01

A reflective in-line modal interferometer based on a polarization-maintaining photonic crystal fiber (PM-PCF) with two exterior air holes is proposed for simultaneous measurement of chemical vapor and temperature. After fusion-splicing the PM-PCF with a standard single-mode fiber, we collapse all of air holes in the PM-PCF resulting in two types of interference patterns between the core and the cladding modes in the PM-PCF depending on two polarization states. Since two large air holes at the facet of the proposed modal interferometer are left open, a chemical vapor can be infiltrated into the voids. Different sensitivities corresponding to input polarization states are utilized for discrimination between chemical vapor and temperature sensitivities.

Lung ultrasound for the diagnosis of community-acquired pneumonia in children.

PubMed

Stadler, Jacob A M; Andronikou, Savvas; Zar, Heather J

2017-10-01

Ultrasound (US) has been proposed as an alternative first-line imaging modality to diagnose community-acquired pneumonia in children. Lung US has the potential benefits over chest radiography of being radiation free, subject to fewer regulatory requirements, relatively lower cost and with immediate bedside availability of results. However, the uptake of lung US into clinical practice has been slow and it is not yet included in clinical guidelines for community-acquired pneumonia in children. The aim of this review is to give an overview of the equipment and techniques used to perform lung US in children with suspected pneumonia and the interpretation of relevant sonographic findings. We also summarise the current evidence of diagnostic accuracy and reliability of lung US compared to alternative imaging modalities in children and critically consider the strengths and limitations of lung US for use in children presenting with suspected community-acquired pneumonia.

FogBank: a single cell segmentation across multiple cell lines and image modalities.

PubMed

Chalfoun, Joe; Majurski, Michael; Dima, Alden; Stuelten, Christina; Peskin, Adele; Brady, Mary

2014-12-30

Many cell lines currently used in medical research, such as cancer cells or stem cells, grow in confluent sheets or colonies. The biology of individual cells provide valuable information, thus the separation of touching cells in these microscopy images is critical for counting, identification and measurement of individual cells. Over-segmentation of single cells continues to be a major problem for methods based on morphological watershed due to the high level of noise in microscopy cell images. There is a need for a new segmentation method that is robust over a wide variety of biological images and can accurately separate individual cells even in challenging datasets such as confluent sheets or colonies. We present a new automated segmentation method called FogBank that accurately separates cells when confluent and touching each other. This technique is successfully applied to phase contrast, bright field, fluorescence microscopy and binary images. The method is based on morphological watershed principles with two new features to improve accuracy and minimize over-segmentation. First, FogBank uses histogram binning to quantize pixel intensities which minimizes the image noise that causes over-segmentation. Second, FogBank uses a geodesic distance mask derived from raw images to detect the shapes of individual cells, in contrast to the more linear cell edges that other watershed-like algorithms produce. We evaluated the segmentation accuracy against manually segmented datasets using two metrics. FogBank achieved segmentation accuracy on the order of 0.75 (1 being a perfect match). We compared our method with other available segmentation techniques in term of achieved performance over the reference data sets. FogBank outperformed all related algorithms. The accuracy has also been visually verified on data sets with 14 cell lines across 3 imaging modalities leading to 876 segmentation evaluation images. FogBank produces single cell segmentation from confluent cell sheets with high accuracy. It can be applied to microscopy images of multiple cell lines and a variety of imaging modalities. The code for the segmentation method is available as open-source and includes a Graphical User Interface for user friendly execution.

Visual and tactile length matching in spatial neglect.

PubMed

Bisiach, Edoardo; McIntosh, Robert D; Dijkerman, H Chris; McClements, Kevin I; Colombo, Mariarosa; Milner, A David

2004-01-01

Previous studies have shown that many patients with spatial neglect underestimate the horizontal extent of leftwardly located shapes (presented on screen or on paper) relative to rightwardly located shapes. This has been used to help explain their leftward biases in line bisection. In the present study we have tested patients with right hemisphere damage, either with or without neglect, on a comparable length matching task, but using 3-dimensional objects. The task was executed first visually without tactile contact, and second through touch without vision. In both sense modalities, we found that patients with neglect, but not those without, tended to underestimate leftward located objects relative to rightward located objects, differing significantly in this regard from healthy subjects. However these lateral biases were not as frequent or as pronounced as in previous studies using 2-D visual shapes. Despite the similar asymmetries in the two sense modalities, we found only a small correlation between them, and clear double dissociations were observed among our patients. We conclude that leftward length underestimation cannot be attributed to any one single cause. First it cannot be entirely due to impairments in the visual pathways, such as hemianopia and/or processing biases, since the disorder is also seen in the tactile modality. At the same time, however, length underestimation phenomena cannot be fully explained as a disruption of a supramodal central size processor, since they can occur in either vision or touch alone. Our data would fit best with a multiple-factor model in which some patients show leftward length underestimation for modality-specific reasons, while others do so due to a more high-level disruption of size judgements.

A comparison of paper-and-pencil and computerized forms of Line Orientation and Enhanced Cued Recall Tests.

PubMed

Aşkar, Petek; Altun, Arif; Cangöz, Banu; Cevik, Vildan; Kaya, Galip; Türksoy, Hasan

2012-04-01

The purpose of this study was to assess whether a computerized battery of neuropsychological tests could produce similar results as the conventional forms. Comparisons on 77 volunteer undergraduates were carried out with two neuropsychological tests: Line Orientation Test and Enhanced Cued Recall Test. Firstly, students were assigned randomly across the test medium (paper-and-pencil versus computerized). Secondly, the groups were given the same test in the other medium after a 30-day interval between tests. Results showed that the Enhanced Cued Recall Test-Computer-based did not correlate with the Enhanced Cued Recall Test-Paper-and-pencil results. Line Orientation Test-Computer-based scores, on the other hand, did correlate significantly with the Line Orientation Test-Paper-and-pencil version. In both tests, scores were higher on paper-and-pencil tests compared to computer-based tests. Total score difference between modalities was statistically significant for both Enhanced Cued Recall Tests and for the Line Orientation Test. In both computer-based tests, it took less time for participants to complete the tests.

Terahertz wide aperture reflection tomography.

PubMed

Pearce, Jeremy; Choi, Hyeokho; Mittleman, Daniel M; White, Jeff; Zimdars, David

2005-07-01

We describe a powerful imaging modality for terahertz (THz) radiation, THz wide aperture reflection tomography (WART). Edge maps of an object's cross section are reconstructed from a series of time-domain reflection measurements at different viewing angles. Each measurement corresponds to a parallel line projection of the object's cross section. The filtered backprojection algorithm is applied to recover the image from the projection data. To our knowledge, this is the first demonstration of a reflection computed tomography technique using electromagnetic waves. We demonstrate the capabilities of THz WART by imaging the cross sections of two test objects.

Unsteady Aerodynamic Force Sensing from Strain Data

NASA Technical Reports Server (NTRS)

Pak, Chan-Gi

2017-01-01

A simple approach for computing unsteady aerodynamic forces from simulated measured strain data is proposed in this study. First, the deflection and slope of the structure are computed from the unsteady strain using the two-step approach. Velocities and accelerations of the structure are computed using the autoregressive moving average model, on-line parameter estimator, low-pass filter, and a least-squares curve fitting method together with analytical derivatives with respect to time. Finally, aerodynamic forces over the wing are computed using modal aerodynamic influence coefficient matrices, a rational function approximation, and a time-marching algorithm.

When the gold standard is not always golden: The value of invasive hemodynamic assessment to overcome the pitfalls of echocardiography in challenging cases of mitral stenosis.

PubMed

Harper, Yenal; Salem, Salem A; Alsafwah, Shadwan; Koshy, Santhosh; Garg, Nadish

2018-01-01

Mitral stenosis is a uncommon valvular lesion in the developed countries. Noninvasive evaluation is the first-line modality for assessment of mitral stenosis, however the noninvasive methods may have limitations in certain cases. Invasive hemodynamics can be used as adjunct tool for assessment of mitral stenosis in such difficult cases. Mitral valve using three-dimensional planimetry is a promising technique for assessment of mitral stenosis. © 2018 Wiley Periodicals, Inc.

Patient Comprehension and Attitudes toward Maintenance Chemotherapy for Lung Cancer

PubMed Central

Gerber, David E.; Hamann, Heidi A.; Rasco, Drew W.; Woodruff, Sharon; Craddock Lee, Simon J.

2012-01-01

Objective Maintenance chemotherapy is a recently approved approach to the treatment of advanced non-small cell lung cancer (NSCLC). We sought to gain insight into patients’ perceptions of maintenance chemotherapy using qualitative methods. Methods We conducted thematic content analysis of focus groups at a freestanding cancer center and at an associated safety-net county hospital. Patients with advanced NSCLC who had started but not yet completed first-line platinum doublet chemotherapy were provided visual and written explanations of maintenance chemotherapy before being guided in group discussion. Results Key themes to emerge for consideration of maintenance chemotherapy included (1) survival benefits, disease control, and “buying time”; (2) the importance of “doing something”; (3) quality of life concerns; (4) the role of provider opinion/preference; and (5) the importance of logistics. Conclusions Patients undergoing first-line chemotherapy for advanced NSCLC were able to understand the concept of maintenance chemotherapy, distinguish it from traditional treatment paradigms, identify pros and cons of this approach, and convey reasons for considering it. Practice Implications Advances in oncology care that alter therapy modalities and delivery may significantly impact patient perceptions and treatment experiences. Clinical team members may wish to elicit treatment preferences of first-line patients through clinical discussions that anticipate these considerations. PMID:22632736

Automatic modal identification of cable-supported bridges instrumented with a long-term monitoring system

NASA Astrophysics Data System (ADS)

Ni, Y. Q.; Fan, K. Q.; Zheng, G.; Chan, T. H. T.; Ko, J. M.

2003-08-01

An automatic modal identification program is developed for continuous extraction of modal parameters of three cable-supported bridges in Hong Kong which are instrumented with a long-term monitoring system. The program employs the Complex Modal Indication Function (CMIF) algorithm to identify modal properties from continuous ambient vibration measurements in an on-line manner. By using the LabVIEW graphical programming language, the software realizes the algorithm in Virtual Instrument (VI) style. The applicability and implementation issues of the developed software are demonstrated by using one-year measurement data acquired from 67 channels of accelerometers deployed on the cable-stayed Ting Kau Bridge. With the continuously identified results, normal variability of modal vectors caused by varying environmental and operational conditions is observed. Such observation is very helpful for selection of appropriate measured modal vectors for structural health monitoring applications.

Evaluation of PET and MR datasets in integrated 18F-FDG PET/MRI: A comparison of different MR sequences for whole-body restaging of breast cancer patients.

PubMed

Grueneisen, Johannes; Sawicki, Lino Morris; Wetter, Axel; Kirchner, Julian; Kinner, Sonja; Aktas, Bahriye; Forsting, Michael; Ruhlmann, Verena; Umutlu, Lale

2017-04-01

To investigate the diagnostic value of different MR sequences and 18F-FDG PET data for whole-body restaging of breast cancer patients utilizing PET/MRI. A total of 36 patients with suspected tumor recurrence of breast cancer based on clinical follow-up or abnormal findings in follow-up examinations (e.g. CT, MRI) were prospectively enrolled in this study. All patients underwent a PET/CT and subsequently an additional PET/MR scan. Two readers were instructed to identify the occurrence of a tumor relapse in subsequent MR and PET/MR readings, utilizing different MR sequence constellations for each session. The diagnostic confidence for the determination of a malignant or benign lesion was qualitatively rated (3-point ordinal scale) for each lesion in the different reading sessions and the lesion conspicuity (4-point ordinal scale) for the three different MR sequences was additionally evaluated. Tumor recurrence was present in 25/36 (69%) patients. All three PET/MRI readings showed a significantly higher accuracy as well as higher confidence levels for the detection of recurrent breast cancer lesions when compared to MRI alone (p<0.05). Furthermore, all three PET/MR sequence constellations showed comparable diagnostic accuracy for the identification of a breast cancer recurrence (p>0.05), yet the highest confidence levels were obtained, when all three MR sequences were used for image interpretation. Moreover, contrast-enhanced T1-weighted VIBE imaging showed significantly higher values for the delineation of malignant and benign lesions when compared to T2w HASTE and diffusion-weighted imaging. Integrated PET/MRI provides superior restaging of breast cancer patients over MRI alone. Facing the need for appropriate and efficient whole-body PET/MR protocols, our results show the feasibility of fast and morphologically adequate PET/MR protocols. However, considering an equivalent accuracy for the detection of breast cancer recurrences in the three PET/MR readings, the application of contrast-agent and the inclusion of DWI in the study protocol seems to be debatable. Copyright © 2017 Elsevier B.V. All rights reserved.

Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia.

PubMed

Morin, Mélanie; Carroll, Marie-Soleil; Bergeron, Sophie

2017-07-01

Pelvic floor muscle physical therapy is recommended in clinical guidelines for women with provoked vestibulodynia (PVD). Including isolated or combined treatment modalities, physical therapy is viewed as an effective first-line intervention, yet no systematic review concerning the effectiveness of physical therapy has been conducted. To systematically appraise the current literature on the effectiveness of physical therapy modalities for decreasing pain during intercourse and improving sexual function in women with PVD. A systematic literature search using PubMed, Scopus, CINHAL, and PEDro was conducted until October 2016. Moreover, a manual search from reference lists of included articles was performed. Ongoing trials also were reviewed using clinicaltrial.gov and ISRCTNregistry. Randomized controlled trials, prospective and retrospective cohorts, and case reports evaluating the effect of isolated or combined physical therapy modalities in women with PVD were included in the review. Main outcome measures were pain during intercourse, sexual function, and patient's perceived improvement. The literature search resulted in 43 eligible studies including 7 randomized controlled trials, 20 prospective studies, 5 retrospective studies, 6 case reports, and 6 study protocols. Most studies had a high risk of bias mainly associated with the lack of a comparison group. Another common bias was related to insufficient sample size, non-validated outcomes, non-standardized intervention, and use of other ongoing treatment. The vast majority of studies showed that physical therapy modalities such as biofeedback, dilators, electrical stimulation, education, multimodal physical therapy, and multidisciplinary approaches were effective for decreasing pain during intercourse and improving sexual function. The positive findings for the effectiveness of physical therapy modalities in women with PVD should be investigated further in robust and well-designed randomized controlled trials. Morin M, Carroll M-S, Bergeron S. Systematic Review of the Effectiveness of Physical Therapy Modalities in Women With Provoked Vestibulodynia. Sex Med Rev 2017;5:295-322. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Least-squares sequential parameter and state estimation for large space structures

NASA Technical Reports Server (NTRS)

Thau, F. E.; Eliazov, T.; Montgomery, R. C.

1982-01-01

This paper presents the formulation of simultaneous state and parameter estimation problems for flexible structures in terms of least-squares minimization problems. The approach combines an on-line order determination algorithm, with least-squares algorithms for finding estimates of modal approximation functions, modal amplitudes, and modal parameters. The approach combines previous results on separable nonlinear least squares estimation with a regression analysis formulation of the state estimation problem. The technique makes use of sequential Householder transformations. This allows for sequential accumulation of matrices required during the identification process. The technique is used to identify the modal prameters of a flexible beam.

Cervical porcupine quill foreign body involving the spinal cord of a dog: A description of various imaging modality findings.

PubMed

Le Roux, Christelle; Venter, Frans J; Kirberger, Robert M

2017-12-08

Although porcupine quill injuries are common in dogs, the detailed appearance of the quill on diagnostic ultrasound, computed tomography, and magnetic resonance imaging has not been sufficiently described. A 4-year-old, intact, female Jack Russel terrier presented with severe neck pain and ataxia after an altercation with a porcupine 2 weeks earlier. Radiology, diagnostic ultrasound, computed tomography and magnetic resonance imaging were all utilised to identify a quill imbedded in the cervical vertebral canal and cervical musculature and were compared to each other. Surgical removal of the quill, guided by imaging findings, led to the resolution of the clinical signs in the patient. Previous ultrasound imaging reports have just stated that the quill consists of paralell hyperechoic lines, and do not mention the finer hyperechoic lines inbetween and do not try to provide a reason for the appearance. Previous computed tomography (CT) reports just mention identifying the quill on CT images (whether or not CT could identify the fragments), but do not go into detail about the attenuating appearance of the quill nor try to relate this to the composition of the quill. This is to the authors' knowledge the first report with detailed imaging descriptions of a case of cranial cervical vertebral canal porcupine quill foreign body in a dog. This is also the first report to allude to a possible difference in imaging findings related to quill structure because of keratin orientation and melanin content. The ideal imaging modality to use remains elusive, but ultrasound, computed tomography and magnetic resonance imaging could all identify the quill.

Imaging of plantar fascia disorders: findings on plain radiography, ultrasound and magnetic resonance imaging.

PubMed

Draghi, Ferdinando; Gitto, Salvatore; Bortolotto, Chandra; Draghi, Anna Guja; Ori Belometti, Gioia

2017-02-01

Plantar fascia (PF) disorders commonly cause heel pain and disability in the general population. Imaging is often required to confirm diagnosis. This review article aims to provide simple and systematic guidelines for imaging assessment of PF disease, focussing on key findings detectable on plain radiography, ultrasound and magnetic resonance imaging (MRI). Sonographic characteristics of plantar fasciitis include PF thickening, loss of fibrillar structure, perifascial collections, calcifications and hyperaemia on Doppler imaging. Thickening and signal changes in the PF as well as oedema of adjacent soft tissues and bone marrow can be assessed on MRI. Radiographic findings of plantar fasciitis include PF thickening, cortical irregularities and abnormalities in the fat pad located deep below the PF. Plantar fibromatosis appears as well-demarcated, nodular thickenings that are iso-hypoechoic on ultrasound and show low-signal intensity on MRI. PF tears present with partial or complete fibre interruption on both ultrasound and MRI. Imaging description of further PF disorders, including xanthoma, diabetic fascial disease, foreign-body reactions and plantar infections, is detailed in the main text. Ultrasound and MRI should be considered as first- and second-line modalities for assessment of PF disorders, respectively. Indirect findings of PF disease can be ruled out on plain radiography. Teaching Points • PF disorders commonly cause heel pain and disability in the general population.• Imaging is often required to confirm diagnosis or reveal concomitant injuries.• Ultrasound and MRI respectively represent the first- and second-line modalities for diagnosis.• Indirect findings of PF disease can be ruled out on plain radiography.

Imaging Ultrasound Guidance and on-line Estimation of Thermal Behavior in HIFU Exposed Targets

NASA Astrophysics Data System (ADS)

Chauhan, Sunita; Haryanto, Amir

2006-05-01

Elevated temperatures have been used for many years to combat several diseases including treatment of certain types of cancers/tumors. High Intensity Focused Ultrasound (HIFU) has emerged as a potential non-invasive modality for trackless targeting of deep-seated cancers of human body. For the procedures which require thermal elevation such as hyperthermia and tissue ablation, temperature becomes a parameter of vital importance in order to monitor the treatment on-line. Also, embedding invasive temperature probes for this purpose beats the supremacy of the non-invasive ablating modality. In this paper, we describe the use of a non-invasive and inexpensive conventional imaging ultrasound modality for lesion positioning and estimation of thermal behavior of the tissue on exposure to HIFU. Representative results of our online lesion tracking algorithm for discerning lesioning behavior using image capture, processing and phase-shift measurements are presented.

99mTc-EDDA/HYNIC-TOC somatostatin receptor scintigraphy in daily clinical practice.

PubMed

Chrapko, Beata Ewa; Nocuń, Anna; Gołebiewska, Renata; Stefaniak, Bogusław; Korobowicz, Elzbieta; Czekajska-Chehab, Elzbieta; Sawicki, Marek; Polkowski, Wojciech Piotr

2010-04-01

This study aimed to assess the impact of 99mTc-EDDA/HYNIC-TOC (99mTc-TOC) somatostatin receptor scintigraphy (SRS) in clinical practice. One hundred seventeen patients were divided into 6 groups: 1, initial detection and localization of suspected neuroendocrine tumor (NET); 2, tumor staging before therapy; 3, staging of NET of unknown origin, 4, restaging after surgery of primary tumor; 5, diagnosis of solitary pulmonary nodules (SPNs), and 6, follow-up after "cold" somatostatin analogues treatment. In group 1, clinical suspicions were not confirmed in any of the patients; in group 2, most of the primary lesions showed overexpression of somatostatin receptors (SSRT); in group 3, the primary tumor was not identified in any of the patients; in group 4, recurrences were depicted in 7 out of 47 patients; in group 5, only 1 malignant SPN was detected, and in group 6, regression of primary mass and metastases were seen on follow-up SRS in 1 patient. 99mTc-TOC SRS is useful in staging of SSRT-overexpressing tumors of known and unknown primary origin, as well as in restaging after primary tumor surgery. This method is less effective in detecting suspected NET and assessing SPNs. Further investigation is necessary to evaluate the usefulness of SRS in monitoring patients after biological treatment.

A systematic review of recommendations and guidelines for the management of osteoarthritis: The chronic osteoarthritis management initiative of the U.S. bone and joint initiative.

PubMed

Nelson, Amanda E; Allen, Kelli D; Golightly, Yvonne M; Goode, Adam P; Jordan, Joanne M

2014-06-01

Although a number of osteoarthritis (OA) management guidelines exist, uptake has been suboptimal. Our aim was to review and critically evaluate existing OA management guidelines to better understand potential issues and barriers. A systematic review of the literature in MEDLINE published from January 1, 2000 to April 1, 2013 was performed and supplemented by bibliographic reviews, following PRISMA guidelines and a written protocol. Following initial title and abstract screening, 2 authors independently reviewed full-text articles; a third settled disagreements. Two independent reviewers extracted data into a standardized form. Two authors independently assessed guideline quality using the AGREE II instrument; three generated summary recommendations based on the extracted guideline data. Overall, 16 articles were included in the final review. There was broad agreement on recommendations by the various organizations. For non-pharmacologic modalities, education/self-management, exercise, weight loss if overweight, walking aids as indicated, and thermal modalities were widely recommended. For appropriate patients, joint replacement was recommended; arthroscopy with debridement was not recommended for symptomatic knee OA. Pharmacologic modalities most recommended included acetaminophen/paracetamol (first line) and NSAIDs (topical or oral, second line). Intra-articular corticosteroids were generally recommended for hip and knee OA. Controversy remains about the use of acupuncture, knee braces, heel wedges, intra-articular hyaluronans, and glucosamine/chondroitin. The relative agreement on many OA management recommendations across organizations indicates a problem with dissemination and implementation rather than a lack of quality guidelines. Future efforts should focus on optimizing implementation in primary care settings, where the majority of OA care occurs. Copyright © 2014 Elsevier Inc. All rights reserved.

Polysemous Verbs and Modality in Native and Non-Native Argumentative Writing: A Corpus-Based Study

ERIC Educational Resources Information Center

Salazar, Danica; Verdaguer, Isabel

2009-01-01

The present study is a corpus-based analysis of a selection of polysemous lexical verbs used to express modality in student argumentative writing. Twenty-three lexical verbs were searched for in three 100,000-word corpora of argumentative essays written in English by American, Filipino and Spanish university students. Concordance lines were…

First-line intra-arterial versus intravenous chemotherapy in unilateral sporadic group D retinoblastoma: evidence of better visual outcomes, ocular survival and shorter time to success with intra-arterial delivery from retrospective review of 20 years of treatment.

PubMed

Munier, Francis L; Mosimann, Pascal; Puccinelli, Francesco; Gaillard, Marie-Claire; Stathopoulos, Christina; Houghton, Susan; Bergin, Ciara; Beck-Popovic, Maja

2017-08-01

The introduction of intra-arterial chemotherapy (IAC) as salvage treatment has improved the prognosis for eye conservation in group D retinoblastoma. The aim of this study was to compare the outcomes of consecutive patients with advanced unilateral disease treated with either first-line intravenous chemotherapy (IVC) or first-line IAC. This is a retrospective mono-centric comparative review of consecutive patients. Sporadic unilateral retinoblastoma group D cases treated conservatively at Jules-Gonin Eye Hospital and CHUV between 1997 and 2014. From January 1997 to August 2008, IVC, combined with focal treatments, was the primary treatment approach. From September 2008 to October 2014, IAC replaced IVC as first-line therapy. 48 patients met the inclusion criteria, receiving only either IAC or IVC as primary treatment modality. Outcomes of 23 patients treated by IVC were compared with those of 25 treated by IAC; mean follow-up was 105.3 months (range 29.2-218.6) and 41.7 months (range 19.6-89.5), respectively. Treatment duration was significantly shorter in the IAC group (p<0.001). Ten eyes in the IVC group underwent enucleation. Recordable visual acuity of the salvaged eyes was significantly better in the IAC group (0.9 vs 1.4 logarithm of the minimum angle of resolution, p<0.01). No extraocular disease, metastases or long-term systemic complications were observed in either group. The difference in the time frame between treatment groups had an impact on the availability of intravitreal chemotherapy treatment. Despite this, the results reported here imply that eyes treated with first-line IAC will have shorter treatment period, better ocular survival and visual acuity than first-line IVC. 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/.

Predictive and prognostic value of 18F-DOPA PET/CT in patients affected by recurrent medullary carcinoma of the thyroid.

PubMed

Caobelli, Federico; Chiaravalloti, Agostino; Evangelista, Laura; Saladini, Giorgio; Schillaci, Orazio; Vadrucci, Manuela; Scalorbi, Federica; Donner, Davide; Alongi, Pierpaolo

2018-01-01

Medullary thyroid carcinoma (MTC) is a malignancy accounting for about 5-8% of thyroid cancers. Serum calcitonin and carcinoembryonic antigen (CEA) levels are widely used to monitor disease progression. However, prognostic factors able to predict outcomes are highly desirable. We, therefore, aimed to assess the prognostic role of 18 F-DOPA PET/CT in patients with recurrent MTC. 60 patients (mean age 64 ± 13 years, range 44-82) with recurrent MTC were eligible from a multicenter database. All patients underwent a restaging 18 F-DOPA PET/CT, performed at least 6 months after surgery. CEA/calcitonin levels, local recurrences, nodal involvement and metastases at PET/CT were recorded. SUVmax, SUVmean (also normalized to mediastinal uptake) and metabolic tumor volume were automatically calculated for each lesion, by placing a volume of interest around the lesion with 40% of peak activity as threshold for the automatic contouring. The patients were clinically and radiologically followed up for 21 ± 11 months. Rate of progression-free survival (PFS), disease-specific survival (DSS) and incremental prognostic value of 18 F-DOPA PET/CT over conventional imaging modalities were assessed by Kaplan-Meier curves and Log-Rank test. Cox regression univariate and multivariate analyses were performed for assessing predictors of prognosis. 18 F-DOPA PET/CT showed abnormal findings in 27 patients (45%) and resulted unremarkable in 33 (55%). PFS was significantly longer in patients with an unremarkable PET/CT scan (p = 0.018). Similarly, an unremarkable PET/CT study was associated with a significantly longer DSS (p = 0.04). 18 F-DOPA PET/CT added prognostic value over other imaging modalities both for PFS and for DSS (p < 0.001 and p = 0.012, respectively). Neither semiquantitative PET parameters nor clinical or laboratory data were predictive of a worse PFS and DSS in patients with recurrent MTC. 18 F-DOPA PET/CT scan has an important prognostic value in predicting disease progression and mortality rate.

Impact of 68Ga-DOTA-Peptide PET/CT on the Management of Gastrointestinal Neuroendocrine Tumour (GI-NET): Malaysian National Referral Centre Experience.

PubMed

Tan, Teik Hin; Boey, Ching Yeen; Lee, Boon Nang

2018-04-01

The National Cancer Institute is the only referral centre in Malaysia that provides 68 Ga-DOTA-peptide imaging. The purpose of this study is to determine the impact of 68 Ga-DOTA-peptide PET/CT on the management of gastrointestinal neuroendocrine tumours (GI-NET). A cross-sectional study was performed to review the impact of 68 Ga-DOTA-peptide ( 68 Ga-DOTATATE or 68 Ga-DOTATOC) PET/CT on patients with biopsy-proven GI-NET between January 2011 and December 2015. Suspected NET was excluded. Demographic data, tumoral characteristics, change of disease stage, pre-PET intended management and post-PET management were evaluated. Over a 5-year period, 82 studies of 68 Ga-DOTA-peptide PET/CT were performed on 44 GI-NET patients. The most common primary site was the rectum (50.0%) followed by the small bowel, stomach and colon. Using WHO 2010 grading, 40.9% of patients had low-grade (G1) tumour, 22.7% intermediate (G2) and 4.5% high (G3). Of ten patients scheduled for pre-operative staging, 68 Ga-DOTA-peptide PET/CT only led to therapeutic change in three patients. Furthermore, false-negative results of 68 Ga-DOTA-peptide PET/CT were reported in one patient after surgical confirmation. However, therapeutic changes were seen in 20/36 patients (55.6%) scheduled for post-surgical restaging or assessment of somatostatin analogue (SSA) eligibility. When 68 Ga-DOTA-peptide PET/CT was used for monitoring disease progress during systemic treatment (sandostatin, chemotherapy, everolimus and PRRT) in metastatic disease, impact on management modification was seen in 19/36 patients (52.8%), of which 84.2% had inter-modality change (switch to everolimus, chemotherapy or PRRT) and 15.8% had intra-modality change (increased SSA dosage). 68 Ga-DOTA-peptide PET/CT has a significant impact on management decisions in GI-NET patients as it can provide additional information on occult metastasis/equivocal lesions and supply the clinician an opportunity to select patients for targeted therapy.

Coherent multi-heterodyne spectroscopy using acousto-optic frequency combs.

PubMed

Durán, Vicente; Schnébelin, Cȏme; Guillet de Chatellus, Hugues

2018-05-28

We propose and characterize experimentally a new source of optical frequency combs for performing multi-heterodyne spectrometry. This comb modality is based on a frequency-shifting loop seeded with a continuous-wave (CW) monochromatic laser. The comb lines are generated by successive passes of the CW laser through an acousto-optic frequency shifter. We report the generation of frequency combs with more than 1500 mutually coherent lines, without resorting to non-linear broadening phenomena or external electronic modulation. The comb line spacing is easily reconfigurable from tens of MHz down to the kHz region. We first use a single acousto-optic frequency comb to conduct self-heterodyne interferometry with a high frequency resolution (500 kHz). By increasing the line spacing to 80 MHz, we demonstrate molecular spectroscopy on the sub-millisecond time scale. In order to reduce the detection bandwidth, we subsequently implement an acousto-optic dual-comb spectrometer with the aid of two mutually coherent frequency shifting loops. In each architecture, the potentiality of acousto-optic frequency combs for spectroscopy is validated by spectral measurements of hydrogen cyanide in the near-infrared region.

Coherent multi-heterodyne spectroscopy using acousto-optic frequency combs

NASA Astrophysics Data System (ADS)

Durán, Vicente; Schnébelin, Cȏme; Guillet de Chatellus, Hugues

2018-05-01

We propose and characterize experimentally a new source of optical frequency combs for performing multi-heterodyne spectrometry. This comb modality is based on a frequency shifting loop seeded with a CW monochromatic laser. The comb lines are generated by successive passes of the CW laser through an acousto-optic frequency shifter. We report the generation of frequency combs with more than 1500 mutually coherent lines, without resorting to non-linear broadening phenomena or external electronic modulation. The comb line spacing is easily reconfigurable from tens of MHz down to the kHz region. We first use a single acousto-optic frequency comb to conduct self-heterodyne interferometry with a high frequency resolution (500 kHz). By increasing the line spacing to 80 MHz, we demonstrate molecular spectroscopy on the sub-millisecond time scale. In order to reduce the detection bandwidth, we subsequently implement an acousto-optic dual-comb spectrometer with the aid of two mutually coherent frequency shifting loops. In each architecture, the potentiality of acousto-optic frequency combs for spectroscopy is validated by spectral measurements of hydrogen cyanide in the near-infrared region.

Semiquantitative visual approach to scoring lung cancer treatment response using computed tomography: a pilot study.

PubMed

Gottlieb, Ronald H; Kumar, Prasanna; Loud, Peter; Klippenstein, Donald; Raczyk, Cheryl; Tan, Wei; Lu, Jenny; Ramnath, Nithya

2009-01-01

Our objective was to compare a newly developed semiquantitative visual scoring (SVS) method with the current standard, the Response Evaluation Criteria in Solid Tumors (RECIST) method, in the categorization of treatment response and reader agreement for patients with metastatic lung cancer followed by computed tomography. The 18 subjects (5 women and 13 men; mean age, 62.8 years) were from an institutional review board-approved phase 2 study that evaluated a second-line chemotherapy regimen for metastatic (stages III and IV) non-small cell lung cancer. Four radiologists, blinded to the patient outcome and each other's reads, evaluated the change in the patients' tumor burden from the baseline to the first restaging computed tomographic scan using either the RECIST or the SVS method. We compared the numbers of patients placed into the partial response, the stable disease (SD), and the progressive disease (PD) categories (Fisher exact test) and observer agreement (kappa statistic). Requiring the concordance of 3 of the 4 readers resulted in the RECIST placing 17 (100%) of 17 patients in the SD category compared with the SVS placing 9 (60%) of 15 patients in the partial response, 5 (33%) of the 15 patients in the SD, and 1 (6.7%) of the 15 patients in the PD categories (P < 0.0001). Interobserver agreement was higher among the readers using the SVS method (kappa, 0.54; P < 0.0001) compared with that of the readers using the RECIST method (kappa, -0.01; P = 0.5378). Using the SVS method, the readers more finely discriminated between the patient response categories with superior agreement compared with the RECIST method, which could potentially result in large differences in early treatment decisions for advanced lung cancer.

State-of-the-art: prostate LDR brachytherapy.

PubMed

Voulgaris, S; Nobes, J P; Laing, R W; Langley, S E M

2008-01-01

This article on low dose rate (LDR) prostate brachytherapy reviews long-term results, patient selection and quality of life issues. Mature results from the United States and United Kingdom are reported and issues regarding definitions of biochemical failure are discussed. Latest data comparing brachytherapy with radical prostatectomy or no definitive treatment and also the risk of secondary malignancies after prostate brachytherapy are presented. Urological parameters of patient selection and quality of life issues concerning urinary, sexual and bowel function are reviewed. The position of prostate brachytherapy next to surgery as a first-line treatment modality is demonstrated.

Alzheimer disease: focus on computed tomography.

PubMed

Reynolds, April

2013-01-01

Alzheimer disease is the most common type of dementia, affecting approximately 5.3 million Americans. This debilitating disease is marked by memory loss, confusion, and loss of cognitive ability. The exact cause of Alzheimer disease is unknown although research suggests that it might result from a combination of factors. The hallmarks of Alzheimer disease are the presence of beta-amyloid plaques and neurofibrillary tangles in the brain. Radiologic imaging can help physicians detect these structural characteristics and monitor disease progression and brain function. Computed tomography and magnetic resonance imaging are considered first-line imaging modalities for the routine evaluation of Alzheimer disease.

Successful management of airway hemangioma with propranolol.

PubMed

Mendiratta, Vibhu; Varghese, Bincy; Chander, Ram; Parakh, Ankit; Solanki, Ravi S

2013-06-01

Airway hemangiomas can be difficult to manage and cause anxiety in both the parents and the treating physician. Propranolol, a nonselective beta-blocker, has recently been used for treating proliferating infantile hemangiomas. We report successful management of a proliferating, large, mixed infantile hemangioma with subglottic extension in an Indian infant using oral propranolol in a dose of 2mg/kg/day without any side effects. Induction of early involution and freedom from the side effects of steroid therapy seem encouraging for using propranolol as a first line treatment modality in the management of troublesome hemangiomas. © 2013 The International Society of Dermatology.

Behavioral, Modeling, and Electrophysiological Evidence for Supramodality in Human Metacognition.

PubMed

Faivre, Nathan; Filevich, Elisa; Solovey, Guillermo; Kühn, Simone; Blanke, Olaf

2018-01-10

Human metacognition, or the capacity to introspect on one's own mental states, has been mostly characterized through confidence reports in visual tasks. A pressing question is to what extent results from visual studies generalize to other domains. Answering this question allows determining whether metacognition operates through shared, supramodal mechanisms or through idiosyncratic, modality-specific mechanisms. Here, we report three new lines of evidence for decisional and postdecisional mechanisms arguing for the supramodality of metacognition. First, metacognitive efficiency correlated among auditory, tactile, visual, and audiovisual tasks. Second, confidence in an audiovisual task was best modeled using supramodal formats based on integrated representations of auditory and visual signals. Third, confidence in correct responses involved similar electrophysiological markers for visual and audiovisual tasks that are associated with motor preparation preceding the perceptual judgment. We conclude that the supramodality of metacognition relies on supramodal confidence estimates and decisional signals that are shared across sensory modalities. SIGNIFICANCE STATEMENT Metacognitive monitoring is the capacity to access, report, and regulate one's own mental states. In perception, this allows rating our confidence in what we have seen, heard, or touched. Although metacognitive monitoring can operate on different cognitive domains, we ignore whether it involves a single supramodal mechanism common to multiple cognitive domains or modality-specific mechanisms idiosyncratic to each domain. Here, we bring evidence in favor of the supramodality hypothesis by showing that participants with high metacognitive performance in one modality are likely to perform well in other modalities. Based on computational modeling and electrophysiology, we propose that supramodality can be explained by the existence of supramodal confidence estimates and by the influence of decisional cues on confidence estimates. Copyright © 2018 the authors 0270-6474/18/380263-15$15.00/0.

Current treatment options for recurrent/metastatic head and neck cancer: a post-ASCO 2011 update and review of last year's literature.

PubMed

Kurzweg, T; Möckelmann, N; Laban, S; Knecht, R

2012-10-01

The majority of patients with a squamous cell carcinoma of the head and neck present with locally advanced tumors. The first-line treatment of locally advanced tumor stages consists of a combined modality management. Despite these aggressive protocols, many patients develop locoregional recurrences or metastasis and place particularly high demands on the interdisciplinary treatment team. Treatment with a curative intent must be differentiated from a palliative one. In addition to prior treatment, resectability, age and performance status, patient wishes must be taken into consideration in treatment planning, especially considering that most therapies offer little to no overall survival benefit. Salvage surgery, chemo- and target therapies, and reirradiation are head and neck surgeon's and radiooncologist's weapons in the fight against these strong opponents. This review focuses on publications and meeting news from last year and reviews the current status of the clinical application of each treatment modality in recurrent or metastatic head and neck cancer.

Evolution of multidisciplinary brain metastasis management: case study and literature review.

PubMed

Colaco, Rovel; Martin, Pierre; Chiang, Veronica

2015-06-01

Up to 40 percent of all cancer patients develop brain metastasis (BM) during the course of their disease. Despite advances in diagnosis and therapy, prognosis in patients with BM remains poor for many patients, but for some, survival can be of the order of several years in duration. Difficulty in predicting long-term survivors has created controversy in contemporary management of BM. Minimizing medical and neurocognitive side effects (disease borne or iatrogenic) to enhance functional independence and improving overall quality of life in these individuals requires a coordinated approach of first-line and salvage surgical, chemotherapeutic (cytotoxic, targeted, or immune based), and radiation (whole brain radiotherapy or stereotactic radiosurgery) modalities. This goal needs to be balanced against the more traditional targets of management such as symptom relief, reducing tumor burden, and local tumor control, thereby increasing progression-free survival. This case study and literature review demonstrates the role of various treatment modalities in the management of BM.

A New Modality for Cancer Treatment--Nanoparticle Mediated Microwave Induced Photodynamic Therapy.

PubMed

Yao, Mengyu; Ma, Lun; Li, Lihua; Zhang, Junying; Lim, Rebecca; Chen, Wei; Zhang, Yu

2016-10-01

Photodynamic therapy (PDT) has attracted ever-growing attention as a promising modality for cancer treatment. However, due to poor tissue penetration by light, photodynamic therapy has rarely been used for deeply situated tumors. This problem can be solved if photosensitizers are activated by microwaves (MW) that are able to penetrate deeply into tissues. Here, for the first time, we report microwave-induced photodynamic therapy and exploit copper cysteamine nanoparticles as a new type of photosensitizer that can be activated by microwaves to produce singlet oxygen for cancer treatment. Both in vitro and in vivo studies on a rat osteosarcoma cell line (UMR 106-01) have shown significant cell destruction using copper cysteamine (Cu-Cy) under microwave activation. The heating effects and the release of copper ions from Cu-Cy upon MW stimulation are the main mechanisms for the generation of reactive oxygen species that are lethal bullets for cancer destruction. The copper cysteamine nanoparticle-based microwave-induced photodynamic therapy opens a new door for treating cancer and other diseases.

Treatment outcome for gastric mucosa-associated lymphoid tissue lymphoma according to Helicobacter pylori infection status: a single-center experience.

PubMed

Ryu, Kwang Duck; Kim, Gwang Ha; Park, Seong Oh; Lee, Kwang Jae; Moon, Jung Youn; Jeon, Hye Kyung; Baek, Dong Hoon; Lee, Bong Eun; Song, Geun Am

2014-07-01

Helicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas. In total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas. Of the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas. H. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status.

Treatment Outcome for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according to Helicobacter pylori Infection Status: A Single-Center Experience

PubMed Central

Ryu, Kwang Duck; Kim, Gwang Ha; Park, Seong Oh; Lee, Kwang Jae; Moon, Jung Youn; Jeon, Hye Kyung; Baek, Dong Hoon; Lee, Bong Eun; Song, Geun Am

2014-01-01

Background/Aims Helicobacter pylori eradication therapy has been used as a first-line treatment for H. pylori-positive gastric mucosa-associated lymphoid tissue (MALT) lymphoma. However, the management strategy for H. pylori-negative MALT lymphoma remains controversial. Therefore, the aim of this study was to examine the success rate of each treatment option for H. pylori-positive and H. pylori-negative gastric MALT lymphomas. Methods In total, 57 patients with gastric MALT lymphoma diagnosed between December 2000 and June 2012 were enrolled in the study. The treatment responses were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphomas. Results Of the 57 patients, 43 (75%) had H. pylori infection. Forty-eight patients received H. pylori eradication as a first-line treatment, and complete remission was achieved in 31 of the 39 patients (80%) with H. pylori-positive MALT lymphoma and in five (56%) of the nine patients with H. pylori-negative MALT lymphoma; no significant difference was observed between the groups (p=0.135). The other treatment modalities, including radiation therapy, chemotherapy, and surgery, were effective irrespective of H. pylori infection status, with no significant difference in the treatment response between H. pylori-positive and H. pylori-negative MALT lymphomas. Conclusions H. pylori eradication therapy may be considered as a first-line treatment regardless of H. pylori infection status. PMID:25071906

Prognostic factors of afatinib as a first-line therapy for advanced EGFR mutation-positive lung adenocarcinoma: a real-world, large cohort study.

PubMed

Liang, Sheng-Kai; Lee, Meng-Rui; Liao, Wei-Yu; Ho, Chao-Chi; Ko, Jen-Chung; Shih, Jin-Yuan

2018-05-04

Lung cancer remains the primary cause of cancer-related mortality worldwide. Several treatment modalities are available for lung cancer, including surgery, radiation, and chemotherapy. Among the chemotherapeutics available, afatinib has been shown to be effective for those with epidermal growth factor receptor ( EGFR ) mutation-positive lung adenocarcinoma. Herein, we analyzed the factors affecting the prognosis of patients who received afatinib as a first-line therapy for advanced EGFR mutation-positive lung adenocarcinoma in the real-world setting. Patients who received afatinib as a first-line therapy and were reimbursed by the National Health Insurance were recruited in this study. Data on patient characteristics and treatment courses were collected. In total, 259 patients were enrolled (median follow-up, 22.0 months). Of them, 82 (31.7%) were identified to have brain metastases at baseline, which were associated with poor Eastern Cooperative Oncology Group performance status, high incidence of central nervous system progression, and short overall survival. However, the results of our analysis showed that overall survival was not affected by reductions in the afatinib dosage or any upfront local treatments for brain tumors. Multivariate analyses showed that brain metastases at diagnosis and treatment response to afatinib are two important prognostic factors for the overall survival of patients with EGFR mutation-positive lung adenocarcinoma.

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems.

PubMed

Ogwumike, Omoyemi O; Adeniyi, Ade F

2013-04-15

The growing interest in marathon runners and marathons in Nigeria has not been reflected in reports of injuries and other health problems associated with these events. This study therefore outlines the incidence of injuries, marathon-related health problems and delivery of physiotherapy at the maiden and second editions of the Splash 105.5 FM/ICPC Integrity Marathon in Ibadan city, south-west Nigeria in 2009 and 2010. Using a data entry sheet, demographics and information on running experience, past and present injuries and other health problems reported en route and at the finish line by the runners were documented. The prevalence of injuries and other health problems reported by previous and first-time runners were compared. In both events, 16.3% and 17.2% of the runners respectively reported injuries with significant occurrence in first-time runners (p = 0.003 for 2009; p = 0.002 for 2010) mostly at the finish line. The reported injury type and site were muscle cramps and the thigh (39.7% and 76.4% respectively). Heat exhaustion was reported by 42.8% of runners in 2009 and 56.3% in 2010. Cryotherapy was mostly used in combination with other physiotherapy modalities in both years. Most of the injuries and other health problems were reported by first-time marathon runners mainly at the finish line. The most reported site of injury was the thigh while muscle cramps and heat exhaustions were the most reported types of injuries and health problems. First-time marathon runners should be adequately informed of the predisposition to injury during marathons and adequate body conditioning should be emphasized. Ample preparation and effective involvement of the physiotherapy team is essential for management of injured runners en route and at the finish line in a marathon.

Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea.

PubMed

Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

2016-11-01

Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP.This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA.Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively.The MAD treatment resulted in a significant reduction in apnea-hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA.These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP.

Therapeutic outcomes of mandibular advancement devices as an initial treatment modality for obstructive sleep apnea

PubMed Central

Park, Pona; Jeon, Hyoung Won; Han, Doo Hee; Won, Tae-Bin; Kim, Dong-Young; Rhee, Chae-Seo; Kim, Hyun Jik

2016-01-01

Abstract Although continuous positive airway pressure (CPAP) is a highly efficacious treatment for obstructive sleep apnea (OSA), there is a need for alternative treatment options, such as sleep surgeries and mandibular advancement devices (MADs), to overcome the limitations of CPAP. This study aimed to analyze the therapeutic outcomes of OSA subjects who were treated with a MAD, and to estimate the clinical impact of MAD as a first-line treatment for OSA. Forty-seven patients diagnosed with OSA received an adjustable MAD as an initial treatment. Drug-induced sleep endoscopic findings and sleep parameters (both pre-MAD and post-MAD treatment), such as apnea index, oxygen saturation, and degree of daytime sleepiness, were assessed retrospectively. The MAD treatment resulted in a significant reduction in apnea–hypopnea index, and also a significant elevation in lowest oxygen saturation. Satisfactory results of MAD treatment as a first treatment modality were observed in 27 patients, and a successful outcome was reached in approximately 72% of patients. The OSA patients who had lower body mass index and upper airway narrowing at the level of palate and tongue base showed relatively higher rates of a satisfactory outcome even in cases of moderate or severe OSA. These results suggest that the use of a MAD may be an alternative treatment option in OSA patients with retropalatal and retroglossal area narrowing regardless of disease severity. Additionally, MADs can be recommended as an initial treatment modality, and the effectiveness of MADs in achieving success may not be inferior to CPAP. PMID:27861349

Treatment of lymphangiomas with OK-432 (Picibanil).

PubMed

Rautio, Riitta; Keski-Nisula, Leo; Laranne, Jussi; Laasonen, Erkki

2003-01-01

To determine the efficacy of OK-432 sclerotherapy in the treatment of lymphangiomas. The treatment was begun for 14 patients with lymphangioma. The age range of the patients at the time of the first injection was from 10 months to 42 years. Eleven of the lesions involved the head and neck region, two the thorax and one was localized in the extremity. Prior to treatment all patients were investigated with either magnetic resonance imaging, computed tomography, ultrasound or a combination of these modalities. The injections were performed with ultrasound and/or fluoroscopic guidance. Eight patients received OK-432 as first-line treatment; five were treated after surgery and one after medical therapy. On average, 2.2 intracystic injections were performed per patient. Nine of the lesions were macrocystic and five were mixed lesions. Eleven patients showed complete or marked response to the OK-432 sclerotherapy, two patients had moderate shrinkage of their lesions and only one patient showed no response to therapy. Macrocystic lesions showed the best response to therapy. Those patients who received OK-432 as first-line treatment showed complete or marked response. It was found that treatment of lymphangiomas with OK-432 was safe and effective.

FDG-PET Imaging in Hematological Malignancies

PubMed Central

Valls, L.; Badve, C.; Avril, S.; Herrmann, K.; Faulhaber, P.; O'Donnell, J.; Avril, N.

2016-01-01

The majority of aggressive lymphomas is characterized by an up regulated glycolytic activity, which enables the visualization by F-18 FDG-PET/CT. One-stop hybrid FDG-PET/CT combines the functional and morphologic information, outperforming both, CT and FDG-PET as separate imaging modalities. This has resulted in several recommendations using FDG-PET/CT for staging, restaging, monitoring during therapy, and assessment of treatment response as well as identification of malignant transformation. FDG-PET/CT may obviate the need for a bone marrow biopsy in patients with Hodgkin's lymphoma and diffuse large B-cell lymphoma. FDG-PET/CT response assessment is recommended for FDG-avid lymphomas, whereas CT-based response evaluation remains important in lymphomas with low or variable FDG avidity. The treatment induced change in metabolic activity allows for assessment of response after completion of therapy as well as prediction of outcome early during therapy. The five point scale Deauville Criteria allows the assessment of treatment response based on visual FDG-PET analysis. Although the use of FDG-PET/CT for prediction of therapeutic response is promising it should only be conducted in the context of clinical trials. Surveillance FDG-PET/CT after complete remission is discouraged due to the relative high number of false-positive findings, which in turn may result in further unnecessary investigations. Future directions include the use of new PET tracers such as F-18 fluorothymidine (FLT), a surrogate biomarker of cellular proliferation and Ga-68 CXCR4, a chemokine receptor imaging biomarker as well as innovative digital PET/CT and PET/MRI techniques. PMID:27090170

Drug desensitization in the management of hypersensitivity reactions to monoclonal antibodies and chemotherapy.

PubMed

Mezzano, Veronica; Giavina-Bianchi, Pedro; Picard, Matthieu; Caiado, Joana; Castells, Mariana

2014-04-01

Hypersensitivity reactions to monoclonal antibodies and chemotherapy, which may vary in severity from mild to life-threatening, can lead to their discontinuation and replacement by alternative agents that are often less effective, more toxic, and/or more expensive. Drug desensitization has emerged as the best treatment modality capable of allowing re-introduction of the hypersensitivity reaction-inducing medication in highly sensitized patients in need of first line therapies. In recent years, the availability of new anti-neoplastic drugs and therapeutic monoclonal antibodies has increased, as has the potential for hypersensitivity reactions. Development of desensitization protocols for these new medications requires a careful assessment of the potential risks and benefits. The purposes of this review are to provide an overview of the presentation of hypersensitivity reactions amenable to desensitization and to increase awareness of the indications for and outcomes of desensitization protocols. Rapid drug desensitization has proven to be a safe and effective way of administering first line therapy to patients with hypersensitivity reactions, providing an extremely powerful treatment modality for patients for whom alternative drugs are deemed unacceptable. Rapid drug desensitization protocols should be administered only by highly trained allergists and nurses who have experience in determining which reactions are amenable to desensitization, and can identify high risk patients and provide them with appropriate care. Efforts should be made to increase awareness of the remarkable safety and efficacy of rapid drug desensitization among non-allergists, especially in the fields of oncology and rheumatology, so as to favor its universal application. Development of desensitization units to provide state-of-the-art care is possible only through coordinated teamwork.

Crossmodal attention switching: auditory dominance in temporal discrimination tasks.

PubMed

Lukas, Sarah; Philipp, Andrea M; Koch, Iring

2014-11-01

Visual stimuli are often processed more efficiently than accompanying stimuli in another modality. In line with this "visual dominance", earlier studies on attentional switching showed a clear benefit for visual stimuli in a bimodal visual-auditory modality-switch paradigm that required spatial stimulus localization in the relevant modality. The present study aimed to examine the generality of this visual dominance effect. The modality appropriateness hypothesis proposes that stimuli in different modalities are differentially effectively processed depending on the task dimension, so that processing of visual stimuli is favored in the dimension of space, whereas processing auditory stimuli is favored in the dimension of time. In the present study, we examined this proposition by using a temporal duration judgment in a bimodal visual-auditory switching paradigm. Two experiments demonstrated that crossmodal interference (i.e., temporal stimulus congruence) was larger for visual stimuli than for auditory stimuli, suggesting auditory dominance when performing temporal judgment tasks. However, attention switch costs were larger for the auditory modality than for visual modality, indicating a dissociation of the mechanisms underlying crossmodal competition in stimulus processing and modality-specific biasing of attentional set. Copyright © 2014 Elsevier B.V. All rights reserved.

Control of large flexible spacecraft by the independent modal-space control method

NASA Technical Reports Server (NTRS)

Meirovitch, L.; Shenar, J.

1984-01-01

The problem of control of a large-order flexible structure in the form of a plate-like lattice by the Independent Modal-Space Control (IMSC) method is presented. The equations of motion are first transformed to the modal space, thus obtaining internal (plant) decoupling of the system. Then, the control laws are designed in the modal space for each mode separately, so that the modal equations of motion are rendered externally (controller) decoupled. This complete decoupling applies both to rigid-body modes and elastic modes. The application of linear optimal control, in conjunction with a quadratic performance index, is first reviewed. A solution for high-order systems is proposed here by the IMSC method, whereby the problem is reduced to a number of modal minimum-fuel problems for the controlled modes.

The art and science of straight lines in radiology.

PubMed

Day, Cynthia M; Sodickson, Aaron

2011-02-01

The purpose of this article is to review the physical basis for straight radiographic lines, identify the possible components that may form a straight line interface in the body, provide illustrative examples across multiple organ systems and modalities, and explore how the detection of these interfaces can support specific diagnoses. Detection of a straight line interface can help the radiologist recognize otherwise difficult or subtle pathologic processes, and identification of its components can provide valuable clues to diagnosis.

The Role of Therapeutic Endoscopy in Patients With Cirrhosis-Related Causes of Gastrointestinal Bleeding.

PubMed

Kezer, Camille A; Gupta, Neil

2018-06-09

This article aims to review current therapeutic endoscopic treatments available for the management of gastrointestinal bleeding related to cirrhosis. Endoscopic band ligation is an effective treatment for primary prophylaxis, acute bleeding, and secondary prophylaxis of esophageal varices as well as for acute bleeding and secondary prophylaxis of select gastric varices. Sclerotherapy is a treatment option for acute bleeding and secondary prophylaxis of esophageal varices when band ligation is technically difficult. Cyanoacrylate glue injection is an effective treatment for acute bleeding of gastric and ectopic varices. Argon plasma coagulation is first-line and radiofrequency ablation is second-line treatment for chronic bleeding secondary to gastric antral vascular ectasia. There are a variety of endoscopic treatment modalities for cirrhosis-related gastrointestinal bleeding, and the appropriate therapy depends on the location of the bleed, history or presence of acute bleeding, and risk factors for intervention-related adverse events.

Platinum resistance in breast and ovarian cancer cell lines.

PubMed

Eckstein, Niels

2011-10-04

Breast and ovarian cancers are among the 10 leading cancer types in females with mortalities of 15% and 6%, respectively. Despite tremendous efforts to conquer malignant diseases, the war on cancer declared by Richard Nixon four decades ago seems to be lost. Approximately 21,800 women in the US will be diagnosed with ovarian cancer in 2011. Therefore, its incidence is relatively low compared to breast cancer with 207.090 prognosed cases in 2011. However, overall survival unmasks ovarian cancer as the most deadly gynecological neoplasia. Platinum-based chemotherapy is emerging as an upcoming treatment modality especially in triple negative breast cancer. However, in ovarian cancer Platinum-complexes for a long time are established as first line treatment. Emergence of a resistant phenotype is a major hurdle in curative cancer therapy approaches and many scientists around the world are focussing on this issue. This review covers new findings in this field during the past decade.

3D shape reconstruction of specular surfaces by using phase measuring deflectometry

NASA Astrophysics Data System (ADS)

Zhou, Tian; Chen, Kun; Wei, Haoyun; Li, Yan

2016-10-01

The existing estimation methods for recovering height information from surface gradient are mainly divided into Modal and Zonal techniques. Since specular surfaces used in the industry always have complex and large areas, considerations must be given to both the improvement of measurement accuracy and the acceleration of on-line processing speed, which beyond the capacity of existing estimations. Incorporating the Modal and Zonal approaches into a unifying scheme, we introduce an improved 3D shape reconstruction version of specular surfaces based on Phase Measuring Deflectometry in this paper. The Modal estimation is firstly implemented to derive the coarse height information of the measured surface as initial iteration values. Then the real shape can be recovered utilizing a modified Zonal wave-front reconstruction algorithm. By combining the advantages of Modal and Zonal estimations, the proposed method simultaneously achieves consistently high accuracy and dramatically rapid convergence. Moreover, the iterative process based on an advanced successive overrelaxation technique shows a consistent rejection of measurement errors, guaranteeing the stability and robustness in practical applications. Both simulation and experimentally measurement demonstrate the validity and efficiency of the proposed improved method. According to the experimental result, the computation time decreases approximately 74.92% in contrast to the Zonal estimation and the surface error is about 6.68 μm with reconstruction points of 391×529 pixels of an experimentally measured sphere mirror. In general, this method can be conducted with fast convergence speed and high accuracy, providing an efficient, stable and real-time approach for the shape reconstruction of specular surfaces in practical situations.

Comparison of cellular lethality in DNA repair-proficient or -deficient cell lines resulting from exposure to 70 MeV/n protons or 290 MeV/n carbon ions.

PubMed

Genet, Stefan C; Maeda, Junko; Fujisawa, Hiroshi; Yurkon, Charles R; Fujii, Yoshihiro; Romero, Ashley M; Genik, Paula C; Fujimori, Akira; Kitamura, Hisashi; Kato, Takamitsu A

2012-11-01

Charged particle therapy utilizing protons or carbon ions has been rapidly intensifying over recent years. The present study was designed to jointly investigate these two charged particle treatment modalities with respect to modeled anatomical depth-dependent dose and linear energy transfer (LET) deliveries to cells with either normal or compromised DNA repair phenotypes. We compared cellular lethality in response to dose, LET and Bragg peak location for accelerated protons and carbon ions at 70 and 290 MeV/n, respectively. A novel experimental live cell irradiation OptiCell™ in vitro culture system using three different Chinese hamster ovary (CHO) cells as a mammalian model was conducted. A wild-type DNA repair-competent CHO cell line (CHO 10B2) was compared to two other CHO cell lines (51D1 and xrs5), each genetically deficient with respect to one of the two major DNA repair pathways (homologous recombination and non-homologous end joining pathways, respectively) following genotoxic insults. We found that wild-type and homologous recombination-deficient (Rad51D) cellular lethality was dependent on both the dose and LET of the carbon ions, whereas it was only dependent on dose for protons. The non-homologous end joining deficient cell line (Ku80 mutant) showed nearly identical dose-response profiles for both carbon ions and protons. Our results show that the increasingly used modality of carbon ions as charged particle therapy is advantageous to protons in a radiotherapeutic context, primarily for tumor cells proficient in non-homologous end joining DNA repair where cellular lethality is dependent not only on the dose as in the case of more common photon therapeutic modalities, but more importantly on the carbon ion LETs. Genetic characterization of patient tumors would be key to individualize and optimize the selection of radiation modality, clinical outcome and treatment cost.

Image Guided Radiation Therapy (IGRT) Practice Patterns and IGRT's Impact on Workflow and Treatment Planning: Results From a National Survey of American Society for Radiation Oncology Members

DOE Office of Scientific and Technical Information (OSTI.GOV)

Nabavizadeh, Nima, E-mail: nabaviza@ohsu.edu; Elliott, David A.; Chen, Yiyi

Purpose: To survey image guided radiation therapy (IGRT) practice patterns, as well as IGRT's impact on clinical workflow and planning treatment volumes (PTVs). Methods and Materials: A sample of 5979 treatment site–specific surveys was e-mailed to the membership of the American Society for Radiation Oncology (ASTRO), with questions pertaining to IGRT modality/frequency, PTV expansions, method of image verification, and perceived utility/value of IGRT. On-line image verification was defined as images obtained and reviewed by the physician before treatment. Off-line image verification was defined as images obtained before treatment and then reviewed by the physician before the next treatment. Results: Of 601 evaluablemore » responses, 95% reported IGRT capabilities other than portal imaging. The majority (92%) used volumetric imaging (cone-beam CT [CBCT] or megavoltage CT), with volumetric imaging being the most commonly used modality for all sites except breast. The majority of respondents obtained daily CBCTs for head and neck intensity modulated radiation therapy (IMRT), lung 3-dimensional conformal radiation therapy or IMRT, anus or pelvis IMRT, prostate IMRT, and prostatic fossa IMRT. For all sites, on-line image verification was most frequently performed during the first few fractions only. No association was seen between IGRT frequency or CBCT utilization and clinical treatment volume to PTV expansions. Of the 208 academic radiation oncologists who reported working with residents, only 41% reported trainee involvement in IGRT verification processes. Conclusion: Consensus guidelines, further evidence-based approaches for PTV margin selection, and greater resident involvement are needed for standardized use of IGRT practices.« less

Image Guided Radiation Therapy (IGRT) Practice Patterns and IGRT's Impact on Workflow and Treatment Planning: Results From a National Survey of American Society for Radiation Oncology Members.

PubMed

Nabavizadeh, Nima; Elliott, David A; Chen, Yiyi; Kusano, Aaron S; Mitin, Timur; Thomas, Charles R; Holland, John M

2016-03-15

To survey image guided radiation therapy (IGRT) practice patterns, as well as IGRT's impact on clinical workflow and planning treatment volumes (PTVs). A sample of 5979 treatment site-specific surveys was e-mailed to the membership of the American Society for Radiation Oncology (ASTRO), with questions pertaining to IGRT modality/frequency, PTV expansions, method of image verification, and perceived utility/value of IGRT. On-line image verification was defined as images obtained and reviewed by the physician before treatment. Off-line image verification was defined as images obtained before treatment and then reviewed by the physician before the next treatment. Of 601 evaluable responses, 95% reported IGRT capabilities other than portal imaging. The majority (92%) used volumetric imaging (cone-beam CT [CBCT] or megavoltage CT), with volumetric imaging being the most commonly used modality for all sites except breast. The majority of respondents obtained daily CBCTs for head and neck intensity modulated radiation therapy (IMRT), lung 3-dimensional conformal radiation therapy or IMRT, anus or pelvis IMRT, prostate IMRT, and prostatic fossa IMRT. For all sites, on-line image verification was most frequently performed during the first few fractions only. No association was seen between IGRT frequency or CBCT utilization and clinical treatment volume to PTV expansions. Of the 208 academic radiation oncologists who reported working with residents, only 41% reported trainee involvement in IGRT verification processes. Consensus guidelines, further evidence-based approaches for PTV margin selection, and greater resident involvement are needed for standardized use of IGRT practices. Copyright © 2016 Elsevier Inc. All rights reserved.

The Perceptual Basis of the Modality Effect in Multimedia Learning

ERIC Educational Resources Information Center

Rummer, Ralf; Schweppe, Judith; Furstenberg, Anne; Scheiter, Katharina; Zindler, Antje

2011-01-01

Various studies have demonstrated an advantage of auditory over visual text modality when learning with texts and pictures. To explain this modality effect, two complementary assumptions are proposed by cognitive theories of multimedia learning: first, the visuospatial load hypothesis, which explains the modality effect in terms of visuospatial…

Evidence-Based Treatment Options in Recurrent and/or Metastatic Squamous Cell Carcinoma of the Head and Neck

PubMed Central

Argiris, Athanassios; Harrington, Kevin J.; Tahara, Makoto; Schulten, Jeltje; Chomette, Pauline; Ferreira Castro, Ana; Licitra, Lisa

2017-01-01

The major development of the past decade in the first-line treatment of recurrent and/or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN) was the introduction of cetuximab in combination with platinum plus 5-fluorouracil chemotherapy (CT), followed by maintenance cetuximab (the “EXTREME” regimen). This regimen is supported by a phase 3 randomized trial and subsequent observational studies, and it confers well-documented survival benefits, with median survival ranging between approximately 10 and 14 months, overall response rates between 36 and 44%, and disease control rates of over 80%. Furthermore, as indicated by patient-reported outcome measures, the addition of cetuximab to platinum-based CT leads to a significant reduction in pain and problems with social eating and speech. Conversely, until very recently, there has been a lack of evidence-based second-line treatment options, and the therapies that have been available have shown low response rates and poor survival outcomes. Presently, a promising new treatment option in R/M SCCHN has emerged: immune checkpoint inhibitors (ICIs), which have demonstrated favorable results in second-line clinical trials. Nivolumab and pembrolizumab are the first two ICIs that were approved by the US Food and Drug Administration. We note that the trials that showed benefit with ICIs included not only patients who previously received ≥1 platinum-based regimens for R/M SCCHN but also patients who experienced recurrence within 6 months after combined modality therapy with a platinum agent for locally advanced disease. In this review, we outline the available clinical and observational evidence for the EXTREME regimen and the initial results from clinical trials for ICIs in patients with R/M SCCHN. We propose that these treatment options can be integrated into a new continuum of care paradigm, with first-line EXTREME regimen followed by second-line ICIs. A number of ongoing clinical trials are comparing regimens with ICIs, alone and in combination with other ICIs or CT, with the EXTREME regimen for first-line treatment of R/M SCCHN. As we eagerly await the results of these trials, the EXTREME regimen remains the standard of care for the first-line treatment of R/M SCCHN. PMID:28536670

Cushing’s disease

PubMed Central

2012-01-01

Cushing’s disease, or pituitary ACTH dependent Cushing’s syndrome, is a rare disease responsible for increased morbidity and mortality. Signs and symptoms of hypercortisolism are usually non specific: obesity, signs of protein wasting, increased blood pressure, variable levels of hirsutism. Diagnosis is frequently difficult, and requires a strict algorithm. First-line treatment is based on transsphenoidal surgery, which cures 80% of ACTH-secreting microadenomas. The rate of remission is lower in macroadenomas. Other therapeutic modalities including anticortisolic drugs, radiation techniques or bilateral adrenalectomy will thus be necessary to avoid long-term risks (metabolic syndrome, osteoporosis, cardiovascular disease) of hypercortisolism. This review summarizes potential pathophysiological mechanisms, diagnostic approaches, and therapies. PMID:22710101

MR Imaging of the Diabetic Foot.

