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Sample records for mdct generally underestimates

  1. Underestimation of left atrial size measured with transthoracic echocardiography compared with 3D MDCT.

    PubMed

    Koka, Anish R; Yau, James; Van Why, Carolyn; Cohen, Ira S; Halpern, Ethan J

    2010-05-01

    High-resolution 64-MDCT images of the beating heart can be used for measurement of left atrial volume with 3D chamber reconstruction. The purpose of this study was to correlate measurements of left atrial volume obtained with clinical transthoracic echocardiography (TTE) and measurements obtained with 64-MDCT 3D reconstructions of the left atrium. Patients who underwent TTE and MDCT within 3 days were identified. TTE images were graded as excellent, good, or suboptimal. Two independent observers calculated estimates of left atrial volume from TTE and 64-MDCT images using 3D chamber reconstructions and conventional geometric assumptions on MDCT echocardiographic views. MDCT estimates of phantom volume on 3D chamber reconstructions agreed with actual volumes within 1.5%. The TTE images of 37 of the 52 patients were judged to be of good or excellent quality and were included in the analysis. Mean left atrial volume measured on 3D chamber reconstructions was 61 +/- 14 mL/m(2). Estimates of left atrial volume obtained with TTE were significantly lower (28 +/- 12 mL/m(2)) than similar estimates obtained with MDCT echocardiographic views (53 +/- 15 mL/m(2)) (p < 0.001). TTE left atrial volume and 3D chamber reconstruction left atrial volume exhibited moderate correlation (r = 0.60-0.70), but the correlation improved when analysis was limited to the 26 studies with excellent-quality TTE images (r = 0.71). MDCT echocardiographic estimates of left atrial volume with the area-length method had excellent correlation (r = 0.89) with and were closest to estimates made on 3D chamber reconstructions. Left atrial volume is significantly underestimated on TTE images, and TTE estimates have moderate correlation with left atrial volume measured with MDCT. Measured and estimated left atrial volumes at MDCT can provide important additive prognostic information in the care of patients undergoing MDCT for other reasons. Future studies are needed to obtain normative MDCT measurements of

  2. Dose reduction in paediatric MDCT: general principles.

    PubMed

    Paterson, A; Frush, D P

    2007-06-01

    The number of multi-detector array computed tomography (MDCT) examinations performed per annum continues to increase in both the adult and paediatric populations. Estimates from 2003 suggested that CT contributed 17% of a radiology department's workload, yet was responsible for up to 75% of the collective population dose from medical radiation. The effective doses for some CT examinations today overlap with those argued to have an increased risk of cancer. This is especially pertinent for paediatric CT, as children are more radiosensitive than adults (and girls more radiosensitive than boys). In addition, children have a longer life ahead of them, in which radiation induced cancers may become manifest. Radiologists must be aware of these facts and practise the ALARA (as low as is reasonably achievable) principle, when it comes to deciding CT protocols and parameters.

  3. Health information regarding diabetes mellitus reduces misconceptions and underestimation of consequences in the general population.

    PubMed

    Dorner, Thomas E; Lackinger, Christian; Schindler, Karin; Stein, K Viktoria; Rieder, Anita; Ludvik, Bernhard

    2013-11-01

    To evaluate self-assessed knowledge about diabetes mellitus, to assess determinants of health knowledge and to evaluate consequences of health knowledge on appraisal about consequences of the disease. Population-based computer-assisted web interview survey, supplemented with a paper-and-pencil survey via post. Representative sample of the general Austrian population aged 15 years and older. Men (n 1935) and women (n 2065) with and without diabetes mellitus. Some 20.5% of men and 17.7% of women with diabetes, and 46.2% of men and 36.7% of women without diabetes, rated their knowledge about diabetes mellitus to be ‘very bad’ or ‘rather bad’. Individuals with diabetes and individuals with a family member with diabetes rated their information level more often as ‘very good’ or ‘rather good’, with adjusted OR (95% CI) of 1.7 (1.1, 2.8) and 2.1 (1.6, 2.7), respectively, in men and 2.7 (1.5, 4.8) and 2.7 (2.1, 3.5), respectively, in women. Additional significant influencing factors on diabetes knowledge were age and educational level in both sexes, and city size in men. Independent of personal diabetes status, diabetes knowledge was associated with a lower perception of restrictions on daily life of diabetes patients and with a lower probability of underestimating health consequences of diabetes. Health knowledge is associated with fewer misconceptions and less underestimation of health consequences in individuals both with and without diabetes mellitus. Thus health information about diabetes is important on the individual level towards disease management as well as on the public health level towards disease prevention.

  4. FIA's volume-to-biomass conversion method (CRM) generally underestimates biomass in comparison to published equations

    Treesearch

    David. C. Chojnacky

    2012-01-01

    An update of the Jenkins et al. (2003) biomass estimation equations for North American tree species resulted in 35 generalized equations developed from published equations. These 35 equations, which predict aboveground biomass of individual species grouped according to a taxa classification (based on genus or family and sometimes specific gravity), generally predicted...

  5. MDCT of abdominopelvic oncologic emergencies

    PubMed Central

    Tirumani, Sree Harsha; Gunabushanam, Gowthaman; Chintapalli, Kedar N; Ryan, John G; Reinhold, Caroline

    2013-01-01

    Abstract Acute complications arising in abdominopelvic malignancies represent a unique subset of patients presenting to the emergency room. The acute presentation can be due to complications occurring in the tumor itself or visceral or vascular structures harboring the tumor. Multidetector computed tomography (MDCT) is the investigation of choice in the workup of these patients and enables appropriate and timely management. Management of the complication depends primarily on the extent of the underlying malignancy and the involvement of other viscera. The purpose of this article is to depict the imaging features of these complications on MDCT. PMID:23876309

  6. Comparison between MDCT and Grayscale IVUS in a Quantitative Analysis of Coronary Lumen in Segments with or without Atherosclerotic Plaques.

    PubMed

    Falcão, João L A A; Falcão, Breno A A; Gurudevan, Swaminatha V; Campos, Carlos M; Silva, Expedito R; Kalil-Filho, Roberto; Rochitte, Carlos E; Shiozaki, Afonso A; Coelho-Filho, Otavio R; Lemos, Pedro A

    2015-01-27

    Background: The diagnostic accuracy of 64-slice MDCT in comparison with IVUS has been poorly described and is mainly restricted to reports analyzing segments with documented atherosclerotic plaques. Objectives: We compared 64-slice multidetector computed tomography (MDCT) with gray scale intravascular ultrasound (IVUS) for the evaluation of coronary lumen dimensions in the context of a comprehensive analysis, including segments with absent or mild disease. Methods: The 64-slice MDCT was performed within 72 h before the IVUS imaging, which was obtained for at least one coronary, regardless of the presence of luminal stenosis at angiography. A total of 21 patients were included, with 70 imaged vessels (total length 114.6 ± 38.3 mm per patient). A coronary plaque was diagnosed in segments with plaque burden > 40%. Results: At patient, vessel, and segment levels, average lumen area, minimal lumen area, and minimal lumen diameter were highly correlated between IVUS and 64-slice MDCT (p < 0.01). However, 64-slice MDCT tended to underestimate the lumen size with a relatively wide dispersion of the differences. The comparison between 64-slice MDCT and IVUS lumen measurements was not substantially affected by the presence or absence of an underlying plaque. In addition, 64-slice MDCT showed good global accuracy for the detection of IVUS parameters associated with flow-limiting lesions. Conclusions: In a comprehensive, multi-territory, and whole-artery analysis, the assessment of coronary lumen by 64-slice MDCT compared with coronary IVUS showed a good overall diagnostic ability, regardless of the presence or absence of underlying atherosclerotic plaques.

  7. Comparison between MDCT and Grayscale IVUS in a Quantitative Analysis of Coronary Lumen in Segments with or without Atherosclerotic Plaques

    PubMed Central

    Falcão, João L. A. A.; Falcão, Breno A. A.; Gurudevan, Swaminatha V.; Campos, Carlos M.; Silva, Expedito R.; Kalil-Filho, Roberto; Rochitte, Carlos E.; Shiozaki, Afonso A.; Coelho-Filho, Otavio R.; Lemos, Pedro A.

    2015-01-01

    Background The diagnostic accuracy of 64-slice MDCT in comparison with IVUS has been poorly described and is mainly restricted to reports analyzing segments with documented atherosclerotic plaques. Objectives We compared 64-slice multidetector computed tomography (MDCT) with gray scale intravascular ultrasound (IVUS) for the evaluation of coronary lumen dimensions in the context of a comprehensive analysis, including segments with absent or mild disease. Methods The 64-slice MDCT was performed within 72 h before the IVUS imaging, which was obtained for at least one coronary, regardless of the presence of luminal stenosis at angiography. A total of 21 patients were included, with 70 imaged vessels (total length 114.6 ± 38.3 mm per patient). A coronary plaque was diagnosed in segments with plaque burden > 40%. Results At patient, vessel, and segment levels, average lumen area, minimal lumen area, and minimal lumen diameter were highly correlated between IVUS and 64-slice MDCT (p < 0.01). However, 64-slice MDCT tended to underestimate the lumen size with a relatively wide dispersion of the differences. The comparison between 64-slice MDCT and IVUS lumen measurements was not substantially affected by the presence or absence of an underlying plaque. In addition, 64-slice MDCT showed good global accuracy for the detection of IVUS parameters associated with flow-limiting lesions. Conclusions In a comprehensive, multi-territory, and whole-artery analysis, the assessment of coronary lumen by 64-slice MDCT compared with coronary IVUS showed a good overall diagnostic ability, regardless of the presence or absence of underlying atherosclerotic plaques. PMID:25993595

  8. Comparison between MDCT and Grayscale IVUS in a Quantitative Analysis of Coronary Lumen in Segments with or without Atherosclerotic Plaques.

    PubMed

    Falcão, João L A A; Falcão, Breno A A; Gurudevan, Swaminatha V; Campos, Carlos M; Silva, Expedito R; Kalil-Filho, Roberto; Rochitte, Carlos E; Shiozaki, Afonso A; Coelho-Filho, Otavio R; Lemos, Pedro A

    2015-04-01

    The diagnostic accuracy of 64-slice MDCT in comparison with IVUS has been poorly described and is mainly restricted to reports analyzing segments with documented atherosclerotic plaques. We compared 64-slice multidetector computed tomography (MDCT) with gray scale intravascular ultrasound (IVUS) for the evaluation of coronary lumen dimensions in the context of a comprehensive analysis, including segments with absent or mild disease. The 64-slice MDCT was performed within 72 h before the IVUS imaging, which was obtained for at least one coronary, regardless of the presence of luminal stenosis at angiography. A total of 21 patients were included, with 70 imaged vessels (total length 114.6 ± 38.3 mm per patient). A coronary plaque was diagnosed in segments with plaque burden > 40%. At patient, vessel, and segment levels, average lumen area, minimal lumen area, and minimal lumen diameter were highly correlated between IVUS and 64-slice MDCT (p < 0.01). However, 64-slice MDCT tended to underestimate the lumen size with a relatively wide dispersion of the differences. The comparison between 64-slice MDCT and IVUS lumen measurements was not substantially affected by the presence or absence of an underlying plaque. In addition, 64-slice MDCT showed good global accuracy for the detection of IVUS parameters associated with flow-limiting lesions. In a comprehensive, multi-territory, and whole-artery analysis, the assessment of coronary lumen by 64-slice MDCT compared with coronary IVUS showed a good overall diagnostic ability, regardless of the presence or absence of underlying atherosclerotic plaques.

  9. Have We Substantially Underestimated the Impact of Improved Sanitation Coverage on Child Health? A Generalized Additive Model Panel Analysis of Global Data on Child Mortality and Malnutrition

    PubMed Central

    Prüss-Ustün, Annette

    2016-01-01

    Background Although widely accepted as being one of the most important public health advances of the past hundred years, the contribution that improving sanitation coverage can make to child health is still unclear, especially since the publication of two large studies of sanitation in India which found no effect on child morbidity. We hypothesis that the value of sanitation does not come directly from use of improved sanitation but from improving community coverage. If this is so we further hypothesise that the relationship between sanitation coverage and child health will be non-linear and that most of any health improvement will accrue as sanitation becomes universal. Methods We report a fixed effects panel analysis of country level data using Generalized Additive Models in R. Outcome variables were under 5 childhood mortality, neonatal mortality, under 5 childhood mortality from diarrhoea, proportion of children under 5 with stunting and with underweight. Predictor variables were % coverage by improved sanitation, improved water source, Gross Domestic Product per capita and Health Expenditure per capita. We also identified three studies reporting incidence of diarrhoea in children under five alongside gains in community coverage in improved sanitation. Findings For each of the five outcome variables, sanitation coverage was independently associated with the outcome but this association was highly non-linear. Improving sanitation coverage was very strongly associated with under 5 years diarrhoea mortality, under 5years all-cause mortality, and all-cause neonatal mortality. There was a decline as sanitation coverage increased up to about 20% but then no further decline was seen until about 70% (60% for diarrhoea mortality and 80% for neonatal mortality, respectively). The association was less strong for stunting and underweight but a threshold about 50% coverage was also seen. Three large trials of sanitation on diarrhoea morbidity gave results that were similar

  10. Underestimation of Project Costs

    NASA Technical Reports Server (NTRS)

    Jones, Harry W.