PubMed

McCarthy, Eoghan; Morrison, William B; Zoga, Adam C

2017-02-01

Abnormalities of the peripheral nervous, vascular, and immune systems contribute to the development of numerous foot and ankle pathologies in the diabetic population. Although radiographs remain the most practical first-line imaging tool, magnetic resonance (MR) is the tertiary imaging modality of choice, allowing for optimal assessment of bone and soft tissue abnormalities. MR allows for the accurate distinction between osteomyelitis/septic arthritis and neuropathic osteoarthropathy. Furthermore, it provides an excellent presurgical anatomic road map of involved tissues and devitalized skin to ensure successful limited amputations when required. Signal abnormality in the postoperative foot aids in the diagnosis of recurrent infection. Copyright © 2016 Elsevier Inc. All rights reserved.

Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 Clinical Guidelines for the Management of Adults with Major Depressive Disorder

PubMed Central

Giacobbe, Peter; Kennedy, Sidney H.; Blumberger, Daniel M.; Daskalakis, Zafiris J.; Downar, Jonathan; Modirrousta, Mandana; Patry, Simon; Vila-Rodriguez, Fidel; Lam, Raymond W.; MacQueen, Glenda M.; Parikh, Sagar V.; Ravindran, Arun V.

2016-01-01

Background: The Canadian Network for Mood and Anxiety Treatments (CANMAT) conducted a revision of the 2009 guidelines by updating the evidence and recommendations. The scope of the 2016 guidelines remains the management of major depressive disorder (MDD) in adults, with a target audience of psychiatrists and other mental health professionals. Methods: Using the question-answer format, we conducted a systematic literature search focusing on systematic reviews and meta-analyses. Evidence was graded using CANMAT-defined criteria for level of evidence. Recommendations for lines of treatment were based on the quality of evidence and clinical expert consensus. “Neurostimulation Treatments” is the fourth of six sections of the 2016 guidelines. Results: Evidence-informed responses were developed for 31 questions for 6 neurostimulation modalities: 1) transcranial direct current stimulation (tDCS), 2) repetitive transcranial magnetic stimulation (rTMS), 3) electroconvulsive therapy (ECT), 4) magnetic seizure therapy (MST), 5) vagus nerve stimulation (VNS), and 6) deep brain stimulation (DBS). Most of the neurostimulation treatments have been investigated in patients with varying degrees of treatment resistance. Conclusions: There is increasing evidence for efficacy, tolerability, and safety of neurostimulation treatments. rTMS is now a first-line recommendation for patients with MDD who have failed at least 1 antidepressant. ECT remains a second-line treatment for patients with treatment-resistant depression, although in some situations, it may be considered first line. Third-line recommendations include tDCS and VNS. MST and DBS are still considered investigational treatments. PMID:27486154

[Secondary telangiectatic osteosarcoma of the left femur. A case presentation of an unusual course of disease].

PubMed

Zajonz, D; Werner, M; Panzert, S; Strübing, A S; Tiepolt, S; Fabsits, E; Brandmaier, P; Heyde, C-E; Prietzel, T

2014-05-01

This article presents the unusual case of a 73-year-old male patient who was treated with primary interlocking nailing after a pathological femoral fracture. Despite comprehensive diagnostics including several biopsies, a tumor could not be detected. In 2008 when progressive cystic femoral destruction leading to loosening of the nail necessitated a partial femoral prosthesis, an osteosarcoma could first be diagnosed in the resected bone. Advanced progression of the tumor required an extended hip exarticulation. During the current restaging of the now 84-year-old patient no tumor could be detected. When a malignancy cannot be excluded even by repeated biopsies of radiologically suspicious structures, an adequate tumor staging followed by close monitoring should be carried out. For a clinically silent, long-term course of cystic destruction of a long bone over several years, an age over 60 years and a lack of distant metastases, an atypical osteosarcoma should be considered in the differential diagnosis.

Cetuximab plus gemcitabine/oxaliplatin (GEMOXCET) in first-line metastatic pancreatic cancer: a multicentre phase II study

PubMed Central

Kullmann, F; Hollerbach, S; Dollinger, M M; Harder, J; Fuchs, M; Messmann, H; Trojan, J; Gäbele, E; Hinke, A; Hollerbach, C; Endlicher, E

2009-01-01

Targeting the epidermal growth factor receptor pathway in pancreatic cancer seems to be an attractive therapeutic approach. This study assessed the efficacy of cetuximab plus the combination of gemcitabine/oxaliplatin in metastatic pancreatic cancer. Eligible subjects had histological or cytological diagnosis of metastatic pancreatic adenocarcinoma. The primary end point was response according to RECIST. Patients received cetuximab 400 mg m−2 at first infusion followed by weekly 250 mg m−2 combined with gemcitabine 1000 mg m−2 as a 100 min infusion on day 1 and oxaliplatin 100 mg m−2 as a 2-h infusion on day 2 every 2 weeks. Between January 2005 and August 2006, a total of 64 patients (22 women (34%), 42 men (66%); median age 64 years (range 31–78)) were enrolled at seven study centres. On October 2007, a total of 17 patients were alive. Sixty-two patients were evaluable for baseline and 61 for assessment of response to treatment in an intention-to-treat analysis. Six patients had an incomplete drug combination within the first cycle of the treatment plan (n=4 hypersensitivity reactions to the first cetuximab infusion, n=2 refused to continue therapy). Reported grade 3/4 toxicities (% of patients) were leukopaenia 15%, anaemia 8%, thrombocytopaenia 10%, diarrhoea 7%, nausea 18%, infection 18% and allergy 7%. Cetuximab-attributable skin reactions occurred as follows: grade 0: 20%, grade 1: 41%, grade 2: 30% and grade 3: 10%. The intention-to-treat analysis of 61 evaluable patients showed an overall response rate of 33%, including 1 (2%) complete and 19 (31%) partial remissions. There were 31% patients with stable and 36% with progressive disease or discontinuation of the therapy before re-staging. The presence of a grade 2 or higher skin rash was associated with a higher likelihood of achieving objective response. Median time to progression was 118 days, with a median overall survival of 213 days. A clinical benefit response was noted in 24 of the evaluable 61 patients (39%). The addition of cetuximab to the combination of gemcitabine and oxaliplatin is well tolerated but does not increase response or survival in patients with metastatic pancreatic cancer. PMID:19293797

Multi-modal management of acromegaly: a value perspective.

PubMed

Kimmell, Kristopher T; Weil, Robert J; Marko, Nicholas F

2015-10-01

The Acromegaly Consensus Group recently released updated guidelines for medical management of acromegaly patients. We subjected these guidelines to a cost analysis. We conducted a cost analysis of the recommendations based on published efficacy rates as well as publicly available cost data. The results were compared to findings from a previously reported comparative effectiveness analysis of acromegaly treatments. Using decision tree software, two models were created based on the Acromegaly Consensus Group's recommendations and the comparative effectiveness analysis. The decision tree for the Consensus Group's recommendations was subjected to multi-way tornado analysis to identify variables that most impacted the value analysis of the decision tree. The value analysis confirmed the Consensus Group's recommendations of somatostatin analogs as first line therapy for medical management. Our model also demonstrated significant value in using dopamine agonist agents as upfront therapy as well. Sensitivity analysis identified the cost of somatostatin analogs and growth hormone receptor antagonists as having the most significant impact on the cost effectiveness of medical therapies. Our analysis confirmed the value of surgery as first-line therapy for patients with surgically accessible lesions. Surgery provides the greatest value for management of patients with acromegaly. However, in accordance with the Acromegaly Consensus Group's recent recommendations, somatostatin analogs provide the greatest value and should be used as first-line therapy for patients who cannot be managed surgically. At present, the substantial cost is the most significant negative factor in the value of medical therapies for acromegaly.

Unusual Bone Superscan, MIBG Superscan, and 68Ga DOTATATE PET/CT in Metastatic Pheochromocytoma.

PubMed

Tan, Teik Hin; Wong, Teck Huat; Hassan, Siti Zarina Amir; Lee, Boon Nang

2015-11-01

A 17-year-old adolescent boy with biochemically raised 2-hour urinary metanephrine and normetanephrine as well as CT findings of retroperitoneal soft tissue mass and bony metastases was referred for further assessment. Apart from Ga DOTATATE PET/CT evaluation, pretargeted systemic radionuclide therapy assessment with I-MIBG scintigraphy showed unusual phenomenon of MIBG superscan. Postsurgically, restaging Tc-MDP bone scintigraphy showed typical bone superscan features. The MIBG superscan was better delineated on post-I-MIBG therapy images.

A pulmonary metastasis of a cystosarcoma phyllodes of the breast detected by 18F-FDG PET/CT.

PubMed

Treglia, Giorgio; Muoio, Barbara; Caldarella, Carmelo; Parapatt, George Koshy

2014-03-01

We describe a pulmonary metastasis of a cystosarcoma phyllodes of the breast (CPB) detected by F-FDG PET/CT. A 65-year-old female patient previously operated on for a cystosarcoma phyllodes of the left breast underwent F-FDG PET/CT for restaging. F-FDG PET/CT showed an area of increased F-FDG uptake corresponding to a 2-cm right pulmonary nodule. Histology suggested the presence of a pulmonary metastasis of CPB.

Etoposide radiosensitizes p53-defective cholangiocarcinoma cell lines independent of their G2 checkpoint efficacies

PubMed Central

Hematulin, Arunee; Meethang, Sutiwan; Utapom, Kitsana; Wongkham, Sopit; Sagan, Daniel

2018-01-01

Radiotherapy has been accounted as the most comprehensive cancer treatment modality over the past few decades. However, failure of this treatment modality occurs in several malignancies due to the resistance of cancer cells to radiation. It was previously reported by the present authors that defective cell cycle checkpoints could be used as biomarkers for predicting the responsiveness to radiation in individual patients with cholangiocarcinoma (CCA). However, identification of functional defective cell cycle checkpoints from cells from a patient's tissues is cumbersome and not applicable in the clinic. The present study evaluated the radiosensitization potential of etoposide in p53-defective CCA KKU-M055 and KKU-M214 cell lines. Treatment with etoposide enhanced the responsiveness of two p53-defective CCA cell lines to radiation independent of G2 checkpoint function. In addition, etoposide treatment increased radiation-induced cell death without altering the dominant mode of cell death of the two cell lines. These findings indicate that etoposide could be used as a radiation sensitizer for p53-defective tumors, independent of the function of G2 checkpoint. PMID:29541168

Method of fan sound mode structure determination computer program user's manual: Modal calculation program

NASA Technical Reports Server (NTRS)

Pickett, G. F.; Wells, R. A.; Love, R. A.

1977-01-01

A computer user's manual describing the operation and the essential features of the Modal Calculation Program is presented. The modal Calculation Program calculates the amplitude and phase of modal structures by means of acoustic pressure measurements obtained from microphones placed at selected locations within the fan inlet duct. In addition, the Modal Calculation Program also calculates the first-order errors in the modal coefficients that are due to tolerances in microphone location coordinates and inaccuracies in the acoustic pressure measurements.

Review of the treatment options for chronic constipation.

PubMed

Johanson, John F

2007-05-02

Constipation is a common gastrointestinal motility disorder that is often chronic, negatively affects patients' daily lives, and is associated with high healthcare costs. There is a considerable range of treatment modalities available for patients with constipation; however, the clinical evidence supporting their use varies widely. Nonpharmacologic modalities, such as increased exercise or fluid intake and bowel habit training, are generally recommended as first-line approaches, but data on the effectiveness of these measures are limited. The clinical benefits of various traditional pharmacologic agents (many of which are available over the counter, such as laxatives and fiber supplements) remain unclear. Although these modalities may benefit some patients with temporary constipation, their efficacy in patients for whom constipation is chronic is less well defined. Some studies suggest benefit with psyllium, polyethylene glycol, and lactulose; however, the use of other agents, such as calcium polycarbophil, methylcellulose, bran, magnesium hydroxide, and stimulant laxatives, is not supported by strong clinical evidence. More recently, newer agents have been approved for the treatment of patients with chronic constipation on the basis of comprehensive clinical investigation programs. Tegaserod, with its well-established clinical profile, and lubiprostone, the latest addition to the treatment armamentarium, represent the new generation of therapies for chronic constipation. This article reviews the efficacy and safety of traditional therapies used in the management of the multiple symptoms associated with chronic constipation and discusses recently approved and emerging therapies for this disorder.

A Complete Multimode Equivalent-Circuit Theory for Electrical Design

PubMed Central

Williams, Dylan F.; Hayden, Leonard A.; Marks, Roger B.

1997-01-01

This work presents a complete equivalent-circuit theory for lossy multimode transmission lines. Its voltages and currents are based on general linear combinations of standard normalized modal voltages and currents. The theory includes new expressions for transmission line impedance matrices, symmetry and lossless conditions, source representations, and the thermal noise of passive multiports. PMID:27805153

Impact of 18F-fluorodeoxyglucose positron emission tomography before and after definitive radiation therapy in patients with apparently solitary plasmacytoma.

PubMed

Kim, Paul J; Hicks, Rodney J; Wirth, Andrew; Ryan, Gail; Seymour, John F; Prince, H Miles; Mac Manus, Michael P

2009-07-01

To evaluate the impact of (18)F-fluorodeoxyglucose positron emission tomography (FDG-PET) on management of patients with apparently isolated plasmacytoma. Twenty-one patients with apparently solitary plasmacytoma who underwent FDG-PET for staging or restaging were identified from a central PET database. They were either candidates for or had received definitive radiation therapy (RT). Seventeen patients had initial staging scans for bone (n = 11) or soft tissue (n = 6) plasmacytomas, and 11 had PET scans after RT. Only 1 of 14 known untreated sites of plasmacytoma was not identified on staging PET (lesion sensitivity = 93%). Three plasmacytomas were excised before PET. Staging PET influenced management in 6 of 17 patients (35%) by showing multiple myeloma (n = 1), discouraging RT after complete resection (n = 1), excluding plasmacytoma at a second site (n = 1), by increasing RT fields (n = 2), or by suggesting sarcoidosis (n = 1). Fifteen of 17 patients with initial staging PET scans received definitive RT. Restaging PET scans after RT showed complete metabolic response in 8 of 11 cases and progressive disease in 2. Two patients with either no response or partial metabolic response had late responses. Staging sestamibi and PET scans were concordant in five of six occasions (one sestamibi scan was false negative). FDG-PET has value for staging and RT planning in plasmacytoma and potentially could have a role in response-assessment after RT. Slow resolution of FDG uptake posttreatment does not necessarily imply an adverse prognosis.

Shock treatment: using immersive digital realism to restage and re-examine milgram's 'obedience to authority' research.

PubMed

Haslam, S Alexander; Reicher, Stephen D; Millard, Kathryn

2015-01-01

Attempts to revisit Milgram's 'Obedience to Authority' (OtA) paradigm present serious ethical challenges. In recent years new paradigms have been developed to circumvent these challenges but none involve using Milgram's own procedures and asking naïve participants to deliver the maximum level of shock. This was achieved in the present research by using Immersive Digital Realism (IDR) to revisit the OtA paradigm. IDR is a dramatic method that involves a director collaborating with professional actors to develop characters, the strategic withholding of contextual information, and immersion in a real-world environment. 14 actors took part in an IDR study in which they were assigned to conditions that restaged Milgrams's New Baseline ('Coronary') condition and four other variants. Post-experimental interviews also assessed participants' identification with Experimenter and Learner. Participants' behaviour closely resembled that observed in Milgram's original research. In particular, this was evidenced by (a) all being willing to administer shocks greater than 150 volts, (b) near-universal refusal to continue after being told by the Experimenter that "you have no other choice, you must continue" (Milgram's fourth prod and the one most resembling an order), and (c) a strong correlation between the maximum level of shock that participants administered and the mean maximum shock delivered in the corresponding variant in Milgram's own research. Consistent with an engaged follower account, relative identification with the Experimenter (vs. the Learner) was also a good predictor of the maximum shock that participants administered.

Utility of Ultrasound and Magnetic Resonance Imaging in Patients with Disorders of Sex Development Who Undergo Prophylactic Gonadectomy.

PubMed

Alaniz, V I; Kobernik, E K; Dillman, J; Quint, E H

2016-12-01

To evaluate ultrasonography and magnetic resonance imaging (MRI) in identifying gonads in patients with disorders of sex development (DSD) who undergo prophylactic gonadectomy, and to assess the capacity of preoperative imaging to detect premalignant and malignant transformation. Retrospective cohort at a tertiary referral center of 39 patients with DSD who underwent MRI and/or ultrasonography before prophylactic gonadectomy. None. Identification of gonads on preoperative imaging. Thirty-three patients underwent ultrasonography, which identified 54% (35/65) of gonads and 14 patients had MRI, which identified 41% (11/27) of gonads. There was no significant difference between imaging modalities in the proportion of gonads identified (P = .25). The proportion of pathology-confirmed dysgenetic gonads identified was higher on ultrasound compared with MRI (51% vs 8%; P = .02). There was no difference in the proportion of pathology-confirmed testes identified on ultrasound and MRI (54% vs 71%; P = .33). Eleven out of 39 patients (28%) were diagnosed with a premalignant lesion, and there were no distinguishing characteristics documented on imaging reports to suggest transformation. The only diagnosed malignancy in this series had imaging describing a "normal-sized ovary." Ultrasonography and MRI identified 40%-50% of gonads in patients with DSD who underwent prophylactic gonadectomy, with no significant difference between the 2 modalities. Clinicians should, therefore, consider ultrasonography as a first-line imaging modality. Premalignant lesions were not detected on either imaging modality. The only malignancy was described as a "normal-sized ovary" which should raise concern in a patient with complete gonadal dysgenesis expected to have streak gonads. Copyright © 2016 North American Society for Pediatric and Adolescent Gynecology. Published by Elsevier Inc. All rights reserved.

Ocean acoustic interferometry.

PubMed

Brooks, Laura A; Gerstoft, Peter

2007-06-01

Ocean acoustic interferometry refers to an approach whereby signals recorded from a line of sources are used to infer the Green's function between two receivers. An approximation of the time domain Green's function is obtained by summing, over all source positions (stacking), the cross-correlations between the receivers. Within this paper a stationary phase argument is used to describe the relationship between the stacked cross-correlations from a line of vertical sources, located in the same vertical plane as two receivers, and the Green's function between the receivers. Theory and simulations demonstrate the approach and are in agreement with those of a modal based approach presented by others. Results indicate that the stacked cross-correlations can be directly related to the shaded Green's function, so long as the modal continuum of any sediment layers is negligible.

Combination of peptide receptor radionuclide therapy with fractionated external beam radiotherapy for treatment of advanced symptomatic meningioma

PubMed Central

2012-01-01

Background External beam radiotherapy (EBRT) is the treatment of choice for irresectable meningioma. Due to the strong expression of somatostatin receptors, peptide receptor radionuclide therapy (PRRT) has been used in advanced cases. We assessed the feasibility and tolerability of a combination of both treatment modalities in advanced symptomatic meningioma. Methods 10 patients with irresectable meningioma were treated with PRRT (177Lu-DOTA0,Tyr3 octreotate or - DOTA0,Tyr3 octreotide) followed by external beam radiotherapy (EBRT). EBRT performed after PRRT was continued over 5–6 weeks in IMRT technique (median dose: 53.0 Gy). All patients were assessed morphologically and by positron emission tomography (PET) before therapy and were restaged after 3–6 months. Side effects were evaluated according to CTCAE 4.0. Results Median tumor dose achieved by PRRT was 7.2 Gy. During PRRT and EBRT, no side effects > CTCAE grade 2 were noted. All patients reported stabilization or improvement of tumor-associated symptoms, no morphologic tumor progression was observed in MR-imaging (median follow-up: 13.4 months). The median pre-therapeutic SUVmax in the meningiomas was 14.2 (range: 4.3–68.7). All patients with a second PET after combined PRRT + EBRT showed an increase in SUVmax (median: 37%; range: 15%–46%) to a median value of 23.7 (range: 8.0–119.0; 7 patients) while PET-estimated volume generally decreased to 81 ± 21% of the initial volume. Conclusions The combination of PRRT and EBRT is feasible and well tolerated. This approach represents an attractive strategy for the treatment of recurring or progressive symptomatic meningioma, which should be further evaluated. PMID:22720902

Seeing cilia: imaging modalities for ciliary motion and clinical connections.

PubMed

Peabody, Jacelyn E; Shei, Ren-Jay; Bermingham, Brent M; Phillips, Scott E; Turner, Brett; Rowe, Steven M; Solomon, George M

2018-06-01

The respiratory tract is lined with multiciliated epithelial cells that function to move mucus and trapped particles via the mucociliary transport apparatus. Genetic and acquired ciliopathies result in diminished mucociliary clearance, contributing to disease pathogenesis. Recent innovations in imaging technology have advanced our understanding of ciliary motion in health and disease states. Application of imaging modalities including transmission electron microscopy, high-speed video microscopy, and micron-optical coherence tomography could improve diagnostics and be applied for precision medicine. In this review, we provide an overview of ciliary motion, imaging modalities, and ciliopathic diseases of the respiratory system including primary ciliary dyskinesia, cystic fibrosis, chronic obstructive pulmonary disease, and idiopathic pulmonary fibrosis.

The SPLASH/ICPC integrity marathon in Ibadan, Nigeria: incidence and management of injuries and marathon-related health problems

PubMed Central

2013-01-01

Background The growing interest in marathon runners and marathons in Nigeria has not been reflected in reports of injuries and other health problems associated with these events. This study therefore outlines the incidence of injuries, marathon-related health problems and delivery of physiotherapy at the maiden and second editions of the Splash 105.5 FM/ICPC Integrity Marathon in Ibadan city, south-west Nigeria in 2009 and 2010. Methods Using a data entry sheet, demographics and information on running experience, past and present injuries and other health problems reported en route and at the finish line by the runners were documented. The prevalence of injuries and other health problems reported by previous and first-time runners were compared. Results In both events, 16.3% and 17.2% of the runners respectively reported injuries with significant occurrence in first-time runners (p = 0.003 for 2009; p = 0.002 for 2010) mostly at the finish line. The reported injury type and site were muscle cramps and the thigh (39.7% and 76.4% respectively). Heat exhaustion was reported by 42.8% of runners in 2009 and 56.3% in 2010. Cryotherapy was mostly used in combination with other physiotherapy modalities in both years. Conclusion Most of the injuries and other health problems were reported by first-time marathon runners mainly at the finish line. The most reported site of injury was the thigh while muscle cramps and heat exhaustions were the most reported types of injuries and health problems. First-time marathon runners should be adequately informed of the predisposition to injury during marathons and adequate body conditioning should be emphasized. Ample preparation and effective involvement of the physiotherapy team is essential for management of injured runners en route and at the finish line in a marathon. PMID:24499546

Diagnosis and Differential Diagnosis of Hydrocephalus in Adults.

PubMed

Langner, Sönke; Fleck, Steffen; Baldauf, Jörg; Mensel, Birger; Kühn, Jens Peter; Kirsch, Michael

2017-08-01

Purpose  Hydrocephalus is caused by an imbalance of production and absorption of cerebrospinal fluid (CSF) or obstruction of its pathways, resulting in ventricular dilatation and increased intracranial pressure. Imaging plays a crucial role in the diagnosis, differential diagnosis and planning of treatment. Methods  This review article presents the different types of hydrocephalus und their typical imaging appearance, describes imaging techniques, and discusses differential diagnoses of the different forms of hydrocephalus. Results and Conclusion  Imaging plays a central role in the diagnosis of hydrocephalus. While magnetic resonance (MR) imaging is the first-line imaging modality, computed tomography (CT) is often the first-line imaging test in emergency patients. Key points   · Occlusive hydrocephalus is caused by obstruction of CSF pathways.. · Malabsorptive hydrocephalus is caused by impaired CSF absorption.. · The MR imaging protocol should always include sagittal high-resolution T2-weighted images.. · When an inflammatory etiology is suspected, imaging with contrast agent administration is necessary.. Citation Format · Langner S, Fleck S, Baldauf J et al. Diagnosis and Differential Diagnosis of Hydrocephalus in Adults. Fortschr Röntgenstr 2017; 189: 728 - 739. © Georg Thieme Verlag KG Stuttgart · New York.

Nivolumab as salvage treatment in a patient with HIV-related relapsed/refractory Hodgkin lymphoma and liver failure with encephalopathy.

PubMed

Sandoval-Sus, Jose D; Mogollon-Duffo, Francis; Patel, Ankita; Visweshwar, Nathan; Laber, Damian A; Kim, Richard; Jagal, Michael V

2017-01-01

We report the first case to our knowledge of a patient with relapsed/refractory classical hodgkin lymphoma and liver failure with encephalopathy along with human immunodeficiency virus/acquired immunodeficiency syndrome infection, successfully treated with nivolumab without major side effects and encouraging prolonged disease control. In December 2015, at the time of the patient's progression from his Hodgkin lymphoma after fourth line treatment, he developed persistent fevers, abdominal distension, jaundice and worsening of his liver function tests. Magnetic resonance imaging of abdomen/pelvis demonstrated hepatomegaly with innumerable new liver lesions, splenomegaly with multiple splenic nodules and several new mediastinal, intraperitoneal and retroperitoneal lymphadenopathy. In accordance with the patient's wishes before admission, and after agreement with the family, nivolumab (3 mg/kg every 2 weeks) was given. Of note, antiretroviral therapy was on hold due to liver function tests, his viral load was undectable and cluster of differentiation 4 counts were 103/uL at the time of nivolumab administration. One week after the first dose of nivolumab both his hepatic encephalopathy and constitutional symptoms started to improve, and after 2 doses, (January 2016) his LFTs were almost back to normal. After 5 months of nivolumab treatment (10 doses), restaging (computerized tomography scans of neck, chest, abdomen, pelvis) done on May 2016 showed resolution of hepatosplenomegaly with two residual small hepatic lesions, heterogeneous spleen with no splenic lesions, and stable non-enlarged retroperitoneal lymph nodes without intraabdominal lymphadenopathy; consistent with partial response. We report a case of a patient with human immunodeficiency virus/acquired immunodeficiency syndrome -related relapsed/refractory classical Hodgkin lymphoma and acute liver failure with encephalopathy successfully treated with nivolumab after failing all standard therapeutic options. Unlike classic cytotoxic chemotherapy, which relies on preserved organ function to ameliorate potential severe side effects (i.e. myelosuppression), elimination of monoclonal antibodies is fairly independent of baseline renal and hepatic function since they are usually metabolized by circulating phagocytes and/or by their target antigen-expressing cell.

Endourological treatment of nonmalignant upper urinary tract complications after urinary diversion.

PubMed

El-Nahas, Ahmed R; Shokeir, Ahmed A

2010-12-01

Endourological modalities are considered the first line of treatment for benign ureterointestinal anastomotic strictures except in long strictures, completely obliterated lumen, prior radiation, and poor renal function. Endoureterotomy provided better success than balloon dilatation. In poor-operative risk patients, metal or double-J stents are viable options. Endourological treatments of upper tract stones after diversion are indicated for stones not suitable for shock wave lithotripsy (SWL) or to salvage SWL failure. Percutaneous nephrolithotomy was preferred for large or complex renal stones, whereas ureteroscopy was used for smaller stones. The evaluation of stone-free status and regular follow-up are mandatory because of the high recurrence rate. Copyright © 2010 Elsevier Inc. All rights reserved.

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group.

PubMed

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly.

Lasers in Melasma: A Review with Consensus Recommendations by Indian Pigmentary Expert Group

PubMed Central

Sarkar, Rashmi; Aurangabadkar, Sanjeev; Salim, T; Das, Anupam; Shah, Swapnil; Majid, Imran; Singh, Mohan; Ravichandran, G; Godse, Kiran; Arsiwala, Shehnaz; Arya, Latika; Gokhale, Narendra; Sarma, Nilendu; Torsekar, R G; Sonthalia, Sidharth; Somani, V K

2017-01-01

Lasers have come up as the newest therapeutic modality in dermatological conditions including melasma. In this article, as a group of experts from Pigmentary Disorders Society in collaboration with South Asian Pigmentary Disorders Forum (SPF), we have tried to discuss the lasers which have been used in melasma and formulate simple consensus guidelines. Following thorough literature search, we have summarised the rationale of using the lasers and the supporting evidences have also been provided. It is clear that laser cannot be the first line treatment for melasma. However, it can be used as an adjuvant therapy in resistant cases, provided the selection of patient and counselling has been done properly. PMID:29263531

Different patterns of modality dominance across development.

PubMed

Barnhart, Wesley R; Rivera, Samuel; Robinson, Christopher W

2018-01-01

The present study sought to better understand how children, young adults, and older adults attend and respond to multisensory information. In Experiment 1, young adults were presented with two spoken words, two pictures, or two word-picture pairings and they had to determine if the two stimuli/pairings were exactly the same or different. Pairing the words and pictures together slowed down visual but not auditory response times and delayed the latency of first fixations, both of which are consistent with a proposed mechanism underlying auditory dominance. Experiment 2 examined the development of modality dominance in children, young adults, and older adults. Cross-modal presentation attenuated visual accuracy and slowed down visual response times in children, whereas older adults showed the opposite pattern, with cross-modal presentation attenuating auditory accuracy and slowing down auditory response times. Cross-modal presentation also delayed first fixations in children and young adults. Mechanisms underlying modality dominance and multisensory processing are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

Modal density of rectangular structures in a wide frequency range

NASA Astrophysics Data System (ADS)

Parrinello, A.; Ghiringhelli, G. L.

2018-04-01

A novel approach to investigate the modal density of a rectangular structure in a wide frequency range is presented. First, the modal density is derived, in the whole frequency range of interest, on the basis of sound transmission through the infinite counterpart of the structure; then, it is corrected by means of the low-frequency modal behavior of the structure, taking into account actual size and boundary conditions. A statistical analysis reveals the connection between the modal density of the structure and the transmission of sound through its thickness. A transfer matrix approach is used to compute the required acoustic parameters, making it possible to deal with structures having arbitrary stratifications of different layers. A finite element method is applied on coarse grids to derive the first few eigenfrequencies required to correct the modal density. Both the transfer matrix approach and the coarse grids involved in the finite element analysis grant high efficiency. Comparison with alternative formulations demonstrates the effectiveness of the proposed methodology.

Comparative analysis of success of psoriasis treatment with standard therapeutic modalities and balneotherapy.

PubMed

Baros, Duka Ninković; Gajanin, Vesna S; Gajanin, Radoslav B; Zrnić, Bogdan

2014-01-01

Psoriasis is a chronic, inflammatory, immune-mediated skin disease. In addition to standard therapeutic modalities (antibiotics, cytostatics, phototherapy, photochemotherapy and retinoids), nonstandard methods can be used in the treatment of psoriasis. This includes balneotherapy which is most commonly used in combination with therapeutic resources. The aim of this research was to determine the length of remission of psoriasis in patients treated with standard therapeutic modalities, balneotherapy, and combined treatment (standard therapeutic modalities and balneotherapy). The study analyzed 60 adult patients, of both sexes, with different clinical forms of psoriasis, who were divided into three groups according to the applied therapeutic modalities: the first group (treated with standard therapeutic modalities), the second group (treated with balneotherapy) and the third group (treated with combined therapy-standard methods therapy and balneotherapy). The Psoriasis Area and Severity Index was determined in first, third and sixth week of treatment for all patients. The following laboratory analysis were performed and monitored: C reactive protein, iron with total iron binding capacity, unsaturated iron binding capacity and ferritin, uric acid, rheumatoid factors and antibodies to streptolysin O in the first and sixth week of treatment. The average length of remission in patients treated with standard therapeutic modalities and in those treated with balneotherapy was 1.77 +/- 0.951 months and 1.79 +/- 0.918 months, respectively. There was a statistically significant difference in the duration of remission between the patients treated with combination therapy and patients treated with standard therapeutic modalities (p = 0.019) and balneotherapy (p = 0.032). The best results have been achieved when the combination therapy was administered.

Molecular Imaging and Precision Medicine in Uterine and Ovarian Cancers.

PubMed

Zukotynski, Katherine A; Kim, Chun K

2017-10-01

Gynecologic cancer is a heterogeneous group of diseases both functionally and morphologically. Today, PET coupled with computed tomography (PET/CT) or PET/MR imaging play a central role in the precision medicine algorithm of patients with gynecologic malignancy. In particular, PET/CT and PET/MR imaging are molecular imaging techniques that not only are useful tools for initial staging and restaging but provide anatomofunctional insight and can serve as predictive and prognostic biomarkers of response in patients with gynecologic malignancy. Copyright © 2017 Elsevier Inc. All rights reserved.

Modal analysis of dislocation vibration and reaction attempt frequency

DOE PAGES

Sobie, Cameron; Capolungo, Laurent; McDowell, David L.; ...

2017-02-04

Transition state theory is a fundamental approach for temporal coarse-graining. It estimates the reaction rate for a transition processes by quantifying the activation free energy and attempt frequency for the unit process. To calculate the transition rate of a gliding dislocation, the attempt frequency is often obtained from line tension estimates of dislocation vibrations, a highly simplified model of dislocation behavior. This work revisits the calculation of attempt frequency for a dislocation bypassing an obstacle, in this case a self-interstitial atom (SIA) loop. First, a direct calculation of the vibrational characteristics of a finite pinned dislocation segment is compared tomore » line tension estimates before moving to the more complex case of dislocation-obstacle bypass. The entropic factor associated with the attempt frequency is calculated for a finite dislocation segment and for an infinite glide dislocation interacting with an SIA loop. Lastly, it is found to be dislocation length independent for three cases of dislocation-self interstitial atom (SIA) loop interactions.« less

The effects of aging on the working memory processes of multimodal information.

PubMed

Solesio-Jofre, Elena; López-Frutos, José María; Cashdollar, Nathan; Aurtenetxe, Sara; de Ramón, Ignacio; Maestú, Fernando

2017-05-01

Normal aging is associated with deficits in working memory processes. However, the majority of research has focused on storage or inhibitory processes using unimodal paradigms, without addressing their relationships using different sensory modalities. Hence, we pursued two objectives. First, was to examine the effects of aging on storage and inhibitory processes. Second, was to evaluate aging effects on multisensory integration of visual and auditory stimuli. To this end, young and older participants performed a multimodal task for visual and auditory pairs of stimuli with increasing memory load at encoding and interference during retention. Our results showed an age-related increased vulnerability to interrupting and distracting interference reflecting inhibitory deficits related to the off-line reactivation and on-line suppression of relevant and irrelevant information, respectively. Storage capacity was impaired with increasing task demands in both age groups. Additionally, older adults showed a deficit in multisensory integration, with poorer performance for new visual compared to new auditory information.

Expanding Suicide Crisis Services to Text and Chat.

PubMed

Predmore, Zachary; Ramchand, Rajeev; Ayer, Lynsay; Kotzias, Virginia; Engel, Charles; Ebener, Patricia; Kemp, Janet E; Karras, Elizabeth; Haas, Gretchen L

2017-07-01

Crisis support services have historically been offered by phone-based suicide prevention hotlines, but are increasingly becoming available through alternative modalities, including Internet chat and text messaging. To better understand differences in the use of phone and chat/text services. We conducted semistructured interviews with call responders at the Veterans Crisis Line who utilize multimodal methods to respond to veterans in crisis. Responders indicated that veterans may access the chat/text service primarily for reasons that included a desire for anonymity and possible inability to use the phone. Responders were divided on whether callers and chatters presented with different issues or risk of suicide; however, they suggested that veterans frequently use chat/text to make their first contact with mental health services. We spoke with call responders, not the veterans themselves. Additionally, as this is qualitative research, applicability to other settings may be limited. While new platforms offer promise, participants also indicated that chat services can supplement phone lines, but not replace them.

Task-Modality and L1 Use in EFL Oral Interaction

ERIC Educational Resources Information Center

Azkarai, Agurtzane; del Pilar García Mayo, María

2015-01-01

This study examines whether task-modality (speaking vs. speaking+writing) influences first language (L1) use in task-based English as a foreign language (EFL) learner-learner interaction. Research on the topic has shown that different task-modality triggers different learning opportunities with collaborative speaking tasks drawing learners'…

Research on damping properties optimization of variable-stiffness plate

NASA Astrophysics Data System (ADS)

Wen-kai, QI; Xian-tao, YIN; Cheng, SHEN

2016-09-01

This paper investigates damping optimization design of variable-stiffness composite laminated plate, which means fibre paths can be continuously curved and fibre angles are distinct for different regions. First, damping prediction model is developed based on modal dissipative energy principle and verified by comparing with modal testing results. Then, instead of fibre angles, the element stiffness and damping matrixes are translated to be design variables on the basis of novel Discrete Material Optimization (DMO) formulation, thus reducing the computation time greatly. Finally, the modal damping capacity of arbitrary order is optimized using MMA (Method of Moving Asymptotes) method. Meanwhile, mode tracking technique is employed to investigate the variation of modal shape. The convergent performance of interpolation function, first order specific damping capacity (SDC) optimization results and variation of modal shape in different penalty factor are discussed. The results show that the damping properties of the variable-stiffness plate can be increased by 50%-70% after optimization.

Impact of the incorporation of tyrosine kinase inhibitor agents on the treatment of patients with a diagnosis of advanced renal cell carcinoma: study based on experience at the Hospital Universitario Central de Asturias.

PubMed

Muriel, Carolina; Esteban, Emilio; Corral, Norberto; Fonseca, Paula J; Luque, María; Berros, José Pablo; Fernández, Yolanda; Blay, Pilar; Fra, Joaquín; Villanueva, Noemí; Sanmamed, Miguel; Pardo, Pablo; Izquierdo, Marta; Vieitez, José María; Estrada, Enrique; Lacave, Ángel J

2010-08-01

For nearly the past two decades, cytokines (CKs) have been the only systemic treatment option available for advanced renal cell carcinoma (RCC). In recent years, tyrosine kinase inhibitors (TKIs) have demonstrated clinical activity on this tumour. Our purpose is to describe one centre's experience with the use of CKs and TKIs in the treatment of patients with advanced RCC. This study was designed as a retrospective chart review of RCC patients who were treated with CKs and/or TKIs in our department between July 1996 and June 2008. Efficacy and toxicity were assessed using World Health Organization (WHO) criteria. The Kaplan-Meier method was used to estimate progression-free (PFS) and overall (OS) survival. Ninety-four patients were classified into three groups depending on the modality of treatment administered: 46 were treated with CKs alone and/or chemotherapy (27 with immunotherapy, one with chemotherapy and 18 with both), 28 with TKIs alone (25 with sunitinib and 13 with sorafenib) and 20 with TKIs in second-line treatment following failure with CKs (17 with sunitinib, eight with sorafenib, four with bevacizumab and one with lapatinib). The median age was 60 years in the CK group and 65 and 62, respectively, in TKI in first and second-line treatment groups. Eighty-five percent of patients treated with CKs and 75% in the TKI group in first-line treatment and 80% in second-line treatment were men. Overall, 89% of patients had favourable risk, and 11% had intermediate risk. All patients were considered evaluable for toxicity. The main grade 3-4 (%) toxicity was asthenia for both groups, (ten in TKIs and 15 in CKs). Other grade 1-2 toxicities were mucositis (39), bleeding (8), hypertension (19), skin toxicity (33) and hypothyroidism (12.5) associated with TKIs; and anaemia (33), cough (29), asthenia (39) and emesis (14) associated with CKs. The objective response rate among 80 patients evaluable for activity was 10.6% with CKs and 46.5% and 35%, respectively, with TKIs in first- and second-line treatments. Disease stabilisation with CKs was recorded at 59% of patients and with TKIs 25% and 50% in first- and second-line treatment groups, respectively. The median progression-free survival (PFS) with CKs was 122 days [95% confidence interval (CI) 82-162] and with TKIs 201 days (65-337) in the first and 346 days (256-436) in second-line treatment groups. The median overall survival (OS) was 229 days (142-316) and 2,074 days (1,152-2,996) for patients treated with CKs and TKIs. Our results are in line with the activity and survival rates previously reported in the literature regarding the use of TKIs for patients with advanced RCC in first- and second-line treatment, which has demonstrated an acceptable toxicity level.

A FBG pulse wave demodulation method based on PCF modal interference filter

NASA Astrophysics Data System (ADS)

Zhang, Cheng; Xu, Shan; Shen, Ziqi; Zhao, Junfa; Miao, Changyun; Bai, Hua

2016-10-01

Fiber optic sensor embedded in textiles has been a new direction of researching smart wearable technology. Pulse signal which is generated by heart beat contains vast amounts of physio-pathological information about the cardiovascular system. Therefore, the research for textile-based fiber optic sensor which can detect pulse wave has far-reaching effects on early discovery and timely treatment of cardiovascular diseases. A novel wavelength demodulation method based on photonic crystal fiber (PCF) modal interference filter is proposed for the purpose of developing FBG pulse wave sensing system embedded in smart clothing. The mechanism of the PCF modal interference and the principle of wavelength demodulation based on In-line Mach-Zehnder interferometer (In-line MZI) are analyzed in theory. The fabricated PCF modal interferometer has the advantages of good repeatability and low temperature sensitivity of 3.5pm/°C from 25°C to 60°C. The designed demodulation system can achieve linear demodulation in the range of 2nm, with the wavelength resolution of 2.2pm and the wavelength sensitivity of 0.055nm-1. The actual experiments' result indicates that the pulse wave can be well detected by this demodulation method, which is in accordance with the commercial demodulation instrument (SM130) and more sensitive than the traditional piezoelectric pulse sensor. This demodulation method provides important references for the research of smart clothing based on fiber grating sensor embedded in textiles and accelerates the developments of wearable fiber optic sensors technology.

WE-FG-202-04: Decomposition of FDG-PET Based Differential Uptake Volume Histograms in Rectal Cancer Patients

DOE Office of Scientific and Technical Information (OSTI.GOV)

Schneider, J; Vuong, T; Tomic, N

2016-06-15

Purpose: The goal of this study is to test the possible use of the analytical decomposition of differential uptake volume histograms (dUVHs) obtained from FDG-PET/CT data to isolate sub-volumes within a tumor known as biological target volumes (BTVs). Methods: : A retrospective study was conducted on a cohort of 20 histo-pathologically confirmed rectal adenocarcinoma patients having PET/CT scans for staging. All patients (T3N0) underwent pre-operative endorectal brachytherapy. After surgery, patients were restaged: 10 patients were T0N0 and 10 were restaged as remaining T3N0. The extent of the disease was sampled in order to create dUVHs; subsequently decomposed into the fewestmore » number of analytical Gaussian functions. Results: With the assumption that each function fit corresponded to a single sub-volume within the tumor, six sub-volumes were found to consistently emerge. The first two sub-volumes were influenced by contouring and were not considered in the analysis. For the T3N0 population, abundances for volumes V3-V6 were 63.6%±11.3%, 25.7%±8.4%, 6.1%±4.9%, and 4.7%±2.6%. For the T0N0 population, they were 50.2%±6.8%, 33.4%±4.3%, 11.8%±7.6%, and 4.7%±2.4%. The two populations were compared using two tailed T-tests: volumes 3 and 4 were statistically different with p values of 0.021 and 0.056 respectively. V6 was located at 8.63 ± 2.2 for T0N0 and 6.14 ± 0.78 for T3N0 group (p=0.016). Conclusion: We described a method for dUVH decomposition using FDG-PET images of rectal adenocarcinoma patients that subsequently went for pre-operative brachytherapy. In addition to extracting different sub-volumes corresponding to different FDG uptake levels, we observed different abundances of two sub-volumes as well as positions of the maximum uptake between the two patient groups. In addition to opening the door to further investigation into underlying physiological phenotypes of segmented subvolumes and their use for biological radiotherapy treatment planning, this method may also provide parameters that could correlate to clinical outcomes in radiotherapy patients.« less

Shock Treatment: Using Immersive Digital Realism to Restage and Re-examine Milgram’s ‘Obedience to Authority’ Research

PubMed Central

Haslam, S. Alexander; Reicher, Stephen D.; Millard, Kathryn

2015-01-01

Attempts to revisit Milgram’s ‘Obedience to Authority’ (OtA) paradigm present serious ethical challenges. In recent years new paradigms have been developed to circumvent these challenges but none involve using Milgram’s own procedures and asking naïve participants to deliver the maximum level of shock. This was achieved in the present research by using Immersive Digital Realism (IDR) to revisit the OtA paradigm. IDR is a dramatic method that involves a director collaborating with professional actors to develop characters, the strategic withholding of contextual information, and immersion in a real-world environment. 14 actors took part in an IDR study in which they were assigned to conditions that restaged Milgrams’s New Baseline (‘Coronary’) condition and four other variants. Post-experimental interviews also assessed participants’ identification with Experimenter and Learner. Participants’ behaviour closely resembled that observed in Milgram’s original research. In particular, this was evidenced by (a) all being willing to administer shocks greater than 150 volts, (b) near-universal refusal to continue after being told by the Experimenter that “you have no other choice, you must continue” (Milgram’s fourth prod and the one most resembling an order), and (c) a strong correlation between the maximum level of shock that participants administered and the mean maximum shock delivered in the corresponding variant in Milgram’s own research. Consistent with an engaged follower account, relative identification with the Experimenter (vs. the Learner) was also a good predictor of the maximum shock that participants administered. PMID:25730318

Impact of {sup 18}F-Fluorodeoxyglucose Positron Emission Tomography Before and After Definitive Radiation Therapy in Patients With Apparently Solitary Plasmacytoma

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kim, Paul J.; Hicks, Rodney J.; Wirth, Andrew

2009-07-01

Purpose: To evaluate the impact of {sup 18}F-fluorodeoxyglucose positron emission tomography (FDG-PET) on management of patients with apparently isolated plasmacytoma. Methods and Materials: Twenty-one patients with apparently solitary plasmacytoma who underwent FDG-PET for staging or restaging were identified from a central PET database. They were either candidates for or had received definitive radiation therapy (RT). Results: Seventeen patients had initial staging scans for bone (n = 11) or soft tissue (n = 6) plasmacytomas, and 11 had PET scans after RT. Only 1 of 14 known untreated sites of plasmacytoma was not identified on staging PET (lesion sensitivity = 93%).more » Three plasmacytomas were excised before PET. Staging PET influenced management in 6 of 17 patients (35%) by showing multiple myeloma (n = 1), discouraging RT after complete resection (n = 1), excluding plasmacytoma at a second site (n = 1), by increasing RT fields (n = 2), or by suggesting sarcoidosis (n = 1). Fifteen of 17 patients with initial staging PET scans received definitive RT. Restaging PET scans after RT showed complete metabolic response in 8 of 11 cases and progressive disease in 2. Two patients with either no response or partial metabolic response had late responses. Staging sestamibi and PET scans were concordant in five of six occasions (one sestamibi scan was false negative). Conclusions: FDG-PET has value for staging and RT planning in plasmacytoma and potentially could have a role in response-assessment after RT. Slow resolution of FDG uptake posttreatment does not necessarily imply an adverse prognosis.« less

Demonstration of various rotor instabilities (exhibit of Bently Rotor Dynamics Research Corporation Laborator rigs at symposium on instability in rotaing machinery)

NASA Technical Reports Server (NTRS)

Muszynska, A.

1985-01-01

The operation of rotor rigs used to demonstrate various instability phenomena occurring in rotating machines is described. The instability phenomena demonstrated included oil whirl/whip antiswirl, rub, loose rotating parts, water-lubricated bearing instabilities, and cracked shaft. The rotor rigs were also used to show corrective measures for preventing instabilities. Vibrational response data from the rigs were taken with modern, computerized instrumentation. The rotor nonsynchronous perturbation rig demonstrated modal identification techniques for rotor/bearing systems. Computer-aided data acquisition and presentation, using the dynamic stiffness method, makes it possible to identify rotor and bearing parameters for low modes. The shaft mode demonstrator presented the amplified modal shape line of the shaft excited by inertia forces of unbalance (synchronous perturbation). The first three bending modes of the shaft can be demonstrated. The user-friendly software, Orbits, presented a simulation of rotor precessional motion that is characteristic of various instability phenomena. The data presentation demonstration used data measured on a turbine driven compressor train as an example of how computer aided data acquisition and presentation assists in identifying rotating machine malfunctions.

Through thick and thin: a pictorial review of the endometrium.

PubMed

Caserta, Melanie P; Bolan, Candice; Clingan, M Jennings

2016-12-01

The purpose of this pictorial review is to describe the normal appearance of the endometrium and to provide radiologists with an overview of endometrial pathology utilizing case examples. The normal appearance of the endometrium varies by age, menstrual phase, and hormonal status with differing degrees of acceptable endometrial thickness. Endometrial pathology most often manifests as either focal or diffuse endometrial thickening, and patients frequently present with abnormal vaginal bleeding. Endovaginal ultrasound (US) is the first-line modality for imaging the endometrium. This article will discuss the endometrial measurements used to direct management and workup of symptomatic patients and will discuss when additional imaging may be appropriate. Three-dimensional US is complementary to two-dimensional ultrasound and can be used as a problem-solving technique. Saline-infused sonohysterogram is a useful adjunct to delineate and detect focal intracavitary abnormalities, such as polyps and submucosal fibroids. Magnetic resonance imaging is the preferred imaging modality for staging endometrial cancer because it best depicts the depth of myometrial invasion and cervical stromal involvement. Unique imaging features and complications of endometrial ablation will be introduced. At the completion of this article, the reader will understand the spectrum of normal endometrial findings and will understand the workup of common endometrial pathology.

Quantum Physics and Mathematical Debates Concerning the Problem of the Ontological Priority between Continuous Quantity and Discrete Quantity

NASA Astrophysics Data System (ADS)

Pin, Victor Gómez

In his book about the Categories (that is about the ultimate elements of classification and order), in the chapter concerning the quantity (IV, 20) Aristotle says that this concept recovers two kinds of modalities: the discrete quantity and the continuous quantity and he gives as examples the number for the first one; line, surface, solid, times and space for the second one. The main philosophical problem raised by this text is to determine which of the two modalities of the quantity has the ontological priority over the other (given two concepts A and B, we assume that A has ontological priority over B if every entity that possesses the quality B possesses necessarily the quality A). The problem is magnified by the fact that space, which in some part of Aristotle's Physics is mentioned not only as a category properly speaking but even as the main category whose power can be amazing, is in the evoked text of the Categories's Book reduced to expression of the continuum, and sharing this condition with time. In this matter the controversy is constant through the common history of Science and Philosophy.

Treatment modalities for burning mouth syndrome: a systematic review.

PubMed

de Souza, Isadora Follak; Mármora, Belkiss Câmara; Rados, Pantelis Varvaki; Visioli, Fernanda

2018-06-01

In the burning mouth syndrome (BMS), patients experience a burning sensation in the oral cavity with no associated injury or clinical manifestation. The etiology of this condition is still poorly understood, and therefore, treatment is challenging. The aim of this study is to perform a systematic review of treatment possibilities described in the literature for BMS. PubMed, Embase, and SciELO databases were searched for randomized clinical trials published between 1996 and 2016. Following application of inclusion and exclusion criteria, 29 papers were analyzed and divided into five subcategories according to the type of treatment described: antidepressants, alpha-lipoic acid, phytotherapeutic agents, analgesic and anti-inflammatory agents, and non-pharmacological therapies. In each category, the results found were compared with regard to the methodology employed, sample size, assessment method, presence or absence of adverse effects, and treatment outcomes. The analysis revealed that the use of antidepressants and alpha-lipoic acid has been showing promising results; however, more studies are necessary before we can have a first-line treatment strategy for patients with BMS. To review systematically the literature about Burning Mouth Syndrome treatment may aid the clinicians to choose the treatment modality to improve patients symptoms based on the best evidence.

Patient selection for transcatheter aortic valve replacement: A combined clinical and multimodality imaging approach

PubMed Central

Cocchia, Rosangela; D’Andrea, Antonello; Conte, Marianna; Cavallaro, Massimo; Riegler, Lucia; Citro, Rodolfo; Sirignano, Cesare; Imbriaco, Massimo; Cappelli, Maurizio; Gregorio, Giovanni; Calabrò, Raffaele; Bossone, Eduardo

2017-01-01

Transcatheter aortic valve replacement (TAVR) has been validated as a new therapy for patients affected by severe symptomatic aortic stenosis who are not eligible for surgical intervention because of major contraindication or high operative risk. Patient selection for TAVR should be based not only on accurate assessment of aortic stenosis morphology, but also on several clinical and functional data. Multi-Imaging modalities should be preferred for assessing the anatomy and the dimensions of the aortic valve and annulus before TAVR. Ultrasounds represent the first line tool in evaluation of this patients giving detailed anatomic description of aortic valve complex and allowing estimating with enough reliability the hemodynamic entity of valvular stenosis. Angiography should be used to assess coronary involvement and plan a revascularization strategy before the implant. Multislice computed tomography play a central role as it can give anatomical details in order to choice the best fitting prosthesis, evaluate the morphology of the access path and detect other relevant comorbidities. Cardiovascular magnetic resonance and positron emission tomography are emergent modality helpful in aortic stenosis evaluation. The aim of this review is to give an overview on TAVR clinical and technical aspects essential for adequate selection. PMID:28400918

To increase controllability of a large flexible antenna by modal optimization

NASA Astrophysics Data System (ADS)

Wang, Feng; Wang, Pengpeng; Jiang, Wenjian

2017-12-01

Large deployable antennas are widely used in aerospace engineering to meet the envelop limit of rocket fairing. The high flexibility and low damping of antenna has proposed critical requirement not only for stability control of the antenna itself, but also for attitude control of the satellite. This paper aims to increase controllability of a large flexible antenna by modal optimization. Firstly, Sensitivity analysis of antenna modal frequencies to stiffness of support structure and stiffness of scanning mechanism are conducted respectively. Secondly, Modal simulation results of antenna frequencies are given, influences of scanning angles on moment of inertia and modal frequencies are evaluated, and modal test is carried out to validate the simulation results. All the simulation and test results show that, after modal optimization the modal characteristic of the large deployable antenna meets the controllability requirement well.

Role of cell type and animal species in tumor metastasis

NASA Astrophysics Data System (ADS)

Solban, Nicolas; Georgakoudi, Irene; Rice, William L.; Lin, Charles; Hasan, Tayyaba

2004-06-01

Photodynamic therapy (PDT) is now a reasonably well-known therapeutic option and is approved as a first line treatment of age-related macular degeneration (AMD), a non-oncologic condition. For most cancer applications PDT is approved mainly as a palliative or adjunctive treatment often when all other options have failed. As the modality evolves toward becoming a first-line or curative option, long-term effects of processes involved will need to be studied. Cellular and tissue responses to PDT are more complex than responses to the more conventional therapies, perhaps because PDT is inherently a binary (or ternary) therapy. In addition to the nature and localization of the photosensitizer (PS), the timing of illumination after administration, the mode of administration and the PS and light doses, the efficacy and selectivity of responses are also determined by the physiology and geometry of tumors, the inherent survivability of tumor cells (in circulation and other anatomic sites) and cellular and molecular responses to PDT. The overall outcome of photodynamic treatment in the long term is determined by a combination, in varying degrees, of all of the above factors. In order to enhance and broaden the application of PDT to complex anatomical sites, an understanding of these factors would be useful. In the laboratory, the outcome is also dependent on the specific animal models being studied. This manuscript discusses preliminary studies along these lines using a variety of tools and implications, if any, of the results obtained.

A Survey of Hospice and Palliative Care Physicians Regarding Palliative Sedation Practices.

PubMed

Lux, Michael R; Protus, Bridget McCrate; Kimbrel, Jason; Grauer, Phyllis

2017-04-01

Patients nearing the end of life may experience symptoms that are refractory to standard therapeutic options. Physicians may consider palliative sedation to relieve intolerable suffering. There is limited clinical literature regarding preferred medications for palliative sedation. To determine the preferred medications physicians use when implementing palliative sedation. An Internet-based, cross-sectional survey of hospice and palliative care physicians in the United States. A link to the survey was e-mailed to 3130 physician members of the American Academy of Hospice and Palliative Medicine, of which 381 physicians completed the survey. Physicians were not required to answer all questions. Nearly all (n = 335, 99%) respondents indicated that palliative sedation may be used (acceptable by 73% [n = 248] for refractory symptoms and acceptable by 26% [n = 87] only for imminently dying patients). Seventy-nine percent (n = 252) believed that opioids should not be used to induce palliative sedation but should be continued to provide pain control. Midazolam was the most commonly selected first-line choice for palliative sedation (n = 155, 42%). The most commonly reported second-line agents for the induction of palliative sedation were lorazepam, midazolam (for those who did not select midazolam as first-line agent), and phenobarbital with a reported preference of 20% (n = 49), 19% (n = 46), and 17% (n = 40), respectively. Of the physicians surveyed, 99% (n = 335) felt that palliative sedation is a reasonable treatment modality. Midazolam was considered a drug of choice for inducing and maintaining sedation, and opioids were continued for pain control.

Epidemiology of NIV for Acute Respiratory Failure in COPD Patients: Results from the International Surveys vs. the "Real World".

PubMed

Ozsancak Ugurlu, Aylin; Habesoglu, Mehmet Ali

2017-08-01

Non-invasive ventilation (NIV) has been recommended as the  first-line ventilation modality for acute respiratory failure (ARF) due to acute exacerbation of chronic obstructive pulmonary disease (AECOPD) based on strong evidence. However, everyday clinical practice may differ from findings of multiple randomized controlled trials. Physicians and respiratory therapists involved in NIV management have been queried about its utilization and effectiveness. In addition to these estimates, cohort studies and analysis of large inpatient dataset of patients with AECOPD and ARF managed with NIV have been extensively published over the last two decades. This review summarizes the perception of medical staff vs. the "real life" data about NIV use for ARF in AECOPD patients.

A systematic approach to adnexal masses discovered on ultrasound: the ADNEx MR scoring system.

PubMed

Sadowski, Elizabeth A; Robbins, Jessica B; Rockall, Andrea G; Thomassin-Naggara, Isabelle

2018-03-01

Adnexal lesions are a common occurrence in radiology practice and imaging plays a crucial role in triaging women appropriately. Current trends toward early detection and characterization have increased the need for accurate imaging assessment of adnexal lesions prior to treatment. Ultrasound is the first-line imaging modality for assessing adnexal lesions; however, approximately 20% of lesions are incompletely characterized after ultrasound evaluation. Secondary assessment with MR imaging using the ADNEx MR Scoring System has been demonstrated as highly accurate in the characterization of adnexal lesions and in excluding ovarian cancer. This review will address the role of MR imaging in further assessment of adnexal lesions discovered on US, and the utility of the ADNEx MR Scoring System.

Treatment modalities for advanced ALK-rearranged non-small-cell lung cancer.

PubMed

Sullivan, Ivana; Planchard, David

2016-04-01

The ALK gene plays a key role in the pathogenesis of non-small-cell lung cancer (NSCLC). Patients with NSCLC harboring an ALK-rearrangement represent the second oncogene addiction to be identified in this disease. Crizotinib was the first ALK inhibitor showing pronounced clinical activity, and is now a reference treatment for ALK-positive NSCLC disease. However, despite initial impressive responses to crizotinib, acquired resistance almost invariably develops within 12 months. The pressing need for effective second-line agents has prompted the rapid development of next-generation ALK inhibitors. These agents, notably ceritinib and alectinib as the most developed, have a higher potency against ALK than crizotinib, along with activity against tumors harboring crizotinib-resistant mutations and potentially improved CNS penetration.

RUNX3 confers sensitivity to pheophorbide a-photodynamic therapy in human oral squamous cell carcinoma cell lines.

PubMed

Moon, Sook; Bae, Jung Yoon; Son, Hwa-Kyung; Lee, Doo Young; Park, Gyeongju; You, Hyun; Ko, Hyojin; Kim, Yong-Chul; Kim, Jin

2015-02-01

Photodynamic therapy (PDT) with photosensitizer is one of the promising modalities for cancer treatment. For clinical use of PDT, screening process should be preceded to enhance sensitivity to PDT. Thus, we investigated a molecular biomarker to determine the sensitivity to pheophorbide a (Pa)-PDT in immortalized human oral keratinocytes (IHOK) and oral squamous cell carcinoma (OSCC) cell lines. Two IHOK and several OSCC cell lines were used. After Pa-PDT, cell viability was reduced by more than 50%, and reactive oxygen species were generated in IHOK and OSCC cell lines. Additionally, apoptosis occurred in PDT-treated cells. IHOK(S) and IHOK(P), the two IHOK cell lines derived from the same source, showed a difference in cytotoxicity after Pa-PDT. To explain this difference in cytotoxicity, we looked at the expression of Wnt signaling-related genes in these two cell lines, for the morphology of IHOK(S) which was spindle like and elongated and distinct from IHOK(P) and the parent cell. Among the relevant genes, runt-related transcription factor 3 (RUNX3), an apoptosis-related gene, was selected as a potential marker that confers sensitivity to PDT. We found that the cytotoxicity by Pa-PDT was proportional to RUNX3 expression in OSCC cell lines. Additionally, knockdown of RUNX3 expression reduced cytotoxicity by Pa-PDT, suggesting that RUNX3 might be a biomarker to determine sensitivity to Pa-PDT. This was the first study to find a new target molecule that enhances Pa-PDT effects in IHOK and OSCC cell lines. Hence, the development of a PDT-dependent biomarker could provide a novel approach to improve the effects of PDT on oral precancerous and cancerous lesions.

Modal Interfaces in Hawaii

NASA Technical Reports Server (NTRS)

Wright, E. Alvey

1974-01-01

Hawaii, an archipelago where transportation distances are short but the interfaces are many, seeks elimination of modal changes by totally-submerged hydrofoil craft operating at the water surface directly between tourist resort destinations, by dual mode rapid transit vehicles operating directly between the deplaning bridges at Honolulu International Airport and hotel porte-cochere at Waikiki, by demand responsive vehicles for collection and distribution operating on fixed guideways for line haul, and by roll-on/roll-off inter-island ferries for all models of manually operated ground vehicles. The paper also describes facilitation of unavoidable interfaces by innovative sub-systems.

A remote instruction system empowered by tightly shared haptic sensation

NASA Astrophysics Data System (ADS)

Nishino, Hiroaki; Yamaguchi, Akira; Kagawa, Tsuneo; Utsumiya, Kouichi

2007-09-01

We present a system to realize an on-line instruction environment among physically separated participants based on a multi-modal communication strategy. In addition to visual and acoustic information, commonly used communication modalities in network environments, our system provides a haptic channel to intuitively conveying partners' sense of touch. The human touch sensation, however, is very sensitive for delays and jitters in the networked virtual reality (NVR) systems. Therefore, a method to compensate for such negative factors needs to be provided. We show an NVR architecture to implement a basic framework that can be shared by various applications and effectively deals with the problems. We take a hybrid approach to implement both data consistency by client-server and scalability by peer-to-peer models. As an application system built on the proposed architecture, a remote instruction system targeted at teaching handwritten characters and line patterns on a Korea-Japan high-speed research network also is mentioned.

On-Line Robust Modal Stability Prediction using Wavelet Processing

NASA Technical Reports Server (NTRS)

Brenner, Martin J.; Lind, Rick

1998-01-01

Wavelet analysis for filtering and system identification has been used to improve the estimation of aeroservoelastic stability margins. The conservatism of the robust stability margins is reduced with parametric and nonparametric time- frequency analysis of flight data in the model validation process. Nonparametric wavelet processing of data is used to reduce the effects of external disturbances and unmodeled dynamics. Parametric estimates of modal stability are also extracted using the wavelet transform. Computation of robust stability margins for stability boundary prediction depends on uncertainty descriptions derived from the data for model validation. The F-18 High Alpha Research Vehicle aeroservoelastic flight test data demonstrates improved robust stability prediction by extension of the stability boundary beyond the flight regime. Guidelines and computation times are presented to show the efficiency and practical aspects of these procedures for on-line implementation. Feasibility of the method is shown for processing flight data from time- varying nonstationary test points.

Empirical gradient threshold technique for automated segmentation across image modalities and cell lines.