    2015-01-01

    Large projects almost always exceed their budgets. Estimating cost is difficult and estimated costs are usually too low. Three different reasons are suggested: bad luck, overoptimism, and deliberate underestimation. Project management can usually point to project difficulty and complexity, technical uncertainty, stakeholder conflicts, scope changes, unforeseen events, and other not really unpredictable bad luck. Project planning is usually over-optimistic, so the likelihood and impact of bad luck is systematically underestimated. Project plans reflect optimism and hope for success in a supposedly unique new effort rather than rational expectations based on historical data. Past project problems are claimed to be irrelevant because "This time it's different." Some bad luck is inevitable and reasonable optimism is understandable, but deliberate deception must be condemned. In a competitive environment, project planners and advocates often deliberately underestimate costs to help gain project approval and funding. Project benefits, cost savings, and probability of success are exaggerated and key risks ignored. Project advocates have incentives to distort information and conceal difficulties from project approvers. One naively suggested cure is more openness, honesty, and group adherence to shared overall goals. A more realistic alternative is threatening overrun projects with cancellation. Neither approach seems to solve the problem. A better method to avoid the delusions of over-optimism and the deceptions of biased advocacy is to base the project cost estimate on the actual costs of a large group of similar projects. Over optimism and deception can continue beyond the planning phase and into project execution. Hard milestones based on verified tests and demonstrations can provide a reality check.

  11. MDCT Versus MRI Assessment of Tumor Response After Transarterial Chemoembolization for the Treatment of Hepatocellular Carcinoma

    SciTech Connect

    Kloeckner, Roman; Otto, Gerd; Biesterfeld, Stefan; Oberholzer, Katja; Dueber, Christoph; Pitton, Michael B.

    2010-06-15

    The purpose of this study was to compare the ability of multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) to evaluate treatment results after transarterial chemoembolization (TACE), with a special focus on the influence of Lipiodol on calculation of tumor necrosis according to EASL criteria. A total of 115 nodules in 20 patients (17 males, 3 females; 69.5 {+-} 9.35 years) with biopsy-proven hepatocellular carcinoma were treated with TACE. Embolization was performed using a doxorubicin-Lipiodol emulsion (group I) or DC Beads loaded with doxorubicin (group II). Follow-up included triphasic contrast-enhanced 64-row MDCT (collimation, 0.625 mm; slice, 3 mm; contrast bolus, 120 ml iomeprol; delay by bolus trigger) and contrast-enhanced MRI (T1 native, T2 native; five dynamic contrast-enhanced phases; 0.1 mmol/kg body weight gadolinium-DTPA; slice thickness, 4 mm). Residual tumor and the extent of tumor necrosis were evaluated according to EASL. Contrast enhancement within tumor lesions was suspected to represent vital tumor. In the Lipiodol-based TACE protocol, MDCT underestimated residual viable tumor compared to MRI, due to Lipiodol artifacts (23.2% vs 47.7% after first, 11.9% vs 31.2% after second, and 11.4% vs 23.7% after third TACE; p = 0.0014, p < 0.001, and p < 0.001, respectively). In contrast to MDCT, MRI was completely free of any artifacts caused by Lipiodol. In the DC Bead-based Lipiodol-free TACE protocol, MRI and CT showed similar residual tumor and rating of treatment results (46.4% vs 41.2%, 31.9 vs 26.8%, and 26.0% vs 25.6%; n.s.). In conclusion, MRI is superior to MDCT for detection of viable tumor residuals after Lipiodol-based TACE. Since viable tumor tissue is superimposed by Lipiodol artifacts in MDCT, MRI is mandatory for reliable decision-making during follow-up after Lipiodol-based TACE protocols.

  12. Underestimation of adolescent obesity.

    PubMed

    Buttenheim, Alison M; Goldman, Noreen; Pebley, Anne R

    2013-01-01

    Previous studies assessing the validity of adolescent self-reported height and weight for estimating obesity prevalence have not accounted for, potential bias due to nonresponse in self-reports. The aim of this study was to assess the implications of selective nonresponse in self-reports of height and weight for estimates of adolescent obesity. The authors analyzed 613 adolescents ages 12-17 years from the 2006-2008 Los Angeles Family and Neighborhood Survey, a longitudinal study of Los Angeles County households with an oversample of poor neighborhoods. Obesity prevalence estimates were compared based on (a) self-report, (b) measured height and weight for those who did report, and (c) measured height and weight for those who did report. Among younger teens, measured obesity prevalence was higher for those who did not report height and weight compared with those who did (40% vs. 30%). Consequently, obesity prevalence based on self-reported height and weight underestimated measured prevalence by 12 percentage points (when accounting for nonresponse) versus 9 percentage points (when nonresponse was not accounted for). Results were robust to the choice of difference child growth references. Adolescent obesity surveillance and prevention efforts must take into account selective nonresponse for self-reported height and weight, particularly for younger teens. Results should be replicated in a nationally representative sample.

  13. Underestimation of homeless clients.

    PubMed

    Maddox, Sarah; Segan, Catherine

    2016-06-09

    Issue addressed: In Australia smoking rates among the homeless are extremely high; however, little is known about their interest in quitting and few homeless services offer cessation assistance. In an Australian homeless service, this research examined the clients' smoking from the client, staff and organisational perspectives in order to assess the need for cessation assistance for clients and identify opportunities to increase access to it.Methods: Twenty-six nurses completed an anonymous survey describing their attitudes to providing smoking-cessation support, current practices and estimates of client smoking and interest in quitting. Subsequently, nurses administered a survey to 104 clients to determine their smoking prevalence and interest in quitting. Organisation-wide tobacco-related policy and practices were audited.Results: Most clients (82%) smoked, half of these (52%) reported wanting to quit and 64% reported trying to quit or reduce their smoking in the previous 3 months. Nurses approximated clients' smoking prevalence (88% vs 82% reported by clients), but underestimated interest in quitting (33% vs 52% reported by clients). Among nurses 93% agreed that cessation support should be part of normal client care. The organisation's client-assessment form contained fields for 'respiratory issues' and 'drug issues', but no specific field for smoking status. The organisation's smoking policy focused on providing a smoke-free work environment.Conclusions: Many smokers using homeless services want to quit and are actively trying to reduce and quit smoking. Smoking-cessation assistance that meets the needs of people experiencing homelessness is clearly warranted.So what?: Homeless services should develop, and include in their smoking policy and intake processes, a practice of routinely assessing tobacco use, offering brief interventions and referral to appropriately tailored services.

  14. Cardiac MDCT in children: CT technology overview and interpretation.

    PubMed

    Goo, Hyun Woo

    2011-09-01

    Cardiac multidetector computed tomography (MDCT) for congenital heart disease is a useful, rapid, and noninvasive imaging technique bridging the gaps between echocardiography, cardiac catheterization, and cardiac MRI. Fast scan speed and greater anatomic coverage, combined with flexible ECG-synchronized scans and a low radiation dose, are critical for improving the image quality of cardiac MDCT and minimizing patient risk. Current MDCT techniques can accurately evaluate extracardiac great vessels, lungs, and airways, as well as coronary arteries and intracardiac structures. Radiologists who perform cardiac MDCT in children should be familiarized with optimal cardiac computed tomography (CT) scan techniques and characteristic cardiac CT scan imaging findings. Copyright © 2011 Elsevier Inc. All rights reserved.

  15. Acute schistosomiasis: a risk underestimated by travelers and a diagnosis frequently missed by general practitioners-a cluster analysis of 42 travelers.

    PubMed

    Rochat, Laurence; Bizzini, Alain; Senn, Nicolas; Bochud, Pierre-Yves; Genton, Blaise; de Vallière, Serge

    2015-01-01

    In 2011, a patient was admitted to our hospital with acute schistosomiasis after having returned from Madagascar and having bathed at the Lily waterfalls. On the basis of this patient's indication, infection was suspected in 41 other subjects. This study investigated (1) the knowledge of the travelers about the risks of schistosomiasis and their related behavior to evaluate the appropriateness of prevention messages and (2) the diagnostic workup of symptomatic travelers by general practitioners to evaluate medical care of travelers with a history of freshwater exposure in tropical areas. A questionnaire was sent to the 42 travelers with potential exposure to schistosomiasis. It focused on pre-travel knowledge of the disease, bathing conditions, clinical presentation, first suspected diagnosis, and treatment. Of the 42 questionnaires, 40 (95%) were returned, among which 37 travelers (92%) reported an exposure to freshwater, and 18 (45%) were aware of the risk of schistosomiasis. Among these latter subjects, 16 (89%) still reported an exposure to freshwater. Serology was positive in 28 (78%) of 36 exposed subjects at least 3 months after exposure. Of the 28 infected travelers, 23 (82%) exhibited symptoms and 16 (70%) consulted their general practitioner before the information about the outbreak had spread, but none of these patients had a serology for schistosomiasis done during the first consultation. The usual prevention message of avoiding freshwater contact when traveling in tropical regions had no impact on the behavior of these travelers, who still went swimming at the Lily waterfalls. This prevention message should, therefore, be either modified or abandoned. The clinical presentation of acute schistosomiasis is often misleading. General practitioners should at least request an eosinophil count, when confronted with a returning traveler with fever. If eosinophilia is detected, it should prompt the search for a parasitic disease. © 2015 International Society

  16. Postmortem imaging: MDCT features of postmortem change and decomposition.

    PubMed

    Levy, Angela D; Harcke, Howard Theodore; Mallak, Craig T

    2010-03-01

    Multidetector computed tomography (MDCT) has emerged as an effective imaging technique to augment forensic autopsy. Postmortem change and decomposition are always present at autopsy and on postmortem MDCT because they begin to occur immediately upon death. Consequently, postmortem change and decomposition on postmortem MDCT should be recognized and not mistaken for a pathologic process or injury. Livor mortis increases the attenuation of vasculature and dependent tissues on MDCT. It may also produce a hematocrit effect with fluid levels in the large caliber blood vessels and cardiac chambers from dependent layering erythrocytes. Rigor mortis and algor mortis have no specific MDCT features. In contrast, decomposition through autolysis, putrefaction, and insect and animal predation produce dramatic alterations in the appearance of the body on MDCT. Autolysis alters the attenuation of organs. The most dramatic autolytic changes on MDCT are seen in the brain where cerebral sulci and ventricles are effaced and gray-white matter differentiation is lost almost immediately after death. Putrefaction produces a pattern of gas that begins with intravascular gas and proceeds to gaseous distension of all anatomic spaces, organs, and soft tissues. Knowledge of the spectrum of postmortem change and decomposition is an important component of postmortem MDCT interpretation.

  17. Comparison of conventional radiography and MDCT in suspected scaphoid fractures

    PubMed Central

    Behzadi, Cyrus; Karul, Murat; Henes, Frank Oliver; Laqmani, Azien; Catala-Lehnen, Philipp; Lehmann, Wolfgang; Nagel, Hans-Dieter; Adam, Gerhard; Regier, Marc

    2015-01-01

    AIM: To determine the diagnostic accuracy and radiation dose of conventional radiography and multidetector computed tomography (MDCT) in suspected scaphoid fractures. METHODS: One hundred twenty-four consecutive patients were enrolled in our study who had suffered from a wrist trauma and showed typical clinical symptoms suspicious of an acute scaphoid fracture. All patients had initially undergone conventional radiography. Subsequent MDCT was performed within 10 d because of persisting clinical symptoms. Using the MDCT data as the reference standard, a fourfold table was used to classify the test results. The effective dose and impaired energy were assessed in order to compare the radiation burden of the two techniques. The Wilcoxon test was performed to compare the two diagnostic modalities. RESULTS: Conventional radiography showed 34 acute fractures of the scaphoid in 124 patients (42.2%). Subsequent MDCT revealed a total of 42 scaphoid fractures. The sensitivity of conventional radiography for scaphoid fracture detection was 42.8% and its specificity was 80% resulting in an overall accuracy of 59.6%. Conventional radiography was significantly inferior to MDCT (P < 0.01) concerning scaphoid fracture detection. The mean effective dose of MDCT was 0.1 mSv compared to 0.002 mSv of conventional radiography. CONCLUSION: Conventional radiography is insufficient for accurate scaphoid fracture detection. Regarding the almost negligible effective dose, MDCT should serve as the first imaging modality in wrist trauma. PMID:25628802

  18. State-of-the-art preoperative staging of gastric cancer by MDCT and magnetic resonance imaging

    PubMed Central

    Choi, Joon-Il; Joo, Ijin; Lee, Jeong Min

    2014-01-01

    Gastric cancer is one of the most common and fatal cancers. The importance of accurate staging for gastric cancer has become more critical due to the recent introduction of less invasive treatment options, such as endoscopic mucosal resection or laparoscopic surgery. The tumor-node-metastasis staging system is the generally accepted staging system for predicting the prognosis of patients with gastric cancer. Multidetector row computed tomography (MDCT) is a widely accepted imaging modality for the preoperative staging of gastric cancer that can simultaneously assess locoregional staging, including the gastric mass, regional lymph nodes, and distant metastasis. The diagnostic performance of MDCT for T- and N-staging has been improved by the technical development of isotropic imaging and 3D reformation. Although magnetic resonance imaging (MRI) was not previously used to evaluate gastric cancer due to the modality’s limitations, the development of high-speed sequences has made MRI a feasible tool for the staging of gastric cancer. PMID:24782607

  19. [Detection of intraorbital foreign material using MDCT].

    PubMed

    Hoffstetter, P; Friedrich, C; Framme, C; Hoffstetter, M; Zorger, N; Stierstorfer, K; Ross, C; Uller, W; Müller-Wille, R; Rennert, J; Jung, E M; Schreyer, A G

    2011-06-01

    To judge the possibilities of detection of orbital foreign bodies in multidetector CT (MDCT) with a focus on glass slivers. Experimental systematic measuring of Hounsfield Units (HU) of 20 different materials, containing 16 different types of glass with 4 different types of ophthalmic lenses among them. The measurements were performed using a standardized protocol with an orbita phantom being scanned with 16-slice MDCT. Using the resulting density values, the smallest detectable volume was calculated. Using this data we produced slivers of 5 different glass types in the sub-millimeter range and calculated their volume. Those micro-slivers underwent another CT scan using the same protocol as mentioned above to experimentally discern and confirm the detection limit for micro-slivers made of different materials. Glass has comparatively high density values of at least 2000 HU. The density of glasses with strong refraction is significantly higher and reaches up to 12 400 HU. We calculated a minimum detectable volume of 0.07 mm (3) for glass with a density of 2000 HU. Only glass slivers with a density higher than 8300 HU were experimentally detectable in the sub-millimeter range up to a volume as small as 0.01 mm (3). Less dense glass slivers could not be seen, even though their volume was above the theoretically calculated threshold for detection. Due to its high density of at least 2000 HU, glass is usually easily recognizable as an orbital foreign body. The detection threshold depends on the object's density and size and can be as low as 0.01 mm (3) in the case of glass with strong refraction and thus high density. The detection of glass as an orbital foreign body seems to be secure for slivers with a volume of at least 0.2 mm (3) for all types of glass. © Georg Thieme Verlag KG Stuttgart · New York.