PubMed

Chalfoun, J; Majurski, M; Peskin, A; Breen, C; Bajcsy, P; Brady, M

2015-10-01

New microscopy technologies are enabling image acquisition of terabyte-sized data sets consisting of hundreds of thousands of images. In order to retrieve and analyze the biological information in these large data sets, segmentation is needed to detect the regions containing cells or cell colonies. Our work with hundreds of large images (each 21,000×21,000 pixels) requires a segmentation method that: (1) yields high segmentation accuracy, (2) is applicable to multiple cell lines with various densities of cells and cell colonies, and several imaging modalities, (3) can process large data sets in a timely manner, (4) has a low memory footprint and (5) has a small number of user-set parameters that do not require adjustment during the segmentation of large image sets. None of the currently available segmentation methods meet all these requirements. Segmentation based on image gradient thresholding is fast and has a low memory footprint. However, existing techniques that automate the selection of the gradient image threshold do not work across image modalities, multiple cell lines, and a wide range of foreground/background densities (requirement 2) and all failed the requirement for robust parameters that do not require re-adjustment with time (requirement 5). We present a novel and empirically derived image gradient threshold selection method for separating foreground and background pixels in an image that meets all the requirements listed above. We quantify the difference between our approach and existing ones in terms of accuracy, execution speed, memory usage and number of adjustable parameters on a reference data set. This reference data set consists of 501 validation images with manually determined segmentations and image sizes ranging from 0.36 Megapixels to 850 Megapixels. It includes four different cell lines and two image modalities: phase contrast and fluorescent. Our new technique, called Empirical Gradient Threshold (EGT), is derived from this reference data set with a 10-fold cross-validation method. EGT segments cells or colonies with resulting Dice accuracy index measurements above 0.92 for all cross-validation data sets. EGT results has also been visually verified on a much larger data set that includes bright field and Differential Interference Contrast (DIC) images, 16 cell lines and 61 time-sequence data sets, for a total of 17,479 images. This method is implemented as an open-source plugin to ImageJ as well as a standalone executable that can be downloaded from the following link: https://isg.nist.gov/. © 2015 The Authors Journal of Microscopy © 2015 Royal Microscopical Society.

An adaptive learning control system for large flexible structures

NASA Technical Reports Server (NTRS)

Thau, F. E.

1985-01-01

The objective of the research has been to study the design of adaptive/learning control systems for the control of large flexible structures. In the first activity an adaptive/learning control methodology for flexible space structures was investigated. The approach was based on using a modal model of the flexible structure dynamics and an output-error identification scheme to identify modal parameters. In the second activity, a least-squares identification scheme was proposed for estimating both modal parameters and modal-to-actuator and modal-to-sensor shape functions. The technique was applied to experimental data obtained from the NASA Langley beam experiment. In the third activity, a separable nonlinear least-squares approach was developed for estimating the number of excited modes, shape functions, modal parameters, and modal amplitude and velocity time functions for a flexible structure. In the final research activity, a dual-adaptive control strategy was developed for regulating the modal dynamics and identifying modal parameters of a flexible structure. A min-max approach was used for finding an input to provide modal parameter identification while not exceeding reasonable bounds on modal displacement.

Missing Modality Transfer Learning via Latent Low-Rank Constraint.

PubMed

Ding, Zhengming; Shao, Ming; Fu, Yun

2015-11-01

Transfer learning is usually exploited to leverage previously well-learned source domain for evaluating the unknown target domain; however, it may fail if no target data are available in the training stage. This problem arises when the data are multi-modal. For example, the target domain is in one modality, while the source domain is in another. To overcome this, we first borrow an auxiliary database with complete modalities, then consider knowledge transfer across databases and across modalities within databases simultaneously in a unified framework. The contributions are threefold: 1) a latent factor is introduced to uncover the underlying structure of the missing modality from the known data; 2) transfer learning in two directions allows the data alignment between both modalities and databases, giving rise to a very promising recovery; and 3) an efficient solution with theoretical guarantees to the proposed latent low-rank transfer learning algorithm. Comprehensive experiments on multi-modal knowledge transfer with missing target modality verify that our method can successfully inherit knowledge from both auxiliary database and source modality, and therefore significantly improve the recognition performance even when test modality is inaccessible in the training stage.

Haematological manifestations of lupus

PubMed Central

Fayyaz, Anum; Igoe, Ann; Kurien, Biji T; Danda, Debashish; James, Judith A; Stafford, Haraldine A; Scofield, R Hal

2015-01-01

Our purpose was to compile information on the haematological manifestations of systemic lupus erythematosus (SLE), namely leucopenia, lymphopenia, thrombocytopenia, autoimmune haemolytic anaemia (AIHA), thrombotic thrombocytopenic purpura (TTP) and myelofibrosis. During our search of the English-language MEDLINE sources, we did not place a date-of-publication constraint. Hence, we have reviewed previous as well as most recent studies with the subject heading SLE in combination with each manifestation. Neutropenia can lead to morbidity and mortality from increased susceptibility to infection. Severe neutropenia can be successfully treated with granulocyte colony-stimulating factor. While related to disease activity, there is no specific therapy for lymphopenia. Severe lymphopenia may require the use of prophylactic therapy to prevent select opportunistic infections. Isolated idiopathic thrombocytopenic purpura maybe the first manifestation of SLE by months or even years. Some manifestations of lupus occur more frequently in association with low platelet count in these patients, for example, neuropsychiatric manifestation, haemolytic anaemia, the antiphospholipid syndrome and renal disease. Thrombocytopenia can be regarded as an important prognostic indicator of survival in patients with SLE. Medical, surgical and biological treatment modalities are reviewed for this manifestation. First-line therapy remains glucocorticoids. Through our review, we conclude glucocorticoids do produce a response in majority of patients initially, but sustained response to therapy is unlikely. Glucocorticoids are used as first-line therapy in patients with SLE with AIHA, but there is no conclusive evidence to guide second-line therapy. Rituximab is promising in refractory and non-responding AIHA. TTP is not recognised as a criteria for classification of SLE, but there is a considerable overlap between the presenting features of TTP and SLE, and a few patients with SLE have concurrent TTP. Myelofibrosis is an uncommon yet well-documented manifestation of SLE. We have compiled the cases that were reported in MEDLINE sources. PMID:25861458

Research on natural frequency based on modal test for high speed vehicles

NASA Astrophysics Data System (ADS)

Ma, Guangsong; He, Guanglin; Guo, Yachao

2018-04-01

High speed vehicle as a vibration system, resonance generated in flight may be harmful to high speed vehicles. It is possible to solve the resonance problem by acquiring the natural frequency of the high-speed aircraft and then taking some measures to avoid the natural frequency of the high speed vehicle. Therefore, In this paper, the modal test of the high speed vehicle was carried out by using the running hammer method and the PolyMAX modal parameter identification method. Firstly, the total frequency response function, coherence function of the high speed vehicle are obtained by the running hammer stimulation test, and through the modal assurance criterion (MAC) to determine the accuracy of the estimated parameters. Secondly, the first three order frequencies, the pole steady state diagram of the high speed vehicles is obtained by the PolyMAX modal parameter identification method. At last, the natural frequency of the vibration system was accurately obtained by the running hammer method.

Imaging of Prostate Cancer Using 64Cu-Labeled Prostate-Specific Membrane Antigen Ligand.

PubMed

Singh, Aviral; Kulkarni, Harshad R; Baum, Richard P

2017-04-01

Prostate cancer is the most common noncutaneous cancer among men, rendering the diagnosis and staging of significant medical and public interest. One of the most interesting developments in the application of nuclear oncology has been the development of novel diagnostic agents that are able to facilitate targeted therapies using the concept of theranostics. This review summarizes the current and emerging molecular imaging techniques for the investigation of patients with prostate cancer with emphasis on the potential of 64 Cu-PSMA PET/CT in staging, restaging, and the application of theranostics. Copyright © 2016 Elsevier Inc. All rights reserved.

Asymptomatic solitary cerebral metastasis from papillary carcinoma thyroid: 131I SPECT/CT for accurate staging.

PubMed

Jain, Tarun Kumar; Karunanithi, Sellam; Sharma, Punit; Vijay, Maneesh Kumar; Ballal, Sanjana; Bal, Chandrasekhar

2014-11-01

Isolated asymptomatic brain metastasis in papillary carcinoma thyroid (PCT) is extremely rare. We here present such a case of a 48-year-old woman with PCT. SPECT/CT localized the 131I radiotracer concentration seen on whole-body scan in this patient to the right posterior parietal cortex, suggesting brain metastasis. Contrast-enhanced MRI and 18F-FDG PET/CT confirmed the diagnosis and the patient was taken for gamma-knife radiosurgery. 131I SPECT/CT in this case accurately restaged the patient by detecting asymptomatic isolated brain metastasis and correctly directed the management strategy.

(11)C-Choline PET/CT for restaging prostate cancer. Results from 4,426 scans in a single-centre patient series.

PubMed

Graziani, Tiziano; Ceci, Francesco; Castellucci, Paolo; Polverari, Giulia; Lima, Giacomo Maria; Lodi, Filippo; Morganti, Alessio Giuseppe; Ardizzoni, Andrea; Schiavina, Riccardo; Fanti, Stefano

2016-10-01

To evaluate (11)C-choline PET/CT as a diagnostic tool for restaging prostate cancer (PCa), in a large, homogeneous and clinically relevant population of patients with biochemical recurrence (BCR) of PCa after primary therapy. The secondary aim was to assess the best timing for performing (11)C-choline PET/CT during BCR. We retrospectively analysed 9,632 (11)C-choline PET/CT scans performed in our institution for restaging PCa from January 2007 to June 2015. The inclusion criteria were: (1) proven PCa radically treated with radical prostatectomy (RP) or with primary external beam radiotherapy (EBRT); (2) PSA serum values available; (3) proven BCR (PSA >0.2 ng/mL after RP or PSA >2 ng/mL above the nadir after primary EBRT with rising PSA levels). Finally, 3,203 patients with recurrent PCa matching all the inclusion criteria were retrospectively enrolled and 4,426 scans were analysed. Overall, 52.8 % of the (11)C-choline PET/CT scans (2,337/4,426) and 54.8 % of the patients (1,755/3,203) were positive. In 29.4 % of the scans, at least one distant finding was observed. The mean and median PSA values were, respectively, 4.9 and 2.1 ng/mL at the time of the scan (range 0.2 - 50 ng/mL). In our series, 995 scans were performed in patients with PSA levels between 1 and 2 ng/mL. In this subpopulation the positivity rate in the 995 scans was 44.7 %, with an incidence of distant findings of 19.2 % and an incidence of oligometastatic disease (one to three lesions) of 37.7 %. The absolute PSA value at the time of the scan and ongoing androgen deprivation therapy were associated with an increased probability of a positive (11)C-choline PET/CT scan (p < 0.0001). In the ROC analysis, a PSA value of 1.16 ng/mL was the optimal cut-off value. In patients with a PSA value <1.16 ng/mL, 26.8 % of 1,426 (11)C-choline PET/CT scans were positive, with oligometastatic disease in 84.7 % of positive scans. In a large cohort of patients, the feasibility of (11)C-choline PET/CT for detecting the sites of metastatic disease in PCa patients with BCR was confirmed. The PSA level was the main predictor of a positive scan with 1.16 ng/mL as the optimal cut-off value. In the majority of positive scans oligometastatic disease, potentially treatable with salvage therapies, was observed.

Multiple sensory modalities used by squid in successful predator evasion throughout ontogeny.

PubMed

York, Carly A; Bartol, Ian K; Krueger, Paul S

2016-09-15

Squid rely on multiple sensory systems for predator detection. In this study we examine the role of two sensory systems, the lateral line analogue and vision, in successful predator evasion throughout ontogeny. Squid Doryteuthis pealeii and Lolliguncula brevis were recorded using high-speed videography in the presence of natural predators under light and dark conditions with their lateral line analogue intact or ablated via a pharmacological technique. Paralarval squid showed reduced escape responses when ablated; however, no differences were found between light and dark conditions in non-ablated paralarvae, as was previously shown in juveniles and adults, indicating that the lateral line analogue is integral for predator detection early in life. However, vision does play a role in survival because ablated squid in dark conditions had lower levels of survival than all other treatments. Throughout ontogeny, squid oriented themselves anteriorly towards the oncoming predator, maximizing sensory input to the lateral line analogue system and providing better positioning for tail-first escape jetting, the preferred escape mode. Ablated juveniles and adults had lower response times, escape velocities and peak acceleration than non-ablated individuals, indicating that the lateral line analogue enables squid to respond quicker and with more powerful jets to a predator and maximize escape success. Our findings reveal that the lateral line analogue plays a role in predator detection and successful escape response at the earliest life stages, and continues to contribute to successful evasion by aiding visual cues in juvenile and adult squid. © 2016. Published by The Company of Biologists Ltd.

Integrating Conceptual Knowledge Within and Across Representational Modalities

PubMed Central

McNorgan, Chris; Reid, Jackie; McRae, Ken

2011-01-01

Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via cascading integration sites with successively wider receptive fields. Four experiments provide the first direct behavioral tests of these models using speeded tasks involving feature inference and concept activation. Shallow models predict no within-modal versus cross-modal difference in either task, whereas deep models predict a within-modal advantage for feature inference, but a cross-modal advantage for concept activation. Experiments 1 and 2 used relatedness judgments to tap participants’ knowledge of relations for within- and cross-modal feature pairs. Experiments 3 and 4 used a dual feature verification task. The pattern of decision latencies across Experiments 1 to 4 is consistent with a deep integration hierarchy. PMID:21093853

Modal response of a computational vocal fold model with a substrate layer of adipose tissue.

PubMed

Jones, Cameron L; Achuthan, Ajit; Erath, Byron D

2015-02-01

This study demonstrates the effect of a substrate layer of adipose tissue on the modal response of the vocal folds, and hence, on the mechanics of voice production. Modal analysis is performed on the vocal fold structure with a lateral layer of adipose tissue. A finite element model is employed, and the first six mode shapes and modal frequencies are studied. The results show significant changes in modal frequencies and substantial variation in mode shapes depending on the strain rate of the adipose tissue. These findings highlight the importance of considering adipose tissue in computational vocal fold modeling.

[Familiarity and perceptions of Portuguese cardiologists concerning cardiac magnetic resonance and cardiac computed tomography: the extent of the task ahead].

PubMed

Ferreira, António Miguel; Bettencourt, Nuno; Matos, Pedro; Oliveira, Luís; Almeida, Ana G

2013-01-01

Rapid advances in cardiac magnetic resonance (CMR) and cardiac computed tomography angiography (CCTA) pose challenges for practicing physicians in terms of awareness of their indications, contraindications, advantages and pitfalls. We conducted a nationwide online survey assessing the familiarity, perceptions and patterns of use concerning these imaging modalities based on a questionnaire sent to all physician members of the Portuguese Society of Cardiology. The responses from 205 physicians (21% response rate) were analyzed. Roughly half of them requested less than one CMR (51%) or CCTA (52%) per week. Suspected coronary artery disease in symptomatic patients with intermediate pretest probability was considered a good or excellent indication for CCTA by 59% of respondents when performed as a second-line exam, and by 29% as a first-line exam. Cardiac masses, congenital heart disease and cardiomyopathies were considered good or excellent indications for CMR by over 90% of respondents, while assessment of myocardial viability and acute myocardial infarction with normal coronary arteries were considered good or excellent indications by 75% and 65% of respondents, respectively. Less than half (39%) answered all the questions regarding contraindications for CMR correctly, and 15% were unaware that CMR does not involve ionizing radiation. The main reasons for not referring a patient for CMR were limited availability (45%) and cost (36%). Portuguese cardiologists appear to be moderately aware of the indications, contraindications and advantages of these new imaging modalities. Greater efforts should be made to improve physician education on this subject in order to improve patient care. Copyright © 2012 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

Phase 2 Trial of Induction Gemcitabine, Oxaliplatin, and Cetuximab Followed by Selective Capecitabine-Based Chemoradiation in Patients With Borderline Resectable or Unresectable Locally Advanced Pancreatic Cancer

DOE Office of Scientific and Technical Information (OSTI.GOV)

Esnaola, Nestor F.; Chaudhary, Uzair B.; O'Brien, Paul

Purpose: To evaluate, in a phase 2 study, the safety and efficacy of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer (BRPC or LAPC, respectively). Methods and Materials: Patients received gemcitabine and oxaliplatin chemotherapy repeated every 14 days for 6 cycles, combined with weekly cetuximab. Patients were then restaged; “downstaged” patients with resectable disease underwent attempted resection. Remaining patients were treated with chemoradiation consisting of intensity modulated radiation therapy (54 Gy) and concurrent capecitabine; patients with borderline resectable disease or better at restaging underwent attempted resection. Results:more » A total of 39 patients were enrolled, of whom 37 were evaluable. Protocol treatment was generally well tolerated. Median follow-up for all patients was 11.9 months. Overall, 29.7% of patients underwent R0 surgical resection (69.2% of patients with BRPC; 8.3% of patients with LAPC). Overall 6-month progression-free survival (PFS) was 62%, and median PFS was 10.4 months. Median overall survival (OS) was 11.8 months. In patients with LAPC, median OS was 9.3 months; in patients with BRPC, median OS was 24.1 months. In the group of patients who underwent R0 resection (all of which were R0 resections), median survival had not yet been reached at the time of analysis. Conclusions: This regimen was well tolerated in patients with BRPC or LAPC, and almost one-third of patients underwent R0 resection. Although OS for the entire cohort was comparable to that in historical controls, PFS and OS in patients with BRPC and/or who underwent R0 resection was markedly improved.« less

Phase 2 Trial of Induction Gemcitabine, Oxaliplatin, and Cetuximab Followed by Selective Capecitabine Based Chemoradiation in Patients With Borderline Resectable or Unresectable Locally Advanced Pancreatic Cancer

PubMed Central

Esnaola, Nestor F.; Chaudhary, Uzair B.; O'Brien, Paul; Garrett-Mayer, Elizabeth; Camp, E. Ramsay; Thomas, Melanie B.; Cole, David J.; Montero, Alberto J.; Hoffman, Brenda J.; Romagnuolo, Joseph; Orwat, Kelly P.; Marshall, David T.

2014-01-01

Purpose To evaluate, in a phase 2 study, the safety and efficacy of induction gemcitabine, oxaliplatin, and cetuximab followed by selective capecitabine-based chemoradiation in patients with borderline resectable or unresectable locally advanced pancreatic cancer (BRPC or LAPC, respectively). Methods and Materials Patients received gemcitabine and oxaliplatin chemotherapy repeated every 14 days for 6 cycles, combined with weekly cetuximab. Patients were then restaged; “downstaged” patients with resectable disease underwent attempted resection. Remaining patients were treated with chemoradiation consisting of intensity modulated radiation therapy (54 Gy) and concurrent capecitabine; patients with borderline resectable disease or better at restaging underwent attempted resection. Results A total of 39 patients were enrolled, of whom 37 were evaluable. Protocol treatment was generally well tolerated. Median follow-up for all patients was 11.9 months. Overall, 29.7% of patients underwent R0 surgical resection (69.2% of patients with BRPC; 8.3% of patients with LAPC). Overall 6-month progression-free survival (PFS) was 62%, and median PFS was 10.4 months. Median overall survival (OS) was 11.8 months. In patients with LAPC, median OS was 9.3 months; in patients with BRPC, median OS was 24.1 months. In the group of patients who underwent R0 resection (all of which were R0 resections), median survival had not yet been reached at the time of analysis. Conclusions This regimen was well tolerated in patients with BRPC or LAPC, and almost one-third of patients underwent R0 resection. Although OS for the entire cohort was comparable to that in historical controls, PFS and OS in patients with BRPC and/or who underwent R0 resection was markedly improved. PMID:24606850

Radiation-induced liver injury mimicking liver metastases on FDG-PET-CT after chemoradiotherapy for esophageal cancer : A retrospective study and literature review.

PubMed

Voncken, Francine E M; Aleman, Berthe M P; van Dieren, Jolanda M; Grootscholten, Cecile; Lalezari, Ferry; van Sandick, Johanna W; Steinberg, Jeffrey D; Vegt, Erik

2018-02-01

For esophageal cancer patients treated with neoadjuvant chemoradiotherapy (nCRT), restaging using F‑18-fluorodeoxyglucose (FDG) positron emission tomography computed tomography (PET-CT) following nCRT can detect interval metastases, including liver metastases, in almost 10% of patients. However, in clinical practice, focal FDG liver uptake, unrelated to liver metastases, is observed after chemoradiotherapy. This radiation-induced liver injury (RILI) can potentially lead to overstaging. A systematic search for potential cases of RILI after (chemo)radiotherapy for esophageal cancer was performed in the electronic reports from all PET-CT scans made between 2006 and 2015 in our hospital. Additional data about potential cases were obtained from the electronic medical records. A literature review of RILI was also performed. Of 205 patients undergoing nCRT, 6 cases with localized increased FDG uptake in the caudate or left liver lobe following nCRT for esophageal cancer were identified. None of these patients had signs of liver metastases with additional imaging, during surgery, on biopsy, or during follow-up (range 11-46 months). At our institute, the incidence of RILI after neoadjuvant chemoradiotherapy for esophageal cancer was 3%. In the literature, RILI is described in about 8% of patients at the time of restaging. FDG-avid lesions occur in the high radiation dose area, usually corresponding to the caudate or left liver lobe. FDG accumulation in the caudate or left liver lobe after CRT in the area that received a high radiation dose may be caused by metastases or RILI. Awareness of the pitfall of high FDG uptake in RILI is crucial to avoid misinterpretation and overstaging.

Spectral presaturation inversion recovery MR imaging sequence after gadolinium injection to differentiate fibrotic scar tissue and neoplastic strands in the mesorectal fat in patients undergoing restaging of rectal carcinoma after neoadjuvant chemo- and radiation therapy.

PubMed

Quaia, Emilio; Ulcigrai, Veronica; Coss, Matteo; De Paoli, Luca; Ukmar, Maja; Zanconati, Fabrizio; De Pellegrin, Alessandro; De Manzini, Nicolò; Cova, Maria Assunta

2011-11-01

To retrospectively assess the value of spectral presaturation by inversion-recovery (SPIR) magnetic resonance (MR) imaging sequence after gadolinium injection to differentiate fibrotic scar tissue and tumoral infiltration within the mesorectal fat in patients with rectal carcinoma undergoing MR restaging after neoadjuvant chemo- and radiation therapy (CRT). Forty-three consecutive patients (mean age, 65.8 years; range, 46-85 years; male:female, 29:14) with locally advanced rectal carcinoma underwent CRT followed by surgery. MR imaging was performed before and after completion of CRT by using T2-weighted turbo spin-echo and T1-weighted SPIR sequences before and after gadolinium injection, and MR images were assessed by two radiologists in consensus. Logistic regression was conducted to test the significance of the MR image findings with histology. After CRT the disease was either limited to the rectal wall (n = 18 patients) or presented perirectal infiltration (n = 25) on histology. In 21 patients, mesorectal enhancing strands were observed. Reticular-shaped enhancing strands reaching the mesorectal fascia presented the highest correlation with tumor infiltration of the mesorectal fat (OR 130.33, 95% CI: 4.1-4220.29; logistic regression), whereas linear-shaped enhancing strands either reaching or not reaching the mesorectal fascia (OR 0.25 or 0.1, 95% CI: 0.024-2.6 or 0.01-1.07) revealed the lowest correlation. Reticular-shaped enhancing strands on SPIR MR imaging after gadolinium injection are associated with tumor infiltration of the mesorectal fat. Copyright © 2011 AUR. Published by Elsevier Inc. All rights reserved.

Value of diffusion-weighted MRI and apparent diffusion coefficient measurements for predicting the response of locally advanced rectal cancer to neoadjuvant chemoradiotherapy.

PubMed

Iannicelli, Elsa; Di Pietropaolo, Marco; Pilozzi, Emanuela; Osti, Mattia Falchetto; Valentino, Maria; Masoni, Luigi; Ferri, Mario

2016-10-01

The aim of our study was to assess the performance value of magnetic resonance imaging (MRI) in the restaging of locally advanced rectal cancer after neoadjuvant chemoradiotherapy (CRT) and in the identification of good vs. poor responders to neoadjuvant therapy. A total of 34 patients with locally advanced rectal cancer underwent MRI prior to and after CRT. T stage and tumor regression grade (TRG) on post-CRT MRI was compared with the pathological staging ypT and TRG. Tumor volume and the apparent diffusion coefficient (ADC) were measured using diffusion-weighted imaging (DWI) before and after neoadjuvant CRT; the percentage of tumor volume reduction and the change of ADC (ΔADC) was also calculated. ADC parameters and the percentage of tumor volume reduction were correlated to histopathological results. The diagnostic performance of ADC and volume reduction to assess tumor response was evaluated by calculating the area under the ROC curve and the optimal cut-off values. A significant correlation between the T stage and the TRG defined in DW-MRI after CRT and the ypT and the TRG observed on the surgical specimens was found (p = 0.001; p < 0.001). The mean post-CRT ADC and ΔADC in responder patients was significantly higher compared to non-responder ones (p = 0.001; p = 0.01). Furthermore, the mean post-CRT ADC values were significantly higher in tumors with T-downstage (p = 0.01). DW-MRI may have a significant role in the restaging and in the evaluation of post-CRT response of locally advanced rectal cancer. Quantitative analysis of DWI through ADC map may result in a promising noninvasive tool to evaluate the response to therapy.

Effective Beginning Handwriting Instruction: Multi-Modal, Consistent Format for 2 Years, and Linked to Spelling and Composing

ERIC Educational Resources Information Center

Wolf, Beverly; Abbott, Robert D.; Berninger, Virginia W.

2017-01-01

In Study 1, the treatment group (N = 33 first graders, M = 6 years 10 months, 16 girls) received Slingerland multi-modal (auditory, visual, tactile, motor through hand, and motor through mouth) manuscript (unjoined) handwriting instruction embedded in systematic spelling, reading, and composing lessons; and the control group (N = 16 first graders,…

Application of vision measurements for modal analysis of wires for the purpose of overhead transmission lines monitoring

NASA Astrophysics Data System (ADS)

Mendrok, Krzysztof; Dworakowski, Ziemowit; Holak, Krzysztof; Kohut, Piotr

2017-05-01

Overhead transmission power lines are still one of the crucial elements of electro-energetic system. There are obvious advantages of using overhead transmission in the distribution of electricity. The amount of energy transported through a power line is determined by the distance between the wire and the ground or other objects placed beneath it (eg. trees). This distance is not fixed and depends on the overhang of the wire. This, in turn, is determined by many factors such as ambient temperature, humidity, precipitation, the value of current flowing through the wire. In order to optimize the wires electrical load, the monitoring of that overhang is required. One way to measure it is the non-contact measurement by vision system. It has the advantage, that using high-speed cameras respectively it also allows for vibration measurement and analysis of dynamic performance. That is very important while the wires are susceptible to the influence of wind, and the resulting vibrations interfere with the correct measurement of the overhang. The paper presents the results of vision measurements of the system vibrations and modal analysis carried out on their basis. The study was conducted on a specially made laboratory stand.

MEGALEX: A megastudy of visual and auditory word recognition.

PubMed

Ferrand, Ludovic; Méot, Alain; Spinelli, Elsa; New, Boris; Pallier, Christophe; Bonin, Patrick; Dufau, Stéphane; Mathôt, Sebastiaan; Grainger, Jonathan

2018-06-01

Using the megastudy approach, we report a new database (MEGALEX) of visual and auditory lexical decision times and accuracy rates for tens of thousands of words. We collected visual lexical decision data for 28,466 French words and the same number of pseudowords, and auditory lexical decision data for 17,876 French words and the same number of pseudowords (synthesized tokens were used for the auditory modality). This constitutes the first large-scale database for auditory lexical decision, and the first database to enable a direct comparison of word recognition in different modalities. Different regression analyses were conducted to illustrate potential ways to exploit this megastudy database. First, we compared the proportions of variance accounted for by five word frequency measures. Second, we conducted item-level regression analyses to examine the relative importance of the lexical variables influencing performance in the different modalities (visual and auditory). Finally, we compared the similarities and differences between the two modalities. All data are freely available on our website ( https://sedufau.shinyapps.io/megalex/ ) and are searchable at www.lexique.org , inside the Open Lexique search engine.

Diagnosis and management of newly diagnosed childhood autoimmune haemolytic anaemia. Recommendations from the Red Cell Study Group of the Paediatric Haemato-Oncology Italian Association

PubMed Central

Ladogana, Saverio; Maruzzi, Matteo; Samperi, Piera; Perrotta, Silverio; Del Vecchio, Giovanni C.; Notarangelo, Lucia D.; Farruggia, Piero; Verzegnassi, Federico; Masera, Nicoletta; Saracco, Paola; Fasoli, Silvia; Miano, Maurizio; Girelli, Gabriella; Barcellini, Wilma; Zanella, Alberto; Russo, Giovanna

2017-01-01

Autoimmune haemolytic anaemia is an uncommon disorder to which paediatric haematology centres take a variety of diagnostic and therapeutic approaches. The Red Cell Working Group of the Italian Association of Paediatric Onco-haematology (Associazione Italiana di Ematologia ed Oncologia Pediatrica, AIEOP) developed this document in order to collate expert opinions on the management of newly diagnosed childhood autoimmune haemolytic anaemia. The diagnostic process includes the direct and indirect antiglobulin tests; recommendations are given regarding further diagnostic tests, specifically in the cases that the direct and indirect antiglobulin tests are negative. Clear-cut definitions of clinical response are stated. Specific recommendations for treatment include: dosage of steroid therapy and tapering modality for warm autoimmune haemolytic anaemia; the choice of rituximab as first-line therapy for the rare primary transfusion-dependent cold autoimmune haemolytic anaemia; the indications for supportive therapy; the need for switching to second-line therapy. Each statement is provided with a score expressing the level of appropriateness and the agreement among participants. PMID:28151390

On modal cross-coupling in the asymptotic modal limit

NASA Astrophysics Data System (ADS)

Culver, Dean; Dowell, Earl

2018-03-01

The conditions under which significant modal cross-coupling occurs in dynamical systems responding to high-frequency, broadband forcing that excites many modes is studied. The modal overlap factor plays a key role in the analysis of these systems as the modal density (the ratio of number of modes to the frequency bandwidth) becomes large. The modal overlap factor is effectively the ratio of the width of a resonant peak (the damping ratio times the resonant frequency) to the average frequency interval between resonant peaks (or rather, the inverse of the modal density). It is shown that this parameter largely determines whether substantial modal cross-coupling occurs in a given system's response. Here, two prototypical systems are considered. The first is a simple rectangular plate whose significant modal cross-coupling is the exception rather than the norm. The second is a pair of rectangular plates attached at a point where significant modal cross-coupling is more likely to occur. We show that, for certain cases of modal density and damping, non-negligible cross coupling occurs in both systems. Under similar circumstances, the constraint force between the two plates in the latter system becomes broadband. The implications of this for using Asymptotic Modal Analysis (AMA) in multi-component systems are discussed.

One model for the evaluation of ASAP rehabilitation effort

DOT National Transportation Integrated Search

1974-10-01

The relative effectiveness of Alcohol Safety Action Projects (ASAP) modalities was inferred from recidivism defined as re-arrest for Drinking While Intoxicated (DWI) after entry into a rehabilitation modality. The first phase of the investigation emp...

Endoscope-guided pneumatic dilation for treatment of esophageal achalasia

PubMed Central

Chuah, Seng-Kee; Wu, Keng-Liang; Hu, Tsung-Hui; Tai, Wei-Chen; Changchien, Chi-Sin

2010-01-01

Pneumatic dilation (PD) is considered to be the first line nonsurgical therapy for achalasia. The principle of the procedure is to weaken the lower esophageal sphincter by tearing its muscle fibers by generating radial force. The endoscope-guided procedure is done without fluoroscopic control. Clinicians usually use a low-compliance balloon such as Rigiflex dilator to perform endoscope-guided PD for the treatment of esophageal achalasia. It has the advantage of determining mucosal injury during the dilation process, so that a repeat endoscopy is not needed to assess the mucosal tearing. Previous studies have shown that endoscope-guided PD is an efficient and safe nonsurgical therapy with results that compare well with other treatment modalities. Although the results may be promising, long-term follow-up is required in the near future. PMID:20101764

Diagnostic Imaging and workup of Malignant Pleural Mesothelioma.

PubMed

Cardinale, Luciano; Ardissone, Francesco; Gned, Dario; Sverzellati, Nicola; Piacibello, Edoardo; Veltri, Andrea

2017-08-23

Malignant pleural mesothelioma is the most frequent primary neoplasm of the pleura and its incidence is still increasing.This tumor has a strong association with exposure to occupational or environmental asbestos, often after a long latent period of 30-40 years.Plain chest radiography (CXR) is usually the first-line radiologic examination, but the radiographic findings are nonspecific due to its limited contrast resolution and they need to be complemented by other imaging modalities such as computed tomography (CT), magnetic resonance Imaging (MRI), Positron emission tomography-computed tomography (PET-CT) and ultrasound (US).The aim of this paper is to describe the imaging  features of this malignancy, underlining the peculiarity of CXR, CT, MRI, PET-CT and US and also focusing on diagnostic workup, based on the literature evidence and according to our experience.

Therapeutic Touch in the Management of Responsive Behavior in Patients With Dementia.

PubMed

Kumarappah, Ananthavalli; Senderovich, Helen

2016-01-01

Patients with dementia experience various behavioral symptoms in the course of their illnesses, which greatly affect their quality of life. Current treatment modalities are not always effective, and, thus, nonpharmacological approaches are the preferred first-line therapy for managing such symptoms. They generally address the basic needs of the person with dementia and provide humane care, often producing noticeable improvements in symptoms. Thus, such therapies should precede pharmacological interventions. The following literature review of 5 publications from 2010 to 2015 evaluates the use of therapeutic touch (TT) in the management of responsive behavior in patients with dementia. The results of the review suggest that TT may be beneficial in reducing agitation in individuals with dementia; however, further research is needed to assess the use of TT.

Ares I-X Flight Test Vehicle: Stack 5 Modal Test

NASA Technical Reports Server (NTRS)

Buehrle, Ralph D.; Templeton, Justin D.; Reaves, Mercedes C.; Horta, Lucas G.; Gaspar, James L.; Bartolotta, Paul A.; Parks, Russel A.; Lazor, Danel R.

2010-01-01

Ares I-X was the first flight test vehicle used in the development of NASA's Ares I crew launch vehicle. The Ares I-X used a 4-segment reusable solid rocket booster from the Space Shuttle heritage with mass simulators for the 5th segment, upper stage, crew module and launch abort system. Three modal tests were defined to verify the dynamic finite element model of the Ares I-X flight test vehicle. Test configurations included two partial stacks and the full Ares I-X flight test vehicle on the Mobile Launcher Platform. This report focuses on the first modal test that was performed on the top section of the vehicle referred to as Stack 5, which consisted of the spacecraft adapter, service module, crew module and launch abort system simulators. This report describes the test requirements, constraints, pre-test analysis, test operations and data analysis for the Ares I-X Stack 5 modal test.

Arithmetic Memory Is Modality Specific.

PubMed

Myers, Timothy; Szücs, Dénes

2015-01-01

In regards to numerical cognition and working memory, it is an open question as to whether numbers are stored into and retrieved from a central abstract representation or from separate notation-specific representations. This study seeks to help answer this by utilizing the numeral modality effect (NME) in three experiments to explore how numbers are processed by the human brain. The participants were presented with numbers (1-9) as either Arabic digits or written number words (Arabic digits and dot matrices in Experiment 2) at the first (S1) and second (S2) stimuli. The participant's task was to add the first two stimuli together and verify whether the answer (S3), presented simultaneously with S2, was correct. We hypothesized that if reaction time (RT) at S2/S3 depends on the modality of S1 then numbers are retrieved from modality specific memory stores. Indeed, RT depended on the modality of S1 whenever S2 was an Arabic digit which argues against the concept of numbers being stored and retrieved from a central, abstract representation.

Arithmetic Memory Is Modality Specific

PubMed Central

Myers, Timothy; Szücs, Dénes

2015-01-01

In regards to numerical cognition and working memory, it is an open question as to whether numbers are stored into and retrieved from a central abstract representation or from separate notation-specific representations. This study seeks to help answer this by utilizing the numeral modality effect (NME) in three experiments to explore how numbers are processed by the human brain. The participants were presented with numbers (1–9) as either Arabic digits or written number words (Arabic digits and dot matrices in Experiment 2) at the first (S1) and second (S2) stimuli. The participant’s task was to add the first two stimuli together and verify whether the answer (S3), presented simultaneously with S2, was correct. We hypothesized that if reaction time (RT) at S2/S3 depends on the modality of S1 then numbers are retrieved from modality specific memory stores. Indeed, RT depended on the modality of S1 whenever S2 was an Arabic digit which argues against the concept of numbers being stored and retrieved from a central, abstract representation. PMID:26716692

Comparing Mortality of Peritoneal and Hemodialysis Patients in the First 2 Years of Dialysis Therapy: A Marginal Structural Model Analysis

PubMed Central

Lukowsky, Lilia R.; Mehrotra, Rajnish; Kheifets, Leeka; Arah, Onyebuchi A.; Nissenson, Allen R.

2013-01-01

Summary Background and objectives There are conflicting research results about the survival differences between hemodialysis and peritoneal dialysis, especially during the first 2 years of dialysis treatment. Given the challenges of conducting randomized trials, differential rates of modality switch and transplantation, and time-varying confounding in cohort data during the first years of dialysis treatment, use of novel analytical techniques in observational cohorts can help examine the peritoneal dialysis versus hemodialysis survival discrepancy. Design, setting, participants, & measurements This study examined a cohort of incident dialysis patients who initiated dialysis in DaVita dialysis facilities between July of 2001 and June of 2004 and were followed for 24 months. This study used the causal modeling technique of marginal structural models to examine the survival differences between peritoneal dialysis and hemodialysis over the first 24 months, accounting for modality change, differential transplantation rates, and detailed time-varying laboratory measurements. Results On dialysis treatment day 90, there were 23,718 incident dialysis—22,360 hemodialysis and 1,358 peritoneal dialysis—patients. Incident peritoneal dialysis patients were younger, had fewer comorbidities, and were nine and three times more likely to switch dialysis modality and receive kidney transplantation over the 2-year period, respectively, compared with hemodialysis patients. In marginal structural models analyses, peritoneal dialysis was associated with persistently greater survival independent of the known confounders, including dialysis modality switch and transplant censorship (i.e., death hazard ratio of 0.52 [95% confidence limit 0.34–0.80]). Conclusions Peritoneal dialysis seems to be associated with 48% lower mortality than hemodialysis over the first 2 years of dialysis therapy independent of modality switches or differential transplantation rates. PMID:23307879

Comparing mortality of peritoneal and hemodialysis patients in the first 2 years of dialysis therapy: a marginal structural model analysis.

PubMed

Lukowsky, Lilia R; Mehrotra, Rajnish; Kheifets, Leeka; Arah, Onyebuchi A; Nissenson, Allen R; Kalantar-Zadeh, Kamyar

2013-04-01

There are conflicting research results about the survival differences between hemodialysis and peritoneal dialysis, especially during the first 2 years of dialysis treatment. Given the challenges of conducting randomized trials, differential rates of modality switch and transplantation, and time-varying confounding in cohort data during the first years of dialysis treatment, use of novel analytical techniques in observational cohorts can help examine the peritoneal dialysis versus hemodialysis survival discrepancy. This study examined a cohort of incident dialysis patients who initiated dialysis in DaVita dialysis facilities between July of 2001 and June of 2004 and were followed for 24 months. This study used the causal modeling technique of marginal structural models to examine the survival differences between peritoneal dialysis and hemodialysis over the first 24 months, accounting for modality change, differential transplantation rates, and detailed time-varying laboratory measurements. On dialysis treatment day 90, there were 23,718 incident dialysis-22,360 hemodialysis and 1,358 peritoneal dialysis-patients. Incident peritoneal dialysis patients were younger, had fewer comorbidities, and were nine and three times more likely to switch dialysis modality and receive kidney transplantation over the 2-year period, respectively, compared with hemodialysis patients. In marginal structural models analyses, peritoneal dialysis was associated with persistently greater survival independent of the known confounders, including dialysis modality switch and transplant censorship (i.e., death hazard ratio of 0.52 [95% confidence limit 0.34-0.80]). Peritoneal dialysis seems to be associated with 48% lower mortality than hemodialysis over the first 2 years of dialysis therapy independent of modality switches or differential transplantation rates.

Integrating conceptual knowledge within and across representational modalities.

PubMed

McNorgan, Chris; Reid, Jackie; McRae, Ken

2011-02-01

Research suggests that concepts are distributed across brain regions specialized for processing information from different sensorimotor modalities. Multimodal semantic models fall into one of two broad classes differentiated by the assumed hierarchy of convergence zones over which information is integrated. In shallow models, communication within- and between-modality is accomplished using either direct connectivity, or a central semantic hub. In deep models, modalities are connected via cascading integration sites with successively wider receptive fields. Four experiments provide the first direct behavioral tests of these models using speeded tasks involving feature inference and concept activation. Shallow models predict no within-modal versus cross-modal difference in either task, whereas deep models predict a within-modal advantage for feature inference, but a cross-modal advantage for concept activation. Experiments 1 and 2 used relatedness judgments to tap participants' knowledge of relations for within- and cross-modal feature pairs. Experiments 3 and 4 used a dual-feature verification task. The pattern of decision latencies across Experiments 1-4 is consistent with a deep integration hierarchy. Copyright © 2010 Elsevier B.V. All rights reserved.

Improved quality of life in patients treated with Peptide radionuclides.

PubMed

Traub-Weidinger, T; Raderer, M; Uffmann, M; Angelberger, P; Kurtaran, A; Leimer, M; Preitfellner, J; Dudczak, R; Virgolini, I

2011-07-01

Peptide receptor radionuclide therapy (PRRT) has recently been established as an important treatment modality for somatostatin receptor (SSTR)-positive tumors. The purpose of this study was to evaluate the clinical response, side-effects as well as the quality of life following (90)Y-DOTA-lanreotide (DOTALAN) and/or (90)Y-DOTA-Tyr (3)-DPhe(1)-octreotide (DOTATOC) therapy in patients with progressive metastatic disease during a 6-year follow-up period. Following dosimetric evaluation with (111)In-DOTALAN and (111)In-DOTATOC, 13 patients with estimated absorbed tumor doses of >5 Gy/GBq (carcinoid, n = 5; radioiodine-negative thyroid cancer, n = 4; gastrinoma, n = 1; insulinoma, n = 1; glucagonoma, n = 1; glomus jugularis tumor, n = 1) were assigned for PRRT. A dose of 925 MBq of (90)Y-DOTALAN (four patients) or 1.85-3.7 GBq of (90)Y-DOTATOC (10 patients) was administered intravenously and repeated every 4-8 weeks. Tumor dosimetry was performed prior to and under therapy, re-staging every 2-3 months. Pain intensity, Karnofsky score and general symptoms were evaluated in order to determine quality of life. Patients were followed until death. Altogether, 53 infusions of PRRT (1.85-14.1 GBq) were administered. After the first follow-up of 3 months of (90)Y-DOTALAN therapy, stable disease (SD) was observed in one patient and progressive disease (PD) in three patients. With (90)Y-DOTATOC therapy, SD was found in all 10 patients. During the re-evaluation period (4-27 months), one patient had to be shifted from (90)Y-DOTALAN to (90)Y-DOTATOC therapy due to reduced (111)In-DOTALAN uptake after 5.5 GBq. In the first 6 months after PRRT with DOTATOC, SD was found in nine of 10 patients and PD in one patient. Thereafter, SD was observed in two patients and PD in eight patients. Nine of 13 patients after PRRT with either DOTALAN or DOTATOC died. None of the patients had experienced severe acute hematological side-effects. Transient thrombocytopenia or lymphocytopenia was seen in 10 patients after 3.7 GBq, and a skin reaction in one patient. Total accumulated kidney dose ranged between 4 and 64 Gy, with reduced creatinine clearance in two patients. Pain relief was achieved in three of three patients after ~3.7 GBq ERT within 4-6 months. Appetite, weight, Karnofsky score and general well-being had improved in patients with SD during and after therapy. Based on the results of this study conducted on a small group of patients, we conclude that PRRT may offer an alternative treatment option for SSTR-positive tumors, with only mild transient side-effects and a marked improvement in the quality of life.

Anticipation by multi-modal association through an artificial mental imagery process

NASA Astrophysics Data System (ADS)

Gaona, Wilmer; Escobar, Esaú; Hermosillo, Jorge; Lara, Bruno

2015-01-01

Mental imagery has become a central issue in research laboratories seeking to emulate basic cognitive abilities in artificial agents. In this work, we propose a computational model to produce an anticipatory behaviour by means of a multi-modal off-line hebbian association. Unlike the current state of the art, we propose to apply hebbian learning during an internal sensorimotor simulation, emulating a process of mental imagery. We associate visual and tactile stimuli re-enacted by a long-term predictive simulation chain motivated by covert actions. As a result, we obtain a neural network which provides a robot with a mechanism to produce a visually conditioned obstacle avoidance behaviour. We developed our system in a physical Pioneer 3-DX robot and realised two experiments. In the first experiment we test our model on one individual navigating in two different mazes. In the second experiment we assess the robustness of the model by testing in a single environment five individuals trained under different conditions. We believe that our work offers an underpinning mechanism in cognitive robotics for the study of motor control strategies based on internal simulations. These strategies can be seen analogous to the mental imagery process known in humans, opening thus interesting pathways to the construction of upper-level grounded cognitive abilities.

Low-frequency sound speed and attenuation in sandy seabottom from long-range broadband acoustic measurements.

PubMed

Wan, Lin; Zhou, Ji-Xun; Rogers, Peter H

2010-08-01

A joint China-U.S. underwater acoustics experiment was conducted in the Yellow Sea with a very flat bottom and a strong and sharp thermocline. Broadband explosive sources were deployed both above and below the thermocline along two radial lines up to 57.2 km and a quarter circle with a radius of 34 km. Two inversion schemes are used to obtain the seabottom sound speed. One is based on extracting normal mode depth functions from the cross-spectral density matrix. The other is based on the best match between the calculated and measured modal arrival times for different frequencies. The inverted seabottom sound speed is used as a constraint condition to extract the seabottom sound attenuation by three methods. The first method involves measuring the attenuation coefficients of normal modes. In the second method, the seabottom sound attenuation is estimated by minimizing the difference between the theoretical and measured modal amplitude ratios. The third method is based on finding the best match between the measured and modeled transmission losses (TLs). The resultant seabottom attenuation, averaged over three independent methods, can be expressed as alpha=(0.33+/-0.02)f(1.86+/-0.04)(dB/m kHz) over a frequency range of 80-1000 Hz.

Dual-Modal Magnetic Resonance/Fluorescent Zinc Probes for Pancreatic β-Cell Mass Imaging

PubMed Central

Stasiuk, Graeme J; Minuzzi, Florencia; Sae-Heng, Myra; Rivas, Charlotte; Juretschke, Hans-Paul; Piemonti, Lorenzo; Allegrini, Peter R; Laurent, Didier; Duckworth, Andrew R; Beeby, Andrew; Rutter, Guy A; Long, Nicholas J

2015-01-01

Despite the contribution of changes in pancreatic β-cell mass to the development of all forms of diabetes mellitus, few robust approaches currently exist to monitor these changes prospectively in vivo. Although magnetic-resonance imaging (MRI) provides a potentially useful technique, targeting MRI-active probes to the β cell has proved challenging. Zinc ions are highly concentrated in the secretory granule, but they are relatively less abundant in the exocrine pancreas and in other tissues. We have therefore developed functional dual-modal probes based on transition-metal chelates capable of binding zinc. The first of these, Gd⋅1, binds ZnII directly by means of an amidoquinoline moiety (AQA), thus causing a large ratiometric Stokes shift in the fluorescence from λem=410 to 500 nm with an increase in relaxivity from r1=4.2 up to 4.9 mM−1 s−1. The probe is efficiently accumulated into secretory granules in β-cell-derived lines and isolated islets, but more poorly by non-endocrine cells, and leads to a reduction in T1 in human islets. In vivo murine studies of Gd⋅1 have shown accumulation of the probe in the pancreas with increased signal intensity over 140 minutes. PMID:25736590

The double identity of linguistic doubling.

PubMed

Berent, Iris; Bat-El, Outi; Brentari, Diane; Dupuis, Amanda; Vaknin-Nusbaum, Vered

2016-11-29

Does knowledge of language consist of abstract principles, or is it fully embodied in the sensorimotor system? To address this question, we investigate the double identity of doubling (e.g., slaflaf, or generally, XX; where X stands for a phonological constituent). Across languages, doubling is known to elicit conflicting preferences at different levels of linguistic analysis (phonology vs. morphology). Here, we show that these preferences are active in the brains of individual speakers, and they are demonstrably distinct from sensorimotor pressures. We first demonstrate that doubling in novel English words elicits divergent percepts: Viewed as meaningless (phonological) forms, doubling is disliked (e.g., slaflaf < slafmak), but once doubling in form is systematically linked to meaning (e.g., slaf = ball, slaflaf = balls), the doubling aversion shifts into a reliable (morphological) preference. We next show that sign-naive speakers spontaneously project these principles to novel signs in American Sign Language, and their capacity to do so depends on the structure of their spoken language (English vs. Hebrew). These results demonstrate that linguistic preferences doubly dissociate from sensorimotor demands: A single stimulus can elicit diverse percepts, yet these percepts are invariant across stimulus modality--for speech and signs. These conclusions are in line with the possibility that some linguistic principles are abstract, and they apply broadly across language modality.

Noninvasive imaging of hepatocellular carcinoma: From diagnosis to prognosis

PubMed Central

Jiang, Han-Yu; Chen, Jie; Xia, Chun-Chao; Cao, Li-Kun; Duan, Ting; Song, Bin

2018-01-01

Hepatocellular carcinoma (HCC) is the most common primary liver cancer and a major public health problem worldwide. Hepatocarcinogenesis is a complex multistep process at molecular, cellular, and histologic levels with key alterations that can be revealed by noninvasive imaging modalities. Therefore, imaging techniques play pivotal roles in the detection, characterization, staging, surveillance, and prognosis evaluation of HCC. Currently, ultrasound is the first-line imaging modality for screening and surveillance purposes. While based on conclusive enhancement patterns comprising arterial phase hyperenhancement and portal venous and/or delayed phase wash-out, contrast enhanced dynamic computed tomography and magnetic resonance imaging (MRI) are the diagnostic tools for HCC without requirements for histopathologic confirmation. Functional MRI techniques, including diffusion-weighted imaging, MRI with hepatobiliary contrast agents, perfusion imaging, and magnetic resonance elastography, show promise in providing further important information regarding tumor biological behaviors. In addition, evaluation of tumor imaging characteristics, including nodule size, margin, number, vascular invasion, and growth patterns, allows preoperative prediction of tumor microvascular invasion and patient prognosis. Therefore, the aim of this article is to review the current state-of-the-art and recent advances in the comprehensive noninvasive imaging evaluation of HCC. We also provide the basic key concepts of HCC development and an overview of the current practice guidelines. PMID:29904242

WE-B-210-01: Introduction

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holland, M.

In the last fifteen years, the introduction of plane or diverging wave transmissions rather than line by line scanning focused beams has broken the conventional barriers of ultrasound imaging. By using such large field of view transmissions, the frame rate reaches the theoretical limit of physics dictated by the ultrasound speed and an ultrasonic map can be provided typically in tens of micro-seconds (several thousands of frames per second). Interestingly, this leap in frame rate is not only a technological breakthrough but it permits the advent of completely new ultrasound imaging modes, including shear wave elastography, electromechanical wave imaging, ultrafastmore » doppler, ultrafast contrast imaging, and even functional ultrasound imaging of brain activity (fUltrasound) introducing Ultrasound as an emerging full-fledged neuroimaging modality. At ultrafast frame rates, it becomes possible to track in real time the transient vibrations – known as shear waves – propagating through organs. Such “human body seismology” provides quantitative maps of local tissue stiffness whose added value for diagnosis has been recently demonstrated in many fields of radiology (breast, prostate and liver cancer, cardiovascular imaging, …). Today, Supersonic Imagine company is commercializing the first clinical ultrafast ultrasound scanner, Aixplorer with real time Shear Wave Elastography. This is the first example of an ultrafast Ultrasound approach surpassing the research phase and now widely spread in the clinical medical ultrasound community with an installed base of more than 1000 Aixplorer systems in 54 countries worldwide. For blood flow imaging, ultrafast Doppler permits high-precision characterization of complex vascular and cardiac flows. It also gives ultrasound the ability to detect very subtle blood flow in very small vessels. In the brain, such ultrasensitive Doppler paves the way for fUltrasound (functional ultrasound imaging) of brain activity with unprecedented spatial and temporal resolution compared to fMRI. Combined with contrast agents, our group demonstrated that Ultrafast Ultrasound Localization could provide a first in vivo and non invasive imaging modality at microscopic scales deep into organs. Many of these ultrafast modes should lead to major improvements in ultrasound screening, diagnosis, and therapeutic monitoring. Learning Objectives: Achieve familiarity with recent advances in ultrafast ultrasound imaging technology. Develop an understanding of potential applications of ultrafast ultrasound imaging for diagnosis and therapeutic monitoring. Dr. Tanter is a co-founder of Supersonic Imagine,a French company positioned in the field of medical ultrasound imaging and therapy.« less

WE-B-210-00: Carson/Zagzebski Distinguished Lectureship

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

In the last fifteen years, the introduction of plane or diverging wave transmissions rather than line by line scanning focused beams has broken the conventional barriers of ultrasound imaging. By using such large field of view transmissions, the frame rate reaches the theoretical limit of physics dictated by the ultrasound speed and an ultrasonic map can be provided typically in tens of micro-seconds (several thousands of frames per second). Interestingly, this leap in frame rate is not only a technological breakthrough but it permits the advent of completely new ultrasound imaging modes, including shear wave elastography, electromechanical wave imaging, ultrafastmore » doppler, ultrafast contrast imaging, and even functional ultrasound imaging of brain activity (fUltrasound) introducing Ultrasound as an emerging full-fledged neuroimaging modality. At ultrafast frame rates, it becomes possible to track in real time the transient vibrations – known as shear waves – propagating through organs. Such “human body seismology” provides quantitative maps of local tissue stiffness whose added value for diagnosis has been recently demonstrated in many fields of radiology (breast, prostate and liver cancer, cardiovascular imaging, …). Today, Supersonic Imagine company is commercializing the first clinical ultrafast ultrasound scanner, Aixplorer with real time Shear Wave Elastography. This is the first example of an ultrafast Ultrasound approach surpassing the research phase and now widely spread in the clinical medical ultrasound community with an installed base of more than 1000 Aixplorer systems in 54 countries worldwide. For blood flow imaging, ultrafast Doppler permits high-precision characterization of complex vascular and cardiac flows. It also gives ultrasound the ability to detect very subtle blood flow in very small vessels. In the brain, such ultrasensitive Doppler paves the way for fUltrasound (functional ultrasound imaging) of brain activity with unprecedented spatial and temporal resolution compared to fMRI. Combined with contrast agents, our group demonstrated that Ultrafast Ultrasound Localization could provide a first in vivo and non invasive imaging modality at microscopic scales deep into organs. Many of these ultrafast modes should lead to major improvements in ultrasound screening, diagnosis, and therapeutic monitoring. Learning Objectives: Achieve familiarity with recent advances in ultrafast ultrasound imaging technology. Develop an understanding of potential applications of ultrafast ultrasound imaging for diagnosis and therapeutic monitoring. Dr. Tanter is a co-founder of Supersonic Imagine,a French company positioned in the field of medical ultrasound imaging and therapy.« less

WE-B-210-03: Closing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Holland, M.

In the last fifteen years, the introduction of plane or diverging wave transmissions rather than line by line scanning focused beams has broken the conventional barriers of ultrasound imaging. By using such large field of view transmissions, the frame rate reaches the theoretical limit of physics dictated by the ultrasound speed and an ultrasonic map can be provided typically in tens of micro-seconds (several thousands of frames per second). Interestingly, this leap in frame rate is not only a technological breakthrough but it permits the advent of completely new ultrasound imaging modes, including shear wave elastography, electromechanical wave imaging, ultrafastmore » doppler, ultrafast contrast imaging, and even functional ultrasound imaging of brain activity (fUltrasound) introducing Ultrasound as an emerging full-fledged neuroimaging modality. At ultrafast frame rates, it becomes possible to track in real time the transient vibrations – known as shear waves – propagating through organs. Such “human body seismology” provides quantitative maps of local tissue stiffness whose added value for diagnosis has been recently demonstrated in many fields of radiology (breast, prostate and liver cancer, cardiovascular imaging, …). Today, Supersonic Imagine company is commercializing the first clinical ultrafast ultrasound scanner, Aixplorer with real time Shear Wave Elastography. This is the first example of an ultrafast Ultrasound approach surpassing the research phase and now widely spread in the clinical medical ultrasound community with an installed base of more than 1000 Aixplorer systems in 54 countries worldwide. For blood flow imaging, ultrafast Doppler permits high-precision characterization of complex vascular and cardiac flows. It also gives ultrasound the ability to detect very subtle blood flow in very small vessels. In the brain, such ultrasensitive Doppler paves the way for fUltrasound (functional ultrasound imaging) of brain activity with unprecedented spatial and temporal resolution compared to fMRI. Combined with contrast agents, our group demonstrated that Ultrafast Ultrasound Localization could provide a first in vivo and non invasive imaging modality at microscopic scales deep into organs. Many of these ultrafast modes should lead to major improvements in ultrasound screening, diagnosis, and therapeutic monitoring. Learning Objectives: Achieve familiarity with recent advances in ultrafast ultrasound imaging technology. Develop an understanding of potential applications of ultrafast ultrasound imaging for diagnosis and therapeutic monitoring. Dr. Tanter is a co-founder of Supersonic Imagine,a French company positioned in the field of medical ultrasound imaging and therapy.« less

Modal ring method for the scattering of sound

NASA Technical Reports Server (NTRS)

Baumeister, Kenneth J.; Kreider, Kevin L.

1993-01-01

The modal element method for acoustic scattering can be simplified when the scattering body is rigid. In this simplified method, called the modal ring method, the scattering body is represented by a ring of triangular finite elements forming the outer surface. The acoustic pressure is calculated at the element nodes. The pressure in the infinite computational region surrounding the body is represented analytically by an eigenfunction expansion. The two solution forms are coupled by the continuity of pressure and velocity on the body surface. The modal ring method effectively reduces the two-dimensional scattering problem to a one-dimensional problem capable of handling very high frequency scattering. In contrast to the boundary element method or the method of moments, which perform a similar reduction in problem dimension, the model line method has the added advantage of having a highly banded solution matrix requiring considerably less computer storage. The method shows excellent agreement with analytic results for scattering from rigid circular cylinders over a wide frequency range (1 is equal to or less than ka is less than or equal to 100) in the near and far fields.

Vibration based structural health monitoring of an arch bridge: From automated OMA to damage detection

NASA Astrophysics Data System (ADS)

Magalhães, F.; Cunha, A.; Caetano, E.

2012-04-01

In order to evaluate the usefulness of approaches based on modal parameters tracking for structural health monitoring of bridges, in September of 2007, a dynamic monitoring system was installed in a concrete arch bridge at the city of Porto, in Portugal. The implementation of algorithms to perform the continuous on-line identification of modal parameters based on structural responses to ambient excitation (automated Operational Modal Analysis) has permitted to create a very complete database with the time evolution of the bridge modal characteristics during more than 2 years. This paper describes the strategy that was followed to minimize the effects of environmental and operational factors on the bridge natural frequencies, enabling, in a subsequent stage, the identification of structural anomalies. Alternative static and dynamic regression models are tested and complemented by a Principal Components Analysis. Afterwards, the identification of damages is tried with control charts. At the end, it is demonstrated that the adopted processing methodology permits the detection of realistic damage scenarios, associated with frequency shifts around 0.2%, which were simulated with a numerical model.

The Ultrasonographic Determination of the Position of the Mental Foramen and its Relation to the Mandibular Premolar Teeth.

PubMed

Laher, Abdullah Ebrahim; Motara, Feroza; Moolla, Muhammed

2016-06-01

The position of the mental foramen has been well researched in cadaver specimens, radiographically as well as intraoperatively. To our knowledge, this landmark study is the first to make use of ultrasonography in a study population to determine the position of the mental foramen in relation to the mandibular premolar teeth. Ultrasonography has great potential to further revolutionize the practice of medicine and dento-maxillofacial surgery. To make use of ultrasound to determine the position of the mental foramen and its relation to the mandibular premolar teeth. One hundred Black and Caucasian subjects were enrolled. A high frequency (8MHz) transducer (PLF.805ST) of a diagnostic ultrasound system (model SSA-510A) was applied above the inferior border of the mandible, just lateral to the mentum. With the marker of the transducer pointing cranially, the position of the mental foramen in relation to the closest mandibular premolar tooth was determined. The position was compared across race, sex and age groups. All mental foramina (100%) were visualised. Overall the most frequent position of the mental foramen was in line with the long axis of the second premolar on the right (44%) and between the first and second premolars on the left (44%). There were no statistical differences (p >0.05) between race groups, sex and age groups with regard to the position of the mental foramen in relation to the mandibular premolars. However, in Blacks, the most frequent position of the mental foramen was in line with the long axis of the second premolar and in Caucasians the most common position was between the first and second premolars. The most frequent position of the mental foramen in females was in line with the long axis of the second premolar on the right and between the first and second premolars on the left. In males, the most frequent position of the mental foramen was in line with the long axis of the second premolar bilaterally. The most common position of the mental foramen in the age group category 18-30 years was between the first and second premolars. In patients aged 31-60 years the most frequent position was in line with the long axis of the second premolar. Ultrasound is a sensitive modality to locate the mental foramen. There are differences in the most common position of the mental foramen with regard to the long axis of the premolar teeth. Ultrasonography has the potential to revolutionize the practice of dento-maxillofacial surgery.

Calibration of echocardiographic tissue doppler velocity, using simple universally applicable methods

NASA Astrophysics Data System (ADS)

Dhutia, Niti M.; Zolgharni, Massoud; Willson, Keith; Cole, Graham; Nowbar, Alexandra N.; Manisty, Charlotte H.; Francis, Darrel P.

2014-03-01

Some of the challenges with tissue Doppler measurement include: apparent inconsistency between manufacturers, uncertainty over which part of the trace to make measurements and a lack of calibration of measurements. We develop and test tools to solve these problems in echocardiography laboratories. We designed and constructed an actuator and phantom setup to produce automatic reproducible motion, and used it to compare velocities measured using 3 echocardiographic modalities: M-mode, speckle tracking, and tissue Doppler, against a non-ultrasound, optical gold standard. In the clinical phase, 25 patients underwent M-mode, speckle tracking and tissue Doppler measurements of tissue velocities. In-vitro, the M-mode and speckle tracking velocities were concordant with optical assessment. Of the three possible tissue Doppler measurement conventions (outer, middle and inner line) only the middle line agreed with the optical assessment (discrepancy -0.20 (95% confidence interval -0.44 to 0.03)cm/s, p=0.11, outer +5.19(4.65 to 5.73)cm/s, p<0.0001, inner -6.26(-6.87 to -5.65)cm/s, p<0.0001). All 4 studied manufacturers showed a similar pattern. M-mode was therefore chosen as the in-vivo gold standard. Clinical measurements of tissue velocities by speckle tracking and the middle line of the tissue Doppler were concordant with M-mode, while the outer line significantly overestimated (+1.27(0.96 to 1.59)cm/s, p<0.0001) and the inner line underestimated (-1.81(-2.11 to -1.52)cm/s, p<0.0001). Echocardiographic velocity measurements can be calibrated by simple, inexpensive tools. We found that the middle of the tissue Doppler trace represents velocity correctly. Echocardiographers requiring velocities to match between different equipment, settings or modalities should use the middle line as the "guideline".

DOE Office of Scientific and Technical Information (OSTI.GOV)

Slipchenko, S. O., E-mail: serghpl@mail.ioffe.ru; Podoskin, A. A.; Vinokurov, D. A.

Radiative characteristics of semiconductor stripe-contact lasers operating under quenching conditions of Fabry-Perot-mode lasing are studied. It is found that reversible turning off of Fabry-Perot-mode lasing is caused by switching to closed-mode lasing. Radiative characteristics of the closed mode are controlled by the mode structure with the close-to-zero loss for radiation output, which covers the entire crystal. The main threshold conditions of closed-mode lasing are a decrease in interband absorption in the passive region and an increase in the modal gain of the closed-mode lasing line. It is shown that a decrease in interband absorption in the passive region can bemore » provided by both spontaneous emission from the injection region and lasing-mode photons. An increase in the modal gain of the closed-mode lasing line is provided by shifting the energy minima of the conduction band and maxima of the valence band of the injection region with respect to the energy bands of the passive region.« less

18F-FDG PET/CT Findings of Metastasis to Spongy Body of Penis From Urothelial Carcinoma of Bladder.

PubMed

Wang, Yan-li; Fang, Na; Zeng, Lei; Wu, Zeng-jie; Cui, Xin-jian

2016-05-01

The spongy body of the penis metastasis from other primary sites is a rare clinical entity. It is frequently associated with widespread metastatic disease and poor prognosis clinically. We report a case of a 61-year-old man with a previous history of cystectomy due to infiltrating urothelial carcinoma of the bladder 12 months ago and presented with penile shaft swelling pain and hematuria for 3 months. The restaging F-FDG PET/CT scan demonstrated a hypermetabolic mass at his penile shaft. This lesion was confirmed on phallectomy to be infiltrating urothelial carcinoma metastasis from the known primary bladder tumor.

Semantic control and modality: an input processing deficit in aphasia leading to deregulated semantic cognition in a single modality.

PubMed

Thompson, Hannah E; Jefferies, Elizabeth

2013-08-01

Research suggests that semantic memory deficits can occur in at least three ways. Patients can (1) show amodal degradation of concepts within the semantic store itself, such as in semantic dementia (SD), (2) have difficulty in controlling activation within the semantic system and accessing appropriate knowledge in line with current goals or context, as in semantic aphasia (SA) and (3) experience a semantic deficit in only one modality following degraded input from sensory cortex. Patients with SA show deficits of semantic control and access across word and picture tasks, consistent with the view that their problems arise from impaired modality-general control processes. However, there are a few reports in the literature of patients with semantic access problems restricted to auditory-verbal materials, who show decreasing ability to retrieve concepts from words when they are presented repeatedly with closely related distractors. These patients challenge the notion that semantic control processes are modality-general and suggest instead a separation of 'access' to auditory-verbal and non-verbal semantic systems. We had the rare opportunity to study such a case in detail. Our aims were to examine the effect of manipulations of control demands in auditory-verbal semantic, non-verbal semantic and non-semantic tasks, allowing us to assess whether such cases always show semantic control/access impairments that follow a modality-specific pattern, or whether there are alternative explanations. Our findings revealed: (1) deficits on executive tasks, unrelated to semantic demands, which were more evident in the auditory modality than the visual modality; (2) deficits in executively-demanding semantic tasks which were accentuated in the auditory-verbal domain compared with the visual modality, but still present on non-verbal tasks, and (3) a coupling between comprehension and executive control requirements, in that mild impairment on single word comprehension was greatly increased on more demanding, associative judgements across modalities. This pattern of results suggests that mild executive-semantic impairment, paired with disrupted connectivity from auditory input, may give rise to semantic 'access' deficits affecting only the auditory modality. Copyright © 2013 Elsevier Ltd. All rights reserved.

Enhanced tactile encoding and memory recognition in congenital blindness.

PubMed

D'Angiulli, Amedeo; Waraich, Paul

2002-06-01

Several behavioural studies have shown that early-blind persons possess superior tactile skills. Since neurophysiological data show that early-blind persons recruit visual as well as somatosensory cortex to carry out tactile processing (cross-modal plasticity), blind persons' sharper tactile skills may be related to cortical re-organisation resulting from loss of vision early in their life. To examine the nature of blind individuals' tactile superiority and its implications for cross-modal plasticity, we compared the tactile performance of congenitally totally blind, low-vision and sighted children on raised-line picture identification test and re-test, assessing effects of task familiarity, exploratory strategy and memory recognition. What distinguished the blind from the other children was higher memory recognition and higher tactile encoding associated with efficient exploration. These results suggest that enhanced perceptual encoding and recognition memory may be two cognitive correlates of cross-modal plasticity in congenital blindness.

225Ac-PSMA-617 for PSMA-Targeted α-Radiation Therapy of Metastatic Castration-Resistant Prostate Cancer.

PubMed

Kratochwil, Clemens; Bruchertseifer, Frank; Giesel, Frederik L; Weis, Mirjam; Verburg, Frederik A; Mottaghy, Felix; Kopka, Klaus; Apostolidis, Christos; Haberkorn, Uwe; Morgenstern, Alfred

2016-12-01

Prostate-specific membrane antigen (PSMA) is a promising target in prostate cancer. Recently, we started the first-in-human treatment with an α-radionuclide-labeled PSMA ligand. Although the case series is still ongoing, we here report in advance about two patients in highly challenging clinical situations who showed a complete response to 225 Ac-PSMA-617 therapy. 68 Ga-PSMA-11 PET/CT validated the presence of the PSMA-positive tumor phenotype. A 100-kBq activity of 225 Ac-PSMA-617 per kilogram of body weight was administered bimonthly. Prostate-specific antigen response and hematologic toxicity were measured at least every 4 wk. Restaging was performed with 68 Ga-PSMA-11 PET/CT. Both patients experienced a prostate-specific antigen decline to below the measurable level and showed a complete response on imaging. No relevant hematologic toxicity was observed. Xerostomia was the only mentionable clinical side effect. Targeted α-therapy with 225 Ac-PSMA-617, although still experimental, obviously has strong potential to significantly benefit advanced-stage prostate cancer patients. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Laser a balayage spectral double-bande pour l'imagerie biomedicale multimodale

NASA Astrophysics Data System (ADS)

Goulamhoussen, Nadir

A novel swept laser providing simultaneous dual-band (780nm and 1 300 nm) wavelength scanning has been designed for use in multimodal imaging systems. The swept laser is based on two gain media : a fibered semiconductor optical amplifier (SOA) centered at 1 300nm and a free-space laser diode centered at 780 nm. Simultaneous wavelength tuning for both bands is obtained by separate wavelength filters set up around the same rotating polygonal mirror. For each band, a telescope in an infinite conjugate setup converges the wavelengths dispersed by a grating on the polygon. The polygon reflects back a narrow band of wavelengths for amplification in the gain medium. Rotating the polygon enables wavelength tuning and imaging at a rate of 6 000 to 30 000 spectral lines/s, or A-lines/s in Optical Coherence Tomography (OCT). The 780nm source has a bandwidth of 37 nm, a fibered output power of 54 mW and a coherence length of 11 mm. The 1 300nm source has a bandwidth of 75 nm, a fibered output power of 17mW and a coherence length of 7.2 mm. Three multimodal systems were designed to test the potential of the swept laser in biomedical imaging. A two color OCT which allows three-dimensional in depth imaging of biological tissues with good morphological contrast was first designed, including a novel arrangement for balanced detection in both bands. A simultaneous OCT and SECM instrument was also built in which spectrally encoded confocal microscopy (SECM) provides en face images of subcellular features with high resolution on top of the 3D high penetration image obtained by OCT. Finally, a system combining OCT with fluorescence was designed, thus adding functional imaging to structural OCT images. There are many prospective paths for these three modalities, first among them the adaptation of the systems such that they may be used with imaging probes. One potential solution would be the development of novel fiber components to combine the illumination of theses modalities while demultiplexing their detection, and as would be the development of new optomechanics to enable 3D real-time in vivo imaging.

The Shock and Vibration Digest. Volume 16, Number 4

DTIC Science & Technology

1984-04-01

The 2nd International Modal Analysis Conference, which was held in Orlando, Florida, this past February, was highly successful in all respects. A...announcement of the formation of a new technical society dedicated to advancing the modal analysis technology, the International Society for Modal Testing and... Analysis . This new society is I unique in two respects. First, it is dedicated to a specific branch of a specialized technical field..Second, it is a

Blind identification of full-field vibration modes from video measurements with phase-based video motion magnification

NASA Astrophysics Data System (ADS)

Yang, Yongchao; Dorn, Charles; Mancini, Tyler; Talken, Zachary; Kenyon, Garrett; Farrar, Charles; Mascareñas, David

2017-02-01

Experimental or operational modal analysis traditionally requires physically-attached wired or wireless sensors for vibration measurement of structures. This instrumentation can result in mass-loading on lightweight structures, and is costly and time-consuming to install and maintain on large civil structures, especially for long-term applications (e.g., structural health monitoring) that require significant maintenance for cabling (wired sensors) or periodic replacement of the energy supply (wireless sensors). Moreover, these sensors are typically placed at a limited number of discrete locations, providing low spatial sensing resolution that is hardly sufficient for modal-based damage localization, or model correlation and updating for larger-scale structures. Non-contact measurement methods such as scanning laser vibrometers provide high-resolution sensing capacity without the mass-loading effect; however, they make sequential measurements that require considerable acquisition time. As an alternative non-contact method, digital video cameras are relatively low-cost, agile, and provide high spatial resolution, simultaneous, measurements. Combined with vision based algorithms (e.g., image correlation, optical flow), video camera based measurements have been successfully used for vibration measurements and subsequent modal analysis, based on techniques such as the digital image correlation (DIC) and the point-tracking. However, they typically require speckle pattern or high-contrast markers to be placed on the surface of structures, which poses challenges when the measurement area is large or inaccessible. This work explores advanced computer vision and video processing algorithms to develop a novel video measurement and vision-based operational (output-only) modal analysis method that alleviate the need of structural surface preparation associated with existing vision-based methods and can be implemented in a relatively efficient and autonomous manner with little user supervision and calibration. First a multi-scale image processing method is applied on the frames of the video of a vibrating structure to extract the local pixel phases that encode local structural vibration, establishing a full-field spatiotemporal motion matrix. Then a high-spatial dimensional, yet low-modal-dimensional, over-complete model is used to represent the extracted full-field motion matrix using modal superposition, which is physically connected and manipulated by a family of unsupervised learning models and techniques, respectively. Thus, the proposed method is able to blindly extract modal frequencies, damping ratios, and full-field (as many points as the pixel number of the video frame) mode shapes from line of sight video measurements of the structure. The method is validated by laboratory experiments on a bench-scale building structure and a cantilever beam. Its ability for output (video measurements)-only identification and visualization of the weakly-excited mode is demonstrated and several issues with its implementation are discussed.

Management of staple line leaks after sleeve gastrectomy in a consecutive series of 378 patients.

PubMed

Vix, Michel; Diana, Michele; Marx, Ludovic; Callari, Cosimo; Wu, Hurng-Sheng; Perretta, Silvana; Mutter, Didier; Marescaux, Jacques

2015-02-01

Laparoscopic sleeve gastrectomy (LSG) is gaining acceptance as a stand-alone bariatric procedure with proven efficacy on weight loss and obesity-related comorbidities. A specific and potentially severe complication of LSG is the staple line leak (SLL). Our aim was to report the SLL rate and its management in a prospective cohort of 378 LSGs. A total of 378 patients underwent LSG from July 2005 to July 2011. The gastric transection was performed by an initial 60 mm firing of 4.5 mm staples at the antrum and successive 60 mm firings of 3.5 mm staples at the gastric body and fundus toward the left diaphragmatic crus. A 36 Fr bougie was used to calibrate the gastric tube. The staple line was systematically reinforced with a partial-thickness running suture. The overall complications and SLL rate were 20/378 (5.29%) and 9/378 (2.38%), respectively. SLLs were managed by laparoscopic (n=2) or open (n=1) exploration, drainage and endoscopic self-expandable covered stent, computed tomography-guided percutaneous drainage (n=2), or a self-expandable covered stent alone (n=4). Medical support including total parenteral nutrition and adapted antibiotics was started in all patients. The combined treatment modalities were successful in all cases. SLL was the most common complication of LSG accounting for half of the overall complications. Percutaneous drainage and self-covered stents combined with antibiotics and parenteral nutrition are effective for SLL and should be proposed as first-line treatment in stable patients.

Swarmic autopoiesis and computational creativity

NASA Astrophysics Data System (ADS)

al-Rifaie, Mohammad Majid; Leymarie, Frédéric Fol; Latham, William; Bishop, Mark

2017-10-01

In this paper two swarm intelligence algorithms are used, the first leading the "attention" of the swarm and the latter responsible for the tracing mechanism. The attention mechanism is coordinated by agents of Stochastic Diffusion Search where they selectively attend to areas of a digital canvas (with line drawings) which contains (sharper) corners. Once the swarm's attention is drawn to the line of interest with a sharp corner, the corresponding line segment is fed into the tracing algorithm, Dispersive Flies Optimisation which "consumes" the input in order to generate a "swarmic sketch" of the input line. The sketching process is the result of the "flies" leaving traces of their movements on the digital canvas which are then revisited repeatedly in an attempt to re-sketch the traces they left. This cyclic process is then introduced in the context of autopoiesis, where the philosophical aspects of the autopoietic artist are discussed. The autopoetic artist is described in two modalities: gluttonous and contented. In the Gluttonous Autopoietic Artist mode, by iteratively focussing on areas-of-rich-complexity, as the decoding process of the input sketch unfolds, it leads to a less complex structure which ultimately results in an empty canvas; therein reifying the artwork's "death". In the Contented Autopoietic Artist mode, by refocussing the autopoietic artist's reflections on "meaning" onto different constitutive elements, and modifying her reconstitution, different behaviours of autopoietic creativity can be induced and therefore, the autopoietic processes become less likely to fade away and more open-ended in their creative endeavour.

The role of ultrasound (US) and magnetic resonance imaging (MRI) in penile fracture mapping for modified surgical repair.

PubMed

Zare Mehrjardi, Mohammad; Darabi, Mohsen; Bagheri, Seyed Morteza; Kamali, Koosha; Bijan, Bijan

2017-06-01

To determine the accuracy of ultrasound (US) and magnetic resonance imaging (MRI) in the diagnosis of penile fracture and preoperative mapping for modified surgical repair. Twenty-five consecutive patients were included in the study prospectively over 29 months (from February 2014 to June 2016). US examination and MRI were performed on all patients and interpreted by two expert radiologists independently. The location of the defect in tunica albuginea was mapped onto a designed scheme preoperatively using each imaging modality. The detection rate, as well as agreement between preoperative radiologic mapping and surgical outcomes, was determined for each modality. The mean age of the patients was 28 ± 7.5 years. The most common etiology was intercourse (88%). The most common location of tunica albuginea rupture was mid-shaft of the penis (60%), and the mean length of tunica defects in their greatest dimension was 13.5 ± 3.95 mm. All patients had associated hematoma, but no urethral injury was detected. The detection rate of US and MRI was 88 and 100%, respectively. US mapped the tear location correctly in 18 patients [61 out of 75 items (81%); κ = 0.66], while MRI mapped it precisely in 23 patients [73 out of 75 items (97%); κ = 0.95]. Both modalities are extremely helpful for the diagnosis of penile fracture. Considering the cost-efficiency and accessibility of ultrasonography, US is recommended as the first-line tool for both diagnosis and preoperative mapping. MRI may be used as a complementary study in the patients for whom US fails to visualize or precisely define the tunica defect.

Ares I-X Flight Test Vehicle Modal Test

NASA Technical Reports Server (NTRS)

Buehrle, Ralph D.; Templeton, Justin D.; Reaves, Mercedes C.; Horta, Lucas G.; Gaspar, James L.; Bartolotta, Paul A.; Parks, Russel A.; Lazor, Daniel R.

2010-01-01

The first test flight of NASA's Ares I crew launch vehicle, called Ares I-X, was launched on October 28, 2009. Ares I-X used a 4-segment reusable solid rocket booster from the Space Shuttle heritage with mass simulators for the 5th segment, upper stage, crew module and launch abort system. Flight test data will provide important information on ascent loads, vehicle control, separation, and first stage reentry dynamics. As part of hardware verification, a series of modal tests were designed to verify the dynamic finite element model (FEM) used in loads assessments and flight control evaluations. Based on flight control system studies, the critical modes were the first three free-free bending mode pairs. Since a test of the free-free vehicle was not practical within project constraints, modal tests for several configurations during vehicle stacking were defined to calibrate the FEM. Test configurations included two partial stacks and the full Ares I-X flight test vehicle on the Mobile Launcher Platform. This report describes the test requirements, constraints, pre-test analysis, test execution and results for the Ares I-X flight test vehicle modal test on the Mobile Launcher Platform. Initial comparisons between pre-test predictions and test data are also presented.

18F-Fluorocholine PET/CT Complementing the Role of Dynamic Contrast-Enhanced MRI for Providing Comprehensive Diagnostic Workup in Prostate Cancer Patients With Suspected Relapse Following Radical Prostatectomy.

PubMed

Vadi, Shelvin Kumar; Singh, Baljinder; Basher, Rajender K; Watts, Ankit; Sood, Ashwani K; Lal, Anupam; Kakkar, Nandita; Singh, S K

2017-08-01

The aim of this study was to compare the diagnostic performance of F-fluorocholine (FCH) PET/CT and dynamic contrast-enhanced MRI (DCE-MRI) of pelvis in restaging prostate cancer (PC) patients with biochemical recurrence (BCR) following radical prostatectomy (RP). Twenty PC patients who had undergone RP and had BCR were recruited in this study. All the patients underwent whole-body FCH PET/CT and DCE-MRI of the pelvis. An overall pattern of recurrent disease was analyzed, and diagnostic accuracy for the detection of pelvic disease recurrence by the 2 modalities was evaluated by taking histopathologic analysis as the criterion standard. The whole-body FCH PET/CT images were also analyzed separately for the presence of any extra lesion(s). The initial mean Gleason score was 6.3 ± 1.53 (range, 4-9). The mean prostate-specific antigen levels at the time of relapse were 1.9 ± 2.87 ng/mL (range, 0.24-13.2 ng/mL). MRI findings were positive for primary tumor recurrence in the prostate bed in 6 patients (6/20 [30.0%]), pelvic lymph node metastases in 4 patients (4/20 [20.0%]), and for pelvic skeletal metastases in 2 patients (2/20 [10.0%]), respectively. On the other hand, FCH PET/CT results were positive in the corresponding sites in 7 (7/20 [35.0%]), 9 (9/20 [45.0%]), and 2 patients (2/20 [10.0%]), respectively. F-fluorocholine PET/CT and MRI showed comparable results in terms of sensitivity, specificity, and positive and negative predictive values for PC characterization. The whole-body FCH PET/CT was found to be useful in identifying unknown distant metastases in a significant proportion of patients. The correlative whole-body FCH PET/CT and pelvic DCE-MRI offer a complementary and comprehensive diagnostic workup for better management of PC patients with BCR following RP.

Natural killer cells activity in a metastatic colorectal cancer patient with complete and long lasting response to therapy.

PubMed

Ottaiano, Alessandro; Napolitano, Maria; Capozzi, Monica; Tafuto, Salvatore; Avallone, Antonio; Scala, Stefania

2017-11-16

Here we report a case of a 70-year-old man who received adjuvant chemotherapy with fluorouracile, folinic acid and oxaliplatin after a left hemicolectomy for a stage IIIb adenocarcinoma in May 2009. During follow-up he de-veloped abdominal lymphnodes metastases evidenced by positron emission tomography- computed tomography (PET-CT) scan and increase of carcinoembryonic antigen (CEA) level. Chemotherapy with capecitabine, oxaliplatin and bevacizumab was started in April 2012. Restaging showed a complete response and normalization of CEA. The patient received maintenance therapy with bevacizumab which was stopped in December 2013 for patient choice. In October 2014, a new increase in CEA was documented and PET-CT scan showed lung metastases. Analysis of RAS status revealed the absence of mutations, then the patient started a second-line chemotherapy with fluorouracile, folinic acid, irinotecan (folfiri) and panitumumab achieving, in January 2015, a complete response and normalization of CEA. Thereafter, folfiri was discontinued for toxicity; furthermore, upon the third occurrence of a grade 3 dermatologic toxicity, panitumumab was continued from June 2015 at 60% of the original dose and it was administered every three weeks. Until presentation of this case, the patient maintains a complete response, has no symptoms of disease and CEA is normal. Interestingly, this patient presented a high proportion of circulating natural killer (NK) cells (35.1%) with high cytotoxic activity against tumor cells. Study on the role of NK in patients with advanced colorectal cancer are ongoing.

High speed line-scan confocal imaging of stimulus-evoked intrinsic optical signals in the retina

PubMed Central

Li, Yang-Guo; Liu, Lei; Amthor, Franklin; Yao, Xin-Cheng

2010-01-01

A rapid line-scan confocal imager was developed for functional imaging of the retina. In this imager, an acousto-optic deflector (AOD) was employed to produce mechanical vibration- and inertia-free light scanning, and a high-speed (68,000 Hz) linear CCD camera was used to achieve sub-cellular and sub-millisecond spatiotemporal resolution imaging. Two imaging modalities, i.e., frame-by-frame and line-by-line recording, were validated for reflected light detection of intrinsic optical signals (IOSs) in visible light stimulus activated frog retinas. Experimental results indicated that fast IOSs were tightly correlated with retinal stimuli, and could track visible light flicker stimulus frequency up to at least 2 Hz. PMID:20125743

Active vibration control of thin-plate structures with partial SCLD treatment

NASA Astrophysics Data System (ADS)

Lu, Jun; Wang, Pan; Zhan, Zhenfei

2017-02-01

To effectively suppress the low-frequency vibration of a thin-plate, the strategy adopted is to develop a model-based approach to the investigation on the active vibration control of a clamped-clamped plate with partial SCLD treatment. Firstly, a finite element model is developed based on the constitutive equations of elastic, piezoelectric and viscoelastic materials. The characteristics of viscoelastic materials varying with temperature and frequency are described by GHM damping model. A low-dimensional real modal control model which can be used as the basis for active vibration control is then obtained from the combined reduction. The emphasis is placed on the feedback control system to attenuate the vibration of plates with SCLD treatments. A modal controller in conjunction with modal state estimator is designed to solve the problem of full state feedback, making it much more feasible to real-time control. Finally, the theoretical model is verified by modal test, and an active vibration control is validated by hardware-in-the-loop experiment under different external excitations. The numerical and experimental study demonstrate how the piezoelectric actuators actively control the lower modes (first bending and torsional modes) using modal controller, while the higher frequency vibration attenuated by viscoelastic passive damping layer.

Bayesian operational modal analysis of Jiangyin Yangtze River Bridge

NASA Astrophysics Data System (ADS)

Brownjohn, James Mark William; Au, Siu-Kui; Zhu, Yichen; Sun, Zhen; Li, Binbin; Bassitt, James; Hudson, Emma; Sun, Hongbin

2018-09-01

Vibration testing of long span bridges is becoming a commissioning requirement, yet such exercises represent the extreme of experimental capability, with challenges for instrumentation (due to frequency range, resolution and km-order separation of sensor) and system identification (because of the extreme low frequencies). The challenge with instrumentation for modal analysis is managing synchronous data acquisition from sensors distributed widely apart inside and outside the structure. The ideal solution is precisely synchronised autonomous recorders that do not need cables, GPS or wireless communication. The challenge with system identification is to maximise the reliability of modal parameters through experimental design and subsequently to identify the parameters in terms of mean values and standard errors. The challenge is particularly severe for modes with low frequency and damping typical of long span bridges. One solution is to apply 'third generation' operational modal analysis procedures using Bayesian approaches in both the planning and analysis stages. The paper presents an exercise on the Jiangyin Yangtze River Bridge, a suspension bridge with a 1385 m main span. The exercise comprised planning of a test campaign to optimise the reliability of operational modal analysis, the deployment of a set of independent data acquisition units synchronised using precision oven controlled crystal oscillators and the subsequent identification of a set of modal parameters in terms of mean and variance errors. Although the bridge has had structural health monitoring technology installed since it was completed, this was the first full modal survey, aimed at identifying important features of the modal behaviour rather than providing fine resolution of mode shapes through the whole structure. Therefore, measurements were made in only the (south) tower, while torsional behaviour was identified by a single measurement using a pair of recorders across the carriageway. The modal survey revealed a first lateral symmetric mode with natural frequency 0.0536 Hz with standard error ±3.6% and damping ratio 4.4% with standard error ±88%. First vertical mode is antisymmetric with frequency 0.11 Hz ± 1.2% and damping ratio 4.9% ± 41%. A significant and novel element of the exercise was planning of the measurement setups and their necessary duration linked to prior estimation of the precision of the frequency and damping estimates. The second novelty is the use of the multi-sensor precision synchronised acquisition without external time reference on a structure of this scale. The challenges of ambient vibration testing and modal identification in a complex environment are addressed leveraging on advances in practical implementation and scientific understanding of the problem.

Modality-specific effects on crosstalk in task switching: evidence from modality compatibility using bimodal stimulation.

PubMed

Stephan, Denise Nadine; Koch, Iring

2016-11-01

The present study was aimed at examining modality-specific influences in task switching. To this end, participants switched either between modality compatible tasks (auditory-vocal and visual-manual) or incompatible spatial discrimination tasks (auditory-manual and visual-vocal). In addition, auditory and visual stimuli were presented simultaneously (i.e., bimodally) in each trial, so that selective attention was required to process the task-relevant stimulus. The inclusion of bimodal stimuli enabled us to assess congruence effects as a converging measure of increased between-task interference. The tasks followed a pre-instructed sequence of double alternations (AABB), so that no explicit task cues were required. The results show that switching between two modality incompatible tasks increases both switch costs and congruence effects compared to switching between two modality compatible tasks. The finding of increased congruence effects in modality incompatible tasks supports our explanation in terms of ideomotor "backward" linkages between anticipated response effects and the stimuli that called for this response in the first place. According to this generalized ideomotor idea, the modality match between response effects and stimuli would prime selection of a response in the compatible modality. This priming would cause increased difficulties to ignore the competing stimulus and hence increases the congruence effect. Moreover, performance would be hindered when switching between modality incompatible tasks and facilitated when switching between modality compatible tasks.

Railroad industry modal profile: an outline of the railroad industry workforce trends, challenges, and opportunities - update : final report.

DOT National Transportation Integrated Search

2016-04-01

In 2011, the Federal Railroad Administration (FRA) Office of Research, Development, and Technology (RD&T) published the : first edition of the Railroad Industry Modal Profile: An Outline of the Railroad Industry Workforce Trends, Challenges, and :...

A Cross-Modal Assessment of Reading Achievement in Children.

ERIC Educational Resources Information Center

Webb, Kathryn; And Others

1982-01-01

This study examined the ability of the Listen and Look (LL) test of cross-modal perception and the Metropolitan Readiness Test (MRT) to predict reading achievement. Data from 79 first-grade pupils were analyzed. Both the LL and MRT demonstrated predictive validity. (Author/BW)

Learning outcomes of in-person and virtual field-based geoscience instruction at Grand Canyon National Park: complementary mixed-methods analyses

NASA Astrophysics Data System (ADS)

Semken, S. C.; Ruberto, T.; Mead, C.; Bruce, G.; Buxner, S.; Anbar, A. D.

2017-12-01

Students with limited access to field-based geoscience learning can benefit from immersive, student-centered virtual-reality and augmented-reality field experiences. While no digital modalities currently envisioned can truly supplant field-based learning, they afford students access to geologically illustrative but inaccessible places on Earth and beyond. As leading producers of immersive virtual field trips (iVFTs), we investigate complementary advantages and disadvantages of iVFTs and in-person field trips (ipFTs). Settings for our mixed-methods study were an intro historical-geology class (n = 84) populated mostly by non-majors and an advanced Southwest geology class (n = 39) serving mostly majors. Both represent the diversity of our urban Southwestern research university. For the same credit, students chose either an ipFT to the Trail of Time (ToT) Exhibition at Grand Canyon National Park (control group) or an online Grand Canyon iVFT (experimental group), in the same time interval. Learning outcomes for each group were identically drawn from elements of the ToT and assessed using pre/post concept sketching and inquiry exercises. Student attitudes and cognitive-load factors for both groups were assessed pre/post using the PANAS instrument (Watson et al., 1998) and with affective surveys. Analysis of pre/post concept sketches indicated improved knowledge in both groups and classes, but more so in the iVFT group. PANAS scores from the intro class showed the ipFT students having significantly stronger (p = .004) positive affect immediately prior to the experience than the iVFT students, possibly reflecting their excitement about the trip to come. Post-experience, the two groups were no longer significantly different, possibly due to the fatigue associated with a full-day ipFT. Two lines of evidence suggest that the modalities were comparable in expected effectiveness. First, the information relevant for the concept sketch was specifically covered in both modalities. Second, coding using the ICAP Framework (Chi & Wylie, 2014) suggests that the modalities are qualitatively similar, with each being predominantly active or passive and rarely reaching the constructive or interactive levels. This leaves other factors such as cognitive load to explain the differential learning outcomes by modality.

The year 2012 in the European Heart Journal-Cardiovascular Imaging: Part I.

PubMed

Edvardsen, Thor; Plein, Sven; Saraste, Antti; Knuuti, Juhani; Maurer, Gerald; Lancellotti, Patrizio

2013-06-01

The new multi-modality cardiovascular imaging journal, European Heart Journal - Cardiovascular Imaging, was started in 2012. During its first year, the new Journal has published an impressive collection of cardiovascular studies utilizing all cardiovascular imaging modalities. We will summarize the most important studies from its first year in two articles. The present 'Part I' of the review will focus on studies in myocardial function, myocardial ischaemia, and emerging techniques in cardiovascular imaging.

Dynamic analysis and vibration testing of CFRP drive-line system used in heavy-duty machine tool

NASA Astrophysics Data System (ADS)

Yang, Mo; Gui, Lin; Hu, Yefa; Ding, Guoping; Song, Chunsheng

2018-03-01

Low critical rotary speed and large vibration in the metal drive-line system of heavy-duty machine tool affect the machining precision seriously. Replacing metal drive-line with the CFRP drive-line can effectively solve this problem. Based on the composite laminated theory and the transfer matrix method (TMM), this paper puts forward a modified TMM to analyze dynamic characteristics of CFRP drive-line system. With this modified TMM, the CFRP drive-line of a heavy vertical miller is analyzed. And the finite element modal analysis model of the shafting is established. The results of the modified TMM and finite element analysis (FEA) show that the modified TMM can effectively predict the critical rotary speed of CFRP drive-line. And the critical rotary speed of CFRP drive-line is 20% higher than that of the original metal drive-line. Then, the vibration of the CFRP and the metal drive-line were tested. The test results show that application of the CFRP drive shaft in the drive-line can effectively reduce the vibration of the heavy-duty machine tool.

Computed tomography in children with community-acquired pneumonia.

PubMed

Andronikou, Savvas; Goussard, Pierre; Sorantin, Erich

2017-10-01

Diagnostic imaging plays a significant role in both the diagnosis and treatment of complications of pneumonia in children and chest radiography is the imaging modality of choice. Computed tomography (CT) on the other hand, is not currently a first-line imaging tool for children with suspected uncomplicated community-acquired pneumonia and is largely reserved for when complications of pneumonia are suspected or there is difficulty in differentiating pneumonia from other pathology. This review outlines the situations where CT needs to be considered in children with pneumonia, describes the imaging features of the parenchymal and pleural complications of pneumonia, discusses how CT may have a wider role in developing countries where human immunodeficiency virus (HIV) and tuberculosis are prevalent, makes note of the role of CT scanning for identifying missed foreign body aspiration and, lastly, addresses radiation concerns.

Functional Disorders of Constipation: Paradoxical Puborectalis Contraction and Increased Perineal Descent

PubMed Central

Payne, Isaac; Grimm, Leander M.

2017-01-01

Paradoxical puborectalis contraction (PPC) and increased perineal descent (IPD) are subclasses of obstructive defecation. Often these conditions coexist, which can make the evaluation, workup, and treatment difficult. After a thorough history and examination, workup begins with utilization of proven diagnostic modalities such as cinedefecography and anal manometry. Advancements in technology have increased the surgeon's diagnostic armamentarium. Biofeedback and pelvic floor therapy have proven efficacy for both conditions as first-line treatment. In circumstances where PPC is refractory to biofeedback therapy, botulinum toxin injection is recommended. Historically, pelvic floor repair has been met with suboptimal results. In IPD, surgical therapy now is directed toward the potentially attendant abnormalities such as rectoanal intussusception and rectal prolapse. When these associated abnormalities are not present, an ostomy should be considered in patients with IPD as well as medically refractory PPC. PMID:28144209

Autologous or Reduced-Intensity Conditioning Allogeneic Hematopoietic Cell Transplantation for Chemotherapy-Sensitive Mantle-Cell Lymphoma: Analysis of Transplantation Timing and Modality

PubMed Central

Fenske, Timothy S.; Zhang, Mei-Jie; Carreras, Jeanette; Ayala, Ernesto; Burns, Linda J.; Cashen, Amanda; Costa, Luciano J.; Freytes, César O.; Gale, Robert P.; Hamadani, Mehdi; Holmberg, Leona A.; Inwards, David J.; Lazarus, Hillard M.; Maziarz, Richard T.; Munker, Reinhold; Perales, Miguel-Angel; Rizzieri, David A.; Schouten, Harry C.; Smith, Sonali M.; Waller, Edmund K.; Wirk, Baldeep M.; Laport, Ginna G.; Maloney, David G.; Montoto, Silvia; Hari, Parameswaran N.

2014-01-01

Purpose To examine the outcomes of patients with chemotherapy-sensitive mantle-cell lymphoma (MCL) following a first hematopoietic stem-cell transplantation (HCT), comparing outcomes with autologous (auto) versus reduced-intensity conditioning allogeneic (RIC allo) HCT and with transplantation applied at different times in the disease course. Patients and Methods In all, 519 patients who received transplantations between 1996 and 2007 and were reported to the Center for International Blood and Marrow Transplant Research were analyzed. The early transplantation cohort was defined as those patients in first partial or complete remission with no more than two lines of chemotherapy. The late transplantation cohort was defined as all the remaining patients. Results Auto-HCT and RIC allo-HCT resulted in similar overall survival from transplantation for both the early (at 5 years: 61% auto-HCT v 62% RIC allo-HCT; P = .951) and late cohorts (at 5 years: 44% auto-HCT v 31% RIC allo-HCT; P = .202). In both early and late transplantation cohorts, progression/relapse was lower and nonrelapse mortality was higher in the allo-HCT group. Overall survival and progression-free survival were highest in patients who underwent auto-HCT in first complete response. Multivariate analysis of survival from diagnosis identified a survival benefit favoring early HCT for both auto-HCT and RIC allo-HCT. Conclusion For patients with chemotherapy-sensitive MCL, the optimal timing for HCT is early in the disease course. Outcomes are particularly favorable for patients undergoing auto-HCT in first complete remission. For those unable to achieve complete remission after two lines of chemotherapy or those with relapsed disease, either auto-HCT or RIC allo-HCT may be effective, although the chance for long-term remission and survival is lower. PMID:24344210

Autologous or reduced-intensity conditioning allogeneic hematopoietic cell transplantation for chemotherapy-sensitive mantle-cell lymphoma: analysis of transplantation timing and modality.

PubMed

Fenske, Timothy S; Zhang, Mei-Jie; Carreras, Jeanette; Ayala, Ernesto; Burns, Linda J; Cashen, Amanda; Costa, Luciano J; Freytes, César O; Gale, Robert P; Hamadani, Mehdi; Holmberg, Leona A; Inwards, David J; Lazarus, Hillard M; Maziarz, Richard T; Munker, Reinhold; Perales, Miguel-Angel; Rizzieri, David A; Schouten, Harry C; Smith, Sonali M; Waller, Edmund K; Wirk, Baldeep M; Laport, Ginna G; Maloney, David G; Montoto, Silvia; Hari, Parameswaran N

2014-02-01

To examine the outcomes of patients with chemotherapy-sensitive mantle-cell lymphoma (MCL) following a first hematopoietic stem-cell transplantation (HCT), comparing outcomes with autologous (auto) versus reduced-intensity conditioning allogeneic (RIC allo) HCT and with transplantation applied at different times in the disease course. In all, 519 patients who received transplantations between 1996 and 2007 and were reported to the Center for International Blood and Marrow Transplant Research were analyzed. The early transplantation cohort was defined as those patients in first partial or complete remission with no more than two lines of chemotherapy. The late transplantation cohort was defined as all the remaining patients. Auto-HCT and RIC allo-HCT resulted in similar overall survival from transplantation for both the early (at 5 years: 61% auto-HCT v 62% RIC allo-HCT; P = .951) and late cohorts (at 5 years: 44% auto-HCT v 31% RIC allo-HCT; P = .202). In both early and late transplantation cohorts, progression/relapse was lower and nonrelapse mortality was higher in the allo-HCT group. Overall survival and progression-free survival were highest in patients who underwent auto-HCT in first complete response. Multivariate analysis of survival from diagnosis identified a survival benefit favoring early HCT for both auto-HCT and RIC allo-HCT. For patients with chemotherapy-sensitive MCL, the optimal timing for HCT is early in the disease course. Outcomes are particularly favorable for patients undergoing auto-HCT in first complete remission. For those unable to achieve complete remission after two lines of chemotherapy or those with relapsed disease, either auto-HCT or RIC allo-HCT may be effective, although the chance for long-term remission and survival is lower.

Avoidance from Thought Experiments: Fear of Misconception

ERIC Educational Resources Information Center

Ozdemir, Omer Faruk

2009-01-01

Two independent lines of research--mental simulations and thought experiments--provide strong arguments about the importance of perceptual modalities for the instructional practices in science education. By situating the use of mental simulations in the framework of thought experiments, this study investigated the nature and the role of mental…

Active control of a flexible structure using a modal positive position feedback controller

NASA Technical Reports Server (NTRS)

Poh, S.; Baz, A.

1990-01-01

The feasibility of a new Modal Positive Position Feedback (MPPF) strategy in controlling the vibration of a complex flexible structure using a single piezo-electric active structural member is demonstrated. The control strategy generates its control forces by manipulating only the modal position signals of the structure to provide a damping action to undamped modes. This is in contrast to conventional modal controllers that rely in their operation on negative feedback of both the modal position and velocity. The proposed strategy is very simple to design and implement as it designs the controller at the uncoupled modal level and utilizes simple first order filters to achieve the Positive Position Feedback effect. The performance of the new strategy is enhanced by augmenting it with a time sharing strategy to share a small number of actuators between larger number of modes. The effectiveness of the new strategy is validated experimentally on a flexible box-type structure that has four bays and its first two bending modes are 2.015 and 6.535 Hz respectively. A single piezo-electric actuator is utilized as an active structural member to control several transverse bending modes of the structure. The performance of the active control system is determined in the time and the frequency domains. The results are compared with those obtained when using the Independent Modal Space Control (IMSC) of Meirovitch. The experimental results suggest the potential of the proposed strategy as a viable means for controlling the vibration of large flexible structures in real time.

Dynamic Facial Expressions Prime the Processing of Emotional Prosody.

PubMed

Garrido-Vásquez, Patricia; Pell, Marc D; Paulmann, Silke; Kotz, Sonja A

2018-01-01

Evidence suggests that emotion is represented supramodally in the human brain. Emotional facial expressions, which often precede vocally expressed emotion in real life, can modulate event-related potentials (N100 and P200) during emotional prosody processing. To investigate these cross-modal emotional interactions, two lines of research have been put forward: cross-modal integration and cross-modal priming. In cross-modal integration studies, visual and auditory channels are temporally aligned, while in priming studies they are presented consecutively. Here we used cross-modal emotional priming to study the interaction of dynamic visual and auditory emotional information. Specifically, we presented dynamic facial expressions (angry, happy, neutral) as primes and emotionally-intoned pseudo-speech sentences (angry, happy) as targets. We were interested in how prime-target congruency would affect early auditory event-related potentials, i.e., N100 and P200, in order to shed more light on how dynamic facial information is used in cross-modal emotional prediction. Results showed enhanced N100 amplitudes for incongruently primed compared to congruently and neutrally primed emotional prosody, while the latter two conditions did not significantly differ. However, N100 peak latency was significantly delayed in the neutral condition compared to the other two conditions. Source reconstruction revealed that the right parahippocampal gyrus was activated in incongruent compared to congruent trials in the N100 time window. No significant ERP effects were observed in the P200 range. Our results indicate that dynamic facial expressions influence vocal emotion processing at an early point in time, and that an emotional mismatch between a facial expression and its ensuing vocal emotional signal induces additional processing costs in the brain, potentially because the cross-modal emotional prediction mechanism is violated in case of emotional prime-target incongruency.

[Clinical patterns and treatment of pyoderma gangrenosum in a French department].

PubMed

Anuset, D; Reguiai, Z; Perceau, G; Colomb, M; Durlach, A; Bernard, P

2016-02-01

Pyoderma gangrenosum (PG) is a rare inflammatory neutrophilic dermatosis for which accurate epidemiological data are limited and therapy remains a challenge. The primary study aim was to examine all cases of PG observed in our regional department over a 15-year period in order to describe the relevant characteristics and outcome under therapy. The medical records of all patients with PG from 1997 to 2012 in the Marne department of France were studied retrospectively. Clinical and histological characteristics, comorbidities, therapeutic modalities and outcome were analysed. Forty-two patients were included (30 women, 12 men). A classical, ulcerative form was found in 39 cases and PG was multifocal in 28 cases. The number of lesions did not differ according to age or the presence of comorbidities. The most frequent first-line treatments were doxycycline (23 cases) and oral corticosteroids (15 cases), regardless of age, number of lesions or existence of comorbidities. Complete remission of PG was obtained in 38 cases (median time to remission: 3 months), with relapse occurring in 17 patients (median time to relapse: 12 months after treatment withdrawal). After a median follow-up of 46 months, 8 patients had died (median time to death: 26 months after treatment initiation). This is the first large French series of patients presenting PG and enabling determination of the annual incidence within the Marne department at around 4.6 cases/1000,000 inhabitants. Our study illustrates the value of first-line treatment with tetracycline, which merits confirmation by further prospective, controlled studies. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Line x-ray source for diffraction enhanced imaging in clinical and industrial applications

NASA Astrophysics Data System (ADS)

Wang, Xiaoqin

Mammography is one type of imaging modalities that uses a low-dose x-ray or other radiation sources for examination of breasts. It plays a central role in early detection of breast cancers. The material similarity of tumor-cell and health cell, breast implants surgery and other factors, make the breast cancers hard to visualize and detect. Diffraction enhanced imaging (DEI), first proposed and investigated by D. Chapman is a new x-ray radiographic imaging modality using monochromatic x-rays from a synchrotron source, which produced images of thick absorbing objects that are almost completely free of scatter. It shows dramatically improved contrast over standard imaging when applied to the same phantom. The contrast is based not only on attenuation but also on the refraction and diffraction properties of the sample. This imaging method may improve image quality of mammography, other medical applications, industrial radiography for non-destructive testing and x-ray computed tomography. However, the size, and cost, of a synchrotron source limits the application of the new modality to be applicable at clinical levels. This research investigates the feasibility of a designed line x-ray source to produce intensity compatible to synchrotron sources. It is composed of a 2-cm in length tungsten filament, installed on a carbon steel filament cup (backing plate), as the cathode and a stationary oxygen-free copper anode with molybdenum coating on the front surface serves as the target. Characteristic properties of the line x-ray source were computationally studied and the prototype was experimentally investigated. SIMIION code was used to computationally study the electron trajectories emanating from the filament towards the molybdenum target. A Faraday cup on the prototype device, proof-of-principle, was used to measure the distribution of electrons on the target, which compares favorably to computational results. The intensities of characteristic x-ray for molybdenum, tungsten and rhodium targets were investigated with different window materials for -30kV to -100kV applied potential. Heat loading and thermal management of the target has been investigated computationally using COMSOL code package, and experimental measurements of target temperature rise was taken via thermocouples attached to the target. Temperature measurements for low voltage, low current regime without active cooling were compared to computational results for code-experiment benchmarking. Two different phantoms were used in the simulation of DEI images, which showed that the designed x-ray source with DEI setup could produce images with significant improved contrast. The computational results, along with experimental measurements on the prototype setup, indicate the possibility of scale up to larger area x-ray source adequate for DEI applications.

Measurement of Residual Flexibility for Substructures Having Prominent Flexible Interfaces

NASA Technical Reports Server (NTRS)

Tinker, Michael L.; Bookout, Paul S.

1994-01-01

Verification of a dynamic model of a constrained structure requires a modal survey test of the physical structure and subsequent modification of the model to obtain the best agreement possible with test data. Constrained-boundary or fixed-base testing has historically been the most common approach for verifying constrained mathematical models, since the boundary conditions of the test article are designed to match the actual constraints in service. However, there are difficulties involved with fixed-base testing, in some cases making the approach impractical. It is not possible to conduct a truly fixed-base test due to coupling between the test article and the fixture. In addition, it is often difficult to accurately simulate the actual boundary constraints, and the cost of designing and constructing the fixture may be prohibitive. For use when fixed-base testing proves impractical or undesirable, alternate free-boundary test methods have been investigated, including the residual flexibility technique. The residual flexibility approach has been treated analytically in considerable detail and has had limited frequency response measurements for the method. This concern is well-justified for a number of reasons. First, residual flexibilities are very small numbers, typically on the order of 1.0E-6 in/lb for translational diagonal terms, and orders of magnitude smaller for off-diagonal values. This poses difficulty in obtaining accurate and noise-free measurements, especially for points removed from the excitation source. A second difficulty encountered in residual measurements lies in obtaining a clean residual function in the process of subtracting synthesized modal data from a measured response function. Inaccuracies occur since modes are not subtracted exactly, but only to the accuracy of the curve fits for each mode; these errors are compounded with increasing distance from the excitation point. In this paper, the residual flexibility method is applied to a simple structure in both test and analysis. Measured and predicted residual functions are compared, and regions of poor data in the measured curves are described. It is found that for accurate residual measurements, frequency response functions having prominent stiffness lines in the acceleration/force format are needed. The lack of such stiffness lines increases measurement errors. Interface drive point frequency respose functions for shuttle orbiter payloads exhibit dominant stiffness lines, making the residual test approach a good candidate for payload modal tests when constrained tests are inappropriate. Difficulties in extracting a residual flexibility value from noisy test data are discussed. It is shown that use of a weighted second order least-squares curve fit of the measured residual function allows identification of residual flexibility that compares very well with predictions for the simple structure. This approach also provides an estimate of second order residual mass effects.

Modal control of a plate using a fuzzy logic controller

NASA Astrophysics Data System (ADS)

Sharma, Manu; Singh, S. P.; Sachdeva, B. L.

2007-08-01

This paper presents fuzzy logic based independent modal space control (IMSC) and fuzzy logic based modified independent modal space control (MIMSC) of vibration. The rule base of the controller consists of nine rules, which have been derived based upon simple human reasoning. Input to the controller consists of the first two modal displacements and velocities of the structure and the output of the controller is the modal force to be applied by the actuator. Fuzzy logic is used in such a way that the actuator is never called to apply effort which is beyond safe limits and also the operator is saved from calculating control gains. The proposed fuzzy controller is experimentally tested for active vibration control of a cantilevered plate. A piezoelectric patch is used as a sensor to sense vibrations of the plate and another piezoelectric patch is used as an actuator to control vibrations of the plate. For analytical formulation, a finite element method based upon Hamilton's principle is used to model the plate. For experimentation, the first two modes of the plate are observed using a Kalman observer. Real-time experiments are performed to control the first mode, the second mode and both modes simultaneously. Experiments are also performed to control the first mode by IMSC, the second mode by IMSC and both modes simultaneously by MIMSC. It is found that for the same decibel reduction in the first mode, the voltage applied by the fuzzy logic based controller is less than that applied by IMSC. While controlling the second mode by IMSC, a considerable amount of spillover is observed in the first mode and region just after the second mode, whereas while controlling the second mode by fuzzy logic, spillover effects are much smaller. While controlling two modes simultaneously, with a single sensor/actuator pair, appreciable resonance control is observed both with fuzzy logic based MIMSC as well as with direct MIMSC, but there is a considerable amount of spillover in the off-resonance region. This may be due to the sub-optimal location and/or an insufficient number of actuators. So, another smart plate with two piezoelectric actuators and one piezoelectric sensor is considered. Piezoelectric patches are fixed in an area where modal strains are high. With this configuration of the smart plate, experiments are conducted to control the first three modes of the plate and it is found that spillover effects are greatly reduced.

[RECOMMENDATION FOR EVALUATION AND TREATMENT OF CHRONIC URTICARIA - THE ISRAELI ASSOCIATION FOR ALLERGY AND CLINICAL IMMUNOLOGY].

PubMed

Levin Agmon, Nancy; Kessel, Aharon; Maoz Segal, Ramit; Rottem, Menachem; Tal, Yuval; Confino-Cohen, Ronit; Tobi, Elias

2017-06-01

Chronic urticaria is a disease manifested by a pruritic rash lasting longer than 6 weeks that may severely affect quality of life and daily function. Chronic urticaria can be further divided into chronic spontaneous urticaria which appears without a trigger and chronic inducible urticaria which evolves following distinct physical triggers. These two clinical manifestations could coexist in the same patient. The pathogenesis of chronic urticaria is not fully elucidated, although it is considered an autoimmune disease in at least 50% patients that produce auto- IgG antibodies targeted against the high affinity Fc receptor and to a lesser extent against IgE itself. Auto-antibodies associated with different autoimmune diseases can be detected such as those directed at thyroid proteins. Urticaria tends to spontaneously resolve in 50% of patients within the first year while others will suffer from it for a much longer period of time. The treatment of chronic urticaria has dramatically progressed in the last decade, enabling reduction of systemic corticosteroid use which has been the cornerstone of treatment in the past. The recommended treatment for chronic urticaria is currently based on a stepwise approach that enables achieving disease control with a reasonably good quality of life. The first step of the treatment ladder consists of selective, new generation, anti-H1 histamine blockers, which do not cross the blood brain barrier, starting from the recommended dose (first line) and increasing up to four-fold (second line). The third line of treatment is the addition of immune modulators such as leukotriene receptor blockers (Singulair), anti-IgE biological therapy (Xolair), or cyclosporine. In this review we present the updates and considerations arising during evaluation and treatment of chronic urticaria. The need for specific tests, immunologist/allergologist evaluation, as well as treatment modalities taking into consideration the large body of evidence that has accumulated in the last few years, the new international guidelines as well as their application in Israel have been addressed.

Clinical outcome and evidence of high rate post-surgical anterior hypopituitarism in a cohort of TSH-secreting adenoma patients: Might somatostatin analogs have a role as first-line therapy?

PubMed

Gatto, Federico; Grasso, Ludovica F; Nazzari, Elena; Cuny, Thomas; Anania, Pasquale; Di Somma, Carolina; Colao, Annamaria; Zona, Gianluigi; Weryha, Georges; Pivonello, Rosario; Ferone, Diego

2015-10-01

Thyrotropin-secreting pituitary adenomas (TSHomas) represent a rare subtype of pituitary tumors. Neurosurgery (NCH) is still considered the first-line therapy. In this study we aimed to investigate the outcome of different treatment modalities, including first line somatostatin analogs (SSA) treatment, with a specific focus on neurosurgery-related complications. We retrospectively evaluated thirteen patients diagnosed for TSHomas (9 M; age range 27-61). Ten patients had a magnetic resonance evidence of macroadenoma, three with slight visual field impairment. In the majority of patients, thyroid ultrasonography showed the presence of goiter and/or increased gland vascularization. Median TSH value at diagnosis was 3.29 mU/L (normal ranges 0.2-4.2 mIU/L), with median fT4 2.52 ng/dL (0.9-1.7 ng/dL). Three patients (two microadenoma) were primarily treated with NCH and achieved disease remission, whereas ten patients (nine macroadenomas) were initially treated with SSA. Despite the optimal biochemical response observed during medical treatment in most patients (mean TSH decrease -72%), only two stayed on medical therapy alone, achieving stable biochemical control at the end of the follow-up. The remaining patients (n = 7) underwent NCH later on during their clinical history, followed by radiotherapy or adjuvant SSA treatment in two cases. Noteworthy, five of them developed hypopituitarism. All patients reached a biochemical control, after a multimodal therapeutic approach. Neurosurgery ultimately led to complete disease remission or to biochemical control in majority of patients, whereas resulting in a considerable percentage of post-operative complications (mainly hypopituitarism, 50%). In the light of the optimal results unanimously reported for medical treatment with SSA, our experience suggests that a careful evaluation of risk/benefit ratio should be taken into consideration when directing the treatment approach in patients with TSHoma.

The efficacy of modified docetaxel-cisplatin-5-fluorouracil regimen as first-line treatment in patients with alpha-fetoprotein producing gastric carcinoma

PubMed Central

Bozkaya, Yakup; Doğan, Mutlu; Yazıcı, Ozan; Erdem, Gökmen Umut; Demirci, Nebi Serkan; Zengin, Nurullah

2017-01-01

Alpha-fetoprotein producing gastric carcinoma (AFP-PGC) is a rare cancer for which limited data on the clinicopathological features and treatment modalities exist. The aim of this study was to compare the efficacy of modified docetaxel-cisplatin-5-fluorouracil (mDCF) as the first-line chemotherapy regimen in metastatic AFP-PGC and non-AFP-PGC. The patients diagnosed with metastatic gastric cancer who were given mDCF as first-line therapy were retrospectively reviewed. The patients with a basal serum AFP level over 9 ng/ml were defined as AFP-PGC patients. In total, 169 patients (34 with AFP-PGC and 135 with non-AFP-PGC) were included in this study. AFP-PGC patients had more liver metastases than non-AFP-PGC patients (p < 0.001). A decrease in basal AFP levels after three cycles of chemotherapy was significantly different in AFP-PGC group (p = 0.001). Overall disease control rate was 79.4% (partial response [PR] - 44.1%, stable disease [SD] - 35.3%), and 82.2% (complete response - 3%, PR - 36.2%, SD - 43%) in AFP-PGC and non-AFP-PGC patients, respectively. There was no difference between AFP-PGC and non-AFP-PGC groups in overall and progression-free survival rates (11.3 versus 11.4 months and 7.7 versus 7.1 months, respectively). Rates of grade 3-4 hematologic toxicity were 8.8% and 6.7% for neutropenia in AFP-PGC and non-AFP-PGC group, respectively and 5.9% and 7.4% for anemia. In conclusion, mDCF regimen is well-tolerated with acceptable toxicity outcomes in both AFP-PGC and non-AFP-PGC patients. A statistically significant decrease in AFP levels after mDCF regimen indicate that AFP might be considered as a supplemental marker of response to mDCF chemotherapy in AFP-PGC patients. However, further prospective clinical trials are required in this area. PMID:28273032

An unconventional hypothesis of oxidation in Alzheimer's disease: intersections with excitotoxicity.

PubMed

Barger, Steven W

2004-09-01

There are two major lines of investigation from which a connection has been traditionally drawn between chemical oxidation and Alzheimer's disease. First, a major risk factor for AD is age, and oxidative stress has long been a component of general hypotheses about biological aging. The second line of reasoning is a corollary of the Amyloid Hypothesis, the assumption that the amyloid beta-peptide (A-beta) which comprises AD's pathognomic plaques is a key mediator of the neurodegeneration occurring in this disorder. Under many experimental conditions, A-beta has been shown to evoke oxidative damage to tissues, cells, and biomolecules; even the redox properties of the peptide itself have been hotly debated. These two modalities of conjecture intersect under the Inflammatory Hypothesis of AD, as inflammation produces oxidation, old age is associated with elevation in inflammatory events, and A-beta can further exacerbate such inflammatory reactions in brain cells. This review discusses these arguments about the pathogenesis of AD and how they might be generalized to other neurodegenerative conditions. But, additional speculation is offered in the form of an inclusionary mechanism that may be specific and novel enough to qualify as a third line of theory; namely, the possibility that inflammatory reactions in microglia--activated by A-beta or other factors among the "usual suspects"--initiate programmed oxidation that is converted to the neuron-specific stress of excitotoxicity.

Finite Element Model Development and Validation for Aircraft Fuselage Structures

NASA Technical Reports Server (NTRS)

Buehrle, Ralph D.; Fleming, Gary A.; Pappa, Richard S.; Grosveld, Ferdinand W.

2000-01-01

The ability to extend the valid frequency range for finite element based structural dynamic predictions using detailed models of the structural components and attachment interfaces is examined for several stiffened aircraft fuselage structures. This extended dynamic prediction capability is needed for the integration of mid-frequency noise control technology. Beam, plate and solid element models of the stiffener components are evaluated. Attachment models between the stiffener and panel skin range from a line along the rivets of the physical structure to a constraint over the entire contact surface. The finite element models are validated using experimental modal analysis results. The increased frequency range results in a corresponding increase in the number of modes, modal density and spatial resolution requirements. In this study, conventional modal tests using accelerometers are complemented with Scanning Laser Doppler Velocimetry and Electro-Optic Holography measurements to further resolve the spatial response characteristics. Whenever possible, component and subassembly modal tests are used to validate the finite element models at lower levels of assembly. Normal mode predictions for different finite element representations of components and assemblies are compared with experimental results to assess the most accurate techniques for modeling aircraft fuselage type structures.

Effects of Word Frequency and Modality on Sentence Comprehension Impairments in People with Aphasia

PubMed Central

DeDe, Gayle

2014-01-01

Purpose It is well known that people with aphasia have sentence comprehension impairments. The present study investigated whether lexical factors contribute to sentence comprehension impairments in both the auditory and written modalities using on-line measures of sentence processing. Methods People with aphasia and non-brain-damaged controls participated in the experiment (n=8 per group). Twenty-one sentence pairs containing high and low frequency words were presented in self-paced listening and reading tasks. The sentences were syntactically simple and differed only in the critical words. The dependent variables were response times for critical segments of the sentence and accuracy on the comprehension questions. Results The results showed that word frequency influences performance on measures of sentence comprehension in people with aphasia. The accuracy data on the comprehension questions suggested that people with aphasia have more difficulty understanding sentences containing low frequency words in the written compared to auditory modality. Both group and single case analyses of the response time data also pointed to more difficulty with reading than listening. Conclusions The results show that sentence comprehension in people with aphasia is influenced by word frequency and presentation modality. PMID:22294411

Modal parameter estimation and monitoring for on-line flight flutter analysis

NASA Astrophysics Data System (ADS)

Verboven, P.; Cauberghe, B.; Guillaume, P.; Vanlanduit, S.; Parloo, E.

2004-05-01

The clearance of the flight envelope of a new airplane by means of flight flutter testing is time consuming and expensive. Most common approach is to track the modal damping ratios during a number of flight conditions, and hence the accuracy of the damping estimates plays a crucial role. However, aircraft manufacturers desire to decrease the flight flutter testing time for practical, safety and economical reasons by evolving from discrete flight test points to a more continuous flight test pattern. Therefore, this paper presents an approach that provides modal parameter estimation and monitoring for an aircraft with a slowly time-varying structural behaviour that will be observed during a faster and more continuous exploration of the flight envelope. The proposed identification approach estimates the modal parameters directly from input/output Fourier data. This avoids the need for an averaging-based pre-processing of the data, which becomes inapplicable in the case that only short data records are measured. Instead of using a Hanning window to reduce effects of leakage, these transient effects are modelled simultaneously with the dynamical behaviour of the airplane. The method is validated for the monitoring of the system poles during flight flutter testing.

Effectiveness of Integrative Modalities for Pain and Anxiety in Children and Adolescents with Cancer: A Systematic Review

PubMed Central

Thrane, Susan

2014-01-01

Throughout the trajectory of the cancer experience, children and adolescents will likely face pain and anxiety in a variety of circumstances. Integrative therapies may be used either alone or as an adjunct to standard analgesics. Children are often very receptive to integrative therapies such as music, art, guided imagery, massage, therapeutic play, distraction, and other modalities (Doellman, 2003). The effect of integrative modalities on pain and anxiety in children with cancer has not been systematically examined across the entire cancer experience. An in-depth search of PubMed, CINAHL, MedLine, PsychInfo, and Web of Science, integrative medicine journals, and the reference lists of review articles using the search terms pain, anxiety, pediatric, child*, oncology, cancer, neoplasm, complementary, integrative, non-conventional, and unconventional yielded 164 articles. Of these, 25 warranted full-text review. Cohen’s d calculations show medium (d=.70) to extremely large (8.57) effect sizes indicating that integrative interventions may be very effective for pain and anxiety in children undergoing cancer treatment. Integrative modalities warrant further study with larger sample sizes to better determine their effectiveness in this population. PMID:24371260

Treatment of sentence comprehension and production in aphasia: is there cross-modal generalisation?

PubMed

Adelt, Anne; Hanne, Sandra; Stadie, Nicole

2016-09-09

Exploring generalisation following treatment of language deficits in aphasia can provide insights into the functional relation of the cognitive processing systems involved. In the present study, we first review treatment outcomes of interventions targeting sentence processing deficits and, second report a treatment study examining the occurrence of practice effects and generalisation in sentence comprehension and production. In order to explore the potential linkage between processing systems involved in comprehending and producing sentences, we investigated whether improvements generalise within (i.e., uni-modal generalisation in comprehension or in production) and/or across modalities (i.e., cross-modal generalisation from comprehension to production or vice versa). Two individuals with aphasia displaying co-occurring deficits in sentence comprehension and production were trained on complex, non-canonical sentences in both modalities. Two evidence-based treatment protocols were applied in a crossover intervention study with sequence of treatment phases being randomly allocated. Both participants benefited significantly from treatment, leading to uni-modal generalisation in both comprehension and production. However, cross-modal generalisation did not occur. The magnitude of uni-modal generalisation in sentence production was related to participants' sentence comprehension performance prior to treatment. These findings support the assumption of modality-specific sub-systems for sentence comprehension and production, being linked uni-directionally from comprehension to production.

Standardization and quantification in FDG-PET/CT imaging for staging and restaging of malignant disease.

PubMed

Gámez-Cenzano, Cristina; Pino-Sorroche, Francisco

2014-04-01

There is a growing interest in using quantification in FDG-PET/CT in oncology, especially for evaluating response to therapy. Complex full quantitative procedures with blood sampling and dynamic scanning have been clinically replaced by the use of standardized uptake value measurements that provide an index of regional tracer uptake normalized to the administered dose of FDG. Some approaches have been proposed for assessing quantitative metabolic response, such as EORTC and PERCIST criteria in solid tumors. When using standardized uptake value in clinical routine and multicenter trials, standardization of protocols and quality control procedures of instrumentation is required. Copyright © 2014 Elsevier Inc. All rights reserved.

Nuclear Medicine Imaging in the Dentomaxillofacial Region.

PubMed

Wassef, Heidi R; Colletti, Patrick M

2018-07-01

Nuclear medicine studies evaluate physiology on a molecular level providing earlier detection of lesions before morphologic change is evident. 99m Tc-MDP and 18 F-fluoride bone scans detect osteomyelitis earlier than radiographs and computed tomography (CT); aid in diagnosis of temporomandibular joint disorder; and evaluate activity of condylar hyperplasia, extent of Paget disease, and viability of bone grafts. 18 F-FDG PET/CT distinguish between soft tissue and bone infections and diagnose osteomyelitis complicated by fracture or surgery. FDG PET is more accurate than CT alone and has a major role in staging, restaging, and assessing response to therapy for head and neck malignancies and in detecting sequelae of therapy. Copyright © 2018 Elsevier Inc. All rights reserved.

Experience with a Talker Can Transfer Across Modalities to Facilitate Lipreading

PubMed Central

Sanchez, Kauyumari; Dias, James W.; Rosenblum, Lawrence D.

2013-01-01

Rosenblum, Miller, and Sanchez (2007) found that participants first trained to lipread a particular talker were then better able to perceive the auditory speech of that same talker, compared to that of a novel talker. This suggests that the talker experience a perceiver gains in one sensory modality can be transferred to another modality to make that speech easier to perceive. An experiment was conducted to examine whether this cross-sensory transfer of talker experience could occur: 1) from auditory to lipread speech; 2) with subjects not screened for adequate lipreading skill; 3) when both a familiar and unfamiliar talker are presented during lipreading; and 4) for both old (presentation set) and new words. Subjects were first asked to identify a set of words from a talker. They were then asked to perform a lipreading task from two faces, one of which was of the same talker they heard in the first phase of the experiment. Results revealed that subjects who lipread from the same talker they had heard performed better than those who lipead a different talker, regardless of whether the words were old or new. These results add further evidence that learning of amodal talker information can facilitate speech perception across modalities and also suggest that this information is not restricted to previously heard words. PMID:23955059

Ares I-X Launch Vehicle Modal Test Overview

NASA Technical Reports Server (NTRS)

Buehrle, Ralph D.; Bartolotta, Paul A.; Templeton, Justin D.; Reaves, Mercedes C.; Horta, Lucas G.; Gaspar, James L.; Parks, Russell A.; Lazor, Daniel R.

2010-01-01

The first test flight of NASA's Ares I crew launch vehicle, called Ares I-X, is scheduled for launch in 2009. Ares IX will use a 4-segment reusable solid rocket booster from the Space Shuttle heritage with mass simulators for the 5th segment, upper stage, crew module and launch abort system. Flight test data will provide important information on ascent loads, vehicle control, separation, and first stage reentry dynamics. As part of hardware verification, a series of modal tests were designed to verify the dynamic finite element model (FEM) used in loads assessments and flight control evaluations. Based on flight control system studies, the critical modes were the first three free-free bending mode pairs. Since a test of the free-free vehicle is not practical within project constraints, modal tests for several configurations in the nominal integration flow were defined to calibrate the FEM. A traceability study by Aerospace Corporation was used to identify the critical modes for the tested configurations. Test configurations included two partial stacks and the full Ares I-X launch vehicle on the Mobile Launcher Platform. This paper provides an overview for companion papers in the Ares I-X Modal Test Session. The requirements flow down, pre-test analysis, constraints and overall test planning are described.

Sensorimotor simulations underlie conceptual representations: modality-specific effects of prior activation.

PubMed

Pecher, Diane; Zeelenberg, René; Barsalou, Lawrence W

2004-02-01

According to the perceptual symbols theory (Barsalou, 1999), sensorimotor simulations underlie the representation of concepts. Simulations are componential in the sense that they vary with the context in which the concept is presented. In the present study, we investigated whether representations are affected by recent experiences with a concept. Concept names (e.g., APPLE) were presented twice in a property verification task with a different property on each occasion. The two properties were either from the same perceptual modality (e.g., green, shiny) or from different modalities (e.g., tart, shiny). All stimuli were words. There was a lag of several intervening trials between the first and second presentation. Verification times and error rates for the second presentation of the concept were higher if the properties were from different modalities than if they were from the same modality.

Perceptual learning in temporal discrimination: asymmetric cross-modal transfer from audition to vision.

PubMed

Bratzke, Daniel; Seifried, Tanja; Ulrich, Rolf

2012-08-01

This study assessed possible cross-modal transfer effects of training in a temporal discrimination task from vision to audition as well as from audition to vision. We employed a pretest-training-post-test design including a control group that performed only the pretest and the post-test. Trained participants showed better discrimination performance with their trained interval than the control group. This training effect transferred to the other modality only for those participants who had been trained with auditory stimuli. The present study thus demonstrates for the first time that training on temporal discrimination within the auditory modality can transfer to the visual modality but not vice versa. This finding represents a novel illustration of auditory dominance in temporal processing and is consistent with the notion that time is primarily encoded in the auditory system.