  20. MDCT of acute thrombotic and nonthrombotic pulmonary emboli.

    PubMed

    Bhalla, Sanjeev; Lopez-Costa, Ignacio

    2007-10-01

    Acute pulmonary embolism (PE) remains a common clinical challenge. MDCT pulmonary angiography has become the first line imaging study in the diagnosis of PE because of its speed, accuracy, low-interobserver variability, and ability to provide alternative diagnoses. This review article highlights the role of MDCT in the evaluation of acute thrombotic PE in the era of PIOPED 2. MDCT findings of acute PE and some potential pitfalls are covered as well as some of the controversies in imaging young and pregnant patients. MDCT findings of acute non-thrombotic PE are also covered. This latter group may be occult on the angiographic portion of the study but may declare themselves through secondary findings. Their findings and potential mimics are included so that the interpreting radiologist can make the most of a CT to rule out PE.

  1. Temporal resolution improvement using PICCS in MDCT cardiac imaging

    PubMed Central

    Chen, Guang-Hong; Tang, Jie; Hsieh, Jiang

    2009-01-01

    The current paradigm for temporal resolution improvement is to add more source-detector units and∕or increase the gantry rotation speed. The purpose of this article is to present an innovative alternative method to potentially improve temporal resolution by approximately a factor of 2 for all MDCT scanners without requiring hardware modification. The central enabling technology is a most recently developed image reconstruction method: Prior image constrained compressed sensing (PICCS). Using the method, cardiac CT images can be accurately reconstructed using the projection data acquired in an angular range of about 120°, which is roughly 50% of the standard short-scan angular range (∼240° for an MDCT scanner). As a result, the temporal resolution of MDCT cardiac imaging can be universally improved by approximately a factor of 2. In order to validate the proposed method, two in vivo animal experiments were conducted using a state-of-the-art 64-slice CT scanner (GE Healthcare, Waukesha, WI) at different gantry rotation times and different heart rates. One animal was scanned at heart rate of 83 beats per minute (bpm) using 400 ms gantry rotation time and the second animal was scanned at 94 bpm using 350 ms gantry rotation time, respectively. Cardiac coronary CT imaging can be successfully performed at high heart rates using a single-source MDCT scanner and projection data from a single heart beat with gantry rotation times of 400 and 350 ms. Using the proposed PICCS method, the temporal resolution of cardiac CT imaging can be effectively improved by approximately a factor of 2 without modifying any scanner hardware. This potentially provides a new method for single-source MDCT scanners to achieve reliable coronary CT imaging for patients at higher heart rates than the current heart rate limit of 70 bpm without using the well-known multisegment FBP reconstruction algorithm. This method also enables dual-source MDCT scanner to achieve higher temporal resolution

  2. Is soil carbon storage underestimated?

    PubMed

    Díaz-Hernández, José Luis

    2010-06-01

    An accurate evaluation of the carbon stored in soils is essential to fully understand the role of soils as source or sink of atmospheric CO(2), as well as the feedback processes involved in soil-atmosphere CO(2) exchange. Depth and strategies of sampling have been, and still are, sources of uncertainties, because most current estimates of carbon storage in soils are based on conventional soil surveys and data sets compiled primarily for agricultural purposes. In a study of the Guadix-Baza basin, a semiarid area of southern Spain, sizeable amounts of carbon have been found stored in the subsoil. Total carbon estimated within 2-m was 141.3 kg Cm(-2) compared to 36.1 kg Cm(-2) if estimates were based solely on conventional soil depths (e.g. 40-cm in Regosols and 100-cm in Fluvisols). Thus, the insufficient sampling depth could lead to considerable underestimation of global soil carbon. In order to correctly evaluate the carbon content in world soils, more specific studies must be planned and carried out, especially in those soils where caliche and other carbonated cemented horizons are present.

  3. Silicosis due to Denim Sandblasting in Young People: MDCT Findings.

    PubMed

    Doganay, Selim; Gocmen, Hayrettin; Yikilmaz, Ali; Coskun, Abdulhakim

    2010-04-01

    Occupational lung disease due to silica dust is one of the most common work-related injuries. In denim sandblasting, workers are exposed to silica that may cause immediate mortality, especially in young people. The aim of this study was to assess the multidetector computed tomography (MDCT) findings of silicosis in denim sandblasters and to better define the role of MDCT in the early detection of silicosis. The study included 12 consecutive male patients who were admitted to a pulmonary outpatient clinic between April 2009 and December 2009. All patients had been working as sandblasters for at least one year. All patients underwent chest CT examinations for suspected silicosis. Two radiologists independently assessed the images for the presence and distribution of airspace consolidation, ground-glass opacity, nodules, interlobular septal thickening, parenchymal bands, fibrosis, masses, traction bronchiectasis, honeycombing, lobular low-attenuation areas, emphysema, pleural effusion or thickening, and mediastinal or hilar adenopathy. MDCT detected parenchymal abnormalities in the lungs in eight (67%) of the twelve patients. The most common MDCT finding was ground glass opacity (58%). Other common findings were parencyhmal nodules and interlobular septal thickening, predominantly in the upper zones. Nodules were detected in six (50%) of the twelve patients. In four cases (67%), the nodules were numerous (>10), were predominantly smaller than 10 mm, and were centrilobular in distribution. In five (42%) of the 12 patients, interlobular septal thickening was detected. Only one (8%) patient presented with airspace consolidation; this was bilateral in the upper zones and associated with air bronchograms. In one (8%) patient there were several traction bronchiectases in the upper zones. None of the patients presented with pleural effusion, thickening, or honeycombing. Enlarged mediastinal nodes were identified in half of the patients, predominantly in the precarinal

  4. Silicosis due to Denim Sandblasting in Young People: MDCT Findings

    PubMed Central

    Doganay, Selim; Gocmen, Hayrettin; Yikilmaz, Ali; Coskun, Abdulhakim

    2010-01-01

    Objective: Occupational lung disease due to silica dust is one of the most common work-related injuries. In denim sandblasting, workers are exposed to silica that may cause immediate mortality, especially in young people. The aim of this study was to assess the multidetector computed tomography (MDCT) findings of silicosis in denim sandblasters and to better define the role of MDCT in the early detection of silicosis. Materials and Methods: The study included 12 consecutive male patients who were admitted to a pulmonary outpatient clinic between April 2009 and December 2009. All patients had been working as sandblasters for at least one year. All patients underwent chest CT examinations for suspected silicosis. Two radiologists independently assessed the images for the presence and distribution of airspace consolidation, ground-glass opacity, nodules, interlobular septal thickening, parenchymal bands, fibrosis, masses, traction bronchiectasis, honeycombing, lobular low-attenuation areas, emphysema, pleural effusion or thickening, and mediastinal or hilar adenopathy. Results: MDCT detected parenchymal abnormalities in the lungs in eight (67%) of the twelve patients. The most common MDCT finding was ground glass opacity (58%). Other common findings were parencyhmal nodules and interlobular septal thickening, predominantly in the upper zones. Nodules were detected in six (50%) of the twelve patients. In four cases (67%), the nodules were numerous (>10), were predominantly smaller than 10 mm, and were centrilobular in distribution. In five (42%) of the 12 patients, interlobular septal thickening was detected. Only one (8%) patient presented with airspace consolidation; this was bilateral in the upper zones and associated with air bronchograms. In one (8%) patient there were several traction bronchiectases in the upper zones. None of the patients presented with pleural effusion, thickening, or honeycombing. Enlarged mediastinal nodes were identified in half of the

  5. Assessment of patient and occupational dose in established and new applications of MDCT fluoroscopy.

    PubMed

    Joemai, Raoul M S; Zweers, Dirk; Obermann, Wim R; Geleijns, Jacob

    2009-04-01

    This study aimed to assess patient dose and occupational dose in established and new applications of MDCT fluoroscopy. Electronic personal dosimeters were used to measure occupational dose equivalent. Effective patient dose was derived from the recorded dose-length product. Acquisition parameters that were observed during CT fluoroscopy (CTF) provided the basis for the estimation of an entrance skin dose profile. Two hundred ten CT-guided interventional procedures were included in the study. The median effective patient dose was 10 mSv (range, 0.1-235 mSv; 107 procedures). The median peak entrance skin dose was 0.4 Sv (0.1-2.1 Sv; 27 procedures). From 547 measurements of occupational dose equivalent, a median occupational effective dose of 3 muSv per procedure was derived for the interventional radiologists and 0.4 muSv per procedure for the assisting radiologists and radiology technologists. The estimated maximum occupational effective dose reached 0.4 mSv. The study revealed high effective patient doses, up to 235 mSv, mainly for relatively new applications such as CTF-guided radiofrequency ablations using MDCT, vertebroplasty, and percutaneous ethanol injections of tumors. Entrance doses were occasionally in the range of the warning level for deterministic skin effects but were always below the threshold for serious deterministic effects. The complexity of the procedure, expected benefits of the treatment, and general health state of the patient contribute to the justification of observed high effective patient doses.

  6. Perfusion measurement in acute pancreatitis using dynamic perfusion MDCT.

    PubMed

    Bize, Pierre E; Platon, Alexandra; Becker, Christoph D; Poletti, Pierre-Alexandre

    2006-01-01

    Our objective was to determine whether MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis in the initial phase of the disease. One hundred six patients with abdominal pain were prospectively enrolled in this study. Patients were separated into two groups: P1 (severe) and P2 (mild) acute pancreatitis. Mean perfusion value was 24.8 mL/100 mL/min in the P1 group and 50.5 mL/100 mL/min in the P2 group (p = 0.0016, significant). Our preliminary data suggest that pancreatic perfusion measurement using MDCT with perfusion imaging could help in assessing the severity of acute pancreatitis.

  7. 3-D segmentation of human sternum in lung MDCT images.

    PubMed

    Pazokifard, Banafsheh; Sowmya, Arcot

    2013-01-01

    A fully automatic novel algorithm is presented for accurate 3-D segmentation of the human sternum in lung multi detector computed tomography (MDCT) images. The segmentation result is refined by employing active contours to remove calcified costal cartilage that is attached to the sternum. For each dataset, costal notches (sternocostal joints) are localized in 3-D by using a sternum mask and positions of the costal notches on it as reference. The proposed algorithm for sternum segmentation was tested on 16 complete lung MDCT datasets and comparison of the segmentation results to the reference delineation provided by a radiologist, shows high sensitivity (92.49%) and specificity (99.51%) and small mean distance (dmean=1.07 mm). Total average of the Euclidean distance error for costal notches positioning in 3-D is 4.2 mm.

  8. Vascular involvement in periampullary tumors: MDCT, EUS, and CDU.

    PubMed

    Gusmini, S; Nicoletti, R; Martinenghi, C; Del Maschio, A

    2009-07-01

    In patients affected by periampullary tumors, surgical resection represents the only treatment with curative intent. Preoperative evaluation of vascular involvement is necessary to avoid surgical treatments unable of curative intent resection. The aim of our update article is to assess the performance of multidetector computed tomography (MDCT), endoscopic ultrasonography (EUS), and color Doppler ultrasonography (CDU) in the evaluation of vascular involvement of major peripancreatic vessels, in periampullary tumors, analyzing the current and past literature.

  9. Radiation dose measurement for various parameters in MDCT

    NASA Astrophysics Data System (ADS)

    Lee, Chang-Lae; Kim, Hee-Joung; Jeon, Seong Su; Cho, Hyo-Min; Nam, So Ra; Jung, Ji-Young

    2008-03-01

    The MDCT parameters affecting radiation dose include tube voltage, tube current, change of beam collimation, and size of the human body. The purpose of this study was to measure and evaluate radiation dose for MDCT parameters. A comparative analysis of the radiation dose according to before and after the calibration of the ionization chamber was performed. The ionization chamber was used for measuring radiation dose in the MDCT, as well as of CTDI W according to temperature and pressure correction factors in the CT room. As a result, the patient dose of CTDI W values linearly increased as tube voltage and current were increased, and nonlinearly decreased as beam collimation was increased. And the CTDI W value which was reflected calibration factors, as well as correction factors of temperature and pressure, was found to be greater by the range of 0.479 ~ 3.162 mGy in effective radiation dose than the uncorrected value. Also, Under the abdomen routine CT conditions used in hospitals, patient exposure dose showed a difference of a maximum of 0.7 mSv between before and after the application of such factors. These results imply that the calibration of the ion chamber, and the application of temperature and pressure of the CT room are crucial in measuring and calculating patient exposure dose.

  10. Estimation and comparison of the radiation effective dose during coronary computed tomography angiography examinations on single-source 64-MDCT and dual-source 128-MDCT.

    PubMed

    Khoramian, Daryoush; Sistani, Soroush

    2017-09-14

    To estimate and compare the radiation dose associated with coronary computed tomography angiography (CCTA) examinations on two multi-detector CT scanners (MDCT), 64-MDCT and 128-MDCT, in daily practice. Scan parameters of 90 patients undergoing retrospective electrocardiographic gating spiral CCTA exam were recorded during a period on a single-source 64-MDCT and a dual-source 128-MDCT, and average scan parameters were derived that were used for dosimetry. The computed tomography dose index (CTDI) with a pencil ionisation chamber and polymethyl methacrylate body phantom with diameter of 32 cm was measured on both scanners. The dose-length product (DLP) was calculated and the DLP to effective dose conversion factor (for chest scan at 120 kV of 0.014 mSv mGy(-1) cm(-1)) was used to estimate effective dose (ED). Patients' heart rate, scan length, pitch factor, CTDIv, DLP and ED for 128-MDCT were 64 (5) (beats min(-1)), 161 (10) (mm), 0.26, 47 (12) (mGy), 769 (212) (mGy cm) and 10.3 (3.1) (mSv), respectively [mean (one standard deviation)]. Patients' heart rate, scan length, pitch factor, CTDIv, DLP and ED for 64-MDCT were 60 (7) (beats min(-1)), 172 (14) (mm), 0.2, 60 (6) (mGy), 1068 (98) (mGy cm) and 14.9 (1.4) (mSv), respectively. Our results indicated that the CTDIv, DLP and the effective dose with 128-MDCT is significantly lower than with 64-MDCT (p < 0.05). As differences between the exposure parameter mAs on two CT scanners was not significant (p > 0.05) and the kV was constant for both scanners (120 kV), the differences resulted from a shorter scan length on the 128-MDCT and use of a higher pitch factor (0.26 and 0.2 in the 128-MDCT and 64-MDCT, respectively). Comparison with other published studies confirms the findings and indicates methods for reducing patient dose.

  11. MDCT of hand and wrist infections: emphasis on compartmental anatomy.

    PubMed

    Ahlawat, S; Corl, F M; LaPorte, D M; Fishman, E K; Fayad, L M

    2017-04-01

    Hand and wrist infections can present with a spectrum of manifestations ranging from cellulitis to deep-space collections. The various infectious processes can be categorised as superficial or deep infections based on their respective locations relative to the tendons. Superficial hand infections are located superficial to the tendons and are comprised of cellulitis, lymphangitis, paronychia, pulp-space infections, herpetic whitlow, and include volar as well as dorsal subcutaneous abscesses. Deep hand infections are located deep to the tendon sheaths and include synovial space infections, such as infectious tenosynovitis, deep fascial space infections, septic arthritis, necrotising fasciitis, and osteomyelitis. Knowledge of hand and wrist compartmental anatomy is essential for the accurate diagnosis and management of hand infections. Although early and superficial infections of the hand may respond to non-surgical management, most hand infections are surgical emergencies. Multidetector computed tomography (MDCT), with its muliplanar reformation (MPR) and three-dimensional (3D) capabilities, is a powerful tool in the emergency setting for the evaluation of acute hand and wrist pathology. The clinical and imaging features of hand and wrist infections as evident on MDCT will be reviewed with emphasis on contiguous and closed synovial and deep fascial spaces. Knowledge of hand compartmental anatomy enables accurate characterisation of the infectious process and localise the extent of disease in the acute setting. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  12. MDCT imaging of the stomach: advances and applications.

    PubMed

    Nagpal, Prashant; Prakash, Anjali; Pradhan, Gaurav; Vidholia, Aditi; Nagpal, Nishant; Saboo, Sachin S; Kuehn, David M; Khandelwal, Ashish

    2017-01-01

    The stomach may be involved by a myriad of pathologies ranging from benign aetiologies like inflammation to malignant aetiologies like carcinoma or lymphoma. Multidetector CT (MDCT) of the stomach is the first-line imaging for patients with suspected gastric pathologies. Conventionally, CT imaging had the advantage of simultaneous detection of the mural and extramural disease extent, but advances in MDCT have allowed mucosal assessment by virtual endoscopy (VE). Also, better three-dimensional (3D) post-processing techniques have enabled more robust and accurate pre-operative planning in patients undergoing gastrectomy and even predict the response to surgery for patients undergoing laparoscopic sleeve gastrectomy for weight loss. The ability of CT to obtain stomach volume (for bariatric surgery patients) and 3D VE images depends on various patient and protocol factors that are important for a radiologist to understand. We review the appropriate CT imaging protocol in the patients with suspected gastric pathologies and highlight the imaging pearls of various gastric pathologies on CT and VE.

  13. Mixed-radix Algorithm for the Computation of Forward and Inverse MDCT

    PubMed Central

    Wu, Jiasong; Shu, Huazhong; Senhadji, Lotfi; Luo, Limin

    2008-01-01

    The modified discrete cosine transform (MDCT) and inverse MDCT (IMDCT) are two of the most computational intensive operations in MPEG audio coding standards. A new mixed-radix algorithm for efficient computing the MDCT/IMDCT is presented. The proposed mixed-radix MDCT algorithm is composed of two recursive algorithms. The first algorithm, called the radix-2 decimation in frequency (DIF) algorithm, is obtained by decomposing an N-point MDCT into two MDCTs with the length N/2. The second algorithm, called the radix-3 decimation in time (DIT) algorithm, is obtained by decomposing an N-point MDCT into three MDCTs with the length N/3. Since the proposed MDCT algorithm is also expressed in the form of a simple sparse matrix factorization, the corresponding IMDCT algorithm can be easily derived by simply transposing the matrix factorization. Comparison of the proposed algorithm with some existing ones shows that our proposed algorithm is more suitable for parallel implementation and especially suitable for the layer III of MPEG-1 and MPEG-2 audio encoding and decoding. Moreover, the proposed algorithm can be easily extended to the multidimensional case by using the vector-radix method. PMID:21258639

  14. CT Hounsfield Numbers of Soft Tissues on Unenhanced Abdominal CT Scans: Variability Between Two Different Manufacturers’ MDCT Scanners

    PubMed Central

    Lamba, Ramit; McGahan, John P.; Corwin, Michael T.; Li, Chin-Shang; Tran, Tien; Seibert, J. Anthony; Boone, John M.

    2016-01-01

    OBJECTIVE The purpose of this study is to determine whether Hounsfield numbers of soft tissues on unenhanced abdominal CT of the same patient vary on repeat scans done on two different manufacturers’ MDCT scanners. MATERIALS AND METHODS A database search was performed to identify patients older than 18 years who underwent unenhanced CT of the abdomen and pelvis performed both on a Volume CT (GE Healthcare) and a Definition AS Plus (Siemens Healthcare) 64-MDCT scanner within 12 months of each other. After excluding those patients for whom Hounsfield unit measurements would be affected by mitigating factors, 48 patients (mean age, 58.8 years) were identified. Hounsfield unit measurements were obtained in nine different soft-tissue anatomic locations on each scan, and the location of these sites was kept identical on each scan pair. Data were analyzed to evaluate Hounsfield unit differences between these scanners. RESULTS In general, there was a low consistency in the Hounsfield unit measurements for each of these sites on scans obtained by the two scanners, with the subcutaneous fat in the left posterolateral flank showing the lowest correlation (intraclass correlation coefficient, 0.198). There were differences in the Hounsfield unit measurements obtained in all anatomic sites on scans obtained by both scanners. Mean Hounsfield unit measurements obtained on the Definition AS Plus scanner were lower than those obtained on the Volume CT scanner, with the intriguing exception of the anterior midline subcutaneous fat Hounsfield unit measurements, which were higher on the Definition AS Plus scanner. All differences were statistically significant (p < 0.05). CONCLUSION Hounsfield unit measurements for unenhanced abdominal soft tissues of the same patient vary between scanners of two common MDCT manufacturers. PMID:25341139

  15. CT Hounsfield numbers of soft tissues on unenhanced abdominal CT scans: variability between two different manufacturers' MDCT scanners.

    PubMed

    Lamba, Ramit; McGahan, John P; Corwin, Michael T; Li, Chin-Shang; Tran, Tien; Seibert, J Anthony; Boone, John M

    2014-11-01

    The purpose of this study is to determine whether Hounsfield numbers of soft tissues on unenhanced abdominal CT of the same patient vary on repeat scans done on two different manufacturers' MDCT scanners. A database search was performed to identify patients older than 18 years who underwent unenhanced CT of the abdomen and pelvis performed both on a Volume CT (GE Healthcare) and a Definition AS Plus (Siemens Healthcare) 64-MDCT scanner within 12 months of each other. After excluding those patients for whom Hounsfield unit measurements would be affected by mitigating factors, 48 patients (mean age, 58.8 years) were identified. Hounsfield unit measurements were obtained in nine different soft-tissue anatomic locations on each scan, and the location of these sites was kept identical on each scan pair. Data were analyzed to evaluate Hounsfield unit differences between these scanners. In general, there was a low consistency in the Hounsfield unit measurements for each of these sites on scans obtained by the two scanners, with the subcutaneous fat in the left posterolateral flank showing the lowest correlation (intraclass correlation coefficient, 0.198). There were differences in the Hounsfield unit measurements obtained in all anatomic sites on scans obtained by both scanners. Mean Hounsfield unit measurements obtained on the Definition AS Plus scanner were lower than those obtained on the Volume CT scanner, with the intriguing exception of the anterior midline subcutaneous fat Hounsfield unit measurements, which were higher on the Definition AS Plus scanner. All differences were statistically significant (p < 0.05). Hounsfield unit measurements for unenhanced abdominal soft tissues of the same patient vary between scanners of two common MDCT manufacturers.

  16. Hepatosplenic volumetric assessment at MDCT for staging liver fibrosis.

    PubMed

    Pickhardt, Perry J; Malecki, Kyle; Hunt, Oliver F; Beaumont, Claire; Kloke, John; Ziemlewicz, Timothy J; Lubner, Meghan G

    2017-07-01

    To investigate hepatosplenic volumetry at MDCT for non-invasive prediction of hepatic fibrosis. Hepatosplenic volume analysis in 624 patients (mean age, 48.8 years; 311 M/313 F) at MDCT was performed using dedicated software and compared against pathological fibrosis stage (F0 = 374; F1 = 48; F2 = 40; F3 = 65; F4 = 97). The liver segmental volume ratio (LSVR) was defined by Couinaud segments I-III over segments IV-VIII. All pre-cirrhotic fibrosis stages (METAVIR F1-F3) were based on liver biopsy within 1 year of MDCT. LSVR and total splenic volumes increased with stage of fibrosis, with mean(±SD) values of: F0: 0.26 ± 0.06 and 215.1 ± 88.5 mm(3); F1: 0.25 ± 0.08 and 294.8 ± 153.4 mm(3); F2: 0.331 ± 0.12 and 291.6 ± 197.1 mm(3); F3: 0.39 ± 0.15 and 509.6 ± 402.6 mm(3); F4: 0.56 ± 0.30 and 790.7 ± 450.3 mm(3), respectively. Total hepatic volumes showed poor discrimination (F0: 1674 ± 320 mm(3); F4: 1631 ± 691 mm(3)). For discriminating advanced fibrosis (≥F3), the ROC AUC values for LSVR, total liver volume, splenic volume and LSVR/spleen combined were 0.863, 0.506, 0.890 and 0.947, respectively. Relative changes in segmental liver volumes and total splenic volume allow for non-invasive staging of hepatic fibrosis, whereas total liver volume is a poor predictor. Unlike liver biopsy or elastography, these CT volumetric biomarkers can be obtained retrospectively on routine scans obtained for other indications. • Regional changes in hepatic volume (LSVR) correlate well with degree of fibrosis. • Total liver volume is a very poor predictor of underlying fibrosis. • Total splenic volume is associated with the degree of hepatic fibrosis. • Hepatosplenic volume assessment is comparable to elastography for staging fibrosis. • Unlike elastography, volumetric analysis can be performed retrospectively.

  17. MDCT of extranodal mantle cell lymphoma: a single institute experience.

    PubMed

    Baheti, Akshay D; Tirumani, Sree Harsha; Sewatkar, Rani; Sachin, Saboo S; Shinagare, Atul B; Ramaiya, Nikhil H

    2015-08-01

    To study the pattern of extranodal and particularly gastrointestinal (GI) involvement of mantle cell lymphoma (MCL) on MDCT MATERIALS AND METHODS: In this IRB-approved, HIPAA compliant retrospective study, MDCT features of 78 patients (62 males and 16 females, mean age 57 years) with MCL including 28 patients at presentation were reviewed. Clinical and histopathological (blastoid vs. non-blastoid) data were noted from medical records. Extranodal involvement was present in overall 51/78 patients on CT (65%), 18/28 (64%) patients at presentation. Spleen (21/78-27%) and bowel (19/78-24%) were the most common sites of extranodal involvement by MCL on imaging, followed by lungs (10/78-13%) and skin/subcutaneous tissue (9/78-12%). Bowel involvement was either in the form of endophytic polypoidal lesions (n = 11, mean size 3.1 cm), as focal mild bowel wall thickening (n = 5, mean thickness 1.4 cm), or as combination of the two (n = 3). Blastoid histology was present in 14/78 (24%) patients and was statistically associated with skin/subcutaneous involvement (p < 0.05; Fisher's exact t test). Median follow-up was 72 months during which 21 patients died with median survival of 48 months (26 months for blastoid histology vs. 47 months for non-blastoid histology). There was no statistical correlation between sites of involvement and survival. MCL has a predilection for extranodal disease, predominantly involving the spleen, bowel, lungs, and subcutaneous tissue. GI involvement on CT is in the form of endoluminal polypoidal lesions and mild bowel wall thickening. Skin/subcutaneous involvement was statistically more common with blastoid histology in our study.

  18. Species-area relationships underestimate extinction rates

    NASA Astrophysics Data System (ADS)

    Fattorini, Simone; Borges, Paulo A. V.