Emotion Perception from Face, Voice, and Touch: Comparisons and Convergence

PubMed Central

Schirmer, Annett; Adolphs, Ralph

2017-01-01

Historically, research on emotion perception has focused on facial expressions, and findings from this modality have come to dominate our thinking about other modalities. Here, we examine emotion perception through a wider lens by comparing facial with vocal and tactile processing. We review stimulus characteristics and ensuing behavioral and brain responses, and show that audition and touch do not simply duplicate visual mechanisms. Each modality provides a distinct input channel and engages partly non-overlapping neuroanatomical systems with different processing specializations (e.g., specific emotions versus affect). Moreover, processing of signals across the different modalities converges, first into multi- and later into amodal representations that enable holistic emotion judgments. PMID:28173998

Human squamous cell carcinoma from skin: establishment and characterization of a new cell line (HSC-5).

PubMed

Hozumi, Y; Kondo, S; Shimoura, T; Aso, K

1990-03-01

A new cell line, designated as HSC-5 and derived from human skin squamous cell carcinoma (SCC), has been established in vitro and maintained proliferative in continuous tissue culture for over two years. The cells grow in a monolayer in vitro and have anaplastic epithelioid features. The doubling time was about 35 hr at the 30th passage. Chromosome analysis showed hypotetraploidy with a modal number of 76. A trial of transplantation of the cultured cells into nude mice was not successful. Analysis of cytokeratins from HSC-5 by two-dimensional gel electrophoresis revealed polypeptides No. 5, 8, 13, 18 and 19. The cell line is available to other investigators.

Modality-specific processing precedes amodal linguistic processing during L2 sign language acquisition: A longitudinal study.

PubMed

Williams, Joshua T; Darcy, Isabelle; Newman, Sharlene D

2016-02-01

The present study tracked activation pattern differences in response to sign language processing by late hearing second language learners of American Sign Language. Learners were scanned before the start of their language courses. They were scanned again after their first semester of instruction and their second, for a total of 10 months of instruction. The study aimed to characterize modality-specific to modality-general processing throughout the acquisition of sign language. Results indicated that before the acquisition of sign language, neural substrates related to modality-specific processing were present. After approximately 45 h of instruction, the learners transitioned into processing signs on a phonological basis (e.g., supramarginal gyrus, putamen). After one more semester of input, learners transitioned once more to a lexico-semantic processing stage (e.g., left inferior frontal gyrus) at which language control mechanisms (e.g., left caudate, cingulate gyrus) were activated. During these transitional steps right hemispheric recruitment was observed, with increasing left-lateralization, which is similar to other native signers and L2 learners of spoken language; however, specialization for sign language processing with activation in the inferior parietal lobule (i.e., angular gyrus), even for late learners, was observed. As such, the present study is the first to track L2 acquisition of sign language learners in order to characterize modality-independent and modality-specific mechanisms for bilingual language processing. Copyright © 2015 Elsevier Ltd. All rights reserved.

Damage detection of building structures under ambient excitation through the analysis of the relationship between the modal participation ratio and story stiffness

NASA Astrophysics Data System (ADS)

Park, Hyo Seon; Oh, Byung Kwan

2018-03-01

This paper presents a new approach for the damage detection of building structures under ambient excitation based on the inherent modal characteristics. In this study, without the extraction of modal parameters widely utilized in the previous studies on damage detection, a new index called the modal participation ratio (MPR), which is a representative value of the modal response extracted from dynamic responses measured in ambient vibration tests, is proposed to evaluate the change of the system of a structure according to the reduction of the story stiffness. The relationship between the MPR, representing a modal contribution for a specific mode and degree of freedom in buildings, and the story stiffness damage factor (SSDF), representing the extent of reduction in the story stiffness, is analyzed in various damage scenarios. From the analyses with three examples, several rules for the damage localization of building structures are found based on the characteristics of the MPR variation for the first mode subject to change in the SSDF. In addition, a damage severity function, derived from the relationship between the MPR for the first mode in the lowest story and the SSDF, is constructed to identify the severity of story stiffness reduction. Furthermore, the locations and severities of multiple damages are identified via the superposition of the presented damage severity functions. The presented method was applied to detect damage in a three-dimensional reinforced concrete (RC) structure.

Widening the lens: what the manual modality reveals about language, learning and cognition.

PubMed

Goldin-Meadow, Susan

2014-09-19

The goal of this paper is to widen the lens on language to include the manual modality. We look first at hearing children who are acquiring language from a spoken language model and find that even before they use speech to communicate, they use gesture. Moreover, those gestures precede, and predict, the acquisition of structures in speech. We look next at deaf children whose hearing losses prevent them from using the oral modality, and whose hearing parents have not presented them with a language model in the manual modality. These children fall back on the manual modality to communicate and use gestures, which take on many of the forms and functions of natural language. These homemade gesture systems constitute the first step in the emergence of manual sign systems that are shared within deaf communities and are full-fledged languages. We end by widening the lens on sign language to include gesture and find that signers not only gesture, but they also use gesture in learning contexts just as speakers do. These findings suggest that what is key in gesture's ability to predict learning is its ability to add a second representational format to communication, rather than a second modality. Gesture can thus be language, assuming linguistic forms and functions, when other vehicles are not available; but when speech or sign is possible, gesture works along with language, providing an additional representational format that can promote learning. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

Ray Tracing and Modal Methods for Modeling Radio Propagation in Tunnels With Rough Walls

PubMed Central

Zhou, Chenming

2017-01-01

At the ultrahigh frequencies common to portable radios, tunnels such as mine entries are often modeled by hollow dielectric waveguides. The roughness condition of the tunnel walls has an influence on radio propagation, and therefore should be taken into account when an accurate power prediction is needed. This paper investigates how wall roughness affects radio propagation in tunnels, and presents a unified ray tracing and modal method for modeling radio propagation in tunnels with rough walls. First, general analytical formulas for modeling the influence of the wall roughness are derived, based on the modal method and the ray tracing method, respectively. Second, the equivalence of the ray tracing and modal methods in the presence of wall roughnesses is mathematically proved, by showing that the ray tracing-based analytical formula can converge to the modal-based formula through the Poisson summation formula. The derivation and findings are verified by simulation results based on ray tracing and modal methods. PMID:28935995

Racist Facebook Event against Native Americans: Preservice Teachers Explore Ethical and Critical Multicultural Implications

ERIC Educational Resources Information Center

Aragon, Antonette; Kaminski, Karen

2012-01-01

This exploratory case study sought to analyze data from Collaborative Learning Modalities (Brantmeier, Aragon & Folkestad, 2011) on-line threaded discussions in a teacher education course where pre-service teachers examined the nature of a Facebook event revealing unethical and racist notions against Native Americans. In 2010 a university…

Diagnostic and Therapeutic Approach for Acute Paraquat Intoxication

PubMed Central

Hong, Jung-Rak; Jang, Si-Hyong

2014-01-01

Paraquat (PQ) has known negative human health effects, but continues to be commonly used worldwide as a herbicide. Our clinical data shows that the main prognostic factor is the time required to achieve a negative urine dithionite test. Patient survival is a 100% when the area affected by ground glass opacity is <20% of the total lung volume on high-resolution computed tomography imaging 7 days post-PQ ingestion. The incidence of acute kidney injury is approximately 50%. The average serum creatinine level reaches its peak around 5 days post-ingestion, and usually normalizes within 3 weeks. We obtain two connecting lines from the highest PQ level for the survivors and the lowest PQ level among the non-survivors at a given time. Patients with a PQ level between these two lines are considered treatable. The following treatment modalities are recommended to preserve kidney function: 1) extracorporeal elimination, 2) intravenous antioxidant administration, 3) diuresis with a fluid, and 4) cytotoxic drugs. In conclusion, this review provides a general overview on the diagnostic procedure and treatment modality of acute PQ intoxication, while focusing on our clinical experience. PMID:25408572

Reconfiguration of the multiwavelength operation of optical fiber ring lasers by the modifiable intra-cavity induced losses of an in-fiber tip probe modal Michelson interferometer

NASA Astrophysics Data System (ADS)

Salceda-Delgado, G.; Martinez-Rios, A.; Sierra-Hernandez, J. M.; Rodríguez-Carreón, V. C.; Toral-Acosta, D.; Selvas-Aguilar, R.; Álvarez-Tamayo, R. I.; Castillo-Guzman, A. A.; Rojas-Laguna, R.

2018-03-01

A straightforward and versatile method for switching from single to different multiwavelength laser emission in ring cavity fiber lasers is proposed and demonstrated experimentally. The method is based on using the changeable interference pattern from an optical fiber modal Michelson interferometer as a wavelength selective filter into the ring cavity laser. The interferometer is constructed using a bi-conical tapered fiber and a single-mode fiber segment, with these being spliced together to form an optical fiber tip probe. When the length of the single-mode fiber piece is modified, the phase difference between the interfering modes of the interferometer causes a change in the interferometer free spectral range. As a consequence, the laser intra-cavity losses lead to gain competition, which allows us to adjust the number of simultaneously generated laser lines. A multiwavelength reconfiguration of the laser from one up to a maximum of eight emission lines was obtained, with a maximum SNR of around 47 dBm.

The Finite Element Simulation of the Upper Airway of Patients with Moderate and Severe Obstructive Sleep Apnea Hypopnea Syndrome

PubMed Central

Luo, Huiping; Scholp, Austin

2017-01-01

Objectives To investigate the snoring modes of patients with Obstructive Sleep Apnea Hypopnea Syndrome and to discover the main sources of snoring in soft tissue vibrations. Methods A three-dimensional finite element model was developed with SolidEdge to simulate the human upper airway. The inherent modal simulation was conducted to obtain the frequencies and the corresponding shapes of the soft tissue vibrations. The respiration process was simulated with the fluid-solid interaction method through ANSYS. Results The first 6 orders of modal vibration were 12 Hz, 18 Hz, 21 Hz, 22 Hz, 36 Hz, and 39 Hz. Frequencies of modes 1, 2, 4, and 5 were from tongue vibrations. Frequencies of modes 3 and 6 were from soft palate vibrations. Steady pressure distribution and air distribution lines in the upper airway were shown clearly in the fluid-solid interaction simulation results. Conclusions We were able to observe the vibrations of soft tissue and the modeled airflow by applying the finite element methods. Future studies could focus on improving the soft tissues vibration compliances by adjusting the model parameters. Additionally, more attention should be paid to vibrational components below 20 Hz when performing an acoustic analysis of human snore sounds due to the presence of these frequencies in this model. PMID:29204444

The Finite Element Simulation of the Upper Airway of Patients with Moderate and Severe Obstructive Sleep Apnea Hypopnea Syndrome.

PubMed

Luo, Huiping; Scholp, Austin; Jiang, Jack J

2017-01-01

To investigate the snoring modes of patients with Obstructive Sleep Apnea Hypopnea Syndrome and to discover the main sources of snoring in soft tissue vibrations. A three-dimensional finite element model was developed with SolidEdge to simulate the human upper airway. The inherent modal simulation was conducted to obtain the frequencies and the corresponding shapes of the soft tissue vibrations. The respiration process was simulated with the fluid-solid interaction method through ANSYS. The first 6 orders of modal vibration were 12 Hz, 18 Hz, 21 Hz, 22 Hz, 36 Hz, and 39 Hz. Frequencies of modes 1, 2, 4, and 5 were from tongue vibrations. Frequencies of modes 3 and 6 were from soft palate vibrations. Steady pressure distribution and air distribution lines in the upper airway were shown clearly in the fluid-solid interaction simulation results. We were able to observe the vibrations of soft tissue and the modeled airflow by applying the finite element methods. Future studies could focus on improving the soft tissues vibration compliances by adjusting the model parameters. Additionally, more attention should be paid to vibrational components below 20 Hz when performing an acoustic analysis of human snore sounds due to the presence of these frequencies in this model.

Does the Modality Principle for Multimedia Learning Apply to Science Classrooms?

ERIC Educational Resources Information Center

Harskamp, Egbert G.; Mayer, Richard E.; Suhre, Cor

2007-01-01

This study demonstrated that the modality principle applies to multimedia learning of regular science lessons in school settings. In the first field experiment, 27 Dutch secondary school students (age 16-17) received a self-paced, web-based multimedia lesson in biology. Students who received lessons containing illustrations and narration performed…

Dancing with the SNARC: Measuring spatial-numerical associations on a digital dance mat.

PubMed

Fischer, Ursula; Moeller, Korbinian; Class, Friderike; Huber, Stefan; Cress, Ulrike; Nuerk, Hans-Christoph

2016-12-01

According to the concept of embodied numerosity, bodily experiences influence the way in which we process numerical magnitude. The development of this influence could be anchored in the spatial ordering of numbers along a mental number line representation, which is measured by effects of spatial-numerical associations. The aim of this study was to investigate whether horizontally oriented full-body movement and visual presentation of a number line both contribute to spatial-numerical associations in children. We presented fourth-graders with 2 magnitude comparison tasks that differed in the relevance of magnitude information. In both tasks, we varied the amount of bodily movement in different response conditions (responding verbally, with a foot tap, or by jumping) and the visual presentation (items were presented with or without a number line). From the data, we calculated 2 spatial-numerical effects and expected to find the strongest effects if a full-body response was combined with a number line presentation. The 2 effects were differentially influenced by response modalities, but not presentation. The SNARC (= Spatial Numerical Association of Response Codes) effect was present in all conditions and was not influenced by our manipulations. In contrast, a new relative numerical congruity effect was influenced by the variations in responses in accordance with our hypotheses. The relative numerical congruity effect results suggest that responses involving bodily movement increase activation of spatial-numerical associations compared to verbal responses. These results are the first to demonstrate such an influence in a full-body approach in elementary schoolchildren. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

[Osimertinib (Tagrisso®): Activity, indication and modality of use in non-small cell lung cancer].

PubMed

Giroux Leprieur, Etienne; Cortot, Alexis B; Cadranel, Jacques; Wislez, Marie

2016-10-01

The acquisition of a resistance EGFR mutation in exon 20 (T790M) occurs in half of the cases of secondary resistance to EGFR tyrosine kinase inhibitors (TKI), given in first-line treatment in advanced EGFR-mutated non-small cell lung cancers (NSCLC). Osimertinib (AZD9291, Tagrisso ® ) is a third-generation, irreversible EGFR TKI, active in case of T790M mutation. A large phase I trial showed the efficacy of osimertinib after failure of first-generation EGFR TKI (erlotinib, gefitinib), with response rate at 51% and up to 61% in case of T790M mutation. Progression-free survival was 9.6 months in case of T790M. Toxicity profile was acceptable, with mainly digestive (diarrhea) and skin (rash) side effects. Preliminary data from a phase II trial confirmed these efficacy and safety data. Screening of T790M mutation at the time of progression with TKI can be performed in circulating tumor DNA in plasma, with good diagnostic performances. Copyright © 2016 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Development of a Dynamically Configurable, Object-Oriented Framework for Distributed, Multi-modal Computational Aerospace Systems Simulation

NASA Technical Reports Server (NTRS)

Afjeh, Abdollah A.; Reed, John A.

2003-01-01

The following reports are presented on this project:A first year progress report on: Development of a Dynamically Configurable,Object-Oriented Framework for Distributed, Multi-modal Computational Aerospace Systems Simulation; A second year progress report on: Development of a Dynamically Configurable, Object-Oriented Framework for Distributed, Multi-modal Computational Aerospace Systems Simulation; An Extensible, Interchangeable and Sharable Database Model for Improving Multidisciplinary Aircraft Design; Interactive, Secure Web-enabled Aircraft Engine Simulation Using XML Databinding Integration; and Improving the Aircraft Design Process Using Web-based Modeling and Simulation.

Unstalled flutter stability predictions and comparisons to test data for a composite prop-fan model

NASA Technical Reports Server (NTRS)

Turnberg, J. E.

1986-01-01

The aeroelastic stability analyses for three graphite/epoxy composite Prop-Fan designs and post-test stability analysis for one of the designs, the SR-3C-X2 are presented. It was shown that Prop-Fan stability can be effectively analyzed using the F203 modal aeroelastic stability analysis developed at Hamilton Standard and that first mode torsion-bending coupling has a direct effect on blade stability. Positive first mode torsion-bending coupling is a destabilizing factor and the minimization of this parameter will increase Prop-Fan stability. It was also shown that Prop-Fan stability analysis using F203 is sensitive to the blade modal data used as input. Calculated blade modal properties varied significantly with the structural analysis used, and these variations are reflected in the F203 calculations.

Constrained maximum likelihood modal parameter identification applied to structural dynamics

NASA Astrophysics Data System (ADS)

El-Kafafy, Mahmoud; Peeters, Bart; Guillaume, Patrick; De Troyer, Tim

2016-05-01

A new modal parameter estimation method to directly establish modal models of structural dynamic systems satisfying two physically motivated constraints will be presented. The constraints imposed in the identified modal model are the reciprocity of the frequency response functions (FRFs) and the estimation of normal (real) modes. The motivation behind the first constraint (i.e. reciprocity) comes from the fact that modal analysis theory shows that the FRF matrix and therefore the residue matrices are symmetric for non-gyroscopic, non-circulatory, and passive mechanical systems. In other words, such types of systems are expected to obey Maxwell-Betti's reciprocity principle. The second constraint (i.e. real mode shapes) is motivated by the fact that analytical models of structures are assumed to either be undamped or proportional damped. Therefore, normal (real) modes are needed for comparison with these analytical models. The work done in this paper is a further development of a recently introduced modal parameter identification method called ML-MM that enables us to establish modal model that satisfies such motivated constraints. The proposed constrained ML-MM method is applied to two real experimental datasets measured on fully trimmed cars. This type of data is still considered as a significant challenge in modal analysis. The results clearly demonstrate the applicability of the method to real structures with significant non-proportional damping and high modal densities.

Analysis of the costs of dialysis and the effects of an incentive mechanism for low-cost dialysis modalities.

PubMed

Cleemput, Irina; De Laet, Chris

2013-05-01

Treatment costs of end-stage renal disease with dialysis are high and vary between dialysis modalities. Public healthcare payers aim at stimulating the use of less expensive dialysis modalities, with maintenance of healthcare quality. This study examines the effects of Belgian financial incentive mechanisms for the use of low-cost dialysis treatments. First, the costs of different dialysis modalities were calculated from the hospital's perspective. Data were obtained through a hospital survey. The balance between costs and revenues was simulated for an average Belgian dialysis programme. Incremental profits were calculated in function of the proportion of patients on alternative dialysis modalities. Hospital haemodialysis is the most expensive modality per patient year, followed by peritoneal dialysis and finally satellite haemodialysis. Under current reimbursement rules mean profits of a dialysis programme are maximal if about 28% of patients are treated with a low-cost dialysis modality. This is only slightly lower than the observed percentage in Belgian dialysis centres in the same period. In Belgium, the financial incentives for the use of low-cost dialysis modalities only had a modest impact due to the continuing profits that could be generated by high-cost dialysis. Profit neutrality is crucial for the success of any financial incentive mechanism for low-cost dialysis modalities. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Nonlinear hybrid modal synthesis based on branch modes for dynamic analysis of assembled structure

NASA Astrophysics Data System (ADS)

Huang, Xing-Rong; Jézéquel, Louis; Besset, Sébastien; Li, Lin; Sauvage, Olivier

2018-01-01

This paper describes a simple and fast numerical procedure to study the steady state responses of assembled structures with nonlinearities along continuous interfaces. The proposed strategy is based on a generalized nonlinear modal superposition approach supplemented by a double modal synthesis strategy. The reduced nonlinear modes are derived by combining a single nonlinear mode method with reduction techniques relying on branch modes. The modal parameters containing essential nonlinear information are determined and then employed to calculate the stationary responses of the nonlinear system subjected to various types of excitation. The advantages of the proposed nonlinear modal synthesis are mainly derived in three ways: (1) computational costs are considerably reduced, when analyzing large assembled systems with weak nonlinearities, through the use of reduced nonlinear modes; (2) based on the interpolation models of nonlinear modal parameters, the nonlinear modes introduced during the first step can be employed to analyze the same system under various external loads without having to reanalyze the entire system; and (3) the nonlinear effects can be investigated from a modal point of view by analyzing these nonlinear modal parameters. The proposed strategy is applied to an assembled system composed of plates and nonlinear rubber interfaces. Simulation results have proven the efficiency of this hybrid nonlinear modal synthesis, and the computation time has also been significantly reduced.

Experimentally enhanced model-based deconvolution of propagation-based phase-contrast data

NASA Astrophysics Data System (ADS)

Pichotka, M.; Palma, K.; Hasn, S.; Jakubek, J.; Vavrik, D.

2016-12-01

In recent years phase-contrast has become a much investigated modality in radiographic imaging. The radiographic setups employed in phase-contrast imaging are typically rather costly and complex, e.g. high performance Talbot-Laue interferometers operated at synchrotron light sources. In-line phase-contrast imaging states the most pedestrian approach towards phase-contrast enhancement. Utilizing small angle deflection within the imaged sample and the entailed interference of the deflected and un-deflected beam during spatial propagation, in-line phase-contrast imaging only requires a well collimated X-ray source with a high contrast & high resolution detector. Employing high magnification the above conditions are intrinsically fulfilled in cone-beam micro-tomography. As opposed of 2D imaging, where contrast enhancement is generally considered beneficial, in tomographic modalities the in-line phase-contrast effect can be quite a nuisance since it renders the inverse problem posed by tomographic reconstruction inconsistent, thus causing reconstruction artifacts. We present an experimentally enhanced model-based approach to disentangle absorption and in-line phase-contrast. The approach employs comparison of transmission data to a system model computed iteratively on-line. By comparison of the forward model to absorption data acquired in continuous rotation strong local deviations of the data residual are successively identified as likely candidates for in-line phase-contrast. By inducing minimal vibrations (few mrad) to the sample around the peaks of such deviations the transmission signal can be decomposed into a constant absorptive fraction and an oscillating signal caused by phase-contrast which again allows to generate separate maps for absorption and phase-contrast. The contributions of phase-contrast and the corresponding artifacts are subsequently removed from the tomographic dataset. In principle, if a 3D handling of the sample is available, this method also allows to track discontinuities throughout the volume and therefore states a powerful tool in 3D defectoscopy.

Modeling Bi-modality Improves Characterization of Cell Cycle on Gene Expression in Single Cells

PubMed Central

Danaher, Patrick; Finak, Greg; Krouse, Michael; Wang, Alice; Webster, Philippa; Beechem, Joseph; Gottardo, Raphael

2014-01-01

Advances in high-throughput, single cell gene expression are allowing interrogation of cell heterogeneity. However, there is concern that the cell cycle phase of a cell might bias characterizations of gene expression at the single-cell level. We assess the effect of cell cycle phase on gene expression in single cells by measuring 333 genes in 930 cells across three phases and three cell lines. We determine each cell's phase non-invasively without chemical arrest and use it as a covariate in tests of differential expression. We observe bi-modal gene expression, a previously-described phenomenon, wherein the expression of otherwise abundant genes is either strongly positive, or undetectable within individual cells. This bi-modality is likely both biologically and technically driven. Irrespective of its source, we show that it should be modeled to draw accurate inferences from single cell expression experiments. To this end, we propose a semi-continuous modeling framework based on the generalized linear model, and use it to characterize genes with consistent cell cycle effects across three cell lines. Our new computational framework improves the detection of previously characterized cell-cycle genes compared to approaches that do not account for the bi-modality of single-cell data. We use our semi-continuous modelling framework to estimate single cell gene co-expression networks. These networks suggest that in addition to having phase-dependent shifts in expression (when averaged over many cells), some, but not all, canonical cell cycle genes tend to be co-expressed in groups in single cells. We estimate the amount of single cell expression variability attributable to the cell cycle. We find that the cell cycle explains only 5%–17% of expression variability, suggesting that the cell cycle will not tend to be a large nuisance factor in analysis of the single cell transcriptome. PMID:25032992

Diagnosis and management of pancreaticopleural fistula.

PubMed

Tay, Clifton Ming; Chang, Stephen Kin Yong

2013-04-01

Pancreaticopleural fistula is a rare diagnosis requiring a high index of clinical suspicion due to the predominant manifestation of thoracic symptoms. The current literature suggests that confirmation of elevated pleural fluid amylase is the most important diagnostic test. Magnetic resonance cholangiopancreatography is the recommended imaging modality to visualise the fistula, as it is superior to both computed tomography and endoscopic retrograde cholangiopancreatography (ERCP) in delineating the tract within the pancreatic region. It is also less invasive than ERCP. While a trial of medical regimen has traditionally been the first-line treatment, failure would result in higher rates of complications. Hence, it is suggested that management strategies be planned based on pancreatic ductal imaging, with patients having poor chances of spontaneous closure undergoing either endoscopic or surgical intervention. We also briefly describe a case of pancreaticopleural fistula in a patient who was treated using a modified Puestow procedure after failed endoscopic treatment.

The devil is in the details: an analysis of the subtleties between phosphodiesterase inhibitors for erectile dysfunction.

PubMed

Smith-Harrison, L I; Patel, Abhishek; Smith, Ryan P

2016-04-01

Erectile dysfunction (ED) is a common sexual disorder with numerous etiologies involving multiple organ systems that leads to significant distress and decreased quality of life for the affected men. Fortunately, there are several modalities and interventions for treating ED. Oral medications, intra-urethral compounds, intracorporeal injections, vacuum-assist devices and surgically implanted prostheses are all part of the treatment algorithm. One of the first-lines and certainly the most widely used options for treating ED is the family of oral phosphodiesterase type 5 inhibitors (PDE5I). The introduction of these medications in the late 1990s revolutionized the field of sexual medicine. Currently there are no guidelines and minimal literature to help providers choose among drugs in this class. This review will address differences in efficacy and side effects between various members of the oral selective phosphodiesterase-5 inhibitor class of drugs.

[A case report: anomaly of the fourth branchial pouch with recurring cervical abscesses. Cauterization with trichloroacetic acid closed the fistula opening and cured the patient].

PubMed

Stenquist, Monika; Juhlin, Claes; Aström, Gunnar; Friberg, Ulla

2003-04-24

A fourth branchial pouch sinus is a rare congenital anomaly, which in a 13-year-old girl presented clinically as recurrent deep cervical abscesses. The location of the majority of these anomalies is the left side of the neck (90%). Radiological and endoscopic investigations verified the diagnosis. The internal orifice located at the apex of the pyriform sinus could facilitate contamination by infectious pharyngeal secretions and lead to abscess recurrence. Traditionally, the recommended treatment is radical surgery. It can, however, be technically difficult to excise the whole fistula tract. In this patient we used a non-invasive treatment modality; chemocauterization with 40% trichloroacetic acid (TCA). After three treatments the fistula was closed. To date (month no. 15) there has been no abscess recurrence. TCA chemocauterization seems to be a safe first-line treatment for patients with pyriform sinus fistulas.

Nelson Syndrome: Update on Therapeutic Approaches.

PubMed

Azad, Tej D; Veeravagu, Anand; Kumar, Sunny; Katznelson, Laurence

2015-06-01

To review the pathophysiology and therapeutic modalities availble for Nelson syndrome. We reviewed the current literature including managment for Nelson syndrome. For patients with NS, surgical intervention is often the first-line therapy. With refractory NS or tumors with extrasellar involvement, radiosurgery offers an important alternative or adjuvant option. Pharmacologic interventions have demonstrated limited usefulness, although recent evidence supports the feasibility of a novel somatostatin analog for patients with NS. Modern neuroimaging, improved surgical techniques, and the advent of stereotactic radiotherapy have transformed the management of NS. An up-to-date understanding of the pathophysiology underlying Nelson Syndrome and evidence-based management is imperative. Early detection may allow for more successful therapy in patients with Nelson Syndrome. Improved radiotherapeutic interventions and rapidly evolving pharmacologic therapies offer an opportunity to create targeted, multifocal treatment regiments for patients with Nelson Syndrome. Copyright © 2015 Elsevier Inc. All rights reserved.

[Severe iatrogenic airway obstruction due to lingual lymphangioma].

PubMed

Segado Arenas, A; Flores González, J-C; Rubio Quiñones, F; Quintero Otero, S; Hernández González, A; Pantoja Rosso, S

2011-09-01

Lymphangioma of the tongue is a rare and benign tumour involving congenital and cystic abnormalities derived from lymphatic vessels. Treatment modalities include surgery and a large number of different intralesional injections of sclerosing agents. Presently, OK-432 (Picibanil(®)) is the preferred sclerosant and when administered intralesionally will result in inflammation, sclerosis, and cicatricial contraction of the lesion. We report a case of microcystic lymphangioma of the tongue in a 5-year-old boy treated with an intralesional injection of OK-432. In the immediate postoperative period, the patient suffered severe diffuse swelling, progressive upper airway obstruction with inspiratory stridor, and respiratory distress requiring emergency fiberoptic nasotracheal intubation. Although OK-432 injections are found to be safe and effective as a first line of treatment for lymphangiomas, local swelling with potentially life-threatening airway compromise should be anticipated, especially when treating lesions near the upper airway. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Sonography of pediatric superficial lumps and bumps: illustrative examples from head to toe.

PubMed

Bansal, Anmol Gupta; Rosenberg, Henrietta Kotlus

2017-08-01

Superficial lumps and bumps are extremely common in children, and the vast majority ultimately prove to be benign. Duplex/color Doppler ultrasound (US) has emerged as the first-line imaging modality for the evaluation of these superficial pediatric masses because it provides a means for rapid acquisition of information including size, shape, location, internal content and vascularity. More important, it does so without utilizing radiation, iodinated contrast material or sedation/anesthesia. In this review, we present the sonographic findings of a variety of cases ranging from head to toe that are either uncommonly seen or were diagnosed in an atypical fashion (i.e. ultrasound). In situations where the lesion is too deep, hyperechoic or large to be fully assessed within the field of view or if malignancy is suspected, then additional cross-sectional imaging is warranted for further evaluation.

Steady state, relaxation and first-passage properties of a run-and-tumble particle in one-dimension

NASA Astrophysics Data System (ADS)

Malakar, Kanaya; Jemseena, V.; Kundu, Anupam; Vijay Kumar, K.; Sabhapandit, Sanjib; Majumdar, Satya N.; Redner, S.; Dhar, Abhishek

2018-04-01

We investigate the motion of a run-and-tumble particle (RTP) in one dimension. We find the exact probability distribution of the particle with and without diffusion on the infinite line, as well as in a finite interval. In the infinite domain, this probability distribution approaches a Gaussian form in the long-time limit, as in the case of a regular Brownian particle. At intermediate times, this distribution exhibits unexpected multi-modal forms. In a finite domain, the probability distribution reaches a steady-state form with peaks at the boundaries, in contrast to a Brownian particle. We also study the relaxation to the steady-state analytically. Finally we compute the survival probability of the RTP in a semi-infinite domain with an absorbing boundary condition at the origin. In the finite interval, we compute the exit probability and the associated exit times. We provide numerical verification of our analytical results.

Skin infections in pregnancy.

PubMed

Müllegger, Robert R; Häring, Nina S; Glatz, Martin

2016-01-01

A wide array of infectious diseases can occur in pregnancy. Their acquisition, clinical presentation, and course during gestation may be altered due to an impairment of the maternal cellular immunity. Some infectious diseases can lead to serious consequences for the mother or the offspring, including congenital malformations. This review describes in detail the clinical presentation, course, management, and associated maternal and fetal risks of selected viral (varicella-zoster virus infections, condylomata acuminata), fungal (candida vulvovaginitis), bacterial (Lyme borreliosis), and parasitic (scabies) infections. The treatment options are critically reviewed. First-line therapies include acyclovir and varicella-zoster virus immunoglobulin for varicella-zoster virus infections, surgical modalities for genital warts, topical clotrimazole and oral fluconazole for Candida vulvovaginitis, amoxicillin and cefuroxime for Lyme borreliosis, and permethrin for scabies. A synopsis of maternal and fetal risks of other important infections is also included. Copyright © 2016 Elsevier Inc. All rights reserved.

Maintenance therapy with toceranib following doxorubicin-based chemotherapy for canine splenic hemangiosarcoma.

PubMed

Gardner, Heather L; London, Cheryl A; Portela, Roberta A; Nguyen, Sandra; Rosenberg, Mona P; Klein, Mary K; Clifford, Craig; Thamm, Douglas H; Vail, David M; Bergman, Phil; Crawford-Jakubiak, Martin; Henry, Carolyn; Locke, Jennifer; Garrett, Laura D

2015-06-11

Spenic hemangiosarcoma (HSA) in dogs treated with surgery alone is associated with short survival times, and the addition of doxorubicin (DOX) chemotherapy only modestly improves outcome. The purpose of this study was to evaluate the impact of toceranib administration on progression free survival in dogs with stage I or II HSA following splenectomy and single agent DOX chemotherapy. We hypothesized that dogs with splenic HSA treated with adjuvant DOX followed by toceranib would have prolonged disease-free interval (DFI) and overall survival time (OS) when compared to historical dogs treated with DOX-based chemotherapy alone. Dogs with stage I or II splenic HSA were administered 5 cycles of single-agent DOX every 2 weeks beginning within 14 days of splenectomy. Dogs were restaged 2 weeks after completing DOX, and those without evidence of metastatic disease began toceranib therapy at 3.25 mg/kg every other day. Forty-three dogs were enrolled in this clinical trial. Seven dogs had evidence of metastatic disease either before or at re-staging, and an additional 3 dogs were found to have metastatic disease within 1 week of toceranib administration. Therefore 31 dogs went on to receive toceranib following completion of doxorubicin treatment. Twenty-five dogs that received toceranib developed metastatic disease. The median disease free interval for all dogs enrolled in this study (n = 43) was 138 days, and the median disease free interval for those dogs that went on to receive toceranib (n = 31) was 161 days. The median survival time for all dogs enrolled in this study was 169 days, and the median survival time for those dogs that went on to receive toceranib was 172 days. The use of toceranib following DOX chemotherapy does not improve either disease free interval or overall survival in dogs with stage I or II HSA.

Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer.

PubMed

Epstein, Andrew S; Prigerson, Holly G; O'Reilly, Eileen M; Maciejewski, Paul K

2016-07-10

Accurate illness understanding enables patients to make informed decisions. Evidence of the influence of prognostic discussions on the accuracy of illness understanding by patients would demonstrate the value of discussions. Recent and past oncology provider-patient discussions about prognosis/life expectancy were examined for their association with changes in illness understanding by patients. Patients (N = 178) with advanced cancers refractory to prior chemotherapy whom oncologists expected to die within 6 months were interviewed before and after a visit in which cancer restaging scan results were discussed. Illness understanding scores were the sum of four indicator variables: patient terminal illness acknowledgment, recognition of incurable disease status, knowledge of the advanced stage of the disease, and expectation to live months as opposed to years. Before the restaging scan visit, nine (5%) of 178 patients had completely accurate illness understanding (ie, correctly answered each of the four illness understanding questions). Eighteen patients (10%) reported only recent discussions of prognosis/life expectancy with their oncologists; 68 (38%) reported only past discussions; 24 (13%) reported both recent and past discussions; and 68 (38%) reported that they never had discussions of prognosis/life expectancy with their oncologists. After adjustment for potential confounders (ie, education and race/ethnicity), analysis identified significant, positive changes in illness understanding scores for patients in groups that reported recent only (least-squares mean change score, 0.62; 95% CI, 0.23 to 1.01; P = .002) and both recent and past (least-squares mean change score, 0.37; 95% CI, 0.04 to 0.70; P = 0.028) discussions of prognosis/life expectancy with their oncologists. Patients with advanced cancer who report recent discussions of prognosis/life expectancy with their oncologists come to have a better understanding of the terminal nature of their illnesses. © 2016 by American Society of Clinical Oncology.

Discussions of Life Expectancy and Changes in Illness Understanding in Patients With Advanced Cancer

PubMed Central

Epstein, Andrew S.; O’Reilly, Eileen M.; Maciejewski, Paul K.

2016-01-01

Purpose Accurate illness understanding enables patients to make informed decisions. Evidence of the influence of prognostic discussions on the accuracy of illness understanding by patients would demonstrate the value of discussions. Methods Recent and past oncology provider-patient discussions about prognosis/life expectancy were examined for their association with changes in illness understanding by patients. Patients (N = 178) with advanced cancers refractory to prior chemotherapy whom oncologists expected to die within 6 months were interviewed before and after a visit in which cancer restaging scan results were discussed. Illness understanding scores were the sum of four indicator variables: patient terminal illness acknowledgment, recognition of incurable disease status, knowledge of the advanced stage of the disease, and expectation to live months as opposed to years. Results Before the restaging scan visit, nine (5%) of 178 patients had completely accurate illness understanding (ie, correctly answered each of the four illness understanding questions). Eighteen patients (10%) reported only recent discussions of prognosis/life expectancy with their oncologists; 68 (38%) reported only past discussions; 24 (13%) reported both recent and past discussions; and 68 (38%) reported that they never had discussions of prognosis/life expectancy with their oncologists. After adjustment for potential confounders (ie, education and race/ethnicity), analysis identified significant, positive changes in illness understanding scores for patients in groups that reported recent only (least-squares mean change score, 0.62; 95% CI, 0.23 to 1.01; P = .002) and both recent and past (least-squares mean change score, 0.37; 95% CI, 0.04 to 0.70; P = 0.028) discussions of prognosis/life expectancy with their oncologists. Conclusion Patients with advanced cancer who report recent discussions of prognosis/life expectancy with their oncologists come to have a better understanding of the terminal nature of their illnesses. PMID:27217454

Induction chemotherapy in metastatic neuroblastoma--does dose influence response? A critical review of published data standards, options and recommendations (SOR) project of the National Federation of French Cancer Centres (FNCLCC).

PubMed

Pinkerton, C R; Blanc Vincent, M P; Bergeron, C; Fervers, B; Philip, T

2000-09-01

The purpose of this study was to determine, from a review of published data, whether in stage 4 neuroblastoma in children over 1 year of age, the dose or scheduling of induction chemotherapy influenced the response rate in distant metastases. Publications relating to induction chemotherapy since the introduction of cisplatin/epipodophyllotoxin combinations were identified using Medline, Current Contents and personal reference lists. Thirteen publications were identified which described 17 regimens involving 948 children. The doses and the scheduling of the various regimens were compared with a standard regimen OPEC (vincristine, cisplatin, teniposide, cyclophosphamide). These were correlated with the reported response rates in the bone marrow. Due to a lack of standardisation in the nature of restaging investigations, timing of restaging and definitions of response it was difficult to compare all studies. The complete response rate at distant metastases ranged from less than 40% to over 90%. For individual drugs; the comparative doses given in each course ranged up to 4.2 g/m(2) for cyclophosphamide, 280 mg/m(2) for cisplatin, 600 mg/m(2) for etoposide and 4.5 mg/m(2) for vincristine. There was no evidence of any positive correlation between response rate in the marrow and either the dose of any individual drug or the schedule used. In contrast to a previous study which included a number of older studies where disease assessment was even more variable, this analysis has failed to show any justification for the routine use of very intensive induction regimens in this disease. Such an approach should only be taken in the context of randomised trials in which timing and methods of reassessment can be standardised. Until such studies demonstrate superiority either in terms of response rate or progression-free survival lower morbidity regimens should remain the standard therapy.

Molecular Nodal Staging Using miRNA Expression in Lung Cancer Patients by Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration.

PubMed

Inage, Terunaga; Nakajima, Takahiro; Itoga, Sakae; Ishige, Takayuki; Fujiwara, Taiki; Sakairi, Yuichi; Wada, Hironobu; Suzuki, Hidemi; Iwata, Takekazu; Chiyo, Masako; Yoshida, Shigetoshi; Matsushita, Kazuyuki; Yasufuku, Kazuhiro; Yoshino, Ichiro

2018-06-13

The limited negative predictive value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has often been discussed. The aim of this study was to identify a highly sensitive molecular biomarker for lymph node staging by EBUS-TBNA. Five microRNAs (miRNAs) (miR-200a, miR-200b, miR-200c, miR-141, and let-7e) were selected as biomarker candidates for the detection of nodal metastasis in a miRNA expression analysis. After having established a cutoff level of expression for each marker to differentiate malignant from benign lymph nodes among surgically dissected lymph nodes, the cutoff level was applied to snap-frozen EBUS-TBNA samples. Archived formalin-fixed paraffin- embedded (FFPE) samples rebiopsied by EBUS-TBNA after induction chemoradiotherapy were also analyzed. The expression of all candidate miRNAs was significantly higher in metastatic lymph nodes than in benign ones (p < 0.05) among the surgical samples. miR-200c showed the highest diagnostic yield, with a sensitivity of 95.4% and a specificity of 100%. When the cutoff value for miR-200c was applied to the snap-frozen EBUS-TBNA samples, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 97.4, 81.8, 95.0, 90.0, and 94.0%, respectively. For restaging FFPE EBUS- TBNA samples, the sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy were 100, 60.0, 80.0, 100, and 84.6%, respectively. Among the restaged samples, 4 malignant lymph nodes were false negative by EBUS-TBNA, but they were accurately identified by miR-200c. miR-200c can be used as a highly sensitive molecular staging biomarker that will enhance nodal staging of lung cancer. © 2018 S. Karger AG, Basel.

Survey of eye practitioners' preference of diagnostic tests and treatment modalities for dry eye in Ghana.

PubMed

Asiedu, Kofi; Kyei, Samuel; Ayobi, Benedict; Agyemang, Frank Okyere; Ablordeppey, Reynolds Kwame

2016-12-01

This study sought to provide an evidence-based profile of the diagnosis, treatment and knowledge or opinions on dry eye among optometrists and ophthalmologists in Ghana. This was a cross-sectional survey RESULTS: The responses of 162 participants are included in the analysis. The most commonly used test to diagnosed dry eye disease was tear break-up time followed by patient history. The most common symptom doctors heard from dry eye patients were burning sensation followed by foreign body sensation. The most often prescribed first- line treatment for dry eye was aqueous-based artificial tears followed by lipid-based artificial tears. Most practitioners considered meibomian gland dysfunction as the most common cause of dry eye followed by pterygium. The most often used test to guide or gauge therapeutic effect is patient history followed closely by tear break-up time. Most practitioners reported that 10%-20% of all their patients they see in a day are diagnosed of dry eye. This study showed tear break up time was the main test majority of practitioners in Ghana used to diagnose dry eye but patient history was the main test used to gauge therapeutic effect over time. Burning sensation was the commonest symptom practitioners heard from dry eye patients whilst artificial tears was their main and first-line treatment for dry eye. Copyright © 2016 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Korean Medication Algorithm for Depressive Disorders 2017: Third Revision

PubMed Central

Seo, Jeong Seok; Wang, Hee Ryung; Woo, Young Sup; Park, Young-Min; Jeong, Jong-Hyun; Kim, Won; Shim, Se-Hoon; Lee, Jung Goo; Jon, Duk-In

2018-01-01

Objective In 2002, the Korean Society for Affective Disorders developed the guidelines for the treatment of major depressive disorder (MDD), and revised it in 2006 and 2012. The third revision of these guidelines was undertaken to reflect advances in the field. Methods Using a 44-item questionnaire, an expert consensus was obtained on pharmacological treatment strategies for MDD 1) without or 2) with psychotic features, 3) depression subtypes, 4) maintenance, 5) special populations, 6) the choice of an antidepressant (AD) regarding safety and adverse effects, and 7) non-pharmacological biological therapies. Recommended first, second, and third-line strategies were derived statistically. Results AD monotherapy is recommended as the first-line strategy for non-psychotic depression in adults, children/adolescents, elderly adults, patient with persistent depressive disorder, and pregnant women or patients with postpartum depression or premenstrual dysphoric disorder. The combination of AD and atypical antipsychotics (AAP) was recommended for psychotic depression in adult, child/adolescent, postpartum depression, and mixed features or anxious distress. Most experts recommended stopping the ongoing initial AD and AAP after a certain period in patients with one or two depressive episodes. As an MDD treatment modality, 92% of experts are considering electroconvulsive therapy and 46.8% are applying it clinically, while 86% of experts are considering repetitive transcranial magnetic stimulation but only 31.6% are applying it clinically. Conclusion The pharmacological treatment strategy in 2017 is similar to that of Korean Medication Algorithm for Depressive Disorder 2012. The preference of AAPs was more increased. PMID:29397669

Expert Consensus Survey on Medication Adherence in Psychiatric Patients and Use of a Digital Medicine System.

PubMed

Hatch, Ainslie; Docherty, John P; Carpenter, Daniel; Ross, Ruth; Weiden, Peter J

2017-07-01

There is an unmet need to objectively assess adherence problems that are a common cause of unexplained or unexpected suboptimal outcome. A digital medicine system (DMS) has been developed to address this need in patients with serious mental illness. To conduct a quantitative expert consensus survey to (1) assess relative importance of causes of suboptimal outcomes, (2) examine modalities used to assess adherence, (3) provide guidance on when and how to use the DMS in clinical practice once available, and (4) suggest interventions for specific reasons for nonadherence. A panel of 58 experts in psychiatry completed a 23-question survey (October 13 through December 23, 2013) and rated their responses on a 9-point Likert scale. A χ² test of score distributions was used to determine consensus (P < .05). The panel rated adherence as the most important factor in suboptimal outcomes and yet the least likely to be assessed accurately. All predefined uses of the DMS received high mean first-line ratings (≥ 7.4). The experts recognized the utility of the DMS in managing adherence problems, identified clinical situations appropriate for DMS, and assessed potential benefits and challenges of this technology. Consensus was reached on first-line interventions for 10 of 11 reasons for nonadherence. The results provide a guide to clinicians on the evaluation of suboptimal outcomes, when and how to use the DMS, and the most appropriate interventions to address detected adherence problems. © Copyright 2017 Physicians Postgraduate Press, Inc.

The management of lower gastrointestinal bleeding.

PubMed

Marion, Y; Lebreton, G; Le Pennec, V; Hourna, E; Viennot, S; Alves, A

2014-06-01

Lower gastrointestinal (LGI) bleeding is generally less severe than upper gastrointestinal (UGI) bleeding with spontaneous cessation of bleeding in 80% of cases and a mortality of 2-4%. However, unlike UGI bleeding, there is no consensual agreement about management. Once the patient has been stabilized, the main objective and greatest difficulty is to identify the location of bleeding in order to provide specific appropriate treatment. While upper endoscopy and colonoscopy remain the essential first-line examinations, the development and availability of angiography have made this an important imaging modality for cases of active bleeding; they allow diagnostic localization of bleeding and guide subsequent therapy, whether therapeutic embolization, interventional colonoscopy or, if other techniques fail or are unavailable, surgery directed at the precise site of bleeding. Furthermore, newly developed endoscopic techniques, particularly video capsule enteroscopy, now allow minimally invasive exploration of the small intestine; if this is positive, it will guide subsequent assisted enteroscopy or surgery. Other small bowel imaging techniques include enteroclysis by CT or magnetic resonance imaging. At the present time, exploratory surgery is no longer a first-line approach. In view of the lesser gravity of LGI bleeding, it is most reasonable to simply stabilize the patient initially for subsequent transfer to a specialized center, if minimally invasive techniques are not available at the local hospital. In all cases, the complexity and diversity of LGI bleeding require a multidisciplinary collaboration involving the gastroenterologist, radiologist, intensivist and surgeon to optimize diagnosis and treatment of the patient. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Behold the voice of wrath: cross-modal modulation of visual attention by anger prosody.

PubMed

Brosch, Tobias; Grandjean, Didier; Sander, David; Scherer, Klaus R

2008-03-01

Emotionally relevant stimuli are prioritized in human information processing. It has repeatedly been shown that selective spatial attention is modulated by the emotional content of a stimulus. Until now, studies investigating this phenomenon have only examined within-modality effects, most frequently using pictures of emotional stimuli to modulate visual attention. In this study, we used simultaneously presented utterances with emotional and neutral prosody as cues for a visually presented target in a cross-modal dot probe task. Response times towards targets were faster when they appeared at the location of the source of the emotional prosody. Our results show for the first time a cross-modal attentional modulation of visual attention by auditory affective prosody.

WE-B-210-02: The Advent of Ultrafast Imaging in Biomedical Ultrasound

DOE Office of Scientific and Technical Information (OSTI.GOV)

Tanter, M.

In the last fifteen years, the introduction of plane or diverging wave transmissions rather than line by line scanning focused beams has broken the conventional barriers of ultrasound imaging. By using such large field of view transmissions, the frame rate reaches the theoretical limit of physics dictated by the ultrasound speed and an ultrasonic map can be provided typically in tens of micro-seconds (several thousands of frames per second). Interestingly, this leap in frame rate is not only a technological breakthrough but it permits the advent of completely new ultrasound imaging modes, including shear wave elastography, electromechanical wave imaging, ultrafastmore » doppler, ultrafast contrast imaging, and even functional ultrasound imaging of brain activity (fUltrasound) introducing Ultrasound as an emerging full-fledged neuroimaging modality. At ultrafast frame rates, it becomes possible to track in real time the transient vibrations – known as shear waves – propagating through organs. Such “human body seismology” provides quantitative maps of local tissue stiffness whose added value for diagnosis has been recently demonstrated in many fields of radiology (breast, prostate and liver cancer, cardiovascular imaging, …). Today, Supersonic Imagine company is commercializing the first clinical ultrafast ultrasound scanner, Aixplorer with real time Shear Wave Elastography. This is the first example of an ultrafast Ultrasound approach surpassing the research phase and now widely spread in the clinical medical ultrasound community with an installed base of more than 1000 Aixplorer systems in 54 countries worldwide. For blood flow imaging, ultrafast Doppler permits high-precision characterization of complex vascular and cardiac flows. It also gives ultrasound the ability to detect very subtle blood flow in very small vessels. In the brain, such ultrasensitive Doppler paves the way for fUltrasound (functional ultrasound imaging) of brain activity with unprecedented spatial and temporal resolution compared to fMRI. Combined with contrast agents, our group demonstrated that Ultrafast Ultrasound Localization could provide a first in vivo and non invasive imaging modality at microscopic scales deep into organs. Many of these ultrafast modes should lead to major improvements in ultrasound screening, diagnosis, and therapeutic monitoring. Learning Objectives: Achieve familiarity with recent advances in ultrafast ultrasound imaging technology. Develop an understanding of potential applications of ultrafast ultrasound imaging for diagnosis and therapeutic monitoring. Dr. Tanter is a co-founder of Supersonic Imagine,a French company positioned in the field of medical ultrasound imaging and therapy.« less

Sight and sound converge to form modality-invariant representations in temporo-parietal cortex

PubMed Central

Man, Kingson; Kaplan, Jonas T.; Damasio, Antonio; Meyer, Kaspar

2013-01-01

People can identify objects in the environment with remarkable accuracy, irrespective of the sensory modality they use to perceive them. This suggests that information from different sensory channels converges somewhere in the brain to form modality-invariant representations, i.e., representations that reflect an object independently of the modality through which it has been apprehended. In this functional magnetic resonance imaging study of human subjects, we first identified brain areas that responded to both visual and auditory stimuli and then used crossmodal multivariate pattern analysis to evaluate the neural representations in these regions for content-specificity (i.e., do different objects evoke different representations?) and modality-invariance (i.e., do the sight and the sound of the same object evoke a similar representation?). While several areas became activated in response to both auditory and visual stimulation, only the neural patterns recorded in a region around the posterior part of the superior temporal sulcus displayed both content-specificity and modality-invariance. This region thus appears to play an important role in our ability to recognize objects in our surroundings through multiple sensory channels and to process them at a supra-modal (i.e., conceptual) level. PMID:23175818

Rectal Tumour Staging with Endorectal Ultrasound: Is There Any Difference between Western and Eastern European Countries?

PubMed

Fábián, Anna; Bor, Renáta; Farkas, Klaudia; Bálint, Anita; Milassin, Ágnes; Rutka, Mariann; Tiszlavicz, László; Wittmann, Tibor; Nagy, Ferenc; Molnár, Tamás; Szepes, Zoltán

2016-01-01

Background. Rectal tumour management depends highly on locoregional extension. Rectal endoscopic ultrasound (ERUS) is a good alternative to computed tomography and magnetic resonance imaging. However, in Hungary only a small amount of rectal tumours is examined with ERUS. Methods. Our retrospective study (2006-2012) evaluates the diagnostic accuracy of ERUS and compares the results, the first data from Central Europe, with those from Western Europe. The effect of neoadjuvant therapy, rectal probe type, and investigator's experience were also assessed. Results. 311 of the 647 ERUS assessed locoregional extension. Histological comparison was available in 177 cases: 67 patients underwent surgery alone; 110 received neoadjuvant chemoradiotherapy (CRT); ERUS preceded CRT in 77 and followed it in 33 patients. T-staging was accurate in 72% of primarily operated patients. N-staging was less accurate (62%). CRT impaired staging accuracy (64% and 59% for T- and N-staging). Rigid probes were more accurate (79%). At least 30 examinations are needed to master the technique. Conclusions. The sensitivity of ERUS complies with the literature. ERUS is easy to learn and more accurate in early stages but unnecessary for restaging after CRT. Staging accuracy is similar in Western and Central Europe, although the number of examinations should be increased.

Experiential Education, Outdoor Adventure As a Modality in Residential Treatment. A Survey of Programs, Principles, Research and Practice.

ERIC Educational Resources Information Center

Duindam, Ton

Orthopedagogisch Centrum (OC) Michiel is a multifunctional regional institution in the Netherlands that serves troubled families and youth at risk. Outdoor programs are used as a treatment modality for adolescents with behavior disorders, drug addictions, or criminal records. Outward Bound was the first experiential outdoor program in the…

Effects of Modality on the Neural Correlates of Encoding Processes Supporting Recollection and Familiarity

ERIC Educational Resources Information Center

Gottlieb, Lauren J.; Rugg, Michael D.

2011-01-01

Prior research has demonstrated that the neural correlates of successful encoding ("subsequent memory effects") partially overlap with neural regions selectively engaged by the on-line demands of the study task. The primary goal of the present experiment was to determine whether this overlap is associated solely with encoding processes supporting…

Activating Basic Category Exemplars in Sentence Contexts: A Dynamical Account

ERIC Educational Resources Information Center

Raczaszek-Leonardi, Joanna; Shapiro, Lewis P.; Tuller, Betty; Kelso, J. A. Scott

2008-01-01

This paper examines the influence of context on the processing of category names embedded in sentences. The investigation focuses on the nature of information available immediately after such a word is heard as well as on the dynamics of adaptation to context. An on-line method (Cross Modal Lexical Priming) was used to trace how this process…

EIT in resonator chains: similarities and differences with atomic media

NASA Technical Reports Server (NTRS)

Matsko, A. B.; Maleki, L.; Savchenkov, A. A.; Ilchenko, V. S.

2004-01-01

We theoretically study a parallel configuration of two interacting whispering gallery mode optical resonators and show a narrow-band modal structure as a basis for a widely tunable delay line. For the optimum coupling configuration the system can possess an unusually narrow spectral feature with a much narrower bandwidth than the loaded bandwidth of each individual resonator.

Math Snacks: Using Animations and Games to Fill the Gaps in Mathematics

ERIC Educational Resources Information Center

Valdiz, Alfred; Trujillo, Karen; Wiburg, Karin

2013-01-01

Math Snacks animations and support materials were developed for use on the web and mobile technologies to teach ratio, proportion, scale factor, and number line concepts using a multi-modal approach. Included in Math Snacks are: Animations which promote the visualization of a concept image; written lessons which provide cognitive complexity for…

Experience with a talker can transfer across modalities to facilitate lipreading.

PubMed

Sanchez, Kauyumari; Dias, James W; Rosenblum, Lawrence D

2013-10-01

Rosenblum, Miller, and Sanchez (Psychological Science, 18, 392-396, 2007) found that subjects first trained to lip-read a particular talker were then better able to perceive the auditory speech of that same talker, as compared with that of a novel talker. This suggests that the talker experience a perceiver gains in one sensory modality can be transferred to another modality to make that speech easier to perceive. An experiment was conducted to examine whether this cross-sensory transfer of talker experience could occur (1) from auditory to lip-read speech, (2) with subjects not screened for adequate lipreading skill, (3) when both a familiar and an unfamiliar talker are presented during lipreading, and (4) for both old (presentation set) and new words. Subjects were first asked to identify a set of words from a talker. They were then asked to perform a lipreading task from two faces, one of which was of the same talker they heard in the first phase of the experiment. Results revealed that subjects who lip-read from the same talker they had heard performed better than those who lip-read a different talker, regardless of whether the words were old or new. These results add further evidence that learning of amodal talker information can facilitate speech perception across modalities and also suggest that this information is not restricted to previously heard words.

Cold atmospheric plasma, a novel promising anti-cancer treatment modality.

PubMed

Yan, Dayun; Sherman, Jonathan H; Keidar, Michael

2017-02-28

Over the past decade, cold atmospheric plasma (CAP), a near room temperature ionized gas has shown its promising application in cancer therapy. Two CAP devices, namely dielectric barrier discharge and plasma jet, show significantly anti-cancer capacity over dozens of cancer cell lines in vitro and several subcutaneous xenograft tumors in vivo. In contrast to conventional anti-cancer approaches and drugs, CAP is a selective anti-cancer treatment modality. Thus far establishing the chemical and molecular mechanism of the anti-cancer capacity of CAP is far from complete. In this review, we provide a comprehensive introduction of the basics of CAP, state of the art research in this field, the primary challenges, and future directions to cancer biologists.

Night-time sedating H1-antihistamine increases daytime somnolence but not treatment efficacy in chronic spontaneous urticaria: a randomized controlled trial

PubMed Central

Staevska, M; Gugutkova, M; Lazarova, C; Kralimarkova, T; Dimitrov, V; Zuberbier, T; Church, MK; Popov, TA

2014-01-01

Background Many physicians believe that the most effective way to treat chronic urticaria is to take a nonsedating second-generation H1-antihistamine in the morning and a sedating first-generation H1-antihistamine, usually hydroxyzine, at night to enhance sleep. But is this belief well founded? Objectives To test this belief by comparing the effectiveness and prevalence of unwanted sedative effects when treating patients with chronic spontaneous urticaria (CSU) with levocetirizine 15 mg daily plus hydroxyzine 50 mg at night (levocetirizine plus hydroxyzine) vs. levocetirizine 20 mg daily (levocetirizine monotherapy). Methods In this randomized, double-blind, cross-over study, 24 patients with difficult-to-treat CSU took levocetirizine plus hydroxyzine or levocetirizine monotherapy for periods of 5 days each. At the end of each treatment period, assessments were made of quality of life (Chronic Urticaria Quality of Life Questionnaire, CU-Q2oL), severity of urticaria symptoms (Urticaria Activity Score, UAS), sleep disturbance during the night and daytime somnolence. Results Both treatments significantly decreased UAS, night-time sleep disturbances and CU-Q2oL scores (P < 0·001) without significant differences between the two. Compared with baseline, daytime somnolence was significantly reduced by levocetirizine monotherapy (P = 0·006) but not by levocetirizine plus hydroxyzine (P = 0·218). Direct comparison of the two treatment modalities in terms of daytime somnolence favoured levocetirizine monotherapy (P = 0·026). Conclusions The widespread belief that sleep is aided by the addition of a sedating first-generation H1-antihistamine, usually hydroxyzine, at night is not supported. These results are in line with the urticaria guidelines, which state that first-line treatment for urticaria should be new-generation, nonsedating H1-antihistamines only. PMID:24472058

Novel Integral Equation Methods Applied to the Analysis of New Guiding and Radiating Structures and Optically-Inspired Phenomena at Microwaves

NASA Astrophysics Data System (ADS)

Gomez-Diaz, Juan Sebastian

This PhD. dissertation presents a multidisciplinary work, which involves the development of different novel formulations applied to the accurate and efficient analysis of a wide variety of new structures, devices, and phenomena at themicrowave frequency region. The objectives of the present work can be divided into three main research lines: (1) The first research line is devoted to the Green's function analysis of multilayered enclosures with convex arbitrarily-shaped cross section. For this purpose, three accurate spatial-domain formulations are developed at the Green's functions level. These techniques are then efficiently incorporated into a mixed-potential integral equation framework, which allows the fast and accurate analysis of multilayered printed circuits in shielded enclosures. The study of multilayered shielded circuits has lead to the development of the novel hybridwaveguide-microstrip filter technology, which is light, compact, low-loss and presents important advantages for the space industry. (2) The second research line is related to the impulse-regime study ofmetamaterial-based composite right/left-handed (CRLH) structures and the subsequent theoretical and practical demonstration of several novel optically-inspired phenomena and applications at microwaves, in both, the guided and the radiative region. This study allows the development of new devices for ultra wide band and high data-rate communications systems. Besides, this research line also deals with the simple and accurate characterization of CRLH leaky-wave antennas using transmission line theory. (3) The third and last research line presents a novel CRLH parallel-plate waveguide leaky-wave antenna structure, and a rigorous iterative modal-based technique for its fast and complete characterization, including a systematic calculation of the antenna physical dimensions. It is important to point out that all the theoretical developments and novel structures presented in thiswork have been numerically confirmed, by the use of both, home-made software and commercial full-wave simulations, and experimentally verified, by the use of measurements from fabricated prototypes.

[Breastfeeding prevalence during the first year of life in Aragon. CALINA study].

PubMed

Cuadrón Andrés, L; Samper Villagrasa, M P; Álvarez Sauras, M L; Lasarte Velillas, J J; Rodríguez Martínez, G

2013-11-01

To study the current prevalence of breastfeeding (BF) in Aragon (Spain) during the first 12 months of life, and analyse its demographic, perinatal and social influential factors. Obstetric, perinatal and feeding aspects were evaluated in a longitudinal and observational study, in a representative cohort of infant population from Aragon born between March 2009 to March 2010, controlled until 12 months of age (N=1.602). Exclusive or predominant BF was more frequent than the rest of feeding modalities during the first 4 months of life. Maintenance prevalence of any BF modality was 82.5% at 1(st) month of age, 71.8% at 3(rd), 54.3% at 6(th), and 27.8% at 12 months of age. Maternal variables that were significantly associated with BF maintenance both at 1 and 6 months of age were: delivery modality (higher probability in case of vaginal delivery), academic level (higher probability if university studies), origin (higher probability in mothers from Africa), adiposity (higher probability of normal weight or overweight mothers compared with obese ones), and not to smoke during gestation. BF prevalence in Aragon (Spain) during the first 12 months of age is high and has increased compared with previous data. BF continues in more than half of infants at six months and in a quarter of infants at 12 months of age. Maternal factors that significantly influence BF initiation and maintenance are, delivery modality, academic level, origin (immigration), adiposity and smoking habit. Copyright © 2013 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

CADx Mammography

NASA Astrophysics Data System (ADS)

Costaridou, Lena

Although a wide variety of Computer-Aided Diagnosis (CADx) schemes have been proposed across breast imaging modalities, and especially in mammography, research is still ongoing to meet the high performance CADx requirements. In this chapter, methodological contributions to CADx in mammography and adjunct breast imaging modalities are reviewed, as they play a major role in early detection, diagnosis and clinical management of breast cancer. At first, basic terms and definitions are provided. Then, emphasis is given to lesion content derivation, both anatomical and functional, considering only quantitative image features of micro-calcification clusters and masses across modalities. Additionally, two CADx application examples are provided. The first example investigates the effect of segmentation accuracy on micro-calcification cluster morphology derivation in X-ray mammography. The second one demonstrates the efficiency of texture analysis in quantification of enhancement kinetics, related to vascular heterogeneity, for mass classification in dynamic contrast-enhanced magnetic resonance imaging.

The Initial Indian Experience with Cytoreductive Surgery and HIPEC in the Treatment of Peritoneal Metastases.

PubMed

Bhatt, Aditi; Mehta, Sanket; Seshadri, Ramakrishnan Ayloor; Sethna, Kayomarz; Zaveri, Shabber; Rajan, Firoz; Mahajan, Vikas; Singh, Shivendra; Raj, E Hemanth; Sugarbaker, Paul H

2016-06-01

Worldwide, cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has been used for nearly 3 decades to treat peritoneal metastases (PM), improve quality of life, and prolong survival substantially in selected patients. In India, the use of the combined modality of treatment dates back a decade with majority of the efforts taking place within the last 5 years. The first PSOGI workshop (India) held in April 2015, at Bangalore, India offered an opportunity for Indian surgeons performing CRS and HIPEC to share their experience. To study the methodologies of CRS and HIPEC (hospital set up, equipment, training and surgical background) as well as the outcomes in terms of perioperative morbidity and mortality and short and long term survival of patients treated in India, Indian surgeons who had treated at least 10 patients with this combined modality were invited to present their experience. Data collection was retrospective. Analysis of the pooled data was carried out. Eight surgeons treated 384 patients with CRS and HIPEC over a period of 10 years. The commonest primary sites were ovary (as first line therapy n = 124), followed by appendix, including pseudomyxoma peritonei (n = 99), colorectum (n = 77), recurrent ovary (as second line therapy, n = 33), stomach (n = 15), primary peritoneal cancer (n = 10), peritoneal mesothelioma (n = 9) and rare tumors in 17 patients. The weighted mean PCI for all 384 patients was 18.25. 349/384 patients (90.88 %) had a complete cytoreduction (completeness of cytoreduction score of CC-0/1). Grade 3-5 complications developed in 108 patients (27.34 %) and 30 day mortality occurred in 28 (7.29 %) patients. This study showed that CRS and HIPEC can be performed with an acceptable morbidity and mortality in Indian patients. Most of the surgeons are on the learning curve and further improvement in these outcomes is expected over a period of time. Pooling of data related to both common and rare peritoneal cancers would be useful in knowing the disease behavior, response to treatment and outcomes in Indian patients. The 2015 PSOGI meeting provided a unique platform for data presentation with feedback from international experts in the field of peritoneal surface oncology. Future meetings are planned to expand the evaluation of Indian data and progress.