    2012-04-01

    The species-area relationship (SAR), i.e. the increase in species number with area, has been repeatedly used to predict species extinction, at both local and global scales, with habitat reduction. He and Hubbell (Nature, 2011; 473, 368-371), however, argued that the function that relates species loss with decreasing habitat area cannot be simply obtained reversing the species-area accumulation curve. Using a statistically more appropriate curve based on endemics (EAR), they concluded that the SAR overestimates species extinction. Although we agree that SARs and EARs have different shapes, this does not imply that SARs overestimate species extinction. Empirical evidence suggests that SARs do not overestimate, but underestimate species extinction by habitat loss and fragmentation. We discuss various examples taken from recent literature to show that SARs underestimate species extinction.

  19. Polyarteritis nodosa: MDCT as a 'One-Stop Shop' Modality for Whole-Body Arterial Evaluation

    SciTech Connect

    Tsai, W.-L.; Tsai, I-C.; Lee Tain; Hsieh, C.-W.

    2008-07-15

    Polyarteritis nodosa is a rare disease, which is characterized by aneurysm formation and occlusion in the arteries of multiple systems. Due to its extensive involvement, whole-body evaluation is necessary for diagnosis and treatment monitoring. We report a case of polyarteritis nodosa using multidetector-row computed tomography (MDCT) as a 'one-stop shop' modality for whole-body arterial evaluation. With precise protocol design, MDCT can be used as a reliable noninvasive modality providing comprehensive whole-body arterial evaluation.

  20. Physicians underestimate calcium intake in women.

    PubMed

    Snyder, Sandra M; Tyler, Carl V; Panaite, Vanessa; Smolak, Michael J; Powell, Brenda L; Young, Christopher W; Conway, Jessica L; Ford, Donald B; Zyzanski, Stephen J

    2010-06-01

    Personalized nutritional counseling about calcium intake during office encounters requires rapid estimation of calcium intake. We compared the accuracy of physician estimates to a validated calcium intake measure and characterized women whose intakes were incorrectly deemed inadequate by physicians. As part of a controlled trial of brief, office-based calcium intake counseling of women, family physicians estimated calcium intake from patients' self-reported intake of dairy food/beverage intake and from their supplement use. We compared estimates to the Short Calcium Questionnaire (SCQ), a validated 7-day dietary recall measure completed by patients. Sensitivity/specificity of physician-estimated calcium intake was estimated by comparison with the SCQ. For 97 women, SCQ rated 32 (33%) as inadequate, 55 (57%) as adequate, and 10 (10%) as excessive. When compared to SCQ, the sensitivity of physician-estimated calcium intake inadequacy was 97% (95% confidence interval [CI]: 94%-100%), specificity was 51% (95% CI: 41%-61%), and positive predictive value was 49% (95% CI: 39%-59%). Women with underestimated intakes were more likely to report a family history of osteoporosis and take a daily multivitamin. The major source of physician underestimation of calcium intake was underestimate of dairy product contribution. More accurate estimates of dairy-based calcium intake will lead to greater specificity in identifying inadequate calcium intake.

  1. Abstract Convex Underestimation Assisted Multistage Differential Evolution.

    PubMed

    Zhou, Xiao-Gen; Zhang, Gui-Jun

    2017-09-01

    In differential evolution (DE), different strategies applied in different evolutionary stages may be more effective than a single strategy used in the entire evolutionary process. However, it is not trivial to appropriately determine the evolutionary stage. In this paper, we present an abstract convex underestimation-assisted multistage DE. In the proposed algorithm, the underestimation is calculated through the supporting vectors of some neighboring individuals. Based on the variation of the average underestimation error (UE), the evolutionary process is divided into three stages. Each stage includes a pool of suitable candidate strategies. At the beginning of each generation, the evolutionary stage is first estimated according to the average UE of the previous generation. Subsequently, a strategy is automatically chosen from the corresponding candidate pool to create a mutant vector. In addition, a centroid-based strategy which utilizes the information of multiple superior individuals is designed to balance the population diversity and convergence speed in the second stage. Experiments are conducted on 23 widely used test functions, CEC 2013, and CEC 2014 benchmark sets to demonstrate the performance of the proposed algorithm. The results reveal that the proposed algorithm exhibits better performance compared with several advanced DE variants and some non-DE approaches.

  2. SDU: A Semidefinite Programming-Based Underestimation Method for Stochastic Global Optimization in Protein Docking

    PubMed Central

    Paschalidis, Ioannis Ch.; Shen, Yang; Vakili, Pirooz; Vajda, Sandor

    2007-01-01

    This paper introduces a new stochastic global optimization method targeting protein-protein docking problems, an important class of problems in computational structural biology. The method is based on finding general convex quadratic underestimators to the binding energy function that is funnel-like. Finding the optimum underestimator requires solving a semidefinite programming problem, hence the name semidefinite programming-based underestimation (SDU). The underestimator is used to bias sampling in the search region. It is established that under appropriate conditions SDU locates the global energy minimum with probability approaching one as the sample size grows. A detailed comparison of SDU with a related method of convex global underestimator (CGU), and computational results for protein-protein docking problems are provided. PMID:19759849

  3. SDU: A Semidefinite Programming-Based Underestimation Method for Stochastic Global Optimization in Protein Docking.

    PubMed

    Paschalidis, Ioannis Ch; Shen, Yang; Vakili, Pirooz; Vajda, Sandor

    2007-04-01

    This paper introduces a new stochastic global optimization method targeting protein-protein docking problems, an important class of problems in computational structural biology. The method is based on finding general convex quadratic underestimators to the binding energy function that is funnel-like. Finding the optimum underestimator requires solving a semidefinite programming problem, hence the name semidefinite programming-based underestimation (SDU). The underestimator is used to bias sampling in the search region. It is established that under appropriate conditions SDU locates the global energy minimum with probability approaching one as the sample size grows. A detailed comparison of SDU with a related method of convex global underestimator (CGU), and computational results for protein-protein docking problems are provided.

  4. MDCT of the S-shaped sinoatrial node artery.

    PubMed

    Saremi, Farhood; Channual, Stephanie; Abolhoda, Amir; Gurudevan, Swaminatha V; Narula, Jagat; Milliken, Jeffrey C

    2008-06-01

    The purpose of this study was to use 64-MDCT to investigate the anatomic characteristics of the S-shaped variant of the sinoatrial node (SAN) artery and to describe the clinical implications of the findings in ablative procedures involving the left atrium. Coronary CT angiograms of 250 patients (152 men, 98 women; mean age, 60 +/- 12 [SD] years) were retrospectively analyzed for identification of the origin, number, anatomic course, mode of termination, and S-shaped variant of the SAN artery. At least one SAN artery was detected in 244 patients. The S-shaped variant was seen in 35 (14.3%) of these patients. Thirty-four of the variants (30.6% of all left SAN arteries) arose from the proximal to middle portion of the left circumflex artery (mean distance between the ostium of the left circumflex artery and the origin of S-shaped variant, 28.7 +/- 13.1 mm). The other variant (0.7% of all right SAN arteries) originated from the distal right coronary artery. The S-shaped variant was the only artery supplying the SAN in 28 (11.4%) of the patients. In patients with two arteries supplying the SAN, the right SAN artery and the S-shaped variant of the left SAN artery were seen together in seven patients. The S-shaped SAN artery (mean distance from atrial wall, 2.43 +/- 0.992 mm) had a predictable proximal course, lying in the posterior aspect in a groove between the orifices of the left superior pulmonary vein and the left atrial appendage close to the left atrial wall. The terminal segment of the artery approached the nodal tissue posterior to the superior vena cava in 22 patients, anterior to the vena cava in 10 patients, and through branches surrounding the vena cava in two patients. The S-shaped variation of the SAN artery is common and has a characteristic anatomic course. MDCT can be used to plan surgical and catheter-based left atrial interventions in which this artery is at risk of injury.

  5. Quantification of arterial plaque and lumen density with MDCT

    SciTech Connect

    Paul, Narinder S.; Blobel, Joerg; Kashani, Hany; Rice, Murray; Ursani, Ali

    2010-08-15

    Purpose: This study aimed to derive a mathematical correction function in order to normalize the CT number measurements for small volume arterial plaque and small vessel mimicking objects, imaged with multidetector CT (MDCT). Methods: A commercially available calcium plaque phantom (QRM GmbH, Moehrendorf, Germany) and a custom built cardiovascular phantom were scanned with 320 and 64 MDCT scanners. The calcium hydroxyapatite plaque phantom contained objects 0.5-5.0 mm in diameter with known CT attenuation nominal values ranging 50-800 HU. The cardiovascular phantom contained vessel mimicking objects 1.0-5.0 mm in diameter with different contrast media. Both phantoms were scanned using clinical protocols for CT angiography and images were reconstructed with different filter kernels. The measured CT number (HU) and diameter of each object were analyzed on three clinical postprocessing workstations. From the resultant data, a mathematical formula was derived based on absorption function exp(-{mu}{sup *}d) to demonstrate the relation between measured CT numbers and object diameters. Results: The percentage reduction in measured CT number (HU) for the group of selected filter kernels, apparent during CT angiography, is dependent only on the object size (plaque or vessel diameter). The derived formula of the form 1-c{sup *}exp(-a{sup *}d{sup b}) showed reduction in CT number for objects between 0.5 and 5 mm in diameter, with asymptote reaching background noise for small objects with diameters nearing the CT in-plane resolution (0.35 mm). No reduction was observed for the objects with diameters equal or larger than 5 mm. Conclusions: A clear mathematical relationship exists between object diameter and reduction in measured CT number in HU. This function is independent of exposure parameters and inherent attenuation properties of the objects studied. Future developments include the incorporation of this mathematical model function into quantification software in order to

  6. WHO claims maternal mortality has been underestimated.

    PubMed

    Court, C

    1996-02-17

    New data produced by the WHO and Unicef demonstrated that maternal mortality has been underestimated by a third, with nearly 80,000 more pregnancy-related deaths than previously reported. About 585,000 maternal deaths occur every year, 99% of them in developing countries. 55% of the deaths occur in Asia, which is responsible for 61% of the world's births, while Africa accounts for 40% of deaths and 20% of the world's births. Developed countries account for only 1% of maternal deaths and 11% of all births. Specific statistical models were used to assess the amount of underreporting that is common in developing countries, but can also occur in developed countries. When a pregnant woman is moved from the obstetrics department because of complications and subsequently dies, the original cause of the complication often is missing from the death certificate. A representative of WHO's maternal health and safe motherhood program remarked that these estimates are a great improvement over previous data. They also should encourage action to expand access to quality care for all women during pregnancy and childbirth. In North Africa, southern Africa, eastern Asia, Central America, and South America the estimates of maternal mortality were slightly lower than those available from earlier studies. The situation was particularly worrisome in eastern, middle, and western Africa, where the earlier estimates had been underestimated by almost one-third.

  7. Three-dimensional reconstruction of upper airways from MDCT

    NASA Astrophysics Data System (ADS)

    Perchet, Diane; Fetita, Catalin; Preteux, Francoise

    2005-03-01

    Under the framework of clinical respiratory investigation, providing accurate modalities for morpho-functional analysis is essential for diagnosis improvement, surgical planning and follow-up. This paper focuses on the upper airways investigation and develops an automated approach for 3D mesh reconstruction from MDCT acquisitions. In order to overcome the difficulties related to the complex morphology of the upper airways and to the image gray level heterogeneity of the airway lumens and thin bony septa, the proposed 3D reconstruction methodology combines 2D segmentation and 3D surface regularization approaches. The segmentation algorithm relies on mathematical morphology theory and provides airway lumen robust discrimination from the surrounding tissues, while preserving the connectivity relationship between the different anatomical structures. The 3D regularization step uses an energy-based modeling in order to achieve a smooth and well-fitted 3D surface of the upper airways. An accurate 3D mesh representation of the reconstructed airways makes it possible to develop specific clinical applications such as virtual endoscopy, surgical planning and computer assisted intervention. In addition, building up patient-specific 3D models of upper airways is highly valuable for the study and design of inhaled medication delivery via computational fluid dynamics (CFD) simulations.

  8. Accurate 3D quantification of the bronchial parameters in MDCT

    NASA Astrophysics Data System (ADS)

    Saragaglia, A.; Fetita, C.; Preteux, F.; Brillet, P. Y.; Grenier, P. A.

    2005-08-01

    The assessment of bronchial reactivity and wall remodeling in asthma plays a crucial role in better understanding such a disease and evaluating therapeutic responses. Today, multi-detector computed tomography (MDCT) makes it possible to perform an accurate estimation of bronchial parameters (lumen and wall areas) by allowing a quantitative analysis in a cross-section plane orthogonal to the bronchus axis. This paper provides the tools for such an analysis by developing a 3D investigation method which relies on 3D reconstruction of bronchial lumen and central axis computation. Cross-section images at bronchial locations interactively selected along the central axis are generated at appropriate spatial resolution. An automated approach is then developed for accurately segmenting the inner and outer bronchi contours on the cross-section images. It combines mathematical morphology operators, such as "connection cost", and energy-controlled propagation in order to overcome the difficulties raised by vessel adjacencies and wall irregularities. The segmentation accuracy was validated with respect to a 3D mathematically-modeled phantom of a pair bronchus-vessel which mimics the characteristics of real data in terms of gray-level distribution, caliber and orientation. When applying the developed quantification approach to such a model with calibers ranging from 3 to 10 mm diameter, the lumen area relative errors varied from 3.7% to 0.15%, while the bronchus area was estimated with a relative error less than 5.1%.

  9. Quantitative analysis of the central-chest lymph nodes based on 3D MDCT image data

    NASA Astrophysics Data System (ADS)

    Lu, Kongkuo; Bascom, Rebecca; Mahraj, Rickhesvar P. M.; Higgins, William E.

    2009-02-01

    Lung cancer is the leading cause of cancer death in the United States. In lung-cancer staging, central-chest lymph nodes and associated nodal stations, as observed in three-dimensional (3D) multidetector CT (MDCT) scans, play a vital role. However, little work has been done in relation to lymph nodes, based on MDCT data, due to the complicated phenomena that give rise to them. Using our custom computer-based system for 3D MDCT-based pulmonary lymph-node analysis, we conduct a detailed study of lymph nodes as depicted in 3D MDCT scans. In this work, the Mountain lymph-node stations are automatically defined by the system. These defined stations, in conjunction with our system's image processing and visualization tools, facilitate lymph-node detection, classification, and segmentation. An expert pulmonologist, chest radiologist, and trained technician verified the accuracy of the automatically defined stations and indicated observable lymph nodes. Next, using semi-automatic tools in our system, we defined all indicated nodes. Finally, we performed a global quantitative analysis of the characteristics of the observed nodes and stations. This study drew upon a database of 32 human MDCT chest scans. 320 Mountain-based stations (10 per scan) and 852 pulmonary lymph nodes were defined overall from this database. Based on the numerical results, over 90% of the automatically defined stations were deemed accurate. This paper also presents a detailed summary of central-chest lymph-node characteristics for the first time.

  10. Fatigue - an underestimated symptom in psoriatic arthritis.

    PubMed

    Krajewska-Włodarczyk, Magdalena; Owczarczyk-Saczonek, Agnieszka; Placek, Waldemar

    2017-01-01

    The nature of fatigue is very complex and involves physiological, psychological and social phenomena at the same time, and the mechanisms leading to occurrence and severity of fatigue are still poorly understood. The condition of chronic inflammation associated with psoriatic arthritis can be regarded as a potential factor affecting development of fatigue. Only a few studies so far have focused on the occurrence of fatigue in psoriatic arthritis. The problem of chronic fatigue is underestimated in everyday clinical practice. Identification and analysis of subjective fatigue components in each patient can provide an objective basis for optimal fatigue treatment in daily practice. This review presents a definition of chronic fatigue and describes mechanisms that may be associated with development of fatigue, highlighting the role of chronic inflammation, selected fatigue measurement methods and relations of fatigue occurrence with clinical aspects of psoriatic arthritis.

  11. Robust extraction of the aorta and pulmonary artery from 3D MDCT image data

    NASA Astrophysics Data System (ADS)

    Taeprasartsit, Pinyo; Higgins, William E.

    2010-03-01

    Accurate definition of the aorta and pulmonary artery from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. This work presents robust methods for defining the aorta and pulmonary artery in the central chest. The methods work on both contrast enhanced and no-contrast 3D MDCT image data. The automatic methods use a common approach employing model fitting and selection and adaptive refinement. During the occasional event that more precise vascular extraction is desired or the method fails, we also have an alternate semi-automatic fail-safe method. The semi-automatic method extracts the vasculature by extending the medial axes into a user-guided direction. A ground-truth study over a series of 40 human 3D MDCT images demonstrates the efficacy, accuracy, robustness, and efficiency of the methods.

  12. Tools of the trade for CTA: MDCT scanners and contrast medium injection protocols.

    PubMed

    Hallett, Richard L; Fleischmann, Dominik

    2006-12-01

    The introduction of multi-detector row computed tomography (MDCT) scanners in 1998 ushered in new advances in CT angiography (CTA). The subsequent expansion of MDCT scanner capabilities, coupled with advances in understanding of contrast medium (CM) dynamics, has further improved the clinical availability and consistency of CTA. We will review recent advances in CT scanner technology and discuss early CM dynamics. Specifically, we describe an approach tailored to the available scanner technology and to patient size aimed at providing consistently robust CTA studies across all vascular territories. A rational method to design combined CTA scan/injection protocols to facilitate this goal will be described. Our current experience with a simplified protocol for CTA with 64-MDCT will also be explained.

  13. Radiation dose reduction to the male gonads during MDCT: the effectiveness of a lead shield.

    PubMed

    Hohl, Christian; Mahnken, Andreas H; Klotz, Ernst; Das, Marco; Stargardt, Achim; Mühlenbruch, Georg; Schmidt, Thorsten; Günther, Rolf W; Wildberger, Joachim E

    2005-01-01

    Our study was designed to quantify the effect of a standard gonad shield on the testicular radiation exposure due to scatter during routine abdominopelvic MDCT. Routine abdominopelvic MDCT was performed in 34 patients with gonadal lead shielding and 32 patients without this shielding; the testes were not exposed to the direct beam during the examination. We estimated the testicular dose administered with thermoluminescent dosimetry, taking into account each patient's body weight and body mass index (BMI). With a 1-mm lead shield, the mean testicular dose was reduced from 2.40 to 0.32 mSv, a reduction of 87%. The difference was found to be statistically significant (p < 0.0001). No correlation between testicular dose and body weight or BMI was found. Shielding the male gonads reduces the testicular radiation dose during abdominopelvic MDCT significantly and can be recommended for routine use.

  14. Segmentation of the central-chest lymph nodes in 3D MDCT images.

    PubMed

    Lu, Kongkuo; Higgins, William E

    2011-09-01

    Central-chest lymph nodes play a vital role in lung-cancer staging. The definition of lymph nodes from three-dimensional (3D) multidetector computed-tomography (MDCT) images, however, remains an open problem. We propose two methods for computer-based segmentation of the central-chest lymph nodes from a 3D MDCT scan: the single-section live wire and the single-click live wire. For the single-section live wire, the user first applies the standard live wire to a single two-dimensional (2D) section after which automated analysis completes the segmentation process. The single-click live wire is similar but is almost completely automatic. Ground-truth studies involving human 3D MDCT scans demonstrate the robustness, efficiency, and intra-observer and inter-observer reproducibility of the methods.

  15. Feasibility of Free-breathing CCTA using 256-MDCT.

    PubMed

    Liu, Zhuo; Sun, Ye; Zhang, Zhuolu; Chen, Lei; Hong, Nan

    2016-07-01

    Usually, coronary computed tomography angiography (CCTA) is performed during breath-holding to reduce artifact caused by respiration. The objective of this study was to evaluate the feasibility of free-breathing CCTA compared to breath-holding using CT scanner with wide detector. To evaluate the feasibility of CCTA during free-breathing using a 256-MDCT. In 80 patients who underwent CCTA, 40 were performed during breath-holding (group A), and the remaining 40 during free-breathing (group B). The quality scores for coronary arteries were analyzed and defined as: 3 (excellent), 2 (good), and 1 (poor). The image noise, signal-to-noise ratio and effective radiation dose as well as the heart rate variation were compared. The noise, signal-to-noise ratio, and effective radiation dose were not significantly different between the 2 groups. The mean heart rate variation between planning and scanning for group A was 7 ± 7.6 bpm, and larger than 3 ± 2.6 bpm for group B (P = 0.012). Quality scores of the free-breathing group were better than those of the breath-holding group (group A: 2.55 ± 0.64, group B: 2.85 ± 0.36, P = 0.018). Free-breathing CCTA is feasible on wide detector CT scanner to provide acceptable image quality with reduced heart rate variation and better images for certain patients.

  16. In the workup of patients with obscure gastrointestinal bleed, does 64-slice MDCT have a role?

    PubMed

    Kulkarni, Chinmay; Moorthy, Srikanth; Sreekumar, Kp; Rajeshkannan, R; Nazar, Pk; Sandya, Cj; Sivasubramanian, S; Ramchandran, Pv

    2012-01-01

    The purpose was to prospectively determine the sensitivity of 64-slice MDCT in detecting and diagnosing the cause of obscure gastrointestinal bleed (OGIB). Our study included 50 patients (male 30, female 20) in the age range of 3-82 years (average age: 58.52 years) who were referred to our radiology department as part of their workup for clinically evident gastrointestinal (GI) bleed or as part of workup for anemia (with and without positive fecal occult blood test). All patients underwent conventional upper endoscopy and colonoscopy before undergoing CT scan. Following a noncontrast scan, all patients underwent triple-phase contrast CT scan using a 64-slice CT scan system. The diagnostic performance of 64-slice MDCT was compared to the results of capsule endoscopy, 99m-technetium-labeled red blood cell scintigraphy (99mTc-RBC scintigraphy), digital subtraction angiography, and surgery whenever available. CT scan showed positive findings in 32 of 50 patients. The sensitivity, specificity, positive predictive value, and negative predictive values of MDCT for detection of bleed were 72.2%, 42.8%, 81.2%, and 44.4%, respectively. Capsule endoscopy was done in 15 patients and was positive in 10 patients; it had a sensitivity of 71.4%. Eleven patients had undergone 99mTc-RBC scintigraphy prior to CT scan, and the result was positive in seven patients (sensitivity 70%). Digital subtraction angiography was performed in only eight patients and among them all except one patient showed findings consistent with the lesions detected on MDCT. MDCT is a sensitive and noninvasive tool that allows rapid detection and localization of OGIB. It can be used as the first-line investigation in patients with negative endoscopy and colonoscopy studies. MDCT and capsule endoscopy have complementary roles in the evaluation of OGIB.

  17. Arteriovenous fistula and graft evaluation in hemodialysis patients using MDCT: a primer.

    PubMed

    Chen, Min-Chi; Tsai, Wei-Lin; Tsai, I-Chen; Chan, Si-Wa; Liao, Wan-Chun; Lin, Pao-Chun; Yang, Su Jing

    2010-03-01

    Patent arteriovenous fistula (AVF) is related to better prognosis and quality of life for patients on long-term dialysis. When AVF dysfunction is suspected, MDCT is a good noninvasive tool for evaluating the entire AVF structure and determining reversible conditions for treatment. The aim of this article is to introduce the scanning and interpretation techniques and to illustrate the conditions related to early and late fistula failures. MDCT is a fast, noninvasive, and accurate technique for diagnosing AVF complications. Radiologists familiar with these techniques can help to improve the prognosis and quality of life for hemodialysis patients.

  18. 3-T contrast-enhanced MR angiography in evaluation of suspected intracranial aneurysm: comparison with MDCT angiography.

    PubMed

    Nael, Kambiz; Villablanca, J Pablo; Mossaz, Léonard; Pope, Whitney; Juncosa, Alex; Laub, Gerhard; Finn, J Paul

    2008-02-01

    The purpose of this study was to prospectively evaluate a high-spatial-resolution contrast-enhanced 3-T MR angiography protocol for detection and characterization of intracranial aneurysms and to compare the results with those of MDCT angiography. Forty-one patients with suspected intracranial aneurysm underwent high-spatial-resolution 3D contrast-enhanced MR angiography and CT angiography (CTA). With a generalized autocalibrating partially parallel acquisition algorithm with an acceleration factor of 4 at 3 T, contrast-enhanced MR angiographic images were acquired over 20 seconds with a spatial-resolution of 0.7 x 0.7 x 0.8 mm. CTA images were acquired with a spatial resolution of 0.35 x 0.35 x 0.8 mm on a 16-MDCT scanner in 17 seconds. The images from the two studies were evaluated independently by two neuroradiologists for image quality, presence of aneurysm, and characterization of aneurysm. The dimensions of the aneurysm were measured independently with both techniques. A total of 25 aneurysms were identified with both contrast-enhanced MR angiography and CTA. A comparative analysis of detection and depiction of aneurysms showed excellent interobserver agreement for both contrast-enhanced MR angiography (kappa = 0.81) and CTA (kappa = 0.91) images. There was significant correlation between the techniques for both qualitative assessment of aneurysm depiction (rho = 0.92; 95% CI, 0.88-0.95) and quantitative dimensional measurement of aneurysm size (r = 0.94; 95% CI, 0.92-0.97). Contrast-enhanced MR angiography at 3 T is reliable for evaluation and characterization of intracranial aneurysms. The results are comparable with those of MDCTA.

  19. Venous thromboembolism in cancer patients: an underestimated major health problem.

    PubMed

    Khalil, Jihane; Bensaid, Badr; Elkacemi, Hanan; Afif, Mohamed; Bensaid, Younes; Kebdani, Tayeb; Benjaafar, Noureddine

    2015-06-20

    Venous thromboembolism (VTE) is a major health problem among patients with cancer, its incidence in this particular population is widely increasing. Although VTE is associated with high rates of mortality and morbidity in cancer patients, its severity is still underestimated by many oncologists. Thromboprophylaxis of VTE now considered as a standard of care is still not prescribed in many institutions; the appropriate treatment of an established VTE is not yet well known by many physicians and nurses in the cancer field. Patients are also not well informed about VTE and its consequences. Many studies and meta-analyses have addressed this question so have many guidelines that dedicated a whole chapter to clarify and expose different treatment strategies adapted to this particular population. There is a general belief that the prevention and treatment of VTE cannot be optimized without a complete awareness by oncologists and patients. The aim of this article is to make VTE a more clear and understood subject.

  20. Has Northern Hemisphere Heat Flow Been Underestimated?

    NASA Astrophysics Data System (ADS)

    Gosnold, W. D.; Majorowicz, J.; Safanda, J.; Szewczyk, J.

    2005-05-01

    We present three lines of evidence to suggest the hypothesis that heat flow in the northern hemisphere may have been underestimated by 15 to 60 percent in shallow wells due to a large post-glacial warming signal. First, temperature vs. depth (T-z) measurements in parts of Europe and North America show a systematic increase in heat flow with depth. This phenomenon is best recognized in analyses of deep (greater than 2km) boreholes in non-tectonic regions with normal to low background heat flow. In Europe, the increase in heat flow with depth has been observed by analysis of more than 1500 deep boreholes located throughout the Fennoscandian Shield, East European Platform, Danish Basin, Germany, Czech Republic, and Poland. There are significantly fewer deep boreholes in North America, but the increase in heat flow with depth appears in a suite of 759 sites in the IHFC Global Heat Flow Database for the region east of the Rocky Mountains and north of latitude 40 N. Second, surface heat flow values in southern hemisphere shields average approximately 50 mWm-2, but surface heat flow values in northern hemisphere shields average 33 mWm-2. Unless crustal radioactivity or mantle heat flow or both factors are greater in southern hemisphere continents, there is no reason for the northern and southern shield areas having similar ages to have different heat flow values. Third, two recently published surface heat flow maps show anomalously low heat flow in the Canadian Shield in a pattern that is coincident with the Wisconsinan ice sheet. The coincidence of low heat flow and ice accumulation has no geophysical basis, thus the coincidence may suggest the existence of a transient signal caused by a warming event. Recent studies of heat flow in North America indicate that in several sites, the ice base temperature was close to the pressure melting point. We hypothesize that there may have been cold ice-free periods during the Pleistocene that would account for the apparent colder

  1. Computer-aided liver volumetry: performance of a fully-automated, prototype post-processing solution for whole-organ and lobar segmentation based on MDCT imaging.