What Is the Optimal Target Convective Volume in On-Line Hemodiafiltration Therapy?

PubMed

Canaud, Bernard; Koehler, Katrin; Bowry, Sudhir; Stuard, Stefano

2017-01-01

Conventional diffusion-based dialysis modalities including high-flux hemodialysis are limited in their capacity to effectively remove large uremic toxins and to improve outcomes for end-stage chronic kidney disease (ESKD) patients. By increasing convective solute transport, hemodiafiltration (HDF) enhances solute removal capacity over a broad range of middle- and large-size uremic toxins implicated in the pathophysiology of chronic kidney disease. Furthermore, by offering flexible convection volume, on-line HDF permits customizing the treatment dose to the patient's needs. In addition, convective-based modalities have been shown to improve hemodynamic stability and to reduce patients' inflammation profile - both of which are implicated in CKD morbidity and mortality. Growing clinical evidence indicates that HDF-based modalities provide ESKD patients with a number of clinical and biological benefits, including improved outcomes. Interestingly, it has recently emerged that the clinical benefits associated with HDF are positively associated with the total ultrafiltered volume per session (and per week), namely convective dose. In this chapter, we revisit the concept of convective dose and discuss the threshold value above which an improvement in ESKD patient outcome can be expected. This particular point will be addressed by stratifying the level of efficacy of convective volumes, schematically defined as minimal, optimal, personalized, and maximal. In addition, factors and best clinical practices implicated in the achievement of an optimal convective dose are reviewed. To conclude, we show how HDF differs from standard hemodialysis and why HDF offers a paradigm shift in renal replacement therapy. © 2017 S. Karger AG, Basel.

Importance of Interaction between Integrin and Actin Cytoskeleton in Suspension Adaptation of CHO cells.

PubMed

Walther, Christa G; Whitfield, Robert; James, David C

2016-04-01

The biopharmaceutical production process relies upon mammalian cell technology where single cells proliferate in suspension in a chemically defined synthetic environment. This environment lacks exogenous growth factors, usually contributing to proliferation of fibroblastic cell types such as Chinese hamster ovary (CHO) cells. Use of CHO cells for production hence requires a lengthy 'adaptation' process to select clones capable of proliferation as single cells in suspension. The underlying molecular changes permitting proliferation in suspension are not known. Comparison of the non-suspension-adapted clone CHO-AD and a suspension-adapted propriety cell line CHO-SA by flow cytometric analysis revealed a highly variable bi-modal expression pattern for cell-to-cell contact proteins in contrast to the expression pattern seen for integrins. Those have a uni-modal expression on suspension and adherent cells. Integrins showed a conformation distinguished by regularly distributed clusters forming a sphere on the cell membrane of suspension-adapted cells. Actin cytoskeleton analysis revealed reorganisation from the typical fibrillar morphology found in adherent cells to an enforced spherical subcortical actin sheath in suspension cells. The uni-modal expression and specific clustering of integrins could be confirmed for CHO-S, another suspension cell line. Cytochalasin D treatment resulted in breakdown of the actin sheath and the sphere-like integrin conformation demonstrating the link between integrins and actin in suspension-adapted CHO cells. The data demonstrates the importance of signalling changes, leading to an integrin rearrangement on the cell surface, and the necessity of the reinforcement of the actin cytoskeleton for proliferation in suspension conditions.

The Psychohistory of Child Maltreatment Among Antebellum Slaveholders.

PubMed

Adams, Kenneth Alan

2016-01-01

Examining the inner workings of the slaveholder family, including slave caretakers, this article probes the psychodynamics of slaveholder development to assess the extent of child abuse in the Old South. Childcare was haphazard and premised on paternal absence, maternal ambivalence, and the exigencies of slave surrogacy. Corporal punishment, sanctified by southern religion, was the rule. The likelihood of slave negligence and retaliatory attacks against slaveholder children are addressed. Childrearing practices such as swaddling, aunt adoption, and maternal incest are considered, as well as the possible usage of a West African cleansing ritual. The article classifies planter families within the Ambivalent Mode of parent-child relations and suggests the restaging of childhood trauma as the underlying dynamic in the march to civil war.

Management of epithelial ovarian cancer from diagnosis to restaging: an overview of the role of imaging techniques with particular regard to the contribution of 18F-FDG PET/CT.

PubMed

Musto, Alessandra; Grassetto, Gaia; Marzola, Maria Cristina; Rampin, Lucia; Chondrogiannis, Sotirios; Maffione, Anna Margherita; Colletti, Patrick M; Perkins, Alan C; Fagioli, Giorgio; Rubello, Domenico

2014-06-01

Epithelial ovarian carcinoma is a major form of cancer affecting women in the western world. The silent nature of this disease results in late presentation at an advanced stage in many patients. It is therefore important to assess the role of imaging techniques in the management of these patients. This article presents a review of the literature on the role of (18)F-FDG-PET/CT in the different stages of management of epithelial ovarian cancer. Moreover, a comparison with other imaging techniques has been made and the relationship between (18)F-PET/CT and the assay of serum CA-125 levels has been discussed.

Staging and follow-up of lacrimal gland carcinomas by 18F-FDG PET/CT imaging.

PubMed

Tafti, Bashir Akhavan; Shaba, Wisam; Li, Yuxin; Yevdayev, Ella; Berenji, Gholam Reza

2012-10-01

A 74-year-old man with right eye proptosis, diplopia, and orbital discomfort for 3 to 4 months underwent biopsy, the specimen of which showed transitional cell carcinoma of the lacrimal gland. 18F-FDG PET/CT was also performed for staging purposes. Six months after orbital exenteration, a follow-up CT scan demonstrated soft tissue thickening along the nasal bridge but could not differentiate between postsurgical changes and cancer recurrence. A concurrent PET/CT scan did not show any evidence of abnormal metabolic activity, further emphasizing the higher accuracy of PET/CT in staging and restaging of head and neck cancers. An annual follow-up scan was still negative for active disease.

Detection of figure and caption pairs based on disorder measurements

NASA Astrophysics Data System (ADS)

Faure, Claudie; Vincent, Nicole

2010-01-01

Figures inserted in documents mediate a kind of information for which the visual modality is more appropriate than the text. A complete understanding of a figure often necessitates the reading of its caption or to establish a relationship with the main text using a numbered figure identifier which is replicated in the caption and in the main text. A figure and its caption are closely related; they constitute single multimodal components (FC-pair) that Document Image Analysis cannot extract with text and graphics segmentation. We propose a method to go further than the graphics and text segmentation in order to extract FC-pairs without performing a full labelling of the page components. Horizontal and vertical text lines are detected in the pages. The graphics are associated with selected text lines to initiate the detector of FC-pairs. Spatial and visual disorders are introduced to define a layout model in terms of properties. It enables to cope with most of the numerous spatial arrangements of graphics and text lines. The detector of FC-pairs performs operations in order to eliminate the layout disorder and assigns a quality value to each FC-pair. The processed documents were collected in medic@, the digital historical collection of the BIUM (Bibliothèque InterUniversitaire Médicale). A first set of 98 pages constitutes the design set. Then 298 pages were collected to evaluate the system. The performances are the result of a full process, from the binarisation of the digital images to the detection of FC-pairs.

Final Technical Report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Rasure, John, et. al.

Through past DOE funding, the MIND Research network has funded a national consortium effort that used multi-modal neuroimaging, genetics, and clinical assessment of subjects to study schizophrenia in both first episode and persistently ill patients. Although active recruitment of research participants is complete, this consortium remains active and productive in terms of analysis of this unique multi-modal data collected on over 320 subjects.

Visual and Spoken Texts in MCALL Courseware: The Effects of Text Modalities on the Vocabulary Retention of EFL Learners

ERIC Educational Resources Information Center

Sabet, Masoud Khalili; Shalmani, Hamed Babaie

2010-01-01

The present study sought to explore the effects of Multimedia Computer-Assisted Language Learning (MCALL) programs drawing on two different text modalities on the vocabulary retention of Iranian EFL learners. The two groups under study received treatment on vocabulary items under two multimedia conditions: The first group received treatment on the…

Determination of orthotropic material properties by modal analysis

NASA Astrophysics Data System (ADS)

Lai, Junpeng

The methodology for determination of orthotropic material properties in plane stress condition will be presented. It is applied to orthotropic laminated plates like printed wiring boards. The first part of the thesis will focus on theories and methodologies. The static beam model and vibratory plate model is presented. The methods are validated by operating a series of test on aluminum. In the static tests, deflection and two directions of strain are measured, thus four of the properties will be identified: Ex, Ey, nuxy, nuyx. Moving on to dynamic test, the first ten modes' resonance frequencies are obtained. The technique of modal analysis is adopted. The measured data is processed by FFT and analyzed by curve fitting to extract natural frequencies and mode shapes. With the last material property to be determined, a finite element method using ANSYS is applied. Along with the identified material properties in static tests, and proper initial guess of the unknown shear modulus, an iterative process creates finite element model and conducts modal analysis with the updating model. When the modal analysis result produced by ANSYS matches the natural frequencies acquired by dynamic test, the process will halt. Then we obtained the last material property in plane stress condition.

Damage location and quantification of a pretensioned concrete beam using stochastic subspace identification

NASA Astrophysics Data System (ADS)

Cancelli, Alessandro; Micheli, Laura; Laflamme, Simon; Alipour, Alice; Sritharan, Sri; Ubertini, Filippo

2017-04-01

Stochastic subspace identification (SSID) is a first-order linear system identification technique enabling modal analysis through the time domain. Research in the field of structural health monitoring has demonstrated that SSID can be used to successfully retrieve modal properties, including modal damping ratios, using output-only measurements. In this paper, the utilization of SSID for indirectly retrieving structures' stiffness matrix was investigated, through the study of a simply supported reinforced concrete beam subjected to dynamic loads. Hence, by introducing a physical model of the structure, a second-order identification method is achieved. The reconstruction is based on system condensation methods, which enables calculation of reduced order stiffness, damping, and mass matrices for the structural system. The methods compute the reduced order matrices directly from the modal properties, obtained through the use of SSID. Lastly, the reduced properties of the system are used to reconstruct the stiffness matrix of the beam. The proposed approach is first verified through numerical simulations and then validated using experimental data obtained from a full-scale reinforced concrete beam that experienced progressive damage. Results show that the SSID technique can be used to diagnose, locate, and quantify damage through the reconstruction of the stiffness matrix.

Reading behind the Lines: The Factors Affecting the Text Reception Threshold in Hearing Aid Users

ERIC Educational Resources Information Center

Zekveld, Adriana A.; Pronk, Marieke; Danielsson, Henrik; Rönnberg, Jerker

2018-01-01

Purpose: The visual Text Reception Threshold (TRT) test (Zekveld et al., 2007) has been designed to assess modality-general factors relevant for speech perception in noise. In the last decade, the test has been adopted in audiology labs worldwide. The 1st aim of this study was to examine which factors best predict interindividual differences in…

Sinistrals' Upper Hand: Evidence for Handedness Differences in the Representation of Body Space

ERIC Educational Resources Information Center

Hach, Sylvia; Schutz-Bosbach, Simone

2010-01-01

A difference in the perception of extrapersonal space has been shown to exist between dextrals and sinistrals. On the classical line bisection task, this difference is evident in a greater left bias for dextrals compared to sinistrals. Different modalities and regions of space can be affected. However, it has not yet been investigated whether a…

ACSPRI 2014 4th International Social Science Methodology Conference Report

DTIC Science & Technology

2015-04-01

Validity, trustworthiness and rigour: quality and the idea of qualitative research . Journal of Advanced Nursing, 304-310. Spencer, L., Ritchie, J...increasing data quality; the Total Survey Error framework; multi-modal on-line surveying, quality frameworks for assessing qualitative research ; and...provided an overview of the current perspectives on causal claims in qualitative research . Three approaches to generating plausible causal

Technology Enhanced Teaching and Learning: A Study That Examines How Three Diverse Universities Are Influencing Change

ERIC Educational Resources Information Center

McCready, Peggy A.

2013-01-01

Recent trends toward on-line learning and open education suggest that the role of technology will only become more prominent in higher education. As a result, faculty members will increasingly be expected to infuse more technology in face-to-face courses, while teaching in multiple course delivery modalities. Senior administrators and technology…

Delivering and Evaluating On-Line Degree Programs in Culinary Arts/Management: A Survey of Educators and Industry Practitioners

ERIC Educational Resources Information Center

Ryll, Stefan

2017-01-01

This quantitative research examines the perceptions of culinary arts/management educators and culinary industry practitioners on the future of online culinary arts education. Specifically pertaining to the recommended procedures by educators and chefs to judge and critique the quality of food products in terms sensory modalities, and what the key…

The lost hope of elimination of Kala-azar (visceral leishmaniasis) by 2010 and cyclic occurrence of its outbreak in India, blame falls on vector control practices or co-infection with human immunodeficiency virus or therapeutic modalities?

PubMed

Muniaraj, Mayilsamy

2014-01-01

The Kala-azar/visceral leishmaniasis (VL) turns epidemic form once in every 15 years in the endemic regions of Indian subcontinent. The goal of elimination of Kala-azar from India by 2010 was lost despite paramount efforts taken by the Government of India and World Health Organization and Regional Office for South East Asia. The main objective of this review was to elucidate the possible reason for the failure of Kala-azar elimination program and to suggest possible remedial measures to achieve the goal in future. The annual numbers of VL cases and deaths recorded in India since 1977 were plotted on a graph, to see if the temporal trends could be associated with changes in the vector control practices or co-infection with human immunodeficiency virus (HIV) or therapeutic modalities used against VL. The VL cases flares up whenever the effect of dichlorodiphenyltrichloroethane (DDT) diminished after the withdrawal of spray. The fading effectiveness was clearly correlated with an increasing number of VL cases. Therapeutic modalities were found to be highly correlating with VL mortality not with VL morbidity. The diminishing efficacy of first and second line drugs and the introduction of new drugs and drugs combination were responsible for ups and downs in the VL mortality. The VL mortality is constantly declining since 1993, but cases started increasing from 2003 to 2007 and then recently again from 2010 to 2011. This shows a serious lacuna in the vector control practices applied. The extent of HIV co-infection did not show any correlation with number/trend of VL cases or death over the study period. It is concluded that, by strict vector control practices, the VL cases can be reduced and by applying proper therapeutic strategies, the VL mortality can be reduced. HIV-VL co-infection does not seem to be in a worried stage.

Primary Gastrointestinal Lymphoma

PubMed Central

Chen, Yinting; Chen, Yanzhu; Chen, Shaojie; Wu, Lili; Xu, Lishu; Lian, Guoda; Yang, Kege; Li, Yaqing; Zeng, Linjuan; Huang, Kaihong

2015-01-01

Abstract Primary gastrointestinal lymphoma (PGIL) is a rare malignant tumor without standard diagnosis and treatment methods. This study is aimed to systematically analyze its clinical characteristics and draw out an appropriate flow chart of diagnosis and treatment process for PGIL in China. This study retrospectively analyzed the clinicopathological characteristics, diagnostic approaches, prognostic factors, and therapeutic modalities in 415 cases of PGIL in Chinese province of Guangdong. A systematic review was conducted in 118 studies containing 5075 patients to further identify clinical manifestations and mortalities of therapeutic modalities. The most common clinical presentations were abdominal pain and bloody stools. Endoscopic biopsy was an important diagnostic means, and usually more than once to make a definite diagnosis. Retrospective multicenter clinical study showed that younger onset age (<60 years), female, one region involved, one lesion, early stage, International Prognostic Index (IPI ≤1), normal lactate dehydrogenase (LDH), normal albumin, and nonemergency operation were significant prognostic factors for B-cell lymphoma; non-B symptom, tumor restricted to gastric or ileocecal region, one lesion, performance status (PS ≤1), normal LDH, and nonsurgery alone were significant prognostic factors for T-cell lymphoma. Site of origin and IPI were independent prognostic factors for B-cell lymphoma; PS was the independent prognostic factor for T-cell lymphoma. And T-cell lymphoma had worse overall survival (OS) and progression-free survival (PFS) than B-cell lymphoma. Among different therapeutic modalities, chemotherapy alone or combined with surgery showed better OS and PFS than surgery alone for diffuse large B-cell lymphoma (DLBCL) of stage I/II E and T-cell lymphoma. For DLBCL of stage III E/IV and mucosa-associated lymphoid tissue lymphoma, OS and PFS did not differ among different therapeutic groups. In meta-analysis, surgery plus chemotherapy showed lowest mortality. Chemotherapy alone or combined with surgery may be the first-line treatment for DLBCL of stage I/II E and T-cell lymphoma. A flow chart of diagnosis and treatment process for PGIL was approximately drew out. PMID:26632732

Complex mode indication function and its applications to spatial domain parameter estimation

NASA Astrophysics Data System (ADS)

Shih, C. Y.; Tsuei, Y. G.; Allemang, R. J.; Brown, D. L.

1988-10-01

This paper introduces the concept of the Complex Mode Indication Function (CMIF) and its application in spatial domain parameter estimation. The concept of CMIF is developed by performing singular value decomposition (SVD) of the Frequency Response Function (FRF) matrix at each spectral line. The CMIF is defined as the eigenvalues, which are the square of the singular values, solved from the normal matrix formed from the FRF matrix, [ H( jω)] H[ H( jω)], at each spectral line. The CMIF appears to be a simple and efficient method for identifying the modes of the complex system. The CMIF identifies modes by showing the physical magnitude of each mode and the damped natural frequency for each root. Since multiple reference data is applied in CMIF, repeated roots can be detected. The CMIF also gives global modal parameters, such as damped natural frequencies, mode shapes and modal participation vectors. Since CMIF works in the spatial domain, uneven frequency spacing data such as data from spatial sine testing can be used. A second-stage procedure for accurate damped natural frequency and damping estimation as well as mode shape scaling is also discussed in this paper.

Is the future the right time?

PubMed

Ouellet, Marc; Santiago, Julio; Israeli, Ziv; Gabay, Shai

2010-01-01

Spanish and English speakers tend to conceptualize time as running from left to right along a mental line. Previous research suggests that this representational strategy arises from the participants' exposure to a left-to-right writing system. However, direct evidence supporting this assertion suffers from several limitations and relies only on the visual modality. This study subjected to a direct test the reading hypothesis using an auditory task. Participants from two groups (Spanish and Hebrew) differing in the directionality of their orthographic system had to discriminate temporal reference (past or future) of verbs and adverbs (referring to either past or future) auditorily presented to either the left or right ear by pressing a left or a right key. Spanish participants were faster responding to past words with the left hand and to future words with the right hand, whereas Hebrew participants showed the opposite pattern. Our results demonstrate that the left-right mapping of time is not restricted to the visual modality and that the direction of reading accounts for the preferred directionality of the mental time line. These results are discussed in the context of a possible mechanism underlying the effects of reading direction on highly abstract conceptual representations.

Dual Nuclear/Fluorescence Imaging Potantial of Zinc(II) Phthalocyanine in MIA PaCa-2 Cell Line.

PubMed

Lambrecht, Fatma Yurt; Ince, Mine; Er, Ozge; Ocakoglu, Kasim; Sarı, Fatma Aslıhan; Kayabasi, Cagla; Gunduz, Cumhur

2016-01-01

Pancreatic cancer is very common and difficult to diagnose in early stage. Imaging systems for diagnosing cancer have many disadvantages. However, combining different imaging modalities offers synergistic advantages. Optical imaging is the most multidirectional and widely used imaging modality in both clinical practice and research. In present study, Zinc(II) phthalocyanine [Zn(II)Pc] was synthesized, labeled with iodine- 131 and in vitro study was carried out. The intracellular uptake studies of radiolabeled Zn(II)Pc were performed in WI-38 [ATCC CCL-75™, tissue: human fibroblast lung] and MIA PaCa-2 [ATCC CRL-1420™, tissue: human epithelial pancreas carcinoma] cell lines. The intracellular uptake efficiency of radiolabeled Zn(II)Pc in MIA PaCa-2 cells was determined two times higher than WI-38 cells. Also, fluorescence imaging (FI) efficiency of synthesized Zn(II)Pc was investigated in MIA PaCa-2 cells and significant uptake was observed. Zn(II)Pc might be used as a new agent for dual fluorescence/nuclear imaging for pancreatic cancer. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

Review of Designs for Haptic Data Visualization.

PubMed

Paneels, Sabrina; Roberts, Jonathan C

2010-01-01

There are many different uses for haptics, such as training medical practitioners, teleoperation, or navigation of virtual environments. This review focuses on haptic methods that display data. The hypothesis is that haptic devices can be used to present information, and consequently, the user gains quantitative, qualitative, or holistic knowledge about the presented data. Not only is this useful for users who are blind or partially sighted (who can feel line graphs, for instance), but also the haptic modality can be used alongside other modalities, to increase the amount of variables being presented, or to duplicate some variables to reinforce the presentation. Over the last 20 years, a significant amount of research has been done in haptic data presentation; e.g., researchers have developed force feedback line graphs, bar charts, and other forms of haptic representations. However, previous research is published in different conferences and journals, with different application emphases. This paper gathers and collates these various designs to provide a comprehensive review of designs for haptic data visualization. The designs are classified by their representation: Charts, Maps, Signs, Networks, Diagrams, Images, and Tables. This review provides a comprehensive reference for researchers and learners, and highlights areas for further research.

Combination Treatment of Glioblastoma by Low-Dose Radiation and Genistein.

PubMed

Atefeh, Zamanian; Vahid, Changizi; Hasan, Nedaie; Saeed, Amanpour; Mahnaz, Haddadi

2016-01-01

Gioblastoma multiforme as a chemoresistant and radioresistant malignant cell line needs to novel strategies to treatment. Low-dose hyper-radiosensitivity (LDHRS) seems to be an effective phenomenon to irradiation that can save normal brain fibroblasts. Genistein which is a soy isoflavone can be cytotoxic in some tumor cell lines. So we determined to study the effect of combining these two treatment modalities. After 30 hours incubation with Genistein in different concentrations on U87MG cell line, proliferation and clonogenicity were conducted by both clonogenic and MTT assays. A conventional 2Gy radiation dose was compared with 10 doses of 0.2Gy gamma irradiation with 3 minutes and 1 hour intervals. Finally, concurrent effect of these modalities was assessed. Based on acquired cell doubling time (30 hours), one doubling time treatment by Genistein could decrease clonogenicity. U87MG cell line exhibited HRS at low dose irradiations. 2Gy irradiation was more effective than ultra-fractionation methods in comparison with control group. All groups with 50uM concentration of Genistein showed decrease in the survival. This decrease compared with control group, in 10x0.2Gy with 3 minutes intervals plus 50uM Genistein was significant and for groups with the same dose of Genistein but along with continuous 2Gy was more significant. In one day treatment regimen, 10x0.2Gy ultra-fractionation with 3 minutes and 1 hour intervals seems to be less effective than conventional 2Gy irradiation, however adding 50uM Genistein can decrease survival more. Although 2Gy conventional dose plus 50uM Genistein was the most effective regimen. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

On using the Hilbert transform for blind identification of complex modes: A practical approach

NASA Astrophysics Data System (ADS)

Antunes, Jose; Debut, Vincent; Piteau, Pilippe; Delaune, Xavier; Borsoi, Laurent

2018-01-01

The modal identification of dynamical systems under operational conditions, when subjected to wide-band unmeasured excitations, is today a viable alternative to more traditional modal identification approaches based on processing sets of measured FRFs or impulse responses. Among current techniques for performing operational modal identification, the so-called blind identification methods are the subject of considerable investigation. In particular, the SOBI (Second-Order Blind Identification) method was found to be quite efficient. SOBI was originally developed for systems with normal modes. To address systems with complex modes, various extension approaches have been proposed, in particular: (a) Using a first-order state-space formulation for the system dynamics; (b) Building complex analytic signals from the measured responses using the Hilbert transform. In this paper we further explore the latter option, which is conceptually interesting while preserving the model order and size. Focus is on applicability of the SOBI technique for extracting the modal responses from analytic signals built from a set of vibratory responses. The novelty of this work is to propose a straightforward computational procedure for obtaining the complex cross-correlation response matrix to be used for the modal identification procedure. After clarifying subtle aspects of the general theoretical framework, we demonstrate that the correlation matrix of the analytic responses can be computed through a Hilbert transform of the real correlation matrix, so that the actual time-domain responses are no longer required for modal identification purposes. The numerical validation of the proposed technique is presented based on time-domain simulations of a conceptual physical multi-modal system, designed to display modes ranging from normal to highly complex, while keeping modal damping low and nearly independent of the modal complexity, and which can prove very interesting in test bench applications. Numerical results for complex modal identifications are presented, and the quality of the identified modal matrix and modal responses, extracted using the complex SOBI technique and implementing the proposed formulation, is assessed.

[Biological behavior of hypopharyngeal carcinoma].

PubMed

Zhou, L X

1997-01-01

Hypopharyngeal squamous cell carcinomas (HPC) has an extremely poor prognosis. Characteristics of cell lines of head and neck squamous cell carcinomas including HPC were studied by various methods, e.g., chemosensitivity test and the immunohistochemistry staining method, to determine whether this poor prognosis is due to the biological behavior of this cancer. An HPC cell line was found to be resistant to anti tumor drugs, i.e., PEP, MTX and CPM and moderately sensitive to CDDP, 5-FU and ADM. Thermoresistance to hyperthermatic treatment and weak expression of ICAM-1 on the HPC cell line were observed. DNA synthesis by the HPC cell line was induced by stimulation with a low concentration of EGF and the amount of EGFR on these HPC cells was very high. In addition, cyclinD1 overexpression was found in the HPC cell line. Based on the above findings, further analysis of hypopharyngeal carcinoma cells and the development of a new treatment modality to control tumor growth and metastatic factors influencing the poor outcome are necessary to improve the prognosis of this cancer.

Rotorcraft Blade Mode Damping Identification from Random Responses Using a Recursive Maximum Likelihood Algorithm

NASA Technical Reports Server (NTRS)

Molusis, J. A.

1982-01-01

An on line technique is presented for the identification of rotor blade modal damping and frequency from rotorcraft random response test data. The identification technique is based upon a recursive maximum likelihood (RML) algorithm, which is demonstrated to have excellent convergence characteristics in the presence of random measurement noise and random excitation. The RML technique requires virtually no user interaction, provides accurate confidence bands on the parameter estimates, and can be used for continuous monitoring of modal damping during wind tunnel or flight testing. Results are presented from simulation random response data which quantify the identified parameter convergence behavior for various levels of random excitation. The data length required for acceptable parameter accuracy is shown to depend upon the amplitude of random response and the modal damping level. Random response amplitudes of 1.25 degrees to .05 degrees are investigated. The RML technique is applied to hingeless rotor test data. The inplane lag regressing mode is identified at different rotor speeds. The identification from the test data is compared with the simulation results and with other available estimates of frequency and damping.

A quantitative study to design an experimental setup for photoacoustic imaging.

PubMed

Marion, Adrien; Boutet, Jérôme; Debourdeau, Mathieu; Dinten, Jean-Marc; Vray, Didier

2011-01-01

During the last decade, a new modality called photoacoustic imaging has emerged. The increasing interest for this new modality is due to the fact that it combines advantages of ultrasound and optical imaging, i.e. the high contrast due to optical absorption and the low acoustic attenuation in biological tissues. It is thus possible to study vascularization because blood has high optical absorption coefficient. Papers in the literature often focus on applications and rarely discuss quantitative parameters. The goal of this paper is to provide quantitative elements to design an acquisition setup. By defining the targeted resolution and penetration depth, it is then possible to evaluate which kind of excitation and reception systems have to be used. First, we recall theoretical background related to photoacoustic effect before to describe the experiments based on a nanosecond laser at 1064 nm and 2.25-5 MHz transducers. Second, we present results about the relation linking fluence laser to signal amplitude and axial and lateral resolutions of our acquisition setup. We verify the linear relation between fluence and amplitude before to estimate axial resolution at 550 μm for a 2.25 MHz ultrasonic transducer. Concerning lateral resolution, we show that a reconstruction technique based on curvilinear acquisition of 30 lines improves it by a factor of 3 compared to a lateral displacement. Future works will include improvement of lateral resolution using probes, like in ultrasound imaging, instead of single-element transducers.

Discovery of ammocrypta clara (western sand darter) in the Upper Ohio River of West Virginia

USGS Publications Warehouse

Cincotta, Dan A.; Welsh, Stuart A.

2010-01-01

Ammocrypta clara Jordan and Meek (western sand darter) occurs primarily in the western portions of Mississippi River system, but also has been reported from a Lake Michigan drainage and a few eastern Texas Gulf Slope rivers. Additional range records depict a semi-disjunct distribution within the Ohio River drainage, including collections from Wabash River in Indiana, the Cumberland, Green, Kentucky and Big Sandy rivers of Kentucky, and the upper Tennessee River in Tennessee and Virginia. This paper documents the occurrence of A. clara from the upper Ohio River drainage within the lower Elk River, West Virginia, based on collections from 1986, 1991, 1995, 2005 and 2006. The Elk River population, consistent with those of other Ohio River drainages, has slightly higher counts for numbers of dorsal-fin rays, scales below lateral line and lateral line scales when compared to data from populations outside of the Ohio River drainage. Modal counts of meristic characters are similar among populations, except for higher modal counts of lateral line scales in the Ohio River population. The discovery of the Elk River population extends the range distribution of A. clara in the Eastern Highlands region, documents wide distributional overlap and additional sympatry with its sister species,A. pellucida (eastern sand darter), and softens support for an east-west Central Highlands vicariance hypothesis for the present distribution of A. clara and A. pellucida.

On the V-Line Radon Transform and Its Imaging Applications

PubMed Central

Morvidone, M.; Nguyen, M. K.; Truong, T. T.; Zaidi, H.

2010-01-01

Radon transforms defined on smooth curves are well known and extensively studied in the literature. In this paper, we consider a Radon transform defined on a discontinuous curve formed by a pair of half-lines forming the vertical letter V. If the classical two-dimensional Radon transform has served as a work horse for tomographic transmission and/or emission imaging, we show that this V-line Radon transform is the backbone of scattered radiation imaging in two dimensions. We establish its analytic inverse formula as well as a corresponding filtered back projection reconstruction procedure. These theoretical results allow the reconstruction of two-dimensional images from Compton scattered radiation collected on a one-dimensional collimated camera. We illustrate the working principles of this imaging modality by presenting numerical simulation results. PMID:20706545

Do Different Modalities of Reflection Matter? An Exploration of Adult Second-Language Learners' Reported Strategy Use and Oral Language Production

ERIC Educational Resources Information Center

Huang, Li-Shih

2010-01-01

This paper reports on a small-scale study that was the first to explore raising second-language (L2) learners' awareness of speaking strategies as mediated by three modalities of task-specific reflection--individual written reflection, individual spoken reflection, and group spoken reflection. Though research in such areas as L2 writing, teacher's…

The Association between Peritoneal Dialysis Modality and Peritonitis

PubMed Central

Johnson, David W.; McDonald, Stephen P.; Boudville, Neil; Borlace, Monique; Badve, Sunil V.; Sud, Kamal; Clayton, Philip A.

2014-01-01

Background and objectives There is conflicting evidence comparing peritonitis rates among patients treated with continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). This study aims to clarify the relationship between peritoneal dialysis (PD) modality (APD versus CAPD) and the risk of developing PD-associated peritonitis. Design, setting, participants, & measurements This study examined the association between PD modality (APD versus CAPD) and the risks, microbiology, and clinical outcomes of PD-associated peritonitis in 6959 incident Australian PD patients between October 1, 2003, and December 31, 2011, using data from the Australia and New Zealand Dialysis and Transplant Registry. Median follow-up time was 1.9 years. Results Patients receiving APD were younger (60 versus 64 years) and had fewer comorbidities. There was no association between PD modality and time to first peritonitis episode (adjusted hazard ratio [HR] for APD versus CAPD, 0.98; 95% confidence interval [95% CI], 0.91 to 1.07; P=0.71). However, there was a lower hazard of developing Gram-positive peritonitis with APD than CAPD, which reached borderline significance (HR, 0.90; 95% CI, 0.80 to 1.00; P=0.05). No statistically significant difference was found in the risk of hospitalizations (odds ratio, 1.12; 95% CI, 0.93 to 1.35; P=0.22), but there was a nonsignificant higher likelihood of 30-day mortality (odds ratio, 1.33; 95% CI, 0.93 to 1.88; P=0.11) at the time of the first episode of peritonitis for patients receiving APD. For all peritonitis episodes (including subsequent episodes of peritonitis), APD was associated with lower rates of culture-negative peritonitis (incidence rate ratio [IRR], 0.81; 95% CI, 0.69 to 0.94; P=0.002) and higher rates of gram-negative peritonitis (IRR, 1.28; 95% CI, 1.13 to 1.46; P=0.01). Conclusions PD modality was not associated with a higher likelihood of developing peritonitis. However, APD was associated with a borderline reduction in the likelihood of a first episode of Gram-positive peritonitis compared with CAPD, and with lower rates of culture-negative peritonitis and higher rates of Gram-negative peritonitis. Peritonitis outcomes were comparable between both modalities. PMID:24626434

Hybrid-modality high-resolution imaging: for diagnostic biomedical imaging and sensing for disease diagnosis

NASA Astrophysics Data System (ADS)

Murukeshan, Vadakke M.; Hoong Ta, Lim

2014-11-01

Medical diagnostics in the recent past has seen the challenging trend to come up with dual and multi-modality imaging for implementing better diagnostic procedures. The changes in tissues in the early disease stages are often subtle and can occur beneath the tissue surface. In most of these cases, conventional types of medical imaging using optics may not be able to detect these changes easily due to its penetration depth of the orders of 1 mm. Each imaging modality has its own advantages and limitations, and the use of a single modality is not suitable for every diagnostic applications. Therefore the need for multi or hybrid-modality imaging arises. Combining more than one imaging modalities overcomes the limitation of individual imaging method and integrates the respective advantages into a single setting. In this context, this paper will be focusing on the research and development of two multi-modality imaging platforms. The first platform combines ultrasound and photoacoustic imaging for diagnostic applications in the eye. The second platform consists of optical hyperspectral and photoacoustic imaging for diagnostic applications in the colon. Photoacoustic imaging is used as one of the modalities in both platforms as it can offer deeper penetration depth compared to optical imaging. The optical engineering and research challenges in developing the dual/multi-modality platforms will be discussed, followed by initial results validating the proposed scheme. The proposed schemes offer high spatial and spectral resolution imaging and sensing, and is expected to offer potential biomedical imaging solutions in the near future.

Predictors of treatment with dialysis modalities in observational studies for comparative effectiveness research*

PubMed Central

Kuttykrishnan, Sooraj; Kalantar-Zadeh, Kamyar; Arah, Onyebuchi A.; Cheung, Alfred K.; Brunelli, Steve; Heagerty, Patrick J.; Katz, Ronit; Molnar, Miklos Z.; Nissenson, Allen; Ravel, Vanessa; Streja, Elani; Himmelfarb, Jonathan; Mehrotra, Rajnish

2015-01-01

Background The Institute of Medicine has identified the comparative effectiveness of renal replacement therapies as a kidney-related topic among the top 100 national priorities. Given the importance of ensuring internal and external validity, the goal of this study was to identify potential sources of bias in observational studies that compare outcomes with different dialysis modalities. Methods This observational cohort study used data from the electronic medical records of all patients that started maintenance dialysis in the calendar years 2007–2011 and underwent treatment for at least 60 days in any of the 2217 facilities operated by DaVita Inc. Each patient was assigned one of six dialysis modalities for each 91-day period from the date of first dialysis (thrice weekly in-center hemodialysis (HD), peritoneal dialysis (PD), less-frequent HD, home HD, frequent HD and nocturnal in-center HD). Results Of the 162 644 patients, 18% underwent treatment with a modality other than HD for at least one 91-day period. Except for PD, patients started treatment with alternative modalities after variable lengths of treatment with HD; the time until a change in modality was shortest for less-frequent HD (median time = 6 months) and longest for frequent HD (median time = 15 months). Between 30 and 78% of patients transferred to another dialysis facility prior to change in modality. Finally, there were significant differences in baseline and time-varying clinical characteristics associated with dialysis modality. Conclusions This analysis identified numerous potential sources of bias in studies of the comparative effectiveness of dialysis modalities. PMID:25883196

Dynamic assessment of reinforced concrete beams repaired with externally bonded FRP sheets

NASA Astrophysics Data System (ADS)

Bonfiglioli, B.; Pascale, G.

2006-01-01

This research deals with RC beams strengthened with FRP. An experimental research is presented which is aimed at evaluating the capability of an experimental modal analysis to assess the stiffness decrease due to damage, as well as the stiffness recovery due to strengthening. Ten beams were tested. All of them were subjected to loading cycles with increasing load levels in order to induce cracking of different severity in them. The beams were then retrofitted by externally bonded FRP sheets. Three types of composites were used. The number of layers was varied, too. Modal tests were carried out after each loading-unloading cycle. The modal frequencies and damping ratios were determined for the first four vibration modes. The results obtained indicate that an experimental modal analysis can give useful information on the severity of damage and the effectiveness of strengthening.

Study of modal coupling procedures for the shuttle: A matrix method for damping synthesis

NASA Technical Reports Server (NTRS)

Hasselman, T. K.

1972-01-01

The damping method was applied successfully to real structures as well as analytical models. It depends on the ability to determine an appropriate modal damping matrix for each substructure. In the past, modal damping matrices were assumed diagonal for lack of being able to determine the coupling terms which are significant in the general case of nonproportional damping. This problem was overcome by formulating the damped equations of motion as a linear perturbation of the undamped equations for light structural damping. Damped modes are defined as complex vectors derived from the complex frequency response vectors of each substructure and are obtained directly from sinusoidal vibration tests. The damped modes are used to compute first order approximations to the modal damping matrices. The perturbation approach avoids ever having to solve a complex eigenvalue problem.

All-Arthroscopic Treatment of Intra- and Extra-Articular Localized Villonodular Synovitis of Knee.

PubMed

Simonetta, Roberto; Florio, Michela; Familiari, Filippo; Gasparini, Giorgio; Rosa, Michele Attilio

2017-09-01

Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferative neoplastic condition affecting synovial-lined anatomic spaces. PVNS is characterized by hypertrophy of a synovial membrane by villous, nodular, and villonodular proliferation, with pigmentation secondary to hemosiderin deposition. The two forms of PVNS that have been described are diffuse (DPVNS) and localized (LPVNS). The knee is the most commonly involved anatomic location, followed by hip, ankle, shoulder, and elbow. Diagnosis of PVNS is not always obvious clinically. Various imaging modalities are often necessary to exclude other conditions and narrow the diagnosis. Magnetic resonance imaging has become the modality of choice for diagnosing PVNS. We present a case of intra-articular LPVNS with an extra-articular extension through the posterior capsule that has been successfully removed in an all-arthroscopic fashion.

A program to compute three-dimensional subsonic unsteady aerodynamic characteristics using the doublet lattice method, L216 (DUBFLEX). Volume 2: Supplemental system design and maintenance document

NASA Technical Reports Server (NTRS)

Harrison, B. A.; Richard, M.

1979-01-01

The information necessary for execution of the digital computer program L216 on the CDC 6600 is described. L216 characteristics are based on the doublet lattice method. Arbitrary aerodynamic configurations may be represented with combinations of nonplanar lifting surfaces composed of finite constant pressure panel elements, and axially summetric slender bodies composed of constant pressure line elements. Program input consists of configuration geometry, aerodynamic parameters, and modal data; output includes element geometry, pressure difference distributions, integrated aerodynamic coefficients, stability derivatives, generalized aerodynamic forces, and aerodynamic influence coefficient matrices. Optionally, modal data may be input on magnetic field (tape or disk), and certain geometric and aerodynamic output may be saved for subsequent use.

Multilayer modal actuator-based piezoelectric transformers.

PubMed

Huang, Yao-Tien; Wu, Wen-Jong; Wang, Yen-Chieh; Lee, Chih-Kung

2007-02-01

An innovative, multilayer piezoelectric transformer equipped with a full modal filtering input electrode is reported herein. This modal-shaped electrode, based on the orthogonal property of structural vibration modes, is characterized by full modal filtering to ensure that only the desired vibration mode is excited during operation. The newly developed piezoelectric transformer is comprised of three layers: a multilayered input layer, an insulation layer, and a single output layer. The electrode shape of the input layer is derived from its structural vibration modal shape, which takes advantage of the orthogonal property of the vibration modes to achieve a full modal filtering effect. The insulation layer possesses two functions: first, to couple the mechanical vibration energy between the input and output, and second, to provide electrical insulation between the two layers. To meet the two functions, a low temperature, co-fired ceramic (LTCC) was used to provide the high mechanical rigidity and high electrical insulation. It can be shown that this newly developed piezoelectric transformer has the advantage of possessing a more efficient energy transfer and a wider optimal working frequency range when compared to traditional piezoelectric transformers. A multilayer piezoelectric, transformer-based inverter applicable for use in LCD monitors or portable displays is presented as well.

Alignment of multimodality, 2D and 3D breast images

NASA Astrophysics Data System (ADS)

Grevera, George J.; Udupa, Jayaram K.

2003-05-01

In a larger effort, we are studying methods to improve the specificity of the diagnosis of breast cancer by combining the complementary information available from multiple imaging modalities. Merging information is important for a number of reasons. For example, contrast uptake curves are an indication of malignancy. The determination of anatomical locations in corresponding images from various modalities is necessary to ascertain the extent of regions of tissue. To facilitate this fusion, registration becomes necessary. We describe in this paper a framework in which 2D and 3D breast images from MRI, PET, Ultrasound, and Digital Mammography can be registered to facilitate this goal. Briefly, prior to image acquisition, an alignment grid is drawn on the breast skin. Modality-specific markers are then placed at the indicated grid points. Images are then acquired by a specific modality with the modality specific external markers in place causing the markers to appear in the images. This is the first study that we are aware of that has undertaken the difficult task of registering 2D and 3D images of such a highly deformable (the breast) across such a wide variety of modalities. This paper reports some very preliminary results from this project.

Fiducial marker for correlating images

DOEpatents

Miller, Lisa Marie [Rocky Point, NY; Smith, Randy J [Wading River, NY; Warren, John B [Port Jefferson, NY; Elliott, Donald [Hampton Bays, NY

2011-06-21

The invention relates to a fiducial marker having a marking grid that is used to correlate and view images produced by different imaging modalities or different imaging and viewing modalities. More specifically, the invention relates to the fiducial marking grid that has a grid pattern for producing either a viewing image and/or a first analytical image that can be overlaid with at least one other second analytical image in order to view a light path or to image different imaging modalities. Depending on the analysis, the grid pattern has a single layer of a certain thickness or at least two layers of certain thicknesses. In either case, the grid pattern is imageable by each imaging or viewing modality used in the analysis. Further, when viewing a light path, the light path of the analytical modality cannot be visualized by viewing modality (e.g., a light microscope objective). By correlating these images, the ability to analyze a thin sample that is, for example, biological in nature but yet contains trace metal ions is enhanced. Specifically, it is desired to analyze both the organic matter of the biological sample and the trace metal ions contained within the biological sample without adding or using extrinsic labels or stains.

Dynamic Stability Analysis of Linear Time-varying Systems via an Extended Modal Identification Approach

NASA Astrophysics Data System (ADS)

Ma, Zhisai; Liu, Li; Zhou, Sida; Naets, Frank; Heylen, Ward; Desmet, Wim

2017-03-01

The problem of linear time-varying(LTV) system modal analysis is considered based on time-dependent state space representations, as classical modal analysis of linear time-invariant systems and current LTV system modal analysis under the "frozen-time" assumption are not able to determine the dynamic stability of LTV systems. Time-dependent state space representations of LTV systems are first introduced, and the corresponding modal analysis theories are subsequently presented via a stability-preserving state transformation. The time-varying modes of LTV systems are extended in terms of uniqueness, and are further interpreted to determine the system's stability. An extended modal identification is proposed to estimate the time-varying modes, consisting of the estimation of the state transition matrix via a subspace-based method and the extraction of the time-varying modes by the QR decomposition. The proposed approach is numerically validated by three numerical cases, and is experimentally validated by a coupled moving-mass simply supported beam experimental case. The proposed approach is capable of accurately estimating the time-varying modes, and provides a new way to determine the dynamic stability of LTV systems by using the estimated time-varying modes.

Are 6-month-old human infants able to transfer emotional information (happy or angry) from voices to faces? An eye-tracking study.

PubMed

Palama, Amaya; Malsert, Jennifer; Gentaz, Edouard

2018-01-01

The present study examined whether 6-month-old infants could transfer amodal information (i.e. independently of sensory modalities) from emotional voices to emotional faces. Thus, sequences of successive emotional stimuli (voice or face from one sensory modality -auditory- to another sensory modality -visual-), corresponding to a cross-modal transfer, were displayed to 24 infants. Each sequence presented an emotional (angry or happy) or neutral voice, uniquely, followed by the simultaneous presentation of two static emotional faces (angry or happy, congruous or incongruous with the emotional voice). Eye movements in response to the visual stimuli were recorded with an eye-tracker. First, results suggested no difference in infants' looking time to happy or angry face after listening to the neutral voice or the angry voice. Nevertheless, after listening to the happy voice, infants looked longer at the incongruent angry face (the mouth area in particular) than the congruent happy face. These results revealed that a cross-modal transfer (from auditory to visual modalities) is possible for 6-month-old infants only after the presentation of a happy voice, suggesting that they recognize this emotion amodally.

New developments in the management of narcolepsy.

PubMed

Abad, Vivien C; Guilleminault, Christian

2017-01-01

Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%-0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy's strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss. Current treatment modalities alleviate the main symptoms of excessive daytime somnolence (EDS) and cataplexy and, to a lesser extent, reduce nocturnal sleep disruption, hypnagogic hallucinations, and sleep paralysis. Sodium oxybate (SXB), a sodium salt of γ hydroxybutyric acid, is a first-line agent for cataplexy and EDS and may help sleep disruption, hypnagogic hallucinations, and sleep paralysis. Various antidepressant medications including norepinephrine serotonin reuptake inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants are second-line agents for treating cataplexy. In addition to SXB, modafinil and armodafinil are first-line agents to treat EDS. Second-line agents for EDS are stimulants such as methylphenidate and extended-release amphetamines. Emerging therapies include non-hypocretin-based therapy, hypocretin-based treatments, and immunotherapy to prevent hypocretin neuronal death. Non-hypocretin-based novel treatments for narcolepsy include pitolisant (BF2.649, tiprolisant); JZP-110 (ADX-N05) for EDS in adults; JZP 13-005 for children; JZP-386, a deuterated sodium oxybate oral suspension; FT 218 an extended-release formulation of SXB; and JNJ-17216498, a new formulation of modafinil. Clinical trials are investigating efficacy and safety of SXB, modafinil, and armodafinil in children. γ-amino butyric acid (GABA) modulation with GABA A receptor agonists clarithromycin and flumazenil may help daytime somnolence. Other drugs investigated include GABA B agonists (baclofen), melanin-concentrating hormone antagonist, and thyrotropin-releasing hormone agonists. Hypocretin-based therapies include hypocretin peptide replacement administered either through an intracerebroventricular route or intranasal route. Hypocretin neuronal transplant and transforming stem cells into hypothalamic neurons are also discussed in this article. Immunotherapy to prevent hypocretin neuronal death is reviewed.

New developments in the management of narcolepsy

PubMed Central

Abad, Vivien C; Guilleminault, Christian

2017-01-01

Narcolepsy is a life-long, underrecognized sleep disorder that affects 0.02%–0.18% of the US and Western European populations. Genetic predisposition is suspected because of narcolepsy’s strong association with HLA DQB1*06-02, and genome-wide association studies have identified polymorphisms in T-cell receptor loci. Narcolepsy pathophysiology is linked to loss of signaling by hypocretin-producing neurons; an autoimmune etiology possibly triggered by some environmental agent may precipitate hypocretin neuronal loss. Current treatment modalities alleviate the main symptoms of excessive daytime somnolence (EDS) and cataplexy and, to a lesser extent, reduce nocturnal sleep disruption, hypnagogic hallucinations, and sleep paralysis. Sodium oxybate (SXB), a sodium salt of γ hydroxybutyric acid, is a first-line agent for cataplexy and EDS and may help sleep disruption, hypnagogic hallucinations, and sleep paralysis. Various antidepressant medications including norepinephrine serotonin reuptake inhibitors, selective serotonin reuptake inhibitors, and tricyclic antidepressants are second-line agents for treating cataplexy. In addition to SXB, modafinil and armodafinil are first-line agents to treat EDS. Second-line agents for EDS are stimulants such as methylphenidate and extended-release amphetamines. Emerging therapies include non-hypocretin-based therapy, hypocretin-based treatments, and immunotherapy to prevent hypocretin neuronal death. Non-hypocretin-based novel treatments for narcolepsy include pitolisant (BF2.649, tiprolisant); JZP-110 (ADX-N05) for EDS in adults; JZP 13-005 for children; JZP-386, a deuterated sodium oxybate oral suspension; FT 218 an extended-release formulation of SXB; and JNJ-17216498, a new formulation of modafinil. Clinical trials are investigating efficacy and safety of SXB, modafinil, and armodafinil in children. γ-amino butyric acid (GABA) modulation with GABAA receptor agonists clarithromycin and flumazenil may help daytime somnolence. Other drugs investigated include GABAB agonists (baclofen), melanin-concentrating hormone antagonist, and thyrotropin-releasing hormone agonists. Hypocretin-based therapies include hypocretin peptide replacement administered either through an intracerebroventricular route or intranasal route. Hypocretin neuronal transplant and transforming stem cells into hypothalamic neurons are also discussed in this article. Immunotherapy to prevent hypocretin neuronal death is reviewed. PMID:28424564

Shearlet-based edge detection: flame fronts and tidal flats

NASA Astrophysics Data System (ADS)

King, Emily J.; Reisenhofer, Rafael; Kiefer, Johannes; Lim, Wang-Q.; Li, Zhen; Heygster, Georg

2015-09-01

Shearlets are wavelet-like systems which are better suited for handling geometric features in multi-dimensional data than traditional wavelets. A novel method for edge and line detection which is in the spirit of phase congruency but is based on a complex shearlet transform will be presented. This approach to detection yields an approximate tangent direction of detected discontinuities as a byproduct of the computation, which then yields local curvature estimates. Two applications of the edge detection method will be discussed. First, the tracking and classification of flame fronts is a critical component of research in technical thermodynamics. Quite often, the flame fronts are transient or weak and the images are noisy. The standard methods used in the field for the detection of flame fronts do not handle such data well. Fortunately, using the shearlet-based edge measure yields good results as well as an accurate approximation of local curvature. Furthermore, a modification of the method will yield line detection, which is important for certain imaging modalities. Second, the Wadden tidal flats are a biodiverse region along the North Sea coast. One approach to surveying the delicate region and tracking the topographical changes is to use pre-existing Synthetic Aperture Radar (SAR) images. Unfortunately, SAR data suffers from multiplicative noise as well as sensitivity to environmental factors. The first large-scale mapping project of that type showed good results but only with a tremendous amount of manual interaction because there are many edges in the data which are not boundaries of the tidal flats but are edges of features like fields or islands. Preliminary results will be presented.

Hydrostatic Pressure and Temperature Measurements Using an In-Line Mach-Zehnder Interferometer Based on a Two-Mode Highly Birefringent Microstructured Fiber

PubMed Central

Statkiewicz-Barabach, Gabriela; Olszewski, Jacek; Mergo, Pawel; Urbanczyk, Waclaw.

2017-01-01

We present a comprehensive study of an in-line Mach-Zehnder intermodal interferometer fabricated in a boron-doped two-mode highly birefringent microstructured fiber. We observed different interference signals at the output of the interferometer, related to the intermodal interference of the fundamental and the first order modes of the orthogonal polarizations and a beating of the polarimetric signal related to the difference in the group modal birefringence between the fundamental and the first order modes, respectively. The proposed interferometer was tested for measurements of hydrostatic pressure and temperature for different alignments of the input polarizer with no analyzer at the output. The sensitivities to hydrostatic pressure of the intermodal interference signals for x- and y-polarizations had an opposite sign and were equal to 0.229 nm/MPa and −0.179 nm/MPa, respectively, while the temperature sensitivities for both polarizations were similar and equal 0.020 nm/°C and 0.019 nm/°C. In the case of pressure, for the simultaneous excitation of both polarization modes, we observed a displacement of intermodal fringes with a sensitivity depending on the azimuth of the input polarization state, as well as on the displacement of their envelope with a sensitivity of 2.14 nm/MPa, accompanied by a change in the fringes visibility. Such properties of the proposed interferometer allow for convenient adjustments to the pressure sensitivity of the intermodal fringes and possible applications for the simultaneous interrogation of temperature and pressure. PMID:28718796

Chromosomal abnormalities and molecular landscape of metastasizing mucinous salivary adenocarcinoma

PubMed Central

Panaccione, Alex; Zhang, Yi; Mi, Yanfang; Mitani, Yoshitsugu; Yan, Guo; Prasad, Manju L.; McDonald, W. Hayes; El-Naggar, Adel K.; Yarbrough, Wendell G.; Ivanov, Sergey V.

2017-01-01

Background Mucinous adenocarcinoma of the salivary gland (MAC) is a lethal cancer with unknown molecular etiology and a high propensity to lymph node metastasis. Mostly due to its orphan status, MAC remains one of the least explored cancers that lacks cell lines and mouse models that could help translational and pre-clinical studies. Surgery with or without radiation remains the only treatment modality but poor overall survival (10-year, 44%) underscores the urgent need for mechanism-based therapies. Methods We developed the first patient-derived xenograft (PDX) model for pre-clinical MAC studies and a cell line that produces aggressively growing tumors after subcutaneous injection into nude mice. We performed cytogenetic, exome, and proteomic profiling of MAC to identify driving mutations, therapeutic targets, and pathways involved in aggressive cancers based on TCGA database mining and GEO analysis. Results: We identified in MAC KRAS (G13D) and TP53 (R213X) mutations that have been previously reported as drivers in a variety of highly aggressive cancers. Somatic mutations were also found in KDM6A, KMT2D, and other genes frequently mutated in colorectal and other cancers: FAT1, NBEA, RELN, RLP1B, and ZFHX3. Proteomic analysis of MAC implied epigenetic up-regulation of a genetic program involved in proliferation and cancer stem cell maintenance. Conclusion Genomic and proteomic analyses provided the first insight into potential molecular drivers of MAC metastases pointing at common mechanisms of CSC propagation in aggressive cancers. The in vitro/in vivo models that we created should aid in the development and validation of new treatment strategies against MAC. PMID:28249646

Localized neuropathic pain: an expert consensus on local treatments

PubMed Central

Pickering, Gisèle; Martin, Elodie; Tiberghien, Florence; Delorme, Claire; Mick, Gérard

2017-01-01

Background Pain localization is one of the hallmarks for the choice of first-line treatment in neuropathic pain. This literature review has been conducted to provide an overview of the current knowledge regarding the etiology and pathophysiology of localized neuropathic pain (LNP), its assessment and the existing topical pharmacological treatments. Materials and methods Literature review was performed using Medline from 2010 to December 2016, and all studies involving LNP and treatments were examined. A multidisciplinary expert panel of five pain specialists in this article reports a consensus on topical approaches that may be recommended to alleviate LNP and on their advantages in clinical practice. Results Successive international recommendations have included topical 5% lidocaine and 8% capsaicin for LNP treatment. The expert panel considers that these compounds can be a first-line treatment for LNP, especially in elderly patients and patients with comorbidities and polypharmacy. Regulatory LNP indications should cover the whole range of LNP and not be restricted to specific etiologies or sites. Precautions for the use of plasters must be followed cautiously. Conclusion Although there is a real need for more randomized controlled trials for both drugs, publications clearly demonstrate excellent risk/benefit ratios, safety, tolerance and continued efficacy throughout long-term treatment. A major advantage of both plasters is that they have proven efficacy and may reduce the risk of adverse events such as cognitive impairment, confusion, somnolence, dizziness and constipation that are often associated with systemic neuropathic pain treatment and reduce the quality of life. Topical modalities also may be used in combination with other drugs and analgesics with limited drug–drug interactions. PMID:29066862

Novel management strategies for medically-refractory vasospasm following aneurysmal subarachnoid hemorrhage.

PubMed

Al-Mufti, Fawaz; Amuluru, Krishna; Damodara, Nitesh; El-Ghanem, Mohammad; Nuoman, Rolla; Kamal, Naveed; Al-Marsoummi, Sarmad; Morris, Nicholas A; Dangayach, Neha S; Mayer, Stephan A

2018-07-15

Delayed cerebral ischemia (DCI) after aneurysmal subarachnoid hemorrhage (SAH) is an important cause of further morbidity and mortality after an already devastating condition. Though traditionally attributed to vasospasm of large capacitance arteries and the resulting down-stream disruption of cerebral blood flow, the pathogenesis of DCI has proven to be more complex with early brain injury, blood-brain barrier disruption, microthrombosis, cortical spreading depolarizations, and the failure of cerebral autoregulation as newly elucidated factors. Vasospasm is a known consequence of SAH. The standard of care includes close monitoring for neurological deterioration, most often with serial clinical examinations, transcranial Doppler ultrasonography, and vascular imaging (crucial for early detection of DCI and allows for prompt intervention). Nimodipine continues to remain an important pharmacological strategy to improve functional outcomes in patients with SAH at risk for developing vasospasm. The paradigm for first line therapy in patients with vasospasm of induced hypertension, hypervolemia, and hemodilution has recently been challenged. Current American Heart Association guidelines recommend targeting euvolemia and judicious use of the pharmacologically induced hypertension component. Symptomatic vasospasm patients who do not improve with this first line therapy require rescue intervention with mechanical or chemical angioplasty and optimization of cardiac output and hemoglobin levels. This can be escalated in a step-wise fashion to include adjunct treatments such as intrathecal administration of vasodilators and sympatholytic or thrombolytic therapies. This review provides a general overview of the treatment modalities for DCI with a focus on novel management strategies that show promising results for treating vasospasm to prevent DCI. Copyright © 2018. Published by Elsevier B.V.

Long-Term Follow-Up of Primary Medical Versus Surgical Treatment of Prolactinomas in Men: Effects on Hyperprolactinemia, Hypogonadism, and Bone Health.

PubMed

Andereggen, Lukas; Frey, Janine; Andres, Robert H; El-Koussy, Marwan; Beck, Jürgen; Seiler, Rolf W; Christ, Emanuel

2017-01-01

In men with prolactinomas, impaired bone density is the principle consequence of hyperprolactinemia-induced hypogonadism. Although dopamine agonists (DAs) are the first-line approach in prolactinomas, surgery can be considered in selected cases. In this study, we aimed to investigate the long-term control of hyperprolactinemia, hypogonadism, and bone health comparing primary medical and surgical therapy in men who had not had prior DA treatment. This is a retrospective case-note study of 44 consecutive men with prolactinomas and no prior DAs managed in a single tertiary referral center. Clinical, biochemical, and radiologic response to the first-line approach were analyzed in the 2 cohorts. Mean age at diagnosis was 47 years (range, 22-78 years). The prevalence of hypogonadism was 86%, and 27% of patients had pathologic bone density at baseline. The primary therapeutic strategy was surgery for 34% and DAs for 66% of patients. Median long-term follow-up was 63 months (range, 17-238 months). Long-term control of hyperprolactinemia required DAs in 53% of patients with primary surgical therapy, versus 90% of patients with primary medical therapy (P = 0.02). Hypogonadism was controlled in 73% of patients. The prevalence of patients with pathologic bone density was 37% at last follow-up, with no differences between the 2 therapeutic cohorts (P = 0.48). Despite control of hyperprolactinemia and hypogonadism in most patients independent of the primary treatment modality, the prevalence of impaired bone health status remains high, and osteodensitometry should be recommended. Copyright © 2016 Elsevier Inc. All rights reserved.

Should laparoscopy and dye test be a first line evaluation for infertile women in southeast Nigeria?

PubMed

Ikechebelu, J I; Mbamara, S U

2011-01-01

Laparoscopy and dye test is an important investigation in the evaluation of infertile women which has been underutilised in our practice. This review is aimed at determining whether the findings of this procedure are substantial enough to make it a first line evaluation for infertile women. A review of the laparoscopic findings in infertile women who presented for evaluation and treatment at a private fertility centre was carried out. A total of 253 day-case laparoscopy and dye test procedures were reviewed, 115 (45.0%) were done for primary infertility, 137 (54.5%) for secondary infertility and 1 (0.4%) for primary amenorrhoea and infertility. The mean period of infertility was 4.5 years with a range of 2-10 years and the women were aged between 19 and 52 years. Analysis of the result showed that 100 (39.5%) women had normal patent tubes while 153 (60.4%) had tubal pathologies like bilateral tubal occlusion in 97 (38.3%) and unilateral tubal occlusion in 56 (22.1%) women. Pelvic adhesion of varying degrees of severity was present in 108 (42.7%) women. Bilateral tubal occlusion was more common in nulliparous women and those aged between 30-39 years. One or both ovaries were normal (functional) in 189 (74.7%) women. Altogether, only 43 (17.0%) women were "normal" (had patent tubes, functional ovary and no pelvic adhesion). Additional pelvic pathology was present in 142 (56.1%) women. The commonest was uterine fibroid (leiomyomata) of various sizes in 100 (39.5%) of the women, followed by ovarian cyst in 56 (22.2%) and endometriosis in 11 (4.4%) women. Other pathologies observed include uterine abnormalities and unruptured ectopic pregnancy. Only 16 (37.2%) of the 43 "normal" women had no additional pelvic pathology. The high prevalence o tuboperitoneal factor and additional pelvic pathology in these infertile women reveal the importance of laparoscopic evaluation. We recommend the use of laparoscopy and dye test as a first line investigation in our environment to detect these conditions early enough when treatment modalities like assisted reproduction will still be beneficial.

Statistically generated weighted curve fit of residual functions for modal analysis of structures

NASA Technical Reports Server (NTRS)

Bookout, P. S.

1995-01-01

A statistically generated weighting function for a second-order polynomial curve fit of residual functions has been developed. The residual flexibility test method, from which a residual function is generated, is a procedure for modal testing large structures in an external constraint-free environment to measure the effects of higher order modes and interface stiffness. This test method is applicable to structures with distinct degree-of-freedom interfaces to other system components. A theoretical residual function in the displacement/force domain has the characteristics of a relatively flat line in the lower frequencies and a slight upward curvature in the higher frequency range. In the test residual function, the above-mentioned characteristics can be seen in the data, but due to the present limitations in the modal parameter evaluation (natural frequencies and mode shapes) of test data, the residual function has regions of ragged data. A second order polynomial curve fit is required to obtain the residual flexibility term. A weighting function of the data is generated by examining the variances between neighboring data points. From a weighted second-order polynomial curve fit, an accurate residual flexibility value can be obtained. The residual flexibility value and free-free modes from testing are used to improve a mathematical model of the structure. The residual flexibility modal test method is applied to a straight beam with a trunnion appendage and a space shuttle payload pallet simulator.

A Noninvasive Imaging Modality for Cardiac Arrhythmias

PubMed Central

Burnes, John E.; Taccardi, Bruno; Rudy, Yoram

2007-01-01

Background The last decade witnessed an explosion of information regarding the genetic, molecular, and mechanistic basis of heart disease. Translating this information into clinical practice requires the development of novel functional imaging modalities for diagnosis, localization, and guided intervention. A noninvasive modality for imaging cardiac arrhythmias is not yet available. Present electrocardiographic methods cannot precisely localize a ventricular tachycardia (VT) or its key reentrant circuit components. Recently, we developed a noninvasive electrocardiographic imaging modality (ECGI) that can reconstruct epicardial electrophysiological information from body surface potentials. Here, we extend its application to image reentrant arrhythmias. Methods and Results Epicardial potentials were recorded during VT with a 490 electrode sock during an open chest procedure in 2 dogs with 4-day-old myocardial infarctions. Body surface potentials were generated from these epicardial potentials in a human torso model. Realistic geometry errors and measurement noise were added to the torso data, which were then used to noninvasively reconstruct epicardial isochrones, electrograms, and potentials with excellent accuracy. ECGI reconstructed the reentry pathway and its key components, including (1) the central common pathway, (2) the VT exit site, (3) lines of block, and (4) regions of slow and fast conduction. This allowed for detailed characterization of the reentrant circuit morphology. Conclusions ECGI can noninvasively image arrhythmic activation on the epicardium during VT to identify and localize key components of the arrhythmogenic pathway that can be effective targets for antiarrhythmic intervention. PMID:11044435

3D multi-scale FCN with random modality voxel dropout learning for Intervertebral Disc Localization and Segmentation from Multi-modality MR Images.

PubMed

Li, Xiaomeng; Dou, Qi; Chen, Hao; Fu, Chi-Wing; Qi, Xiaojuan; Belavý, Daniel L; Armbrecht, Gabriele; Felsenberg, Dieter; Zheng, Guoyan; Heng, Pheng-Ann

2018-04-01

Intervertebral discs (IVDs) are small joints that lie between adjacent vertebrae. The localization and segmentation of IVDs are important for spine disease diagnosis and measurement quantification. However, manual annotation is time-consuming and error-prone with limited reproducibility, particularly for volumetric data. In this work, our goal is to develop an automatic and accurate method based on fully convolutional networks (FCN) for the localization and segmentation of IVDs from multi-modality 3D MR data. Compared with single modality data, multi-modality MR images provide complementary contextual information, which contributes to better recognition performance. However, how to effectively integrate such multi-modality information to generate accurate segmentation results remains to be further explored. In this paper, we present a novel multi-scale and modality dropout learning framework to locate and segment IVDs from four-modality MR images. First, we design a 3D multi-scale context fully convolutional network, which processes the input data in multiple scales of context and then merges the high-level features to enhance the representation capability of the network for handling the scale variation of anatomical structures. Second, to harness the complementary information from different modalities, we present a random modality voxel dropout strategy which alleviates the co-adaption issue and increases the discriminative capability of the network. Our method achieved the 1st place in the MICCAI challenge on automatic localization and segmentation of IVDs from multi-modality MR images, with a mean segmentation Dice coefficient of 91.2% and a mean localization error of 0.62 mm. We further conduct extensive experiments on the extended dataset to validate our method. We demonstrate that the proposed modality dropout strategy with multi-modality images as contextual information improved the segmentation accuracy significantly. Furthermore, experiments conducted on extended data collected from two different time points demonstrate the efficacy of our method on tracking the morphological changes in a longitudinal study. Copyright © 2018 Elsevier B.V. All rights reserved.

The functional significance of EEG microstates--Associations with modalities of thinking.

PubMed

Milz, P; Faber, P L; Lehmann, D; Koenig, T; Kochi, K; Pascual-Marqui, R D

2016-01-15

The momentary, global functional state of the brain is reflected by its electric field configuration. Cluster analytical approaches consistently extracted four head-surface brain electric field configurations that optimally explain the variance of their changes across time in spontaneous EEG recordings. These four configurations are referred to as EEG microstate classes A, B, C, and D and have been associated with verbal/phonological, visual, subjective interoceptive-autonomic processing, and attention reorientation, respectively. The present study tested these associations via an intra-individual and inter-individual analysis approach. The intra-individual approach tested the effect of task-induced increased modality-specific processing on EEG microstate parameters. The inter-individual approach tested the effect of personal modality-specific parameters on EEG microstate parameters. We obtained multichannel EEG from 61 healthy, right-handed, male students during four eyes-closed conditions: object-visualization, spatial-visualization, verbalization (6 runs each), and resting (7 runs). After each run, we assessed participants' degrees of object-visual, spatial-visual, and verbal thinking using subjective reports. Before and after the recording, we assessed modality-specific cognitive abilities and styles using nine cognitive tests and two questionnaires. The EEG of all participants, conditions, and runs was clustered into four classes of EEG microstates (A, B, C, and D). RMANOVAs, ANOVAs and post-hoc paired t-tests compared microstate parameters between conditions. TANOVAs compared microstate class topographies between conditions. Differences were localized using eLORETA. Pearson correlations assessed interrelationships between personal modality-specific parameters and EEG microstate parameters during no-task resting. As hypothesized, verbal as opposed to visual conditions consistently affected the duration, occurrence, and coverage of microstate classes A and B. Contrary to associations suggested by previous reports, parameters were increased for class A during visualization, and class B during verbalization. In line with previous reports, microstate D parameters were increased during no-task resting compared to the three internal, goal-directed tasks. Topographic differences between conditions included particular sub-regions of components of the metabolic default mode network. Modality-specific personal parameters did not consistently correlate with microstate parameters except verbal cognitive style which correlated negatively with microstate class A duration and positively with class C occurrence. This is the first study that aimed to induce EEG microstate class parameter changes based on their hypothesized functional significance. Beyond the associations of microstate classes A and B with visual and verbal processing, respectively, our results suggest that a finely-tuned interplay between all four EEG microstate classes is necessary for the continuous formation of visual and verbal thoughts. Our results point to the possibility that the EEG microstate classes may represent the head-surface measured activity of intra-cortical sources primarily exhibiting inhibitory functions. However, additional studies are needed to verify and elaborate on this hypothesis. Copyright © 2015 Elsevier Inc. All rights reserved.

Eye-Tracking Measures Reveal How Changes in the Design of Aided AAC Displays Influence the Efficiency of Locating Symbols by School-Age Children without Disabilities

ERIC Educational Resources Information Center

Wilkinson, Krista M.; O'Neill, Tara; McIlvane, William J.

2014-01-01

Purpose: Many individuals with communication impairments use aided augmentative and alternative communication (AAC) systems involving letters, words, or line drawings that rely on the visual modality. It seems reasonable to suggest that display design should incorporate information about how users attend to and process visual information. The…

Finding Support in Moodle: A Face-to-Face Chemistry Course for Engineers

ERIC Educational Resources Information Center

de Vega, Carolina Armijo; McAnally-Salas, Lewis

2011-01-01

The aim of this paper was to know the students' perceptions of using online support in a chemistry course. To achieve this objective, a qualitative research was conducted over a chemistry course that was imparted in a face-to-face modality using a LMS (learning management system) for on-line support. The supports available in the LMS were forums,…

Teacher Education for the 21st Century: Creativity, Aesthetics and Ethics in Preparing Teachers for Our Future

ERIC Educational Resources Information Center

Blumenfeld-Jones, Donald S., ed.

2016-01-01

This book is for anyone interested in how to build a teacher education program utilizing the arts as one central modality for teaching and learning or for those interested in building some of their program along these lines. Throughout the book you will find reference to the intersection of ethics, aesthetics, and teaching. We provide an…

A Coupled Fluid-Structure Interaction Analysis of Solid Rocket Motor with Flexible Inhibitors

NASA Technical Reports Server (NTRS)

Yang, H. Q.; West, Jeff

2014-01-01

A capability to couple NASA production CFD code, Loci/CHEM, with CFDRC's structural finite element code, CoBi, has been developed. This paper summarizes the efforts in applying the installed coupling software to demonstrate/investigate fluid-structure interaction (FSI) between pressure wave and flexible inhibitor inside reusable solid rocket motor (RSRM). First a unified governing equation for both fluid and structure is presented, then an Eulerian-Lagrangian framework is described to satisfy the interfacial continuity requirements. The features of fluid solver, Loci/CHEM and structural solver, CoBi, are discussed before the coupling methodology of the solvers is described. The simulation uses production level CFD LES turbulence model with a grid resolution of 80 million cells. The flexible inhibitor is modeled with full 3D shell elements. Verifications against analytical solutions of structural model under steady uniform pressure condition and under dynamic condition of modal analysis show excellent agreements in terms of displacement distribution and eigen modal frequencies. The preliminary coupled result shows that due to acoustic coupling, the dynamics of one of the more flexible inhibitors shift from its first modal frequency to the first acoustic frequency of the solid rocket motor.

Social Contact Enhances Bodily Self-Awareness.

PubMed

Hazem, Nesrine; Beaurenaut, Morgan; George, Nathalie; Conty, Laurence

2018-03-08

Human self-awareness is arguably the most important and revealing question of modern sciences. Converging theoretical perspectives link self-awareness and social abilities in human beings. In particular, mutual engagement during social interactions-or social contact-would boost self-awareness. Yet, empirical evidence for this effect is scarce. We recently showed that the perception of eye contact induces enhanced bodily self-awareness. Here, we aimed at extending these findings by testing the influence of social contact in auditory and tactile modalities, in order to demonstrate that social contact enhances bodily self-awareness irrespective of sensory modality. In a first experiment, participants were exposed to hearing their own first name (as compared to another unfamiliar name and noise). In a second experiment, human touch (as compared to brush touch and no-touch) was used as the social contact cue. In both experiments, participants demonstrated more accurate rating of their bodily reactions in response to emotional pictures following the social contact condition-a proxy of bodily self-awareness. Further analyses indicated that the effect of social contact was comparable across tactile, auditory and visual modalities. These results provide the first direct empirical evidence in support of the essential social nature of human self-awareness.

Gene therapy as future treatment of erectile dysfunction

PubMed Central

Yoshimura, Naoki; Kato, Ryuichi; Chencellor, Michael B.; Nelson, Joel B.; Glorioso, Joseph C.

2011-01-01

Importance of the field Erectile dysfunction (ED) is a major men’s health problem. Although the high success rate of treating ED by phosphodiesterase 5 (PDE5) inhibitors has been reported, there are a significant number of ED patients who do not respond to currently available treatment modalities. Areas covered in this review To understand the current status of gene therapy application for ED, gene therapy approaches for ED treatment are reviewed. What the reader will gain Gene therapy strategies that can enhance nitric oxide (NO) production or NO-mediated signaling pathways, growth factor-mediated nerve regeneration or K+ channel activity in the smooth muscle could be promising approaches for the treatment of ED. Although the majority of gene therapy studies are still in the preclinical phase, the first clinical trial using non-viral gene transfer of Ca2+-activated, large-conductance K+ channels into the corpus cavernosum of ED patients showed positive results. Take home message Gene therapy represents an exciting future treatment option for ED, especially for people with severe ED unresponsive to current first-line therapies such as PDE5 inhibitors although the long-term safety of both viral and non-viral gene therapies should be established. PMID:20662742

Easily overlooked sonographic findings in the evaluation of neonatal encephalopathy: lessons learned from magnetic resonance imaging.

PubMed

Dinan, David; Daneman, Alan; Guimaraes, Carolina V; Chauvin, Nancy A; Victoria, Teresa; Epelman, Monica

2014-12-01

Findings of neonatal encephalopathy (NE) and specifically those of hypoxic-ischemic injury are frequently evident on magnetic resonance imaging (MRI). Although MRI has become more widely used and has gained widespread acceptance as the study of choice for the evaluation of NE in recent years, its costs are high and access to MRI is sometimes limited for extremely sick neonates. Therefore, head sonography (US) continues to be the first-line imaging modality for the evaluation of the brain in neonates with NE; furthermore, in many of these infants, the diagnosis of NE may have first been made or suggested using head US. US is noninvasive, inexpensive, and portable, allowing examinations to be performed without moving the infant. However, many of the telltale signs of NE on US are subtle and may be easily overlooked, contributing to diagnostic delay or misdiagnosis. We aim to illustrate the spectrum of US findings in NE, with emphasis on those findings that may be easily overlooked on US. Recognition of these findings could potentially improve detection rates, reduce errors, and improve patient management. Copyright © 2014 Elsevier Inc. All rights reserved.

Paracetamol in Patent Ductus Arteriosus Treatment: Efficacious and Safe?

PubMed Central

Bardanzellu, Flaminia; Neroni, Paola; Fanos, Vassilios

2017-01-01

In preterm infants, failure or delay in spontaneous closure of Ductus Arteriosus (DA), resulting in the condition of Patent Ductus Arteriosus (PDA), represents a significant issue. A prolonged situation of PDA can be associated with several short- and long-term complications. Despite years of researches and clinical experience on PDA management, unresolved questions about the treatment and heterogeneity of clinical practices in different centers still remain, in particular regarding timing and modality of intervention. Nowadays, the most reasonable strategy seems to be reserving the treatment only to hemodynamically significant PDA. The first-line therapy is medical, and ibuprofen, related to several side effects especially in terms of nephrotoxicity, is the drug of choice. Administration of oral or intravenous paracetamol (acetaminophen) recently gained attention, appearing effective as traditional nonsteroidal anti-inflammatory drugs (NSAIDs) in PDA closure, with lower toxicity. The results of the studies analyzed in this review mostly support paracetamol efficacy in ductal closure, with inconstant low and transient elevation of liver enzymes as reported side effect. However, more studies are needed to confirm if this therapy shows a real safety profile and to evaluate its long-term outcomes, before considering paracetamol as first-choice drug in PDA treatment. PMID:28828381

Cost-effectiveness analysis of unsafe abortion and alternative first-trimester pregnancy termination strategies in Nigeria and Ghana.

PubMed

Hu, Delphine; Grossman, Daniel; Levin, Carol; Blanchard, Kelly; Adanu, Richard; Goldie, Sue J

2010-06-01

To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). Assuming all modalities are equally available, clinic-based MVA is the most cost-effective option in Nigeria. If clinic-based MVA is not available, MA is the next best strategy. Conversely, in Ghana, MA is the most cost-effective strategy, followed by clinic-based MVA if MA is not available. From a real world policy perspective, increasing access to safe abortion in favor over unsafe abortion is the single most important factor in saving lives and societal costs, and is more influential than the actual choice of safe abortion modality.

Primary borderline parovarian tumor in pregnancy

PubMed Central

Kim, Jong-Hyun

2015-01-01

There are few reports of pregnancy complicated by a primary borderline parovarian tumor. A 32-year-old pregnant woman was found to have an ovarian tumor. At 13 weeks of gestation, cystectomy was performed and a diagnosis of primary borderline parovarian tumor was made. At 38 weeks of gestation, she underwent cesarean section combined with a restaging operation. A normal infant was delivered and there were no signs of recurrence. Currently, the patient is being followed for 24 months after the initial treatment and all imaging data show no evidence of recurrence. This report includes a short review of the existing literature on this topic and documents this case in detail. This case demonstrates the appropriate procedure for evaluating and treating a primary borderline parovarian tumor during pregnancy. PMID:26623422

Molecular Imaging and Precision Medicine in Lung Cancer.

PubMed

Zukotynski, Katherine A; Gerbaudo, Victor H

2017-01-01

Precision medicine allows tailoring of preventive or therapeutic interventions to avoid the expense and toxicity of futile treatment given to those who will not respond. Lung cancer is a heterogeneous disease functionally and morphologically. PET is a sensitive molecular imaging technique with a major role in the precision medicine algorithm of patients with lung cancer. It contributes to the precision medicine of lung neoplasia by interrogating tumor heterogeneity throughout the body. It provides anatomofunctional insight during diagnosis, staging, and restaging of the disease. It is a biomarker of tumoral heterogeneity that helps direct selection of the most appropriate treatment, the prediction of early response to cytotoxic and cytostatic therapies, and is a prognostic biomarker in patients with lung cancer. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

Improving Healthcare Transition Planning and Health-Related Independence for Youth with ASD and their Families

DTIC Science & Technology

2015-10-01

volunteers) recruited Objective 5: Develop and test focus group & individual interview guide; train staff on protocol and procedure • Caregiver and young...and individual items will then be evaluated and revised based on finds from cognitive interviewing and full-scale pretesting . 15. SUBJECT TERMS...first modality assessed caregiver perspectives on health-related transitioning using focus groups . The second modality included individual interviews

Optimal placement of tuning masses for vibration reduction in helicopter rotor blades

NASA Technical Reports Server (NTRS)

Pritchard, Jocelyn I.; Adelman, Howard M.

1988-01-01

Described are methods for reducing vibration in helicopter rotor blades by determining optimum sizes and locations of tuning masses through formal mathematical optimization techniques. An optimization procedure is developed which employs the tuning masses and corresponding locations as design variables which are systematically changed to achieve low values of shear without a large mass penalty. The finite-element structural analysis of the blade and the optimization formulation require development of discretized expressions for two performance parameters: modal shaping parameter and modal shear amplitude. Matrix expressions for both quantities and their sensitivity derivatives are developed. Three optimization strategies are developed and tested. The first is based on minimizing the modal shaping parameter which indirectly reduces the modal shear amplitudes corresponding to each harmonic of airload. The second strategy reduces these amplitudes directly, and the third strategy reduces the shear as a function of time during a revolution of the blade. The first strategy works well for reducing the shear for one mode responding to a single harmonic of the airload, but has been found in some cases to be ineffective for more than one mode. The second and third strategies give similar results and show excellent reduction of the shear with a low mass penalty.

Identification of multi-modal plasma responses to applied magnetic perturbations using the plasma reluctance

DOE PAGES

Logan, Nikolas C.; Paz-Soldan, Carlos; Park, Jong-Kyu; ...

2016-05-03

Using the plasma reluctance, the Ideal Perturbed Equilibrium Code is able to efficiently identify the structure of multi-modal magnetic plasma response measurements and the corresponding impact on plasma performance in the DIII-D tokamak. Recent experiments demonstrated that multiple kink modes of comparable amplitudes can be driven by applied nonaxisymmetric fields with toroidal mode number n = 2. This multi-modal response is in good agreement with ideal magnetohydrodynamic models, but detailed decompositions presented here show that the mode structures are not fully described by either the least stable modes or the resonant plasma response. This paper identifies the measured response fieldsmore » as the first eigenmodes of the plasma reluctance, enabling clear diagnosis of the plasma modes and their impact on performance from external sensors. The reluctance shows, for example, how very stable modes compose a significant portion of the multi-modal plasma response field and that these stable modes drive significant resonant current. Finally, this work is an overview of the first experimental applications using the reluctance to interpret the measured response and relate it to multifaceted physics, aimed towards providing the foundation of understanding needed to optimize nonaxisymmetric fields for independent control of stability and transport.« less

Construction and identification of a D-Vine model applied to the probability distribution of modal parameters in structural dynamics

NASA Astrophysics Data System (ADS)

Dubreuil, S.; Salaün, M.; Rodriguez, E.; Petitjean, F.

2018-01-01

This study investigates the construction and identification of the probability distribution of random modal parameters (natural frequencies and effective parameters) in structural dynamics. As these parameters present various types of dependence structures, the retained approach is based on pair copula construction (PCC). A literature review leads us to choose a D-Vine model for the construction of modal parameters probability distributions. Identification of this model is based on likelihood maximization which makes it sensitive to the dimension of the distribution, namely the number of considered modes in our context. To this respect, a mode selection preprocessing step is proposed. It allows the selection of the relevant random modes for a given transfer function. The second point, addressed in this study, concerns the choice of the D-Vine model. Indeed, D-Vine model is not uniquely defined. Two strategies are proposed and compared. The first one is based on the context of the study whereas the second one is purely based on statistical considerations. Finally, the proposed approaches are numerically studied and compared with respect to their capabilities, first in the identification of the probability distribution of random modal parameters and second in the estimation of the 99 % quantiles of some transfer functions.

A Prospective Observational Study of the Effectiveness and Safety of Botulinum Toxin in the Horizontal Neck Lines.

PubMed

Lee, Jong Hun; Park, Yu Gil; Park, Eun Soo

2018-06-19

Botulinum toxin is used extensively, and its use for aesthetic indications in the lower face and neck is now becoming increasingly popular. It is the ideal alternative to surgical procedures for patients who are too young for facelift surgery or who are unwilling to take recuperation time. We review current approaches to BTX A treatment for horizontal neck lines. Subjects were 20 women with an average age of 43 with mild to moderate horizontal neck lines but have had no treatment by BTX A for the past 3 months. Injections are performed at points 1-1.5 cm apart along the horizontal lines with 1-2 U in each injection site, for a total of 15-30 U. Patients were followed up 3 and 8 days after treatment and then every 4 weeks after initial treatment for 16 weeks. Except day 3 in the first neck line, the mean resulting from evaluation by the actual physician who performed the injection and two blinded physicians has statistical significance as shown by the maximum results at 8 weeks after injection. However, the patient improvement rate and satisfaction level did not exceed 50%. Adverse reactions were mild and transitory. The overall results of applying BTX A are excellent, and the satisfaction level of treated patients is high to a certain extent. Moreover, smoothening of the neck skin was observed due to the intradermal effect. It is also a safe and effective therapeutic modality for any patient desiring rejuvenation of his or her neck, but who at the same time does not desire any recuperation time or is unwilling to undertake the potential risks associated with surgical procedures. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cross-modal Savings in the Contralateral Eyelid Conditioned Response

PubMed Central

Campolattaro, Matthew M.; Buss, Eric W.; Freeman, John H.

2015-01-01

The present experiment monitored bilateral eyelid responses during eyeblink conditioning in rats trained with a unilateral unconditioned stimulus (US). Three groups of rats were used to determine if cross-modal savings occurs when the location of the US is switched from one eye to the other. Rats in each group first received paired or unpaired eyeblink conditioning with a conditioned stimulus (tone or light; CS) and a unilateral periorbital electrical stimulation US. All rats were subsequently given paired training, but with the US location (Group 1), CS modality (Group 2), or US location and CS modality (Group 3) changed. Changing the location of the US alone resulted in an immediate transfer of responding in both eyelids (Group 1) in rats that received paired training prior to the transfer session. Rats in groups 2 and 3 that initially received paired training showed facilitated learning to the new CS modality during the transfer sessions, indicating that cross-modal savings occurs whether or not the location of the US is changed. All rats that were initially given unpaired training acquired conditioned eyeblink responses similar to de novo acquisition rate during the transfer sessions. Savings of CR incidence was more robust than savings of CR amplitude when the US switched sides, a finding that has implications for elucidating the neural mechanisms of cross-modal savings. PMID:26501170

Analysis of flexible aircraft longitudinal dynamics and handling qualities. Volume 2: Data

NASA Technical Reports Server (NTRS)

Waszak, M. R.; Schmidt, D. K.

1985-01-01

Two analysis methods are applied to a family of flexible aircraft in order to investigate how and when structural (especially dynamic aeroelastic) effects affect the dynamic characteristics of aircraft. The first type of analysis is an open loop modal analysis technique. This method considers the effect of modal residue magnitudes on determining vehicle handling qualities. The second method is a pilot in the loop analysis procedure that considers several closed loop system characteristics. Both analyses indicated that dynamic aeroelastic effects caused a degradation in vehicle tracking performance, based on the evaluation of some simulation results. Volume 2 consists of the presentation of the state variable models of the flexible aircraft configurations used in the analysis applications mode shape plots for the structural modes, numerical results from the modal analysis frequency response plots from the pilot in the loop analysis and a listing of the modal analysis computer program.

Molecular imaging needles: dual-modality optical coherence tomography and fluorescence imaging of labeled antibodies deep in tissue

PubMed Central

Scolaro, Loretta; Lorenser, Dirk; Madore, Wendy-Julie; Kirk, Rodney W.; Kramer, Anne S.; Yeoh, George C.; Godbout, Nicolas; Sampson, David D.; Boudoux, Caroline; McLaughlin, Robert A.

2015-01-01

Molecular imaging using optical techniques provides insight into disease at the cellular level. In this paper, we report on a novel dual-modality probe capable of performing molecular imaging by combining simultaneous three-dimensional optical coherence tomography (OCT) and two-dimensional fluorescence imaging in a hypodermic needle. The probe, referred to as a molecular imaging (MI) needle, may be inserted tens of millimeters into tissue. The MI needle utilizes double-clad fiber to carry both imaging modalities, and is interfaced to a 1310-nm OCT system and a fluorescence imaging subsystem using an asymmetrical double-clad fiber coupler customized to achieve high fluorescence collection efficiency. We present, to the best of our knowledge, the first dual-modality OCT and fluorescence needle probe with sufficient sensitivity to image fluorescently labeled antibodies. Such probes enable high-resolution molecular imaging deep within tissue. PMID:26137379

Ares I-X Flight Test Vehicle:Stack 1 Modal Test

NASA Technical Reports Server (NTRS)

Buehrle, Ralph D.; Templeton, Justin D.; Reaves, Mercedes C.; Horta, Lucas G.; Gaspar, James L.; Bartolotta, Paul A.; Parks, Russel A.; Lazor, Daniel R.

2010-01-01

Ares I-X was the first flight test vehicle used in the development of NASA s Ares I crew launch vehicle. The Ares I-X used a 4-segment reusable solid rocket booster from the Space Shuttle heritage with mass simulators for the 5th segment, upper stage, crew module and launch abort system. Three modal tests were defined to verify the dynamic finite element model of the Ares I-X flight test vehicle. Test configurations included two partial stacks and the full Ares I-X flight test vehicle on the Mobile Launcher Platform. This report focuses on the second modal test that was performed on the middle section of the vehicle referred to as Stack 1, which consisted of the subassembly from the 5th segment simulator through the interstage. This report describes the test requirements, constraints, pre-test analysis, test operations and data analysis for the Ares I-X Stack 1 modal test.

Optically defined modal sensors incorporating spiropyran-doped liquid crystals with piezoelectric sensors.

PubMed

Chen, Kuan-Ting; Chang, Chin-Kai; Kuo, Hui-Lung; Lee, Chih-Kung

2011-01-01

We integrated a piezoelectric sensing layer lamina containing liquid crystals (LC) and spiropyran (SP) in a LC/SP mixture to create an optically reconfigurable modal sensor for a cantilever beam. The impedance of this LC/SP lamina was decreased by UV irradiation which constituted the underlying mechanism to modulate the voltage externally applied to the piezoelectric actuating layer. Illuminating a specific pattern onto the LC/SP lamina provided us with a way to spatially modulate the piezoelectric vibration signal. We showed that if an UV illuminated pattern matches the strain distribution of a specific mode, a piezoelectric modal sensor can be created. Since UV illumination can be changed in situ in real-time, our results confirm for the first time since the inception of smart sensors, that an optically tailored modal sensor can be created. Some potential applications of this type of sensor include energy harvesting devices, bio-chips, vibration sensing and actuating devices.

Combined optical tomographic and magnetic resonance imaging of tumor bearing mice

NASA Astrophysics Data System (ADS)

Masciotti, J.; Abdoulaev, G.; Hur, J.; Papa, J.; Bae, J.; Huang, J.; Yamashiro, D.; Kandel, J.; Hielscher, A. H.

2005-04-01

With the advent of small animal imaging systems, it has become possible to non-invasively monitor the progression of diseases in living small animals and study the efficacy of drugs and treatment protocols. Magnetic resonance imaging (MRI) is an established imaging modality capable of obtaining high resolution anatomical images as well as studying cerebral blood volume (CBV), cerebral blood flow (CBF), and cerebral metabolic rate of oxygen (CMRO2). Optical tomography, on the other hand, is an emerging imaging modality, which, while much lower in spatial resolution and insensitive to CBF, can separate the effects of oxyhemoglobin, deoxyhemoglobin, and CBV with high temporal resolution. In this study we present our first results concerning coregistration of MRI and optical data. By applying both modalities to imaging of kidney tumors in mice that undergo VEGF treatment, we illustrate how these imaging modalities can supplement each other and cross validation can be performed.

Use of the Morlet mother wavelet in the frequency-scale domain decomposition technique for the modal identification of ambient vibration responses

NASA Astrophysics Data System (ADS)

Le, Thien-Phu

2017-10-01

The frequency-scale domain decomposition technique has recently been proposed for operational modal analysis. The technique is based on the Cauchy mother wavelet. In this paper, the approach is extended to the Morlet mother wavelet, which is very popular in signal processing due to its superior time-frequency localization. Based on the regressive form and an appropriate norm of the Morlet mother wavelet, the continuous wavelet transform of the power spectral density of ambient responses enables modes in the frequency-scale domain to be highlighted. Analytical developments first demonstrate the link between modal parameters and the local maxima of the continuous wavelet transform modulus. The link formula is then used as the foundation of the proposed modal identification method. Its practical procedure, combined with the singular value decomposition algorithm, is presented step by step. The proposition is finally verified using numerical examples and a laboratory test.

Predictors of treatment with dialysis modalities in observational studies for comparative effectiveness research.

PubMed

Kuttykrishnan, Sooraj; Kalantar-Zadeh, Kamyar; Arah, Onyebuchi A; Cheung, Alfred K; Brunelli, Steve; Heagerty, Patrick J; Katz, Ronit; Molnar, Miklos Z; Nissenson, Allen; Ravel, Vanessa; Streja, Elani; Himmelfarb, Jonathan; Mehrotra, Rajnish

2015-07-01

The Institute of Medicine has identified the comparative effectiveness of renal replacement therapies as a kidney-related topic among the top 100 national priorities. Given the importance of ensuring internal and external validity, the goal of this study was to identify potential sources of bias in observational studies that compare outcomes with different dialysis modalities. This observational cohort study used data from the electronic medical records of all patients that started maintenance dialysis in the calendar years 2007-2011 and underwent treatment for at least 60 days in any of the 2217 facilities operated by DaVita Inc. Each patient was assigned one of six dialysis modalities for each 91-day period from the date of first dialysis (thrice weekly in-center hemodialysis (HD), peritoneal dialysis (PD), less-frequent HD, home HD, frequent HD and nocturnal in-center HD). Of the 162 644 patients, 18% underwent treatment with a modality other than HD for at least one 91-day period. Except for PD, patients started treatment with alternative modalities after variable lengths of treatment with HD; the time until a change in modality was shortest for less-frequent HD (median time = 6 months) and longest for frequent HD (median time = 15 months). Between 30 and 78% of patients transferred to another dialysis facility prior to change in modality. Finally, there were significant differences in baseline and time-varying clinical characteristics associated with dialysis modality. This analysis identified numerous potential sources of bias in studies of the comparative effectiveness of dialysis modalities. © The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

Vibroacoustics of the piano soundboard: (Non)linearity and modal properties in the low- and mid-frequency ranges

NASA Astrophysics Data System (ADS)

Ege, Kerem; Boutillon, Xavier; Rébillat, Marc

2013-03-01

The piano soundboard transforms the string vibration into sound and therefore, its vibrations are of primary importance for the sound characteristics of the instrument. An original vibro-acoustical method is presented to isolate the soundboard nonlinearity from that of the exciting device (here: a loudspeaker) and to measure it. The nonlinear part of the soundboard response to an external excitation is quantitatively estimated for the first time, at ≈-40 dB below the linear part at the ff nuance. Given this essentially linear response, a modal identification is performed up to 3 kHz by means of a novel high resolution modal analysis technique [K. Ege, X. Boutillon, B. David, High-resolution modal analysis, Journal of Sound and Vibration 325 (4-5) (2009) 852-869]. Modal dampings (which, so far, were unknown for the piano in this frequency range) are determined in the mid-frequency domain where FFT-based methods fail to evaluate them with an acceptable precision. They turn out to be close to those imposed by wood. A finite-element modelling of the soundboard is also presented. The low-order modal shapes and the comparison between the corresponding experimental and numerical modal frequencies suggest that the boundary conditions can be considered as blocked, except at very low frequencies. The frequency-dependency of the estimated modal densities and the observation of modal shapes reveal two well-separated regimes. Below ≈1 kHz, the soundboard vibrates more or less like a homogeneous plate. Above that limit, the structural waves are confined by ribs, as already noticed by several authors, and localised in restricted areas (one or a few inter-rib spaces), presumably due to a slightly irregular spacing of the ribs across the soundboard.

Colorectal Cancer Screening: Stool DNA and Other Noninvasive Modalities.

PubMed

Bailey, James R; Aggarwal, Ashish; Imperiale, Thomas F

2016-03-01

Colorectal cancer screening dates to the discovery of precancerous adenomatous tissue. Screening modalities and guidelines directed at prevention and early detection have evolved and resulted in a significant decrease in the prevalence and mortality of colorectal cancer via direct visualization or using specific markers. Despite continued efforts and an overall reduction in deaths attributed to colorectal cancer over the last 25 years, colorectal cancer remains one of the most common causes of malignancy-associated deaths. In attempt to further reduce the prevalence of colorectal cancer and associated deaths, continued improvement in screening quality and adherence remains key. Noninvasive screening modalities are actively being explored. Identification of specific genetic alterations in the adenoma-cancer sequence allow for the study and development of noninvasive screening modalities beyond guaiac-based fecal occult blood testing which target specific alterations or a panel of alterations. The stool DNA test is the first noninvasive screening tool that targets both human hemoglobin and specific genetic alterations. In this review we discuss stool DNA and other commercially available noninvasive colorectal cancer screening modalities in addition to other targets which previously have been or are currently under study.

Estimation of Sonic Fatigue by Reduced-Order Finite Element Based Analyses

NASA Technical Reports Server (NTRS)

Rizzi, Stephen A.; Przekop, Adam

2006-01-01

A computationally efficient, reduced-order method is presented for prediction of sonic fatigue of structures exhibiting geometrically nonlinear response. A procedure to determine the nonlinear modal stiffness using commercial finite element codes allows the coupled nonlinear equations of motion in physical degrees of freedom to be transformed to a smaller coupled system of equations in modal coordinates. The nonlinear modal system is first solved using a computationally light equivalent linearization solution to determine if the structure responds to the applied loading in a nonlinear fashion. If so, a higher fidelity numerical simulation in modal coordinates is undertaken to more accurately determine the nonlinear response. Comparisons of displacement and stress response obtained from the reduced-order analyses are made with results obtained from numerical simulation in physical degrees-of-freedom. Fatigue life predictions from nonlinear modal and physical simulations are made using the rainflow cycle counting method in a linear cumulative damage analysis. Results computed for a simple beam structure under a random acoustic loading demonstrate the effectiveness of the approach and compare favorably with results obtained from the solution in physical degrees-of-freedom.

Modality-independent representations of small quantities based on brain activation patterns.

PubMed

Damarla, Saudamini Roy; Cherkassky, Vladimir L; Just, Marcel Adam

2016-04-01

Machine learning or MVPA (Multi Voxel Pattern Analysis) studies have shown that the neural representation of quantities of objects can be decoded from fMRI patterns, in cases where the quantities were visually displayed. Here we apply these techniques to investigate whether neural representations of quantities depicted in one modality (say, visual) can be decoded from brain activation patterns evoked by quantities depicted in the other modality (say, auditory). The main finding demonstrated, for the first time, that quantities of dots were decodable by a classifier that was trained on the neural patterns evoked by quantities of auditory tones, and vice-versa. The representations that were common across modalities were mainly right-lateralized in frontal and parietal regions. A second finding was that the neural patterns in parietal cortex that represent quantities were common across participants. These findings demonstrate a common neuronal foundation for the representation of quantities across sensory modalities and participants and provide insight into the role of parietal cortex in the representation of quantity information. © 2016 Wiley Periodicals, Inc.

Fully integrated optical coherence tomography, ultrasound, and indocyanine green based fluorescence tri-modality system for intravascular imaging (Conference Presentation)

NASA Astrophysics Data System (ADS)

Li, Yan; Jing, Joseph C.; Qu, Yueqiao; Miao, Yusi; Ma, Teng; Yu, Mingyue; Zhou, Qifa; Chen, Zhongping

2017-02-01

The rupture of atherosclerotic plaques is the leading cause of acute coronary events, so accurate assessment of plaque is critical. A large lipid pool, thin fibrous cap, and inflammatory reaction are the crucial characteristics for identifying vulnerable plaques. In our study, a tri-modality imaging system for intravascular imaging was designed and implemented. The tri-modality imaging system with a 1-mm probe diameter is able to simultaneously acquire optical coherence tomography (OCT), intravascular ultrasound (IVUS), and fluorescence imaging. Moreover, for fluorescence imaging, we used the FDA-approved indocyanine green (ICG) dye as the contrast agent to target lipid-loaded macrophages. Firstly, IVUS is used as the first step for identifying plaque since IVUS enables the visualization of the layered structures of the artery wall. Due to low soft-tissue contrast, IVUS only provides initial identification of the lipid plaque. Then OCT is used for differentiating fibrosis and lipid pool based on its relatively higher soft tissue contrast and high sensitivity/specificity. Last, fluorescence imaging is used for identifying inflammatory reaction to further confirm whether the plaque is vulnerable or not. Ex vivo experiment of a male New Zealand white rabbit aorta was performed to validate the performance of our tri-modality system. H and E histology results of the rabbit aorta were also presented to check assessment accuracy. The miniature tri-modality probe, together with the use of ICG dye suggest that the system is of great potential for providing a more accurate assessment of vulnerable plaques in clinical applications.

Subliminal semantic priming in speech.

PubMed

Daltrozzo, Jérôme; Signoret, Carine; Tillmann, Barbara; Perrin, Fabien

2011-01-01

Numerous studies have reported subliminal repetition and semantic priming in the visual modality. We transferred this paradigm to the auditory modality. Prime awareness was manipulated by a reduction of sound intensity level. Uncategorized prime words (according to a post-test) were followed by semantically related, unrelated, or repeated target words (presented without intensity reduction) and participants performed a lexical decision task (LDT). Participants with slower reaction times in the LDT showed semantic priming (faster reaction times for semantically related compared to unrelated targets) and negative repetition priming (slower reaction times for repeated compared to semantically related targets). This is the first report of semantic priming in the auditory modality without conscious categorization of the prime.

Subliminal Semantic Priming in Speech

PubMed Central

Tillmann, Barbara; Perrin, Fabien

2011-01-01

Numerous studies have reported subliminal repetition and semantic priming in the visual modality. We transferred this paradigm to the auditory modality. Prime awareness was manipulated by a reduction of sound intensity level. Uncategorized prime words (according to a post-test) were followed by semantically related, unrelated, or repeated target words (presented without intensity reduction) and participants performed a lexical decision task (LDT). Participants with slower reaction times in the LDT showed semantic priming (faster reaction times for semantically related compared to unrelated targets) and negative repetition priming (slower reaction times for repeated compared to semantically related targets). This is the first report of semantic priming in the auditory modality without conscious categorization of the prime. PMID:21655277

Cerenkov luminescence imaging: physics principles and potential applications in biomedical sciences.

PubMed

Ciarrocchi, Esther; Belcari, Nicola

2017-12-01

Cerenkov luminescence imaging (CLI) is a novel imaging modality to study charged particles with optical methods by detecting the Cerenkov luminescence produced in tissue. This paper first describes the physical processes that govern the production and transport in tissue of Cerenkov luminescence. The detectors used for CLI and their most relevant specifications to optimize the acquisition of the Cerenkov signal are then presented, and CLI is compared with the other optical imaging modalities sharing the same data acquisition and processing methods. Finally, the scientific work related to CLI and the applications for which CLI has been proposed are reviewed. The paper ends with some considerations about further perspectives for this novel imaging modality.

Individualized Molecular Analyses Guide Efforts (IMAGE): A Prospective Study of Molecular Profiling of Tissue and Blood in Metastatic Triple-Negative Breast Cancer.

PubMed

Parsons, Heather A; Beaver, Julia A; Cimino-Mathews, Ashley; Ali, Siraj M; Axilbund, Jennifer; Chu, David; Connolly, Roisin M; Cochran, Rory L; Croessmann, Sarah; Clark, Travis A; Gocke, Christopher D; Jeter, Stacie C; Kennedy, Mark R; Lauring, Josh; Lee, Justin; Lipson, Doron; Miller, Vincent A; Otto, Geoff A; Rosner, Gary L; Ross, Jeffrey S; Slater, Shannon; Stephens, Philip J; VanDenBerg, Dustin A; Wolff, Antonio C; Young, Lauren E; Zabransky, Daniel J; Zhang, Zhe; Zorzi, Jane; Stearns, Vered; Park, Ben H

2017-01-15

The clinical utility of next-generation sequencing (NGS) in breast cancer has not been demonstrated. We hypothesized that we could perform NGS of a new biopsy from patients with metastatic triple-negative breast cancer (TNBC) in a clinically actionable timeframe. We planned to enroll 40 patients onto a prospective study, Individualized Molecular Analyses Guide Efforts (IMAGE), to evaluate the feasibility of obtaining a new biopsy of a metastatic site, perform NGS (FoundationOne), and convene a molecular tumor board to formulate treatment recommendations within 28 days. We collected blood at baseline and at time of restaging to assess cell-free circulating plasma tumor DNA (ptDNA). We enrolled 26 women with metastatic TNBC who had received ≥1 line of prior chemotherapy, and 20 (77%) underwent NGS of a metastatic site biopsy. Twelve (60%) evaluable patients received treatment recommendations within 28 days of consent. The study closed after 20 patients underwent NGS, based on protocol-specified interim futility analysis. Three patients went on to receive genomically directed therapies. Twenty-four of 26 patients had genetic alterations successfully detected in ptDNA. Among 5 patients, 4 mutations found in tumor tissues were not identified in blood, and 4 mutations found in blood were not found in corresponding tumors. In 9 patients, NGS of follow-up blood samples showed 100% concordance with baseline blood samples. This study demonstrates challenges of performing NGS on prospective tissue biopsies in patients with metastatic TNBC within 28 days, while also highlighting the potential use of blood as a more time-efficient and less invasive method of mutational assessment. Clin Cancer Res; 23(2); 379-86. ©2016 AACR. ©2016 American Association for Cancer Research.

Advances in treatment of obstructive sleep apnea syndrome.

PubMed

Collop, Nancy A

2009-09-01

The treatments for obstructive sleep apnea (OSA) described in this paper represent the latest information and data. Nasal continuous positive airway pressure, initially described in 1981, remains the cornerstone of therapy. Advances in mask interfaces, the use of humidification, the downloading of usage information, the development of pressure delivery modifications, and reductions in the size and noise of the machines have improved the devices over the past decade. Nevertheless, the basic premise of positive pressure delivery to splint the airway remains the primary driver of efficacy. Surgery for OSA, other than tracheostomy, has also been used for about the same period (uvulopalatopharyngoplasty was also initially described in 1981), but its efficacy has probably improved only marginally. The advances in surgical techniques have come through improved patient selection, minimally invasive techniques, and the performance of outcome studies. Surgery clearly remains a second-line or third-line therapy for moderate to severe OSA. Dental appliances were also introduced over two decades ago and clearly have become more mainstream in our treatment approach to OSA. Dental appliances are now considered a reasonable first-line therapy for mild OSA and perhaps even for some patients with moderate OSA. Custom-made appliances are clearly superior to those that cannot be adjusted, and in the hands of an experienced dentist or similarly trained expert, they are moderately successful for most patients. Among the newer therapies, transnasal insufflation and nasal expiratory resistance clearly have promise, again for patients with mild to moderate OSA. Further study may determine who will benefit from such modalities. No medications have been shown to have clinically significant efficacy, and drug treatment remains adjunctive.

Multimodal cues drive host-plant assessment in Asian citrus psyllid (Diaphorina citri).

PubMed

Patt, Joseph M; Meikle, William G; Mafra-Neto, Agenor; Sétamou, Mamoudou; Mangan, Robert; Yang, Chenghai; Malik, Nasir; Adamczyk, John J

2011-12-01

Asian citrus psyllid (Diaphorina citri) transmits the causal agent of Huanglongbing, a devastating disease of citrus trees. In this study we measured behavioral responses of D. citri to combinations of visual, olfactory, and gustatory stimuli in test arenas. Stimuli were presented to the psyllids in droplets or lines of an emulsified wax formulation in two different arena types in no-choice tests. First, when placed on a colored ring situated halfway between the center and perimeter of a petri dish, D. citri spent more time on yellow versus gray rings; however, this response disappeared when either gray or yellow wax droplets were applied. When the psyllids were presented with droplets scented with terpenes, the response to both scent and color was increased. The addition of a dilute (≍0.1 M) sucrose solution to the wax droplets increased the magnitude of D. citri responses. Next, groups of D. citri were placed on plastic laboratory film covering a sucrose solution, to mimic a leaf surface. Test stimuli were presented via two 'midribs' made from lines of emulsified wax formulation. Probing levels were measured as a function of color saturation and scent composition, and concentration. The test scents were based on qualitatively major volatiles emitted by Murraya paniculata (L.) Jack, Citrus aurantifolia (Christm.) Swingle, and C. sinensis (L.) Osbeck. The highest probing response was observed on the middle concentration (20-μl scent/10 ml wax formulation) of the C. aurantifolia-scented wax lines. Results indicate that there are interactive effects between the different sensory modalities in directing host-plant assessment behavior.

Anaphylaxis: a history with emphasis on food allergy

PubMed Central

Boden, Stephen R.; Burks, A. Wesley

2011-01-01

Summary In the century since Paul Portier and Charles Richet described their landmark findings of severe fatal reactions in dogs re-exposed to venom after vaccination with sea anemone venom, treatment for anaphylaxis continues to evolve. The incidence of anaphylaxis continues to be difficult to measure. Underreporting due to patients not seeking medical care as well as failure to identify anaphylaxis affects our understanding of the magnitude of the disease. Treatment with intramuscular epinephrine continues to be the recommended first line therapy although studies indicate that education of both the patients and the medical community is needed. Adverse food reactions continue to be the leading cause of anaphylaxis presenting for emergency care. Current therapy for food-induced anaphylaxis is built on the foundation of strict dietary avoidance, rapid access to injectable epinephrine, and education to recognize signs and symptoms of anaphylaxis. Investigation into therapy with oral and sublingual immunotherapy as well as other modalities holds hope for improved treatment of food-induced anaphylaxis. PMID:21682750

Chemical pharmacotherapy options for managing adult acne.

PubMed

Vera, Nora; Patel, Nupur; Cardwell, Leah A; Saleem, Mohammed; Feldman, Steven R

2017-02-01

The incidence of adult acne is increasing worldwide. Despite clinical overlap with conventional acne, it has distinct features. Areas covered: A literature search of English-language review articles, randomized control studies and retrospective studies conducted over the past 30 years was performed using PubMed and Google Scholar. Search terms included acne, adult, topical medication, oral medication and skin of color. We highlight important clinical features and treatment modalities pertinent to the evaluation and management of adult acne. Given the relative dearth of literature detailing treatment options specific to adult acne, we offer expert opinion regarding management of the condition especially in special populations such as skin of color and pregnancy. Expert Opinion: It is unclear whether adult acne represents a distinct entity or a continuum of adolescent disease. Providers may opt to use topical medication as first-line, but should have a low threshold for switching to systemic therapy given the magnitude of psychosocial and emotional burden associated with the condition.

Management of patients with faecal incontinence

PubMed Central

Duelund-Jakobsen, Jakob; Worsoe, Jonas; Lundby, Lilli; Christensen, Peter; Krogh, Klaus

2016-01-01

Faecal incontinence, defined as the involuntary loss of solid or liquid stool, is a common problem affecting 0.8–8.3% of the adult population. Individuals suffering from faecal incontinence often live a restricted life with reduced quality of life. The present paper is a clinically oriented review of the pathophysiology, evaluation and treatment of faecal incontinence. First-line therapy should be conservative and usually include dietary adjustments, fibre supplement, constipating agents or mini enemas. Biofeedback therapy to improve external anal sphincter function can be offered but the evidence for long-term effect is poor. There is good evidence that colonic irrigation can reduce symptoms and improve quality of life, especially in patients with neurogenic faecal incontinence. Surgical interventions should only be considered if conservative measures fail. Sacral nerve stimulation is a minimally invasive procedure with high rate of success. Advanced surgical procedures should be restricted to highly selected patients and only performed at specialist centres. A stoma should be considered if other treatment modalities fail. PMID:26770270

Variability in the management of lithium poisoning.

PubMed

Roberts, Darren M; Gosselin, Sophie

2014-01-01

Three patterns of lithium poisoning are recognized: acute, acute-on-chronic, and chronic. Intravenous fluids with or without an extracorporeal treatment are the mainstay of treatment; their respective roles may differ depending on the mode of poisoning being treated. Recommendations for treatment selection are available but these are based on a small number of observational studies and their uptake by clinicians is not known. Clinician decision-making in the treatment of four cases of lithium poisoning was assessed at a recent clinical toxicology meeting using an audience response system. Variability in treatment decisions was evident in addition to discordance with published recommendations. Participants did not consistently indicate that hemodialysis was the first-line treatment, instead opting for a conservative approach, and continuous modalities were viewed favorably; this is in contrast to recommendations in some references. The development of multidisciplinary consensus guidelines may improve the management of patients with lithium poisoning but prospective randomized controlled trials are required to more clearly define the role of extracorporeal treatments. © 2014 Wiley Periodicals, Inc.

Gamma Knife radiosurgery in pituitary adenomas: Why, who, and how to treat?

PubMed

Castinetti, Frederic; Brue, Thierry

2010-08-01

Pituitary adenomas are benign tumors that can be either secreting (acromegaly, Cushing's disease, prolactinomas) or non-secreting. Transsphenoidal neurosurgery is the gold standard treatment; however, it is not always effective. Gamma Knife radiosurgery is a specific modality of stereotactic radiosurgery, a precise radiation technique. Several studies reported the efficacy and low risk of adverse effects induced by this technique: in secreting pituitary adenomas, hypersecretion is controlled in about 50% of cases and tumor volume is stabilized or decreased in 80-90% of cases, making Gamma Knife a valuable adjunctive or first-line treatment. As hormone levels decrease progressively, the main drawback is the longer time to remission (12-60 months), requiring an additional treatment during this period. Hypopituitarism is the main side effect, observed in 20-40% cases. Gamma Knife is thus useful in the therapeutic algorithms of pituitary adenomas in well-defined indications, mainly low secreting small lesions well identified on magnetic resonance imaging (MRI).

Chronic bilateral dislocation of temporomandibular joint.

PubMed

Shakya, S; Ongole, R; Sumanth, K N; Denny, C E

2010-01-01

Dislocation of the condyle of the mandible is a common condition that may occur in an acute or chronic form. It is characterised by inability to close the mouth with or without pain. Dislocation has to be differentiated from subluxation which is a self reducible condition. Dislocation can occur in any direction with anterior dislocation being the commonest one. Various predisposing factors have been associated with dislocation like muscle fatigue and spasm, the defect in the bony surface like shallow articular eminence, and laxity of the capsular ligament. People with defect in collagen synthesis like Ehler Danlos syndrome, Marfan syndrome are said to be genetically predisposed to this condition. Various treatment modalities have been used ranging from conservative techniques to surgical methods. Acute dislocations can be reduced manually or with conservative approach and recurrent and chronic cases can be reduced by surgical intervention. Though the dislocation in our case was 4 months a simple manual reduction proved to be successful. We believe that manual reduction can be attempted as first line of treatment prior to surgical intervention.

Diagnosis and Treatment of Dyssynergic Defecation

PubMed Central

Rao, Satish S C; Patcharatrakul, Tanisa

2016-01-01

Dyssynergic defecation is common and affects up to one half of patients with chronic constipation. This acquired behavioral problem is due to the inability to coordinate the abdominal and pelvic floor muscles to evacuate stools. A detailed history, prospective stool diaries, and a careful digital rectal examination will not only identify the nature of bowel dysfunction, but also raise the index of suspicion for this evacuation disorder. Anorectal physiology tests and balloon expulsion test are essential for a diagnosis. Newer techniques such as high-resolution manometry and magnetic resonance defecography can provide mechanistic insights. Recently, randomized controlled trials have shown that biofeedback therapy is more effective than laxatives and other modalities, both in the short term and long term, without side effects. Also, symptom improvements correlated with changes in underlying pathophysiology. Biofeedback therapy has been recommended as the first-line of treatment for dyssynergic defecation. Here, we provide an overview of the burden of illness and pathophysiology of dyssynergic defecation, and how to diagnose and treat this condition with biofeedback therapy. PMID:27270989

Estrogen Enhances Malignant Phenotypes in Human Salivary Adenoid Cystic Carcinoma Cells.

PubMed

Sumida, Tomoki; Ishikawa, Akiko; Kamata, Y U; Nakano, Hiroyuki; Yamada, Tomohiro; Mori, Yoshihide

2016-06-01

Adenoid cystic carcinoma (SGC) is a common type of salivary gland cancer (SGC). Surgery is the first treatment choice because chemoradiotherapy is usually not effective. Therefore, new treatment modalities are urgently needed. In this study, it was investigated whether the estrogen axis could be a treatment target or not. Adenoid cystic carcinoma (ACC) ACCM cells, were used. The specific cell line lacks estrogen receptor (ER). ER was introduced in ACCM cells, and the effect of 17β-estradiol (E2) was investigated on cell proliferation, cell-cycle distribution, and cell motility. E2 induced cell proliferation, and the S-phase fraction increased in a dose-dependent manner. Cell motility was also up-regulated compared to control cells. The estrogen/ER system up-regulated malignant phenotypes in ER-positive ACC, and hormone therapy may have a potential as effective treatment for this malignancy. Copyright© 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

200 MeV Proton Radiography Studies with a Hand Phantom Using a Prototype Proton CT Scanner

PubMed Central

Plautz, Tia; Bashkirov, V.; Feng, V.; Hurley, F.; Johnson, R.P.; Leary, C.; Macafee, S.; Plumb, A.; Rykalin, V.; Sadrozinski, H.F.-W.; Schubert, K.; Schulte, R.; Schultze, B.; Steinberg, D.; Witt, M.; Zatserklyaniy, A.

2014-01-01

Proton radiography has applications in patient alignment and verification procedures for proton beam radiation therapy. In this paper, we report an experiment which used 200 MeV protons to generate proton energy-loss and scattering radiographs of a hand phantom. The experiment used the first-generation proton CT scanner prototype, which was installed on the research beam line of the clinical proton synchrotron at Loma Linda University Medical Center (LLUMC). It was found that while both radiographs displayed anatomical details of the hand phantom, the energy-loss radiograph had a noticeably higher resolution. Nonetheless, scattering radiography may yield more contrast between soft and bone tissue than energy-loss radiography, however, this requires further study. This study contributes to the optimization of the performance of the next-generation of clinical proton CT scanners. Furthermore, it demonstrates the potential of proton imaging (proton radiography and CT), which is now within reach of becoming available as a new, potentially low-dose medical imaging modality. PMID:24710156

Relationship of Various Open Quotients With Acoustic Property, Phonation Types, Fundamental Frequency, and Intensity.

PubMed

Yokonishi, Hisayuki; Imagawa, Hiroshi; Sakakibara, Ken-Ichi; Yamauchi, Akihito; Nito, Takaharu; Yamasoba, Tatsuya; Tayama, Niro

2016-03-01

In the present study, we examined the relationship between various open quotients (Oqs) and phonation types, fundamental frequency (F0), and intensity by multivariate linear regression analysis (MVA) to determine which Oq best reflects vocal fold vibratory characteristics. Using high-speed digital imaging (HSDI), a sustained vowel /e/ at different phonation types, F0s, and intensities was recorded from six vocally healthy male volunteers: the types of phonation included modal, falsetto, modal breathy, and modal pressed phonations; and each phonation was performed at different F0s and intensities. Electroglottography (EGG) and sound signals were simultaneously recorded with HSDI. From the obtained data, 10 conventional Oqs (four Oqs from the glottal area function, four kymographic Oqs, and two EGG-derived Oqs) and two newly introduced Oqs (Oq(edge)+ and Oq(edge)) were evaluated. And, relationships between various Oqs and phonation types, F0, and intensity were evaluated by MVA. Among the various Oqs, Oq(edge)+ and Oq(edge) revealed the strongest correlations with an acoustic property and could best describe changes in phonation types: Oq(edge) was found to be better than Oq(edge)¯. Oq(MLK), the average of five Oqs from five-line multiline kymography was a very good alternative to Oq(edge)¯. EGG-derived Oqs were able to differentiate between modal phonation and falsetto phonation, but it was necessary to consider the change of F0 simultaneously. MVA showed the changes in Oq values between modal and other phonation types, the degree of involvement of intensity, and no relationship between F0 and Oqs. Among Oqs evaluated in this study, Oq(edge)+ and Oq(edge) were considered to best reflect the vocal fold vibratory characteristics. Copyright © 2016 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

Cross-modal representation of spoken and written word meaning in left pars triangularis.

PubMed

Liuzzi, Antonietta Gabriella; Bruffaerts, Rose; Peeters, Ronald; Adamczuk, Katarzyna; Keuleers, Emmanuel; De Deyne, Simon; Storms, Gerrit; Dupont, Patrick; Vandenberghe, Rik

2017-04-15

The correspondence in meaning extracted from written versus spoken input remains to be fully understood neurobiologically. Here, in a total of 38 subjects, the functional anatomy of cross-modal semantic similarity for concrete words was determined based on a dual criterion: First, a voxelwise univariate analysis had to show significant activation during a semantic task (property verification) performed with written and spoken concrete words compared to the perceptually matched control condition. Second, in an independent dataset, in these clusters, the similarity in fMRI response pattern to two distinct entities, one presented as a written and the other as a spoken word, had to correlate with the similarity in meaning between these entities. The left ventral occipitotemporal transition zone and ventromedial temporal cortex, retrosplenial cortex, pars orbitalis bilaterally, and the left pars triangularis were all activated in the univariate contrast. Only the left pars triangularis showed a cross-modal semantic similarity effect. There was no effect of phonological nor orthographic similarity in this region. The cross-modal semantic similarity effect was confirmed by a secondary analysis in the cytoarchitectonically defined BA45. A semantic similarity effect was also present in the ventral occipital regions but only within the visual modality, and in the anterior superior temporal cortex only within the auditory modality. This study provides direct evidence for the coding of word meaning in BA45 and positions its contribution to semantic processing at the confluence of input-modality specific pathways that code for meaning within the respective input modalities. Copyright © 2017 Elsevier Inc. All rights reserved.

Cross-modal perceptual load: the impact of modality and individual differences.

PubMed

Sandhu, Rajwant; Dyson, Benjamin James

2016-05-01

Visual distractor processing tends to be more pronounced when the perceptual load (PL) of a task is low compared to when it is high [perpetual load theory (PLT); Lavie in J Exp Psychol Hum Percept Perform 21(3):451-468, 1995]. While PLT is well established in the visual domain, application to cross-modal processing has produced mixed results, and the current study was designed in an attempt to improve previous methodologies. First, we assessed PLT using response competition, a typical metric from the uni-modal domain. Second, we looked at the impact of auditory load on visual distractors, and of visual load on auditory distractors, within the same individual. Third, we compared individual uni- and cross-modal selective attention abilities, by correlating performance with the visual Attentional Network Test (ANT). Fourth, we obtained a measure of the relative processing efficiency between vision and audition, to investigate whether processing ease influences the extent of distractor processing. Although distractor processing was evident during both attend auditory and attend visual conditions, we found that PL did not modulate processing of either visual or auditory distractors. We also found support for a correlation between the uni-modal (visual) ANT and our cross-modal task but only when the distractors were visual. Finally, although auditory processing was more impacted by visual distractors, our measure of processing efficiency only accounted for this asymmetry in the auditory high-load condition. The results are discussed with respect to the continued debate regarding the shared or separate nature of processing resources across modalities.

A cooperative function for multisensory stimuli in the induction of approach behavior of a potential mate

PubMed Central

Ågmo, Anders

2017-01-01

Intrasexual competition is an important element of natural selection in which the most attractive conspecific has a considerable reproductive advantage over the others. The conspecifics that are approached first often become the preferred mate partners, and could thus from a biological perspective have a reproductive advantage. This underlines the importance of the initial approach and raises the question of what induces this approach, or what makes a conspecific attractive. Identification of the sensory modalities crucial for the activation of approach is necessary for elucidating the central nervous processes involved in the activation of sexual motivation and eventually copulatory behavior. The initial approach to a potential mate depends on distant stimuli in the modalities of audition, olfaction, vision, and other undefined characteristics. This study investigated the role of the different modalities and the combination of these modalities in the sexual incentive value of a female rat. This study provides evidence that the presence of a single-sensory stimulus with one modality (olfaction, vision, or ‘others’, but not audition) is sufficient to attenuate the preference for a social contact with a male rat. However, a multisensory stimulus of multiple modalities is necessary to induce preference for the stimulus over social contact to a level of an intact receptive female. The initial approach behavior, therefore, seems to be induced by the combination of at least two modalities among which olfaction is crucial. This suggests that there is a cooperative function for the different modalities in the induction of approach behavior of a potential mate. PMID:28306729

All-Arthroscopic Treatment of Intra- and Extra-Articular Localized Villonodular Synovitis of Knee

PubMed Central

Simonetta, Roberto; Florio, Michela; Familiari, Filippo; Gasparini, Giorgio; Rosa, Michele Attilio

2017-01-01

Pigmented villonodular synovitis (PVNS) is a rare, benign, proliferative neoplastic condition affecting synovial-lined anatomic spaces. PVNS is characterized by hypertrophy of a synovial membrane by villous, nodular, and villonodular proliferation, with pigmentation secondary to hemosiderin deposition. The two forms of PVNS that have been described are diffuse (DPVNS) and localized (LPVNS). The knee is the most commonly involved anatomic location, followed by hip, ankle, shoulder, and elbow. Diagnosis of PVNS is not always obvious clinically. Various imaging modalities are often necessary to exclude other conditions and narrow the diagnosis. Magnetic resonance imaging has become the modality of choice for diagnosing PVNS. We present a case of intra-articular LPVNS with an extra-articular extension through the posterior capsule that has been successfully removed in an all-arthroscopic fashion. PMID:29270551

Mesure du Deplacement de Frequence au Maximum de la Raie P20 un Laser CO2 a Ondes Guidees (Measurement of the Frequency Shift at the Peak of the P20 Line of a CO2 Waveguide Laser),

DTIC Science & Technology

1986-06-01

VINCENT ET AL . UNCLASSIFIED JUN 86 DREV-4419/86 F/G 28/5 NI iiiimEEmmomEEI 111-25 W1.6 * AD-A170 318 WIAI iLL. f.Pf I)E V jP ’)MEN, fFIlA 4 H l t A 4...triangulaires Hewlett-Packard, modale 3310B (OSC. 1), dont le signal est amplifi6 par un amplificateur haute ten- sion Lansing, modale 80.315 (PZT AL ...CLASSIFICATION 3 PT AL O.G AL CONTROLE * OSC’ I V-~ ----- GAZ 05; C. - - SPEC-. I -_ _ - - 0 G. -ET SYNC 2 REF. - L - BP -- CSPEC 2 - DET. PYR1C - " VDET

In vivo selective cancer-tracking gadolinium eradicator as new-generation photodynamic therapy agent

PubMed Central

Zhang, Tao; Lan, Rongfeng; Chan, Chi-Fai; Law, Ga-Lai; Wong, Wai-Kwok; Wong, Ka-Leung

2014-01-01

In this work, we demonstrate a modality of photodynamic therapy (PDT) through the design of our truly dual-functional—PDT and imaging—gadolinium complex (Gd-N), which can target cancer cells specifically. In the light of our design, the PDT drug can specifically localize on the anionic cell membrane of cancer cells in which its laser-excited photoemission signal can be monitored without triggering the phototoxic generation of reactive oxygen species—singlet oxygen—before due excitation. Comprehensive in vitro and in vivo studies had been conducted for the substantiation of the effectiveness of Gd-N as such a tumor-selective PDT photosensitizer. This treatment modality does initiate a new direction in the development of “precision medicine” in line with stem cell and gene therapies as tools in cancer therapy. PMID:25453097

Plasmonic mode converter for controlling optical impedance and nanoscale light-matter interaction.

PubMed

Hung, Yun-Ting; Huang, Chen-Bin; Huang, Jer-Shing

2012-08-27

To enable multiple functions of plasmonic nanocircuits, it is of key importance to control the propagation properties and the modal distribution of the guided optical modes such that their impedance matches to that of nearby quantum systems and desired light-matter interaction can be achieved. Here, we present efficient mode converters for manipulating guided modes on a plasmonic two-wire transmission line. The mode conversion is achieved through varying the path length, wire cross section and the surrounding index of refraction. Instead of pure optical interference, strong near-field coupling of surface plasmons results in great momentum splitting and modal profile variation. We theoretically demonstrate control over nanoantenna radiation and discuss the possibility to enhance nanoscale light-matter interaction. The proposed converter may find applications in surface plasmon amplification, index sensing and enhanced nanoscale spectroscopy.

Partially coherent lensfree tomographic microscopy⋄

PubMed Central

Isikman, Serhan O.; Bishara, Waheb; Ozcan, Aydogan

2012-01-01

Optical sectioning of biological specimens provides detailed volumetric information regarding their internal structure. To provide a complementary approach to existing three-dimensional (3D) microscopy modalities, we have recently demonstrated lensfree optical tomography that offers high-throughput imaging within a compact and simple platform. In this approach, in-line holograms of objects at different angles of partially coherent illumination are recorded using a digital sensor-array, which enables computing pixel super-resolved tomographic images of the specimen. This imaging modality, which forms the focus of this review, offers micrometer-scale 3D resolution over large imaging volumes of, for example, 10–15 mm3, and can be assembled in light weight and compact architectures. Therefore, lensfree optical tomography might be particularly useful for lab-on-a-chip applications as well as for microscopy needs in resource-limited settings. PMID:22193016

On-line damage detection in rotating machinery

NASA Astrophysics Data System (ADS)

Alkhalifa, Tareq Jawad

This work is concerned with a set of techniques to detect internal defects in uniform circular discs (rotors). An internal defect is intentionally manufactured in stereolithographic discs by a rapid prototyping process using cured resin SL 5170 material. The analysis and results presented here are limited to a uniform circular disc, with internal defects, mounted on a uniform flexible circular shaft. The setup is comprised of a Bently Nevada rotor kit connected to a data acquisition system. The rotor consists of a disc and shaft that is supported by journal bearings and is coupled to a motor by a rubber joint. Damage produces localized changes in the strain energy, which is quantified to characterize the damage. Based on previous research, the Strain Energy Damage Index (SEDI) is utilized to localize the damage due to strain energy differences between damaged and undamaged modes. To accomplish the objective, this work covers three types of analysis: finite element analysis, vibration analysis, and experimental modal analysis. Finite element analysis (using SDRC Ideas software) is performed to develop a multi-degree-of-freedom (MDOF) rotor system with internal damage, and its dynamic characteristics are investigated. The analysis is performed for two different types damage cases: radial damage and circular damage. Parametric study for radial damage and random noise to undamaged disc have been investigated to predict the effect of noise in the damage detection. The developed on-line damage detection technique for rotating equipment incorporates and couples both vibration analysis and experimental modal analysis. The dynamic investigation of the rotating discs (with and without defect) is conducted by vibration signal analysis (using proximity sensors, data acquisition and LabView). The vibration analysis provides a unique vibration signature for the damaged disc, which indicates the existence of the damage. The vibration data are acquired at different running speeds (1000, 2500, 5000 rpm). Then the dynamic investigation of non-rotating discs (with and without defect) is conducted by experimental modal analysis (using STAR software). While the vibration analysis detects and indicates the existence of damage while the disc is rotating, experimental modal analysis (using STAR and MATLAB software) provides the localization of damage through the modal parameters for a non-rotating disc. Both of the experimental diagnostic algorithms are based on measurement of the dynamic behavior of the damaged disc. The results are compared with the reference, or baseline, one, obtained initially for an undamaged disc. (Abstract shortened by UMI.)