    PubMed

    Fananapazir, Ghaneh; Bashir, Mustafa R; Marin, Daniele; Boll, Daniel T

    2015-06-01

    To evaluate the performance of a prototype, fully-automated post-processing solution for whole-liver and lobar segmentation based on MDCT datasets. A polymer liver phantom was used to assess accuracy of post-processing applications comparing phantom volumes determined via Archimedes' principle with MDCT segmented datasets. For the IRB-approved, HIPAA-compliant study, 25 patients were enrolled. Volumetry performance compared the manual approach with the automated prototype, assessing intraobserver variability, and interclass correlation for whole-organ and lobar segmentation using ANOVA comparison. Fidelity of segmentation was evaluated qualitatively. Phantom volume was 1581.0 ± 44.7 mL, manually segmented datasets estimated 1628.0 ± 47.8 mL, representing a mean overestimation of 3.0%, automatically segmented datasets estimated 1601.9 ± 0 mL, representing a mean overestimation of 1.3%. Whole-liver and segmental volumetry demonstrated no significant intraobserver variability for neither manual nor automated measurements. For whole-liver volumetry, automated measurement repetitions resulted in identical values; reproducible whole-organ volumetry was also achieved with manual segmentation, p(ANOVA) 0.98. For lobar volumetry, automated segmentation improved reproducibility over manual approach, without significant measurement differences for either methodology, p(ANOVA) 0.95-0.99. Whole-organ and lobar segmentation results from manual and automated segmentation showed no significant differences, p(ANOVA) 0.96-1.00. Assessment of segmentation fidelity found that segments I-IV/VI showed greater segmentation inaccuracies compared to the remaining right hepatic lobe segments. Automated whole-liver segmentation showed non-inferiority of fully-automated whole-liver segmentation compared to manual approaches with improved reproducibility and post-processing duration; automated dual-seed lobar segmentation showed slight tendencies for underestimating the right hepatic lobe

  2. US and MDCT diagnosis of a rare cause of haematuria in children: Posterior nutcracker syndrome.

    PubMed

    Ozel, A; Tufaner, O; Kaya, E; Maldur, V

    2011-06-01

    Posterior nutcracker syndrome is caused by compression of the left renal vein between the abdominal aorta and the vertebral column. We present the case of a 14-year-old girl with vague left loin pain, mild haematuria and proteinuria. Diagnosis of this rare syndrome was achieved using color Doppler US and multidetector computed tomography (MDCT) angiography.

  3. Three-dimensional MDCT angiography of splanchnic arteries: pearls and pitfalls.

    PubMed

    Dohan, A; Dautry, R; Guerrache, Y; Fargeaudou, Y; Boudiaf, M; Le Dref, O; Sirol, M; Soyer, P

    2015-02-01

    Fast scanning along with high resolution of multidetector computed tomography (MDCT) have expanded the role of non-invasive imaging of splanchnic arteries. Advancements in both MDCT scanner technology and three-dimensional (3D) imaging software provide a unique opportunity for non-invasive investigation of splanchnic arteries. Although standard axial computed tomography (CT) images allow identification of splanchnic arteries, visualization of small or distal branches is often limited. Similarly, a comprehensive assessment of the complex anatomy of splanchnic arteries is often beyond the reach of axial images. However, the submillimeter collimation that can be achieved with MDCT scanners now allows the acquisition of true isotropic data so that a high spatial resolution is now maintained in any imaging plane and in 3D mode. This ability to visualize the complex network of splanchnic arteries using 3D rendering and multiplanar reconstruction is of major importance for an optimal analysis in many situations. The purpose of this review is to discuss and illustrate the role of 3D MDCT angiography in the detection and assessment of abnormalities of splanchnic arteries as well as the limitations of the different reconstruction techniques.

  4. Automated diagnosis of interstitial lung diseases and emphysema in MDCT imaging

    NASA Astrophysics Data System (ADS)

    Fetita, Catalin; Chang Chien, Kuang-Che; Brillet, Pierre-Yves; Prêteux, Françoise

    2007-09-01

    Diffuse lung diseases (DLD) include a heterogeneous group of non-neoplasic disease resulting from damage to the lung parenchyma by varying patterns of inflammation. Characterization and quantification of DLD severity using MDCT, mainly in interstitial lung diseases and emphysema, is an important issue in clinical research for the evaluation of new therapies. This paper develops a 3D automated approach for detection and diagnosis of diffuse lung diseases such as fibrosis/honeycombing, ground glass and emphysema. The proposed methodology combines multi-resolution 3D morphological filtering (exploiting the sup-constrained connection cost operator) and graph-based classification for a full characterization of the parenchymal tissue. The morphological filtering performs a multi-level segmentation of the low- and medium-attenuated lung regions as well as their classification with respect to a granularity criterion (multi-resolution analysis). The original intensity range of the CT data volume is thus reduced in the segmented data to a number of levels equal to the resolution depth used (generally ten levels). The specificity of such morphological filtering is to extract tissue patterns locally contrasting with their neighborhood and of size inferior to the resolution depth, while preserving their original shape. A multi-valued hierarchical graph describing the segmentation result is built-up according to the resolution level and the adjacency of the different segmented components. The graph nodes are then enriched with the textural information carried out by their associated components. A graph analysis-reorganization based on the nodes attributes delivers the final classification of the lung parenchyma in normal and ILD/emphysematous regions. It also makes possible to discriminate between different types, or development stages, among the same class of diseases.

  5. Spectrum of Abdominal Aortic Disease in a Tertiary Health Care Setup: MDCT Based Observational Study

    PubMed Central

    Kumar, DG Santosh; Gadabanahalli, Karthik; Kalyanpur, Arjun

    2016-01-01

    Introduction Abdominal aortic disease is an important cause of clinical disability that requires early detection by imaging methods for prompt and effective management. Understanding regional disease pattern and prevalence has a bearing on healthcare management and resource planning. Non-invasive, conclusive imaging strategy plays an important role in the detection of disease. Multi-Detector Computed Tomography (MDCT) with its technological developments provides affordable, accurate and comprehensive imaging solution. Aim To evaluate regional demography of abdominal aortic disease spectrum detected using MDCT imaging data in a tertiary hospital. Materials and Methods A descriptive study was conducted based on MDCT imaging data of patients who were investigated with clinical diagnosis of abdominal aortic disease, from March 2008-2010, over a period of 24 months. Patients were examined with the contrast-enhanced MDCT examination. Morphological diagnosis of the aortic disease was based on changes in relative aortic caliber, luminal irregularity, presence of wall calcification, dissection or thrombus and evidence of major branch occlusion. Patients were categorized into four groups based on imaging findings. MDCT information and associated clinical parameters were examined and correlated to management of patient. Descriptive statistical data, namely mean, standard deviation and frequency of disease were evaluated. Results A total of 90 out of 210 patients (43%) were detected with the abdominal aortic abnormality defined by imaging criteria. Group I, comprising of patients with atherosclerosis –including those with complications, constituted 65.5% of the patients. Group II represented patients with aneurysms (45.5%). Group III, consisting of 32.2% of the patients, contained those with dissections. The rest of the patients, including patients with aorto-arteritis, were classified as group IV. Eight patients with aneurysm and one patient with aorto-arteritis were

  6. Fish bone foreign bodies in the pharynx and upper esophagus: evaluation with 64-slice MDCT.

    PubMed

    Park, Soyeon; Choi, Dae Seob; Shin, Hwa Seon; Cho, Jae Min; Jeon, Kyung Nyeo; Bae, Kyung-Soo; Koh, Eun Ha; Park, Jung Je

    2014-02-01

    Fish bone (FB) is one of the common causes of foreign body impaction in the pharynx and esophagus. To investigate the efficacy of 64-slice multidetector computed tomography (MDCT) for the evaluation of pharynx and upper esophageal FB foreign bodies. Sixty-six patients with suspected FB foreign body ingestion were examined by plain radiography (n = 40) and unenhanced MDCT (n = 66). We analyzed the presence, location, size, shape, and lying position of the foreign bodies. On MDCT, 46 foreign bodies were detected. Among them, 45 were confirmed by endoscopy. The sensitivity of MDCT for the detection of foreign bodies was 100%, which was superior to that of the plain radiography (51.7%). The location of the foreign bodies was most common in the upper esophagus (n = 22, 47.8%), followed by pharyngoesophageal junction (n = 10, 21.7%), transjunctional (n = 7, 15.2%), hypopharynx (n = 5, 10.9%), and oropharynx (n = 2, 4.3%). Their longest length was 5.3-40.1 mm (mean, 21.3 mm). Thirty-three FBs (71.7%) were linear and 13 (28.3%) were flat in shape. They showed transverse (n = 23, 50.0%), parallel (n = 13, 28.3%), and oblique positions (n = 10, 21.7%) to the long axis of the pharynx and esophagus, respectively. MDCT is useful for the evaluation of the pharynx and upper esophageal FB foreign bodies.

  7. Semi-automatic central-chest lymph-node definition from 3D MDCT images

    NASA Astrophysics Data System (ADS)

    Lu, Kongkuo; Higgins, William E.

    2010-03-01

    Central-chest lymph nodes play a vital role in lung-cancer staging. The three-dimensional (3D) definition of lymph nodes from multidetector computed-tomography (MDCT) images, however, remains an open problem. This is because of the limitations in the MDCT imaging of soft-tissue structures and the complicated phenomena that influence the appearance of a lymph node in an MDCT image. In the past, we have made significant efforts toward developing (1) live-wire-based segmentation methods for defining 2D and 3D chest structures and (2) a computer-based system for automatic definition and interactive visualization of the Mountain central-chest lymph-node stations. Based on these works, we propose new single-click and single-section live-wire methods for segmenting central-chest lymph nodes. The single-click live wire only requires the user to select an object pixel on one 2D MDCT section and is designed for typical lymph nodes. The single-section live wire requires the user to process one selected 2D section using standard 2D live wire, but it is more robust. We applied these methods to the segmentation of 20 lymph nodes from two human MDCT chest scans (10 per scan) drawn from our ground-truth database. The single-click live wire segmented 75% of the selected nodes successfully and reproducibly, while the success rate for the single-section live wire was 85%. We are able to segment the remaining nodes, using our previously derived (but more interaction intense) 2D live-wire method incorporated in our lymph-node analysis system. Both proposed methods are reliable and applicable to a wide range of pulmonary lymph nodes.

  8. Underestimating numerosity of items in visual search tasks.

    PubMed

    Cassenti, Daniel N; Kelley, Troy D; Ghirardelli, Thomas G

    2010-10-01

    Previous research on numerosity judgments addressed attended items, while the present research addresses underestimation for unattended items in visual search tasks. One potential cause of underestimation for unattended items is that estimates of quantity may depend on viewing a large portion of the display within foveal vision. Another theory follows from the occupancy model: estimating quantity of items in greater proximity to one another increases the likelihood of an underestimation error. Three experimental manipulations addressed aspects of underestimation for unattended items: the size of the distracters, the distance of the target from fixation, and whether items were clustered together. Results suggested that the underestimation effect for unattended items was best explained within a Gestalt grouping framework.