Prevalence trend of renal replacement therapy in Thailand: impact of health economics policy.

PubMed

Praditpornsilpa, Kearkiat; Lekhyananda, Sookruetai; Premasathian, Nalinee; Kingwatanakul, Pornchai; Lumpaopong, Adisorn; Gojaseni, Pongsathorn; Sakulsaengprapha, Amporn; Prasithsirikul, Wisit; Phakdeekitcharoen, Bunyong; Lelamali, Kumthorn; Teepprasan, Tavichai; Aumanaphong, Chatsuda; Leerawat, Benjaporn; Pongpiyadej, Jintana; Srangsomvong, Soysaang; Kanjanabuch, Talerngsak; Eiam-Ong, Somchai; Vareesaengthip, Kriengsak; Lumlertkul, Dusit

2011-09-01

The national health insurance fund in Thailand initiated by the national health security act in November, 2002. In October 2007, the national health insurance fund launched the first renal replacement therapy (RRT) reimbursement plan by the "Peritoneal Dialysis-First" (PD First) policy. The rationale of the PD First Policy resulted from the perspective that PD for end stage renal disease (ESRD) treatment offers the most economic and efficient outcome. The present study was conducted to determine whether the increase of RRT penetration by national health policy could impact the national RRT prevalence. The Thailand Renal Replacement Therapy (TRT) database in 2007, 2008, and 2009 were retrieved and analyzed. By TRT registry data, the total yearly prevalence of RRT increased by an average of 14.8% after the implementation of national health insurance and the "PD First" policy from 2007 to 2009. The total yearly prevalence of hemodialaysis (HD) modestly increased (14.7%) while the total yearly prevalence of PD remarkably expanded by 107.3%. The yearly incidence of all RRT modalities increased by an average of 34.8% in 2007 to 2009. The yearly incidence of HD modestly increased (8.1%) while the total yearly incidence of PD remarkably elevated by 157.8%. Civil Servants Medical Benefit Compensation (CSMBS) was the major funding source of RRT cases (34.5%) while national health insurance funding was the second major funding source (26.0%). From 2007-2009, the CSMBS funding was the majority of HD while national health insurance funding was the majority of PD. The sharing of PD by national health insurance increased from 33.9% in 2007, 58.6% in 2208, and 77.2% in 2009. The coverage ofESRD patients by national health insurance fund by the "PD First" policy impacted the RRT prevalence and incidence both the total prevalence and total incidence due to the universal penetration to RRT treatment of Thai population. Also, the policy altered the RRT modality predisposition. PD modality willfinally be the majority ofThaiRRT modalities if the policy can be managed successfully.

Modal Testing of the NPSAT1 Engineering Development Unit

DTIC Science & Technology

2012-07-01

erkläre ich, dass die vorliegende Master Arbeit von mir selbstständig und nur unter Verwendung der angegebenen Quellen und Hilfsmittel angefertigt...logarithmic scale . As 5 Figure 2 shows, natural frequencies are indicated by large values of the first CMIF (peaks), and multiple modes can be detected by...structure’s behavior. Ewins even states, “that no large- scale modal test should be permitted to proceed until some preliminary SDOF analyses have

The optimal hormonal replacement modality selection for multiple organ procurement from brain-dead organ donors

PubMed Central

Mi, Zhibao; Novitzky, Dimitri; Collins, Joseph F; Cooper, David KC

2015-01-01

The management of brain-dead organ donors is complex. The use of inotropic agents and replacement of depleted hormones (hormonal replacement therapy) is crucial for successful multiple organ procurement, yet the optimal hormonal replacement has not been identified, and the statistical adjustment to determine the best selection is not trivial. Traditional pair-wise comparisons between every pair of treatments, and multiple comparisons to all (MCA), are statistically conservative. Hsu’s multiple comparisons with the best (MCB) – adapted from the Dunnett’s multiple comparisons with control (MCC) – has been used for selecting the best treatment based on continuous variables. We selected the best hormonal replacement modality for successful multiple organ procurement using a two-step approach. First, we estimated the predicted margins by constructing generalized linear models (GLM) or generalized linear mixed models (GLMM), and then we applied the multiple comparison methods to identify the best hormonal replacement modality given that the testing of hormonal replacement modalities is independent. Based on 10-year data from the United Network for Organ Sharing (UNOS), among 16 hormonal replacement modalities, and using the 95% simultaneous confidence intervals, we found that the combination of thyroid hormone, a corticosteroid, antidiuretic hormone, and insulin was the best modality for multiple organ procurement for transplantation. PMID:25565890

The taste-visual cross-modal Stroop effect: An event-related brain potential study.

PubMed

Xiao, X; Dupuis-Roy, N; Yang, X L; Qiu, J F; Zhang, Q L

2014-03-28

Event-related potentials (ERPs) were recorded to explore, for the first time, the electrophysiological correlates of the taste-visual cross-modal Stroop effect. Eighteen healthy participants were presented with a taste stimulus and a food image, and asked to categorize the image as "sweet" or "sour" by pressing the relevant button as quickly as possible. Accurate categorization of the image was faster when it was presented with a congruent taste stimulus (e.g., sour taste/image of lemon) than with an incongruent one (e.g., sour taste/image of ice cream). ERP analyses revealed a negative difference component (ND430-620) between 430 and 620ms in the taste-visual cross-modal Stroop interference. Dipole source analysis of the difference wave (incongruent minus congruent) indicated that two generators localized in the prefrontal cortex and the parahippocampal gyrus contributed to this taste-visual cross-modal Stroop effect. This result suggests that the prefrontal cortex is associated with the process of conflict control in the taste-visual cross-modal Stroop effect. Also, we speculate that the parahippocampal gyrus is associated with the process of discordant information in the taste-visual cross-modal Stroop effect. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

Ares I-X Launch Vehicle Modal Test Measurements and Data Quality Assessments

NASA Technical Reports Server (NTRS)

Templeton, Justin D.; Buehrle, Ralph D.; Gaspar, James L.; Parks, Russell A.; Lazor, Daniel R.

2010-01-01

The Ares I-X modal test program consisted of three modal tests conducted at the Vehicle Assembly Building at NASA s Kennedy Space Center. The first test was performed on the 71-foot 53,000-pound top segment of the Ares I-X launch vehicle known as Super Stack 5 and the second test was performed on the 66-foot 146,000- pound middle segment known as Super Stack 1. For these tests, two 250 lb-peak electro-dynamic shakers were used to excite bending and shell modes with the test articles resting on the floor. The third modal test was performed on the 327-foot 1,800,000-pound Ares I-X launch vehicle mounted to the Mobile Launcher Platform. The excitation for this test consisted of four 1000+ lb-peak hydraulic shakers arranged to excite the vehicle s cantilevered bending modes. Because the frequencies of interest for these modal tests ranged from 0.02 to 30 Hz, high sensitivity capacitive accelerometers were used. Excitation techniques included impact, burst random, pure random, and force controlled sine sweep. This paper provides the test details for the companion papers covering the Ares I-X finite element model calibration process. Topics to be discussed include test setups, procedures, measurements, data quality assessments, and consistency of modal parameter estimates.

Multimodal neural correlates of cognitive control in the Human Connectome Project.

PubMed

Lerman-Sinkoff, Dov B; Sui, Jing; Rachakonda, Srinivas; Kandala, Sridhar; Calhoun, Vince D; Barch, Deanna M

2017-12-01

Cognitive control is a construct that refers to the set of functions that enable decision-making and task performance through the representation of task states, goals, and rules. The neural correlates of cognitive control have been studied in humans using a wide variety of neuroimaging modalities, including structural MRI, resting-state fMRI, and task-based fMRI. The results from each of these modalities independently have implicated the involvement of a number of brain regions in cognitive control, including dorsal prefrontal cortex, and frontal parietal and cingulo-opercular brain networks. However, it is not clear how the results from a single modality relate to results in other modalities. Recent developments in multimodal image analysis methods provide an avenue for answering such questions and could yield more integrated models of the neural correlates of cognitive control. In this study, we used multiset canonical correlation analysis with joint independent component analysis (mCCA + jICA) to identify multimodal patterns of variation related to cognitive control. We used two independent cohorts of participants from the Human Connectome Project, each of which had data from four imaging modalities. We replicated the findings from the first cohort in the second cohort using both independent and predictive analyses. The independent analyses identified a component in each cohort that was highly similar to the other and significantly correlated with cognitive control performance. The replication by prediction analyses identified two independent components that were significantly correlated with cognitive control performance in the first cohort and significantly predictive of performance in the second cohort. These components identified positive relationships across the modalities in neural regions related to both dynamic and stable aspects of task control, including regions in both the frontal-parietal and cingulo-opercular networks, as well as regions hypothesized to be modulated by cognitive control signaling, such as visual cortex. Taken together, these results illustrate the potential utility of multi-modal analyses in identifying the neural correlates of cognitive control across different indicators of brain structure and function. Copyright © 2017 Elsevier Inc. All rights reserved.

Radiation recall gastritis secondary to erlotinib in a patient with pancreatic cancer.

PubMed

Graziani, Casey; Hegde, Sanjay; Saif, Muhammad Wasif

2014-12-01

Radiation recall refers to chemotherapy-triggered inflammation in healthy areas previously exposed to irradiation. Chemotherapeutics known to be associated with radiation recall phenomenon include anthracyclines, taxanes and antimetabolites, such as gemcitabine and capecitabine. Case reports detailing radiation recall dermatitis and pneumonitis associated with erlotinib have been previously described in the literature, however, there are no reported cases describing radiation gastritis associated with erlotinib. We report a patient with pancreatic cancer who developed gastrointestinal bleeding secondary to radiation recall gastritis related to erlotinib exposure. A 57-year-old Hispanic male with pancreatic cancer initially received 7 cycles of FOLFIRINOX followed by capecitabine with radiation therapy for 28 fractions for a total of 5,040 cGy. Re-staging with computed tomography demonstrated stable disease. The patient was then treated with erlotinib and capecitabine for approximately two months before restaging demonstrated progressive disease. Shortly after discontinuing erlotinib and capecitabine, the patient reported maroon colored stools. Laboratory studies demonstrated a precipitous drop in hemoglobin and hematocrit from pre-treatment baseline, ultimately requiring transfusion with packed red blood cells. Subsequent esophagogastroduodenoscopy demonstrated findings consistent with radiation gastritis, with oozing in the gastric body and antrum, which was treated therapeutically with argon plasma coagulation. The patient's gastrointestinal bleed was difficult to control. Over the course of a two-month period - the patient required multiple admissions, repeat therapeutic esophagogastroduodenoscopies and transfusions. Radiation recall from erlotinib is rare but can potentially arise in any site that has been previously irradiated. There may be an association between the pathogenesis of radiation recall and erlotinib's up-regulation of the angiogenic growth factor thymidine phosphorylase. Treating physicians are reminded of the potential toxicity from erlotinib either given concomitantly or followed by radiation. We suggest discontinuing erlotinib if radiation gastritis is observed. We encourage physicians with similar experiences with erlotinib to report their findings. Further studies are warranted to investigate the pathogenesis of this unique phenomenon and its association with erlotinib. Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

Complementary Therapies and Medicines and Reproductive Medicine.

PubMed

Smith, Caroline A; Armour, Mike; Ee, Carolyn

2016-03-01

Complementary therapies and medicines are a broad and diverse range of treatments, and are frequently used by women and their partners during the preconception period to assist with infertility, and to address pregnancy-related conditions. Despite frequent use, the evidence examining the efficacy, effectiveness, and safety for many modalities is lacking, with variable study quality. In this article, we provide an overview of research evidence with the aim of examining the evidence to inform clinical practice. During the preconception period, there is mixed evidence for acupuncture to improve ovulation, or increase pregnancy rates. Acupuncture may improve sperm quality, but there is insufficient evidence to determine whether this results in improved pregnancy and live birth rates. Acupuncture can be described as a low-risk intervention. Chinese and Western herbal medicines may increase pregnancy rates; however, study quality is low. The evaluation of efficacy, effectiveness, and safety during the first trimester of pregnancy has most commonly reported on herbs, supplements, and practices such as acupuncture. There is high-quality evidence reporting the benefits of herbal medicines and acupuncture to treat nausea in pregnancy. The benefit from ginger to manage symptoms of nausea in early pregnancy is incorporated in national clinical guidelines, and vitamin B6 is recommended as a first-line treatment for nausea and vomiting in pregnancy. The safety of ginger and vitamin B6 is considered to be well established, and is based on epidemiological studies. Acupuncture has been shown to reduce back pain and improve function for women in early pregnancy. There is little evidence to support the use of cranberries in pregnancy for prevention of urinary tract infections, and chiropractic treatment for back pain. Overall the numbers of studies are small and of low quality, although the modalities appear to be low risk of harm. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

On-line MR imaging for dose validation of abdominal radiotherapy

NASA Astrophysics Data System (ADS)

Glitzner, M.; Crijns, S. P. M.; de Senneville, B. Denis; Kontaxis, C.; Prins, F. M.; Lagendijk, J. J. W.; Raaymakers, B. W.

2015-11-01

For quality assurance and adaptive radiotherapy, validation of the actual delivered dose is crucial. Intrafractional anatomy changes cannot be captured satisfactorily during treatment with hitherto available imaging modalitites. Consequently, dose calculations are based on the assumption of static anatomy throughout the treatment. However, intra- and interfraction anatomy is dynamic and changes can be significant. In this paper, we investigate the use of an MR-linac as a dose tracking modality for the validation of treatments in abdominal targets where both respiratory and long-term peristaltic and drift motion occur. The on-line MR imaging capability of the modality provides the means to perform respiratory gating of both delivery and acquisition yielding a model-free respiratory motion management under free breathing conditions. In parallel to the treatment, the volumetric patient anatomy was captured and used to calculate the applied dose. Subsequently, the individual doses were warped back to the planning grid to obtain the actual dose accumulated over the entire treatment duration. Ultimately, the planned dose was validated by comparison with the accumulated dose. Representative for a site subject to breathing modulation, two kidney cases (25 Gy target dose) demonstrated the working principle on volunteer data and simulated delivery. The proposed workflow successfully showed its ability to track local dosimetric changes. Integration of the on-line anatomy information could reveal local dose variations  -2.3-1.5 Gy in the target volume of a volunteer dataset. In the adjacent organs at risk, high local dose errors ranging from  -2.5 to 1.9 Gy could be traced back.

Dependency of a therapy-resistant state of cancer cells on a lipid peroxidase pathway* | Office of Cancer Genomics

Cancer.gov

Plasticity of the cell state has been proposed to drive resistance to multiple classes of cancer therapies, thereby limiting their effectiveness. A high-mesenchymal cell state observed in human tumors and cancer cell lines has been associated with resistance to multiple treatment modalities across diverse cancer lineages, but the mechanistic underpinning for this state has remained incompletely understood.

The 12th Annual International Meeting on Simulation Healthcare (IMSH) 2012

DTIC Science & Technology

2012-03-01

Title: Videorecording of Simulated Technical Errors as an Instructional Modality in a Central Venous Catheterization Course Sub Content: Knowledge...bedside procedures, such as insertion of peripheral and central venous catheters, are performed routinely by a wide spectrum of healthcare providers...with Chest Tubes and a Central Venous Line Monday January 30th 2012 4:00 pm – 5:15 pm Training Education and Assessment Shelby Marx, Donald

RF Bearing Estimation in Wireless Sensor Networks

DTIC Science & Technology

2010-01-01

are the main design drivers. Techniques based on ultrasonic and infrared signal modalities have short range and require line-of-sight. Clearly, RF...generating a Doppler shifted RF signal . The small frequency change can be measured even on low cost resource constrained nodes using a radio...is already included in the power budget and RF range is superior to most other signals . Radio signal strength (RSS) based approaches are the most

Quantifying Pharmaceutical Film Coating with Optical Coherence Tomography and Terahertz Pulsed Imaging: An Evaluation.

PubMed

Lin, Hungyen; Dong, Yue; Shen, Yaochun; Zeitler, J Axel

2015-10-01

Spectral domain optical coherence tomography (OCT) has recently attracted a lot of interest in the pharmaceutical industry as a fast and non-destructive modality for quantification of thin film coatings that cannot easily be resolved with other techniques. Because of the relative infancy of this technique, much of the research to date has focused on developing the in-line measurement technique for assessing film coating thickness. To better assess OCT for pharmaceutical coating quantification, this paper evaluates tablets with a range of film coating thickness measured using OCT and terahertz pulsed imaging (TPI) in an off-line setting. In order to facilitate automated coating quantification for film coating thickness in the range of 30-200 μm, an algorithm that uses wavelet denoising and a tailored peak finding method is proposed to analyse each of the acquired A-scan. Results obtained from running the algorithm reveal an increasing disparity between the TPI and OCT measured intra-tablet variability when film coating thickness exceeds 100 μm. The finding further confirms that OCT is a suitable modality for characterising pharmaceutical dosage forms with thin film coatings, whereas TPI is well suited for thick coatings. © 2015 The Authors. Journal of Pharmaceutical Sciences published by Wiley Periodicals, Inc. and the American Pharmacists Association.

Experimental investigation of MRgHIFU sonication with interleaved electronic and mechanical displacement of the focal point for transrectal prostate application

NASA Astrophysics Data System (ADS)

Petrusca, Lorena; Ngo, Jacqueline; Brasset, Lucie; Blanc, Emmanuel; Murillo, Adriana; Auboiroux, Vincent; Cotton, François; Chapelon, Jean-Yves; Salomir, Rares

2012-08-01

High intensity focused ultrasound (HIFU) under MRI guidance may provide minimally invasive treatment for localized prostate cancer. In this study, ex vivo and in vivo experiments were performed using a prostate-dedicated endorectal phased array (16 circular elements arranged on a truncated spherical cap of radius 60 mm) and a translation-rotation mechanical actuator in order to evaluate the lesion formation and the potential interest of dual-modality (electronic and mechanical) interleaved displacement of the focus for volumetric sonication paradigms. Different sonication sequences, including elementary lesions, line scan, slice sweeping and volume sonications, were investigated with a clinical 1.5 T MR scanner. Two orthogonal planes (axial and sagittal) were simultaneously monitored using rapid MR thermometry (PRFS method) and the temperature and thermal dose maps were displayed in real time. No RF interferences were detected in MR acquisition during sonications. The shape of the thermal lesions in vivo was examined at day 5 post-treatment by MRI follow-up (T2w sequence and Gd-T1w-TFE) and postmortem histological analysis. This study suggests that electronic displacement of the focus (along the ultrasound propagation axis) interleaved with mechanical X-Z translations and rotation around B0 can be a suitable modality to treat patient-specific sizes and shapes of a pathologic tissue. The electronic displacement of focus (achieved in less than 0.1 s) is an order of magnitude faster than the mechanical motion of the HIFU device (1 s latency). As an example, for an in vivo volumetric sonication with foci between 32 and 47 mm (7 successive line scans, 11 lines/slice, 4 foci/line) with applied powers between 17.4 and 39.1 Wac, a total duration of sonication of 408.1 s was required to ablate a volume of approximately 5.7 cm3 (semi-chronic lesion measured at day 5), while the maximum temperature elevation reached was 30 °C. While electronic focusing is necessary to speed up the procedure, one should consider as a potential drawback the non-negligible risk for generating secondary lobes with full steering in 3D. Reference-free PRFS thermometry accurately removed the effects of Bo dynamic perturbation in the vicinity of the moving transducer. Therefore, the dual-modality volumetric sonication paradigm represents a cost-effective technological compromise to induce the desired shape of the lesion in the prostate through the limited endorectal space, in a reasonable period of time and without side effects.

Experimental investigation of MRgHIFU sonication with interleaved electronic and mechanical displacement of the focal point for transrectal prostate application.

PubMed

Petrusca, Lorena; Ngo, Jacqueline; Brasset, Lucie; Blanc, Emmanuel; Murillo, Adriana; Auboiroux, Vincent; Cotton, François; Chapelon, Jean-Yves; Salomir, Rares

2012-08-07

High intensity focused ultrasound (HIFU) under MRI guidance may provide minimally invasive treatment for localized prostate cancer. In this study, ex vivo and in vivo experiments were performed using a prostate-dedicated endorectal phased array (16 circular elements arranged on a truncated spherical cap of radius 60 mm) and a translation-rotation mechanical actuator in order to evaluate the lesion formation and the potential interest of dual-modality (electronic and mechanical) interleaved displacement of the focus for volumetric sonication paradigms. Different sonication sequences, including elementary lesions, line scan, slice sweeping and volume sonications, were investigated with a clinical 1.5 T MR scanner. Two orthogonal planes (axial and sagittal) were simultaneously monitored using rapid MR thermometry (PRFS method) and the temperature and thermal dose maps were displayed in real time. No RF interferences were detected in MR acquisition during sonications. The shape of the thermal lesions in vivo was examined at day 5 post-treatment by MRI follow-up (T2w sequence and Gd-T1w-TFE) and postmortem histological analysis. This study suggests that electronic displacement of the focus (along the ultrasound propagation axis) interleaved with mechanical X-Z translations and rotation around B(0) can be a suitable modality to treat patient-specific sizes and shapes of a pathologic tissue. The electronic displacement of focus (achieved in less than 0.1 s) is an order of magnitude faster than the mechanical motion of the HIFU device (1 s latency). As an example, for an in vivo volumetric sonication with foci between 32 and 47 mm (7 successive line scans, 11 lines/slice, 4 foci/line) with applied powers between 17.4 and 39.1 Wac, a total duration of sonication of 408.1 s was required to ablate a volume of approximately 5.7 cm(3) (semi-chronic lesion measured at day 5), while the maximum temperature elevation reached was 30 °C. While electronic focusing is necessary to speed up the procedure, one should consider as a potential drawback the non-negligible risk for generating secondary lobes with full steering in 3D. Reference-free PRFS thermometry accurately removed the effects of B(o) dynamic perturbation in the vicinity of the moving transducer. Therefore, the dual-modality volumetric sonication paradigm represents a cost-effective technological compromise to induce the desired shape of the lesion in the prostate through the limited endorectal space, in a reasonable period of time and without side effects.

Changes of heterogeneous cell populations in the Ishikawa cell line during long-term culture: Proposal for an in vitro clonal evolution model of tumor cells.

PubMed

Kasai, Fumio; Hirayama, Noriko; Ozawa, Midori; Iemura, Masashi; Kohara, Arihiro

2016-06-01

Genomic changes in tumor cell lines can occur during culture, leading to differences between cell lines carrying the same name. In this study, genome profiles between low and high passages were investigated in the Ishikawa 3-H-12 cell line (JCRB1505). Cells contained between 43 and 46 chromosomes and the modal number changed from 46 to 45 during culture. Cytogenetic analysis revealed that a translocation t(9;14), observed in all metaphases, is a robust marker for this cell line. Single-nucleotide polymorphism microarrays showed a heterogeneous copy number in the early passages and distinct profiles at late passages. These results demonstrate that cell culture can lead to elimination of ancestral clones by sequential selection, resulting in extensive replacement with a novel clone. Our observations on Ishikawa cells in vitro are different from the in vivo heterogeneity in which ancestral clones are often retained during tumor evolution and suggest a model for in vitro clonal evolution. Copyright © 2016 Elsevier Inc. All rights reserved.

Neural Bases Of Food Perception: Coordinate-Based Meta-Analyses Of Neuroimaging Studies In Multiple Modalities

PubMed Central

Huerta, Claudia I; Sarkar, Pooja R; Duong, Timothy Q.; Laird, Angela R; Fox, Peter T

2013-01-01

Objective The purpose of this study was to compare the results of the three food-cue paradigms most commonly used for functional neuroimaging studies to determine: i) commonalities and differences in the neural response patterns by paradigm; and, ii) the relative robustness and reliability of responses to each paradigm. Design and Methods functional magnetic resonance imaging (fMRI) studies using standardized stereotactic coordinates to report brain responses to food cues were identified using on-line databases. Studies were grouped by food-cue modality as: i) tastes (8 studies); ii) odors (8 studies); and, iii) images (11 studies). Activation likelihood estimation (ALE) was used to identify statistically reliable regional responses within each stimulation paradigm. Results Brain response distributions were distinctly different for the three stimulation modalities, corresponding to known differences in location of the respective primary and associative cortices. Visual stimulation induced the most robust and extensive responses. The left anterior insula was the only brain region reliably responding to all three stimulus categories. Conclusions These findings suggest visual food-cue paradigm as promising candidate for imaging studies addressing the neural substrate of therapeutic interventions. PMID:24174404

Theory of the control of structures by low authority controllers

NASA Technical Reports Server (NTRS)

Aubrun, J. N.

1978-01-01

The novel idea presented is based on the observation that if a structure is controlled by distributed systems of sensors and actuators with limited authority, i.e., if the controller is allowed to modify only moderately the natural modes and frequencies of the structure, then it should be possible to apply root perturbation techniques to predict analytically the behavior of the total system. Attention is given to the root perturbation formula first derived by Jacobi for infinitesimal perturbations which neglect the induced eigenvector perturbation, a more general form of Jacobi's formula, first-order structural equations and modal state vectors, state-space equations for damper-augmented structures, and modal damping prediction formulas.

The combined effects of high-energy shock waves and ionising radiation on a human bladder cancer cell line.

PubMed

Fickweiler, S; Steinbach, P; Wörle, K; Hofstädter, F

1996-01-01

The effects of high-energy shock waves (HESW) generated by an experimental Siemens lithotripter in combination with 137Cs gamma-rays were examined in vitro. Proliferation after treatment of immobilised pellets of either single cells or multicellular spheroids of the bladder cancer cell line RT4 was determined using colony-forming assays and cell cycle analysis. Surviving and cell cycle fractions were calculated for each shock wave and radiation application mode separately, and for sequential combination in different successions for the purpose of characterizing the interaction of both treatment modalities. Combination of HESW and ionising radiation turned out to act additively or slightly supra-additively on both biologic models.

Highly stable multi-wavelength erbium-doped fiber linear laser based on modal interference

NASA Astrophysics Data System (ADS)

Herrera-Piad, L. A.; Jauregui-Vazquez, D.; Lopez-Dieguez, Y.; Estudillo-Ayala, J. M.; Hernandez-Garcia, J. C.; Sierra-Hernandez, J. M.; Bianchetti, M.; Rojas-Laguna, R.

2018-03-01

We report a linear fiber laser cavity based on an all-fiber Fabry-Perot interferometer and bi-tapered optical fiber for multi-wavelength emission generation. Curvature and strain are used to operate the laser system and the number of lines as well, the emission regions are stronger related to the physical effect applied, due to the phase alteration between the multiple fiber optic modes involved. The original laser emissions present zero wavelength variations, minimal power fluctuations and small spacing mode (1 nm). Additionally, a nonlinear fiber was employed trying to improve the performance of the multiple lasing lines. This system offers a low implementation cost, compactness and good laser parameters.

Using Response Surface Methods to Correlate the Modal Test of an Inflatable Test Article

NASA Technical Reports Server (NTRS)

Gupta, Anju

2013-01-01

This paper presents a practical application of response surface methods (RSM) to correlate a finite element model of a structural modal test. The test article is a quasi-cylindrical inflatable structure which primarily consists of a fabric weave, with an internal bladder and metallic bulkheads on either end. To mitigate model size, the fabric weave was simplified by representing it with shell elements. The task at hand is to represent the material behavior of the weave. The success of the model correlation is measured by comparing the four major modal frequencies of the analysis model to the four major modal frequencies of the test article. Given that only individual strap material properties were provided and material properties of the overall weave were not available, defining the material properties of the finite element model became very complex. First it was necessary to determine which material properties (modulus of elasticity in the hoop and longitudinal directions, shear modulus, Poisson's ratio, etc.) affected the modal frequencies. Then a Latin Hypercube of the parameter space was created to form an efficiently distributed finite case set. Each case was then analyzed with the results input into RSM. In the resulting response surface it was possible to see how each material parameter affected the modal frequencies of the analysis model. If the modal frequencies of the analysis model and its corresponding parameters match the test with acceptable accuracy, it can be said that the model correlation is successful.

A comparison of reduced-order modelling techniques for application in hyperthermia control and estimation.

PubMed

Bailey, E A; Dutton, A W; Mattingly, M; Devasia, S; Roemer, R B

1998-01-01

Reduced-order modelling techniques can make important contributions in the control and state estimation of large systems. In hyperthermia, reduced-order modelling can provide a useful tool by which a large thermal model can be reduced to the most significant subset of its full-order modes, making real-time control and estimation possible. Two such reduction methods, one based on modal decomposition and the other on balanced realization, are compared in the context of simulated hyperthermia heat transfer problems. The results show that the modal decomposition reduction method has three significant advantages over that of balanced realization. First, modal decomposition reduced models result in less error, when compared to the full-order model, than balanced realization reduced models of similar order in problems with low or moderate advective heat transfer. Second, because the balanced realization based methods require a priori knowledge of the sensor and actuator placements, the reduced-order model is not robust to changes in sensor or actuator locations, a limitation not present in modal decomposition. Third, the modal decomposition transformation is less demanding computationally. On the other hand, in thermal problems dominated by advective heat transfer, numerical instabilities make modal decomposition based reduction problematic. Modal decomposition methods are therefore recommended for reduction of models in which advection is not dominant and research continues into methods to render balanced realization based reduction more suitable for real-time clinical hyperthermia control and estimation.

New Optimal Needle Entry Angle for Cervical Transforaminal Epidural Steroid Injections: A Retrospective Study

PubMed Central

Karm, Myong-Hwan; Park, Jun Young; Kim, Doo Hwan; Cho, Hyun-Seok; Lee, Jae-Young; Kwon, Koo; Suh, Jeong Hun

2017-01-01

Objective: A cervical epidural steroid injection is one of the most commonly performed interventions to manage chronic neck pain and cervical radiculopathy. Despite its many severe complications, cervical transforaminal epidural steroid injection (CTFESI) is a clinically necessary modality for managing neck pain and cervical radiculopathy. We aimed in this study to find a safer optimal needle entry angle to decrease the chance of an accidental vertebral artery (VA) puncture even with a proper needle entry angle and to visualize the target of the needle tip. Methods: This retrospective study included 312 patients with neck pain or cervical radiculopathy who had undergone magnetic resonance imaging scans for diagnosis and treatment. The first line was drawn from the midpoint of the two articular pillars and passed through the exact midline of the spinous process. The second line was drawn parallel to the ventral lamina line (conventional transforaminal approach line, CTAL). The third line was drawn parallel to the ventral margin at the midpoint of the superior articular process's ventral border (new transforaminal approach line, NTAL). The angle of intersection between the midline and CTAL versus with NTAL were measured from both sides (right and left) at C5-6, C6-7, and C7-T1 levels. Also, the distance of CTAL and NTAL from VA were measured from both sides at each level. We examined whether the CTAL and NTAL would penetrate the ipsilateral VA, internal carotid artery (ICA), and internal jugular vein (IJV). Results: There were significant differences between CTAL and NTAL angles at all levels (P < 0.001). There were significant differences between the distance of CTAL and NTAL from VA at all levels (P < 0.001). There were also significant differences between the observed frequency of CTAL and NTAL that would penetrate the major ipsilateral vessel (VA, ICA, and IJV) on all levels and sides (P < 0.001~0.030). Conclusion: The angle of NTAL (approximately 70°) is safer than the angle of CTAL (approximately 50°) when considering vascular injuries to vessels, such as the VA, ICA, and IJV. PMID:28553170

Electrophysiological evidence for Audio-visuo-lingual speech integration.

PubMed

Treille, Avril; Vilain, Coriandre; Schwartz, Jean-Luc; Hueber, Thomas; Sato, Marc

2018-01-31

Recent neurophysiological studies demonstrate that audio-visual speech integration partly operates through temporal expectations and speech-specific predictions. From these results, one common view is that the binding of auditory and visual, lipread, speech cues relies on their joint probability and prior associative audio-visual experience. The present EEG study examined whether visual tongue movements integrate with relevant speech sounds, despite little associative audio-visual experience between the two modalities. A second objective was to determine possible similarities and differences of audio-visual speech integration between unusual audio-visuo-lingual and classical audio-visuo-labial modalities. To this aim, participants were presented with auditory, visual, and audio-visual isolated syllables, with the visual presentation related to either a sagittal view of the tongue movements or a facial view of the lip movements of a speaker, with lingual and facial movements previously recorded by an ultrasound imaging system and a video camera. In line with previous EEG studies, our results revealed an amplitude decrease and a latency facilitation of P2 auditory evoked potentials in both audio-visual-lingual and audio-visuo-labial conditions compared to the sum of unimodal conditions. These results argue against the view that auditory and visual speech cues solely integrate based on prior associative audio-visual perceptual experience. Rather, they suggest that dynamic and phonetic informational cues are sharable across sensory modalities, possibly through a cross-modal transfer of implicit articulatory motor knowledge. Copyright © 2017 Elsevier Ltd. All rights reserved.

MODAL TRACKING of A Structural Device: A Subspace Identification Approach

DOE Office of Scientific and Technical Information (OSTI.GOV)

Candy, J. V.; Franco, S. N.; Ruggiero, E. L.

Mechanical devices operating in an environment contaminated by noise, uncertainties, and extraneous disturbances lead to low signal-to-noise-ratios creating an extremely challenging processing problem. To detect/classify a device subsystem from noisy data, it is necessary to identify unique signatures or particular features. An obvious feature would be resonant (modal) frequencies emitted during its normal operation. In this report, we discuss a model-based approach to incorporate these physical features into a dynamic structure that can be used for such an identification. The approach we take after pre-processing the raw vibration data and removing any extraneous disturbances is to obtain a representation ofmore » the structurally unknown device along with its subsystems that capture these salient features. One approach is to recognize that unique modal frequencies (sinusoidal lines) appear in the estimated power spectrum that are solely characteristic of the device under investigation. Therefore, the objective of this effort is based on constructing a black box model of the device that captures these physical features that can be exploited to “diagnose” whether or not the particular device subsystem (track/detect/classify) is operating normally from noisy vibrational data. Here we discuss the application of a modern system identification approach based on stochastic subspace realization techniques capable of both (1) identifying the underlying black-box structure thereby enabling the extraction of structural modes that can be used for analysis and modal tracking as well as (2) indicators of condition and possible changes from normal operation.« less

Development and characterization of a novel human Waldenström Macroglobulinemia cell line (RPCI-WM1; Roswell Park Cancer Institute-Waldenström Macroglobulinemia 1)

PubMed Central

Chitta, Kasyapa S.; Paulus, Aneel; Ailawadhi, Sikander; Foster, Barbara A.; Moser, Michael T.; Starostik, Petr; Masood, Aisha; Sher, Taimur; Miller, Kena C.; Iancu, Dan M.; Conroy, Jeffrey; Nowak, Norma J.; Sait, Sheila N.; Personett, David A.; Coleman, Morton; Furman, Richard R.; Martin, Peter; Ansell, Stephen M.; Lee, Kelvin; Chanan-Khan, Asher A.

2015-01-01

Understanding the biology of Waldenström Macroglobulinemia is hindered by a lack of preclinical models. We report a novel cell line, RPCI-WM1, from a patient treated for WM. The cell line secreted human IgM (hIgM) with k-light chain restriction identical to the primary tumor. The cell line has a modal chromosomal number of 46 and harbors chromosomal changes such as deletion of 6q21, monoallelic deletion of 9p21 (CDKN2A), 13q14 (RB1) and 18q21 (BCL-2) with a consistent amplification of 14q32 (IgH) identical to its founding tumor sample. Clonal relationship was confirmed by identical CDR3 length and single nucleotide polymorphisms as well as a matching IgH sequence of the cell line and founding tumor. Both also harbor a heterozygous, non-synonymous mutation at amino acid 265 in MYD88 gene (L265P). The cell line expresses most of the cell surface markers present on the parent cells. Over all, RPCI-WM1 represents a valuable model to study WM. PMID:22812491

Development and characterization of a novel human Waldenström macroglobulinemia cell line: RPCI-WM1, Roswell Park Cancer Institute - Waldenström Macroglobulinemia 1.

PubMed

Chitta, Kasyapa S; Paulus, Aneel; Ailawadhi, Sikander; Foster, Barbara A; Moser, Michael T; Starostik, Petr; Masood, Aisha; Sher, Taimur; Miller, Kena C; Iancu, Dan M; Conroy, Jeffrey; Nowak, Norma J; Sait, Sheila N; Personett, David A; Coleman, Morton; Furman, Richard R; Martin, Peter; Ansell, Stephen M; Lee, Kelvin; Chanan-Khan, Asher A

2013-02-01

Understanding the biology of Waldenström macroglobulinemia is hindered by a lack of preclinical models. We report a novel cell line, RPCI-WM1, from a patient treated for WM. The cell line secretes human immunoglobulin M (h-IgM) with κ-light chain restriction identical to the primary tumor. The cell line has a modal chromosomal number of 46 and harbors chromosomal changes such as deletion of 6q21, monoallelic deletion of 9p21 (CDKN2A), 13q14 (RB1) and 18q21 (BCL-2), with a consistent amplification of 14q32 (immunoglobulin heavy chain; IgH) identical to its founding tumor sample. The clonal relationship is confirmed by identical CDR3 length and single nucleotide polymorphisms as well as a matching IgH sequence of the cell line and founding tumor. Both also harbor a heterozygous, non-synonymous mutation at amino acid 265 in the MYD88 gene (L265P). The cell line expresses most of the cell surface markers present on the parent cells. Overall, RPCI-WM1 represents a valuable model to study Waldenström macroglobulinemia.

PET/CT versus bone marrow biopsy in the initial evaluation of bone marrow infiltration in various pediatric malignancies.

PubMed

Zapata, Claudia P; Cuglievan, Branko; Zapata, Catalina M; Olavarrieta, Raquel; Raskin, Scott; Desai, Kavita; De Angulo, Guillermo

2018-02-01

Accurate staging is essential in the prognosis and management of pediatric malignancies. Current protocols require screening for marrow infiltration with bone marrow biopsy (BMB) as the gold standard. Positron emission tomography-computed tomography (PET-CT) is commonly used to complete the staging process and can also be used to evaluate marrow infiltration. To compare PET-CT and BMB in the initial evaluation of bone marrow infiltration in pediatric cancers. We retrospectively reviewed new cases of EWS, rhabdomyosarcoma, neuroblastoma, and lymphoma diagnosed between January 2009 and October 2014. Each case had undergone both PET-CT and BMB within 4 weeks without treatment in the interval between screening modalities. We reviewed 69 cases. Bone marrow infiltration was demonstrated in 34 cases by PET-CT and in 18 cases by BMB. The sensitivity and negative predictive value of PET-CT were both 100%. Interestingly, the cases in which infiltration was not detected on BMB had an abnormal marrow signal on PET-CT focal or distant to iliac crest. PET-CT has a high sensitivity when assessing marrow infiltration in pediatric malignancies. Advances in radiologic modalities may obviate the use of invasive, painful, and costly procedures like BMB. Furthermore, biopsy results are limited by insufficient tissue or the degree of marrow infiltration (diffuse vs. focal disease). PET-CT can improve the precision of biopsy when used as a guiding tool. This study proposes the use of PET-CT as first-line screening for bone marrow infiltration to improve the accuracy of staging in new diagnoses. © 2017 Wiley Periodicals, Inc.

Monitoring photodynamic therapy of head and neck malignancies with optical spectroscopies

PubMed Central

Sunar, Ulas

2013-01-01

In recent years there has been significant developments in photosensitizers (PSs), light sources and light delivery systems that have allowed decreasing the treatment time and skin phototoxicity resulting in more frequent use of photodynamic therapy (PDT) in the clinical settings. Compared to standard treatment approaches such as chemo-radiation and surgery, PDT has much reduced morbidity for head and neck malignancies and is becoming an alternative treatment option. It can be used as an adjunct therapy to other treatment modalities without any additive cumulative side effects. Surface illumination can be an option for pre-malignant and early-stage malignancies while interstitial treatment is for debulking of thick tumors in the head and neck region. PDT can achieve equivalent or greater efficacy in treating head and neck malignancies, suggesting that it may be considered as a first line therapy in the future. Despite progressive development, clinical PDT needs improvement in several topics for wider acceptance including standardization of protocols that involve the same administrated light and PS doses and establishing quantitative tools for PDT dosimetry planning and response monitoring. Quantitative measures such as optical parameters, PS concentration, tissue oxygenation and blood flow are essential for accurate PDT dosimetry as well as PDT response monitoring and assessing therapy outcome. Unlike conventional imaging modalities like magnetic resonance imaging, novel optical imaging techniques can quantify PDT-related parameters without any contrast agent administration and enable real-time assessment during PDT for providing fast feedback to clinicians. Ongoing developments in optical imaging offer the promise of optimization of PDT protocols with improved outcomes. PMID:24303476

Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects.

PubMed

Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

2017-12-01

Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy.The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx.24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy.Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. Copyright © 2017 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.

Influencing factors on CPAP adherence and anatomic characteristics of upper airway in OSA subjects

PubMed Central

Park, Pona; Kim, Jinil; Song, Yoon Jae; Lim, Jae Hyun; Cho, Sung Woo; Won, Tae-Bin; Han, Doo Hee; Kim, Dong-Young; Rhee, Chae Seo; Kim, Hyun Jik

2017-01-01

Abstract Although continuous positive airway pressure (CPAP) is the most effective treatment modality, poor adherence still remains a problem for obstructive sleep apnea (OSA) treatment and there is little evidence regarding how this might be improved. This study aims to analyze the anatomic and clinical factors of OSA subjects who failed to comply with CPAP therapy. The medical records of 47 OSA subjects who received CPAP therapy as a first-line treatment modality were retrospectively reviewed. The medical records were reviewed for demographic and polysomnographic data and anatomic findings of the nasal cavity and oropharynx. 24 patients who adhered to CPAP therapy and 23 patients who were nonadherent were enrolled in the study. There were no statistically significant differences in sleep parameters between CPAP-adherent patients and CPAP nonadherent subjects. Mean body mass index of CPAP nonadherent group was significantly higher than CPAP adherent group. Higher grades of septal deviation and hypertrophic change of the inferior turbinate were observed more in the CPAP nonadherent group. In addition, CPAP nonadherent subjects showed considerably bigger tonsils and higher grade palatal position comparing with the CPAP adherent subjects. Subjective discomfort including inconvenience, mouth dryness, and chest discomfort were the main problems for OSA subjects who did not comply with CPAP therapy. Excessive upper airway blockage in the nasal cavity and oropharynx was predominant in CPAP nonadherent subjects, which might cause the reported subjective discomfort that reduces CPAP compliance. Therefore, resolution of these issues is needed to enhance CPAP compliance for control of OSA. PMID:29390419

[Alternative treatments for interstitial cystitis].

PubMed

Gamé, X; Bart, S; Castel-Lacanal, E; De Sèze, M; Karsenty, G; Labat, J-J; Rigaud, J; Scheiber-Nogueira, M C; Ruffion, A

2009-06-01

Interstitial cystitis is the first cause of bladder pain. In case of failure of the usual treatments, several other modalities have been proposed. These therapeutic modalities are posterior sacral root neuromodulation, posterior tibial nerve stimulation, vanilloid agent intravesical instillation, intradetrusor botulinum toxin injections and surgery. A certain efficiency of each of these treatments in the interstitial cystitis has been reported. However, the evaluation of these treatments is limited and the level of evidence is too low to propose these treatments in routine.

Diagnostic Health Monitoring System Development for Army Vehicle Reliability

DTIC Science & Technology

2011-07-01

19-24 3.4 Receiver Operator Characteristics for fault detection ……………………….. 24-28 3.5 Extended diagnostic speed bump modal data analysis...extended diagnostic speed bump was akin to the use of modal impact testing for exciting broadband frequency ranges in mechanical systems for use in...for a front axle wheel crossing measured using long cleat for ( ) first 30, ( ) second 11, ( ) third 11, ( ) fourth 11, and ( ) fifth 11 data series

Weakly-coupled 4-mode step-index FMF and demonstration of IM/DD MDM transmission.

PubMed

Hu, Tao; Li, Juhao; Ge, Dawei; Wu, Zhongying; Tian, Yu; Shen, Lei; Liu, Yaping; Chen, Su; Li, Zhengbin; He, Yongqi; Chen, Zhangyuan

2018-04-02

Weakly coupled-mode division multiplexing (MDM) over few-mode fibers (FMF) for short-reach transmission has attracted great interest, which can avoid multiple-input-multiple-output digital signal processing (MIMO-DSP) by greatly suppressing modal crosstalk. In this paper, step-index FMF supporting 4 linearity polarization (LP) modes for MIMO-free transmission is designed and fabricated for the first time, to our knowledge. Modal crosstalk of the fiber is suppressed by increasing the mode effective refractive index differences. The same fabrication method as standard single-mode fiber is adopted so that it is practical and cost-effective. The mode multiplexer/demultiplexer (MUX/DEMUX) consists of cascaded mode-selective couplers (MSCs), which are designed and fabricated by tapering the proposed FMF with single-mode fiber (SMF). The mode MUX and DEMUX achieve very low modal crosstalk not only for the multiplexing/demultiplexing but also for the coupling to/from the FMF. Based on the fabricated FMF and mode MUX/DEMUX, we successfully demonstrate the first simultaneous 4-modes (LP 01 , LP 11 , LP 21 & LP 31 ) 10-km FMF transmission with 10-Gb/s intensity modulation and MIMO-free direct detection (IM/DD). The modal crosstalk of the whole transmission link is successfully suppressed to less than -16.5 dB. The experimental results indicate that FMF with simple step-index structure supporting 4 weakly-coupled modes is feasible.

Auditory to Visual Cross-Modal Adaptation for Emotion: Psychophysical and Neural Correlates.

PubMed

Wang, Xiaodong; Guo, Xiaotao; Chen, Lin; Liu, Yijun; Goldberg, Michael E; Xu, Hong

2017-02-01

Adaptation is fundamental in sensory processing and has been studied extensively within the same sensory modality. However, little is known about adaptation across sensory modalities, especially in the context of high-level processing, such as the perception of emotion. Previous studies have shown that prolonged exposure to a face exhibiting one emotion, such as happiness, leads to contrastive biases in the perception of subsequently presented faces toward the opposite emotion, such as sadness. Such work has shown the importance of adaptation in calibrating face perception based on prior visual exposure. In the present study, we showed for the first time that emotion-laden sounds, like laughter, adapt the visual perception of emotional faces, that is, subjects more frequently perceived faces as sad after listening to a happy sound. Furthermore, via electroencephalography recordings and event-related potential analysis, we showed that there was a neural correlate underlying the perceptual bias: There was an attenuated response occurring at ∼ 400 ms to happy test faces and a quickened response to sad test faces, after exposure to a happy sound. Our results provide the first direct evidence for a behavioral cross-modal adaptation effect on the perception of facial emotion, and its neural correlate. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

Experiments on vibration control of a piezoelectric laminated paraboloidal shell

NASA Astrophysics Data System (ADS)

Yue, Honghao; Lu, Yifan; Deng, Zongquan; Tzou, Hornsen

2017-01-01

A paraboloidal shell plays a key role in aerospace and optical structural systems applied to large optical reflector, communications antenna, rocket fairing, missile radome, etc. Due to the complexity of analytical procedures, an experimental study of active vibration control of a piezoelectric laminated paraboloidal shell by positive position feedback is carried out. Sixteen PVDF patches are laminated inside and outside of the shell, in which eight of them are used as sensors and eight as actuators to control the vibration of the first two natural modes. Lower natural frequencies and vibration modes of the paraboloidal shell are obtained via the frequency response function analysis by Modal VIEW software. A mathematical model of the control system is formulated by means of parameter identification. The first shell mode is controlled as well as coupled the first and second modes based on the positive position feedback (PPF) algorithm. To minimize the control energy consumption in orbit, an adaptive modal control method is developed in this study by using the PPF in laboratory experiments. The control system collects vibration signals from the piezoelectric sensors to identify location(s) of the largest vibration amplitudes and then select the best two from eight PVDF actuators to apply control forces so that the modal vibration suppression could be accomplished adaptively and effectively.

Modal-space reference-model-tracking fuzzy control of earthquake excited structures

NASA Astrophysics Data System (ADS)

Park, Kwan-Soon; Ok, Seung-Yong

2015-01-01

This paper describes an adaptive modal-space reference-model-tracking fuzzy control technique for the vibration control of earthquake-excited structures. In the proposed approach, the fuzzy logic is introduced to update optimal control force so that the controlled structural response can track the desired response of a reference model. For easy and practical implementation, the reference model is constructed by assigning the target damping ratios to the first few dominant modes in modal space. The numerical simulation results demonstrate that the proposed approach successfully achieves not only the adaptive fault-tolerant control system against partial actuator failures but also the robust performance against the variations of the uncertain system properties by redistributing the feedback control forces to the available actuators.

Anti-extinction in the tactile modality.

PubMed

White, Rebekah C; Aimola Davies, Anne M

2013-01-01

Patients with extinction fail to report a contralesional stimulus when it is presented at the same time as an ipsilesional stimulus, and patients with unilateral neglect fail to report a contralesional stimulus even when there is no competing ipsilesional stimulus. Whereas extinction and neglect are common following stroke, the related phenomenon of anti-extinction is rare--there are four cases of anti-extinction in the literature, and all four cases demonstrated anti-extinction in the visual modality. Patients with anti-extinction do report a contralesional stimulus when it is presented at the same time as an ipsilesional stimulus; but, like patients with neglect, they fail to report a contralesional stimulus when there is no competing ipsilesional stimulus. We present the first case ofanti-extinction in the tactile modality.

Computationally efficient finite-difference modal method for the solution of Maxwell's equations.

PubMed

Semenikhin, Igor; Zanuccoli, Mauro

2013-12-01

In this work, a new implementation of the finite-difference (FD) modal method (FDMM) based on an iterative approach to calculate the eigenvalues and corresponding eigenfunctions of the Helmholtz equation is presented. Two relevant enhancements that significantly increase the speed and accuracy of the method are introduced. First of all, the solution of the complete eigenvalue problem is avoided in favor of finding only the meaningful part of eigenmodes by using iterative methods. Second, a multigrid algorithm and Richardson extrapolation are implemented. Simultaneous use of these techniques leads to an enhancement in terms of accuracy, which allows a simple method such as the FDMM with a typical three-point difference scheme to be significantly competitive with an analytical modal method.

A pilot study of JI-101, an inhibitor of VEGFR-2, PDGFR-β, and EphB4 receptors, in combination with everolimus and as a single agent in an ovarian cancer expansion cohort.

PubMed

Werner, Theresa L; Wade, Mark L; Agarwal, Neeraj; Boucher, Kenneth; Patel, Jesal; Luebke, Aaron; Sharma, Sunil

2015-12-01

JI-101 is an oral multi-kinase inhibitor that targets vascular endothelial growth factor receptor type 2 (VEGFR-2), platelet derived growth factor receptor β (PDGFR-β), and ephrin type-B receptor 4 (EphB4). None of the currently approved angiogenesis inhibitors have been reported to inhibit EphB4, and therefore, JI-101 has a novel mechanism of action. We conducted a pilot trial to assess the pharmacokinetics (PK), tolerability, and efficacy of JI-101 in combination with everolimus in advanced cancers, and pharmacodynamics (PD), tolerability, and efficacy of JI-101 in ovarian cancer. This was the first clinical study assessing anti-tumor activity of JI-101 in a combinatorial regimen. In the PK cohort, four patients received single agent 10 mg everolimus on day 1, 10 mg everolimus and 200 mg JI-101 combination on day 8, and single agent 200 mg JI-101 on day 15. In the PD cohort, eleven patients received single agent JI-101 at 200 mg twice daily for 28 day treatment cycles. JI-101 was well tolerated as a single agent and in combination with everolimus. No serious adverse events were observed. Common adverse events were hypertension, nausea, and abdominal pain. JI-101 increased exposure of everolimus by approximately 22%, suggestive of drug-drug interaction. The majority of patients had stable disease at their first set of restaging scans (two months), although no patients demonstrated a response to the drug per RECIST criteria. The novel mechanism of action of JI-101 is promising in ovarian cancer treatment and further prospective studies of this agent may be pursued in a less refractory patient population or in combination with cytotoxic chemotherapy.

Microtubule actin cross-linking factor 1, a novel target in glioblastoma.

PubMed

Afghani, Najlaa; Mehta, Toral; Wang, Jialiang; Tang, Nan; Skalli, Omar; Quick, Quincy A

2017-01-01

Genetic heterogeneity is recognized as a major contributing factor of glioblastoma resistance to clinical treatment modalities and consequently low overall survival rates. This genetic diversity results in variations in protein expression, both intratumorally and between individual glioblastoma patients. In this regard, the spectraplakin protein, microtubule actin cross-linking factor 1 (MACF1), was examined in glioblastoma. An expression analysis of MACF1 in various types of brain tumor tissue revealed that MACF1 was predominately present in grade III-IV astroctyomas and grade IV glioblastoma, but not in normal brain tissue, normal human astrocytes and lower grade brain tumors. Subsequent genetic inhibition experiments showed that suppression of MACF1 selectively inhibited glioblastoma cell proliferation and migration in cell lines established from patient derived xenograft mouse models and immortalized glioblastoma cell lines that were associated with downregulation of the Wnt-signaling mediators, Axin1 and β-catenin. Additionally, concomitant MACF1 silencing with the chemotherapeutic agent temozolomide (TMZ) used for the clinical treatment of glioblastomas cooperatively reduced the proliferative capacity of glioblastoma cells. In conclusion, the present study represents the first investigation on the functional role of MACF1 in tumor cell biology, as well as demonstrates its potential as a unique biomarker that can be targeted synergistically with TMZ as part of a combinatorial therapeutic approach for the treatment of genetically multifarious glioblastomas.

Medical student knowledge regarding radiology before and after a radiological anatomy module: implications for vertical integration and self-directed learning.

PubMed

Murphy, Kevin P; Crush, Lee; O'Malley, Eoin; Daly, Fergus E; O'Tuathaigh, Colm M P; O'Connor, Owen J; Cryan, John F; Maher, Michael M

2014-10-01

To examine the impact that anatomy-focused radiology teaching has on non-examined knowledge regarding radiation safety and radiology as a specialty. First-year undergraduate medical students completed surveys prior to and after undertaking the first-year anatomy programme that incorporates radiological anatomy. Students were asked opinions on preferred learning methodology and tested on understanding of radiology as a specialty and radiation safety. Pre-module and post-module response rates were 93 % (157/168) and 85 % (136/160), respectively. Pre-module and post-module, self-directed learning (SDL) ranked eighth (of 11) for preferred gross-anatomy teaching formats. Correct responses regarding radiologist/radiographer roles varied from 28-94 % on 16 questions with 4/16 significantly improving post-module. Identification of modalities that utilise radiation significantly improved for five of eight modalities post-module but knowledge regarding relative amount of modality-specific radiation use was variable pre-module and post-module. SDL is not favoured as an anatomy teaching method. Exposure of students to a radiological anatomy module delivered by senior clinical radiologists improved basic knowledge regarding ionising radiation use, but there was no improvement in knowledge regarding radiation exposure relative per modality. A possible explanation is that students recall knowledge imparted in didactic lectures but do little reading around the subject when the content is not examined. • Self-directed learning is not favoured as a gross anatomy teaching format amongst medical students. • An imaging anatomy-focused module improved basic knowledge regarding ionising radiation use. • Detailed knowledge of modality-specific radiation exposure remained suboptimal post-module. • Knowledge of roles within a clinical radiology department showed little change post-module.

Effect of center practices on the choice of the first dialysis modality for children and young adults.

PubMed

Hogan, Julien; Ranchin, Bruno; Fila, Marc; Harambat, Jérome; Krid, Saoussen; Vrillon, Isabelle; Roussey, Gwenaelle; Fischbach, Michel; Couchoud, Cécile

2017-04-01

Peritoneal dialysis (PD) remains the modality of choice in children, but there is no clear evidence to support a better outcome in children treated with PD. We aimed to assess factors that have an impact on the choice of dialysis modality in children and young adults in France and sought to determine the roles of medical factors and center practices. We included all patients aged <20 years at the start of renal replacement therapy (RRT), recorded in the French RRT Registry between 2002 and 2013. Hierarchical logistic regression models were used to study the association between the patient/center characteristics and the probability of receiving PD as the first dialysis modality. We included 806 patients starting RRT in 177 centers, 23 of which were specialized pediatric centers. Six hundred and one patients (74.6 %) started with hemodialysis (HD), whereas 205 (25.4 %) started with PD. A greater probability of PD was found in younger children, whereas starting the treatment in an emergency setting was associated with a low use of PD. We found a significant variability among centers that accounted for 43 % of the total variability. The probability of PD was higher in adult centers and was proportional to the rate of PD in the center. Center practices are a major factor in the choice of dialysis modality. This raises concerns about patient and family choices and to what extent doctors may influence the final decision. Further pediatric studies focusing on children's and parents' wishes are needed to provide care as close as possible to patients' and families' expectations.

First-line sonographic diagnosis of pneumothorax in major trauma: accuracy of e-FAST and comparison with multidetector computed tomography.

PubMed

Ianniello, Stefania; Di Giacomo, Vincenza; Sessa, Barbara; Miele, Vittorio

2014-09-01

Combined clinical examination and supine chest radiography have shown low accuracy in the assessment of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room. The aim of our study was to evaluate the diagnostic accuracy of extended-focused assessment with sonography in trauma (e-FAST), in the diagnosis of pneumothorax, compared with the results of multidetector computed tomography (MDCT) and of invasive interventions (thoracostomy tube placement). This was a retrospective case series involving 368 consecutive unstable adult patients (273 men and 95 women; average age, 25 years; range, 16-68 years) admitted to our hospital's emergency department between January 2011 and December 2012 for major trauma (Injury Severity Score ≥ 15). We evaluated the accuracy of thoracic ultrasound in the detection of pneumothorax compared with the results of MDCT and invasive interventions (thoracostomy tube placement). Institutional review board approval was obtained prior to commencement of this study. Among the 736 lung fields included in the study, 87 pneumothoraces were detected with thoracic CT scans (23.6%). e-FAST detected 67/87 and missed 20 pneumothoraces (17 mild, 3 moderate). The diagnostic performance of ultrasound was: sensitivity 77% (74% in 2011 and 80% in 2012), specificity 99.8%, positive predictive value 98.5%, negative predictive value 97%, accuracy 97.2% (67 true positive; 668 true negative; 1 false positive; 20 false negative); 17 missed mild pneumothoraces were not immediately life-threatening (thickness less than 5 mm). Thoracic ultrasound (e-FAST) is a rapid and accurate first-line, bedside diagnostic modality for the diagnosis of pneumothorax in unstable patients with major chest trauma during the primary survey in the emergency room.

Examining the effects of a mindfulness-based distance learning professional training module on personal and professional functioning: a qualitative study.

PubMed

Whitesman, Simon; Mash, Robert

2016-11-09

Training people to deliver mindfulness-based interventions (MBI) is becoming an important activity as mindfulness has been shown to have clinical benefits across a variety of conditions. Training courses must not only address the principles, skills and theory of mindfulness, but the trainers themselves must be able to embody the practice. There is limited research on the ability of teachers-in-training to embody the practice as a result of teacher training programmes. This study explored the extent to which a short course enabled future teachers to embody mindfulness practice. This first module was part of a larger course of four modules to prepare future teachers of MBIs. Qualitative data was obtained from 10 out of 35 end of course written assignments that asked respondents to reflect on their experience of mindfulness practice during the course. These were systematically selected and a focus group interview was also conducted with local participants. Data was analysed by means of the framework method and key themes identified. The combination of a retreat and on-line learning was perceived to be effective. Students reported significant changes in personal functioning as a result of daily mindfulness practice: self-awareness, improved relationships, enhanced connectedness, better self-regulation, enhanced compassion and curiosity towards self and others and self-acceptance. Participants began to introduce elements of mindfulness into their professional practice. The first module of a post-graduate training programme for health professionals who want to teach MBIs successfully supported students to embody, explore and apply mindfulness in their lives. The integrated teaching modalities of residential retreat and distance-based on-line learning appeared effective.

Treatment practices for Chiari malformation type I with syringomyelia: results of a survey of the American Society of Pediatric Neurosurgeons.

PubMed

Rocque, Brandon G; George, Timothy M; Kestle, John; Iskandar, Bermans J

2011-11-01

The purpose of this study was to report the results of a survey of the American Society of Pediatric Neurosurgeons (ASPN) on treatment of Chiari malformation Type I (CM-I) with syringomyelia. A questionnaire was circulated during the 2006 meeting of the ASPN, in which surgeons were surveyed on their management of patients with CM-I and syringomyelia. The survey consisted of questions about 4 clinical scenarios, common causes of surgical failures, and complications. There were 72 respondents, representing more than 90% of attendees at the 2006 ASPN meeting and approximately half of the society's members. The majority of respondents (85%) reported that they perform posterior fossa decompression as first-line treatment for CM-I with syringomyelia. Seven percent perform bony decompression alone, 36% open the dura, and 27% shrink the tonsils. Very few respondents indicated that they offer syrinx drainage as first-line therapy (< 3%). Although all respondents reported that they treat symptomatic CM-I/syringomyelia patients surgically, 15% of respondents indicated that they do not operate on asymptomatic patients. Finally, respondents stated that their most common complications are pseudomeningocele and chemical meningitis. This survey, given to a representative group of experienced North American pediatric neurosurgeons, confirms that posterior fossa decompression is still the preferred treatment modality in children with CM-I and syringomyelia, regardless of symptoms. Although most surgeons open the dura, preferred techniques for decompression vary. In contrast to the results of past surveys, conservative follow-up is now only used by a minority of respondents and only in the asymptomatic patient, and primary syrinx drainage seems to have lost popularity. A multicenter trial of surgical outcomes has been designed based on the information from this survey.

Adriamycin and cis-platinum as first-line treatment in unresectable locally advanced or metastatic adult soft-tissue sarcomas.

PubMed

Kalofonos, Haralabos P; Bafaloukos, Dimitrios; Kourelis, Theodoros G; Karamouzis, Michalis V; Megas, Panagiotis; Iconomou, Grigorios; Tsiata, Ekaterini; Dimitropoulos, Dimitrios; Kosmidis, Paris; Lampiris, E

2004-06-01

Standard chemotherapy in advanced adult soft-tissue sarcomas (STS) has not yet been established. We evaluated the efficacy and toxicity of the combination of adriamycin (ADR) and cis-platinum (CDDP) as first-line treatment in nonoperable locally advanced or metastatic adult STS. Thirty patients were treated with CDDP 100 mg/m2 on day 1 and ADR 75 mg/m2 equally divided on days 1 to 3, every 3 weeks for 6 cycles. Patients were evaluated for response, toxicity, and survival, while resectability of residual disease was also assessed after the third cycle and the end of chemotherapy. No complete response was observed. Five patients (16.7%, 95% CI: 2.5%-31%) achieved partial response, 16 patients (53.3%, 95% CI: 34%-72%) had stable disease and 9 patients (30%, 95% CI: 13%-47%) had progressive disease. The overall median survival was 11.5 months (range, 4-96 months), and the median time to disease progression was 6 months (range, 0-96 months). Furthermore, two patients with PR and six patients with stable disease underwent further surgery followed by radiotherapy in four of them. At present, 5 patients remain free of relapse for 96, 90, 72, 60, and 48 months, respectively. Treatment-related toxicity was acceptable, with moderate myelosuppression and alopecia as the main adverse events. The ADR/CDDP regimen was well tolerated, but it did not achieve a high response rate. However, patients with resectable disease after chemotherapy achieved long-term survival. Further studies are needed to evaluate the role of combined-modality treatments in the management of patients with advanced STS.

Review of hormone-based treatments in postmenopausal patients with advanced breast cancer focusing on aromatase inhibitors and fulvestrant

PubMed Central

Kümler, Iben; Knoop, Ann S; Jessing, Christina A R; Ejlertsen, Bent; Nielsen, Dorte L

2016-01-01

Background Endocrine therapy constitutes a central modality in the treatment of oestrogen receptor (ER)-positive advanced breast cancer. Purpose To evaluate the evidence for endocrine treatment in postmenopausal patients with advanced breast cancer focusing on the aromatase inhibitors, letrozole, anastrozole, exemestane and fulvestrant. Methods A review was carried out using PubMed. Randomised phase II and III trials reporting on ≥100 patients were included. Results 35 trials met the inclusion criteria. If not used in the adjuvant setting, a non-steroid aromatase inhibitor was the optimal first-line option. In general, the efficacy of the different aromatase inhibitors and fulvestrant was similar in tamoxifen-refractory patients. A randomised phase II trial of palbociclib plus letrozole versus letrozole alone showed significantly increased progression-free survival (PFS) when compared with endocrine therapy alone in the first-line setting (20.2 vs 10.2 months). Furthermore, the addition of everolimus to exemestane in the Breast Cancer Trials of OraL EveROlimus-2 (BOLERO-2) study resulted in an extension of median PFS by 4.5 months after recurrence/progression on a non-steroid aromatase inhibitor. However, overall survival was not significantly increased. Conclusion Conventional treatment with an aromatase inhibitor or fulvestrant may be an adequate treatment option for most patients with hormone receptor-positive advanced breast cancer. Mammalian target of rapamycin (mTOR) inhibition and cyclin-dependent kinase 4/6 (CDK4/6) inhibition might represent substantial advances for selected patients in some specific settings. However, there is an urgent need for prospective biomarker-driven trials to identify patients for whom these treatments are cost-effective. PMID:27843622