  9. Intussusception in Adults: The Role of MDCT in the Identification of the Site and Cause of Obstruction

    PubMed Central

    Valentini, Viola; Buquicchio, Grazia Loretta; Galluzzo, Michele; Ianniello, Stefania; Di Grezia, Graziella; Ambrosio, Rosa; Trinci, Margherita; Miele, Vittorio

    2016-01-01

    Unlike pediatric intussusception, intestinal intussusception is infrequent in adults and it is often secondary to a pathological condition. The growing use of Multi-Detector Computed Tomography (MDCT) in abdominal imaging has increased the number of radiological diagnoses of intussusception, even in transient and nonobstructing cases. MDCT is well suited to delineate the presence of the disease and provides valuable information about several features, such as the site of intussusception, the intestinal segments involved, and the extent of the intussuscepted bowel. Moreover, MDCT can demonstrate the complications of intussusceptions, represented by bowel wall ischemia and perforation, which are mandatory to promptly refer for surgery. However, not all intussusceptions need an operative treatment. In this paper, we review the current role of MDCT in the diagnosis and management of intussusception in adults, focusing on features, as the presence of a leading point, that may guide an accurate selection of patients for surgery. PMID:26819606

  10. Spectrum of MDCT Findings in Bowel Obstruction in a Tertiary Care Rural Hospital in Northern India

    PubMed Central

    Gupta, Ranjana; Mittal, Amit; Gupta, Sharad; Mittal, Kapish; Taneja, Arpit

    2016-01-01

    Introduction Multidetector Computed Tomography (MDCT) provides clinically and surgically important information in bowel obstruction. It can depict the severity, level and cause of obstruction. Aim To depict the spectrum of MDCT findings in cases of small and large bowel obstruction. Materials and Methods Contrast enhanced MDCT examination of 50 patients were retrospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with Ingenuity CT (128 slice MDCT, Philips Medical Systems). The axial sections were reconstructed in coronal and sagital planes to determine site and cause of bowel obstruction. Results There were 34 males and 16 females patients in this study with mean age of 28.4 years. The level of obstruction was in small bowel in 39 patients (76.67%) and large bowel in 11 patients (23.33%). Adhesive bands were the cause of Small Bowel Obstruction (SBO) in 17 patients (43.5% of SBO patients). The most common CT signs in adhesive band SBO were beak sign (seen in 70.6% patients) and fat notch sign (52.9% patients). Five cases of SBO were secondary to benign stricture. Matted adhesions were the cause of obstruction in 3 patients. All these patients showed transition zone in pelvis with positive small bowel faeces sign. Two patients with SBO due to adhesive band had evidence of closed loop obstruction with evidence of gangrenous gut on surgery. Large Bowel Obstruction (LBO) was seen in 11 patients. Most common cause of LBO was primary colonic malignancy, accounting for 7 patients (63.6%). In one patient, the cause was direct invasion of hepatic flexure by carcinoma of gall bladder. Other causes of LBO were pelvic adhesions, faecal impaction and ischaemic stricture. Conclusion SBO is more common than LBO with adhesive bands being the most common cause of SBO. MDCT is very useful for depicting site and cause

  11. Ectopia cordis with tetralogy of Fallot in an infant with pentalogy of Cantrell: high-pitch MDCT exam.

    PubMed

    Santiago-Herrera, Rogerio; Ramirez-Carmona, Rocio; Criales-Vera, Sergio; Calderon-Colmenero, Juan; Kimura-Hayama, Eric

    2011-07-01

    We report the MDCT findings of a 17-month-old girl with Cantrell's pentalogy, a rare congenital disease characterized by several defects in the ventral thoracoabdominal wall including ectopia cordis, and, in this patient, associated with tetralogy of Fallot. This case provides an example of the utility of a wide volume in coverage and high-pitch MDCT scan in the evaluation of complex cardiovascular anatomy in infants with congenital heart disease without the need of an ECG-gating acquisition.

  12. MDCT assessment of CAD in type-2 diabetic subjects with diabetic neuropathy: the role of Charcot neuro-arthropathy.

    PubMed

    Marano, Riccardo; Pitocco, Dario; Di Stasio, Enrico; Savino, Giancarlo; Merlino, Biagio; Trani, Carlo; Pirro, Federica; Rutigliano, Claudia; Santangelo, Carolina; Minoiu, Aurelian Costin; Natale, Luigi; Bonomo, Lorenzo

    2016-03-01

    To compare the CACS and CAD severity assessed by MDCT in neuropathic type-2 diabetic patients with and without Charcot-neuroarthropathy (CN). Thirty-four CN asymptomatic-patients and 36 asymptomatic-patients with diabetic-neuropathy (DN) without CN underwent MDCT to assess CACS and severity of CAD. Patients were classified as positive for significant CAD in presence of at least one stenosis >50 % on MDCT-coronary-angiography (MDCT-CA). Groups were matched for age, sex and traditional CAD risk-factors. The coronary-angiography (CA) was performed in all patients with at least a significant stenosis detected by MDCT-CA, both as reference and eventually as treatment. CN patients showed higher rates of significant CAD in comparison with DN subjects [p < 0.001], while non-significant differences were observed in CACS (p = 0.980). No significant differences were also observed in CACS distribution in all subjects for stenosis ≥/<50 % (p = 0.814), as well as in both groups (p = 0.661 and 0.559, respectively). The MDCT-CA showed an overall diagnostic-accuracy for significant CAD of 87%. These preliminary data suggest that CN-patients have a higher prevalence of severe CAD in comparison with DN-patients, while coronary plaques do not exhibit an increased amount of calcium. MDCT may be helpful to assess the CV risk in such asymptomatic type-2-diabetic patients with autonomic-neuropathy. Type 2-diabetic-patients with CN result having more severe coronary artery plaque-burden. MDCT-CA may stratify the CV risk in type 2-diabetic-patients with CN. Adequate diagnostic is mandatory for optimal management of type 2-diabetic-patients with CN.

  13. Academic self-concept, learning motivation, and test anxiety of the underestimated student.

    PubMed

    Urhahne, Detlef; Chao, Sheng-Han; Florineth, Maria Luise; Luttenberger, Silke; Paechter, Manuela

    2011-03-01

    BACKGROUND. Teachers' judgments of student performance on a standardized achievement test often result in an overestimation of students' abilities. In the majority of cases, a larger group of overestimated students and a smaller group of underestimated students are formed by these judgments. AIMS. In this research study, the consequences of the underestimation of students' mathematical performance potential were examined. SAMPLE. Two hundred and thirty-five fourth grade students and their fourteen mathematics teachers took part in the investigation. METHOD. Students worked on a standardized mathematics achievement test and completed a self-description questionnaire about motivation and affect. Teachers estimated each individual student's potential with regard to mathematics test performance as well as students' expectancy for success, level of aspiration, academic self-concept, learning motivation, and test anxiety. The differences between teachers' judgments on students' test performance and students' actual performance were used to build groups of underestimated and overestimated students. RESULTS. Underestimated students displayed equal levels of test performance, learning motivation, and level of aspiration in comparison with overestimated students, but had lower expectancy for success, lower academic self-concept, and experienced more test anxiety. Teachers expected that underestimated students would receive lower grades on the next mathematics test, believed that students were satisfied with lower grades, and assumed that the students have weaker learning motivation than their overestimated classmates. CONCLUSION. Teachers' judgment error was not confined to test performance but generalized to motivational and affective traits of the students.

  14. [Food-drug interactions: an underestimated risk].

    PubMed

    Sönnichsen, A C; Donner-Banzhoff, N; Baum, E

    2005-11-03

    With only few exceptions, administration of medicaments should, in principle, be independent of food intake (at least half an hour before or two hours after eating). This ensures uniform and assessable bioavailability. However, it also entails the risk that the patient is more likely to forget to take medication postponed to 2 hours after a meal, than when it is directly coupled to a meal. Certain foodstuffs or food constituents, such as, for example, grapefruit, Seville orange juice, red wine, alcoholic drinks in general, or large quantities of caffeine and garlic should be avoided during drug treatment. In addition, specific interactions with certain drugs must also be taken into account (e.g. MAO inhibitors and tyramine, curamine and vitamin K).

  15. Image quality improvement in MDCT cardiac imaging via SMART-RECON method

    NASA Astrophysics Data System (ADS)

    Li, Yinsheng; Cao, Ximiao; Xing, Zhanfeng; Sun, Xuguang; Hsieh, Jiang; Chen, Guang-Hong

    2017-03-01

    Coronary CT angiography (CCTA) is a challenging imaging task currently limited by the achievable temporal resolution of modern Multi-Detector CT (MDCT) scanners. In this paper, the recently proposed SMARTRECON method has been applied in MDCT-based CCTA imaging to improve the image quality without any prior knowledge of cardiac motion. After the prospective ECG-gated data acquisition from a short-scan angular span, the acquired data were sorted into several sub-sectors of view angles; each corresponds to a 1/4th of the short-scan angular range. Information of the cardiac motion was thus encoded into the data in each view angle sub-sector. The SMART-RECON algorithm was then applied to jointly reconstruct several image volumes, each of which is temporally consistent with the data acquired in the corresponding view angle sub-sector. Extensive numerical simulations were performed to validate the proposed technique and investigate the performance dependence.

  16. MDCT Imaging Findings of Liver Cirrhosis: Spectrum of Hepatic and Extrahepatic Abdominal Complications

    PubMed Central

    Sangster, Guillermo P.; Previgliano, Carlos H.; Nader, Mathieu; Chwoschtschinsky, Elisa; Heldmann, Maureen G.

    2013-01-01

    Hepatic cirrhosis is the clinical and pathologic result of a multifactorial chronic liver injury. It is well known that cirrhosis is the origin of multiple extrahepatic abdominal complications and a markedly increased risk of hepatocellular carcinoma (HCC). This tumor is the sixth most common malignancy worldwide and the third most common cause of cancer related death. With the rising incidence of HCC worldwide, awareness of the evolution of cirrhotic nodules into malignancy is critical for an early detection and treatment. Adequate imaging protocol selection with dynamic multiphase Multidetector Computed Tomography (MDCT) and reformatted images is crucial to differentiate and categorize the hepatic nodular dysplasia. Knowledge of the typical and less common extrahepatic abdominal manifestations is essential for accurately assessing patients with known or suspected hepatic disease. The objective of this paper is to illustrate the imaging spectrum of intra- and extrahepatic abdominal manifestations of hepatic cirrhosis seen on MDCT. PMID:23986608

  17. Congenital thoracic vascular anomalies: evaluation with state-of-the-art MR imaging and MDCT.

    PubMed

    Hellinger, Jeffrey C; Daubert, Melissa; Lee, Edward Y; Epelman, Monica

    2011-09-01

    Congenital thoracic vascular anomalies include embryologic developmental disorders of the thoracic aorta, aortic arch branch arteries, pulmonary arteries, thoracic systemic veins, and pulmonary veins. Diagnostic evaluation of these anomalies in pediatric patients has evolved with innovations in diagnostic imaging technology. State-of-the-art magnetic resonance (MR) imaging, MR angiography multidetector-row computed tomographic (MDCT) angiography, and advanced postprocessing visualization techniques offer accurate and reliable high-resolution two-dimensional and three-dimensional noninvasive anatomic displays for interpretation and clinical management of congenital thoracic vascular anomalies. This article reviews vascular MR imaging, MR angiography, MDCT angiography, and advanced visualization techniques and applications for the assessment of congenital thoracic vascular anomalies, emphasizing clinical embryology and the characteristic imaging findings.

  18. Robust method for extracting the pulmonary vascular trees from 3D MDCT images

    NASA Astrophysics Data System (ADS)

    Taeprasartsit, Pinyo; Higgins, William E.

    2011-03-01

    Segmentation of pulmonary blood vessels from three-dimensional (3D) multi-detector CT (MDCT) images is important for pulmonary applications. This work presents a method for extracting the vascular trees of the pulmonary arteries and veins, applicable to both contrast-enhanced and unenhanced 3D MDCT image data. The method finds 2D elliptical cross-sections and evaluates agreement of these cross-sections in consecutive slices to find likely cross-sections. It next employs morphological multiscale analysis to separate vessels from adjoining airway walls. The method then tracks the center of the likely cross-sections to connect them to the pulmonary vessels in the mediastinum and forms connected vascular trees spanning both lungs. A ground-truth study indicates that the method was able to detect on the order of 98% of the vessel branches having diameter >= 3.0 mm. The extracted vascular trees can be utilized for the guidance of safe bronchoscopic biopsy.

  19. High-resolution bone imaging for osteoporosis diagnostics and therapy monitoring using clinical MDCT and MRI.

    PubMed

    Baum, T; Karampinos, D C; Liebl, H; Rummeny, E J; Waldt, S; Bauer, J S

    2013-01-01

    Osteoporosis is classified as a public health problem due to its increased risk for fragility fractures. Osteoporotic fractures, in particular spine and hip fractures, are associated with a high morbidity and mortality, and generate immense financial cost. The World Health Organisation (WHO) based the diagnosis of osteoporosis on the measurement of bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA). However, BMD values of subjects with versus without osteoporotic fractures overlap. Furthermore, it was reported that the anti-fracture effects of drugs could be only partially explained by their effects on BMD. Bone strength reflects the integration of BMD and bone quality. The later can be partly determined by measurements of bone microstructure. Therefore, substantial research efforts have been undertaken to assess bone microstructure by using high-resolution imaging techniques, including high-resolution peripheral quantitative computed tomography (hr-pQCT), high-resolution multi-detector computed tomography (MDCT), and high-resolution magnetic resonance imaging (MRI). Clinical MDCT and MRI systems are broadly available and allow an adequate depiction of the bone microstructure at the clinically most important fracture sites, i.e. radius, spine and hip. Bone microstructure parameters and finite element models can be computed in high-resolution MDCT and MR images. These measurements improved the prediction of bone strength beyond the DXA-derived BMD and revealed pharmacotherapy effects, which are partly not captured by BMD. Therefore, high-resolution bone imaging using clinical MDCT and MRI may be beneficial for osteoporosis diagnostics and allow a highly sensitive monitoring of drug treatment, which plays an important role in the prevention of fragility fractures.

  20. Evaluating the effect of two different anesthetic protocols on 64-MDCT coronary angiography in dogs

    PubMed Central

    Drees, Randi; Johnson, Rebecca A; Pinkerton, Marie; Del Rio, Alejandro Munoz; Saunders, Jimmy H; François, Christopher J

    2014-01-01

    Heart rate is a major factor influencing diagnostic image quality in computed tomographic coronary artery angiography (MDCT-CA) with an ideal heart rate of 60–65 beats/minute in humans. Using standardized contrast bolus volume, two different clinically applicable anesthetic protocols were compared for effect on cardiovascular parameters and 64-MDCT-CA quality in ten healthy dogs. The protocol using midazolam/fentanyl (A) was hypothesized to result in adequate reduction of heart rate achieving adequate image quality for MDCT-CA studies and having low impact on blood pressure, where as the protocol utilizing dexmedetomidine (B) was expected to result in reduction of heart rate to the target heart range resulting in excellent image quality while possibly showing undesirable effect on the blood pressure values measured. Heart rate was 80.6 ± 7.5bpm with protocol A and 79.2 ± 14.2bpm with protocol B during image acquisition (P=1). R-R intervals allowing for the best depiction of the individual coronary artery segments were found in the end diastolic period and varied between the 70–95% interval. Diagnostic quality was rated excellent, good and moderate in the majority of the segments evaluated, with higher scores given for more proximal segments and lower for more distal segments respectively. Blur was the most commonly observed artifact and most affected the distal segments. There was no significant difference for the optimal reconstruction interval, diagnostic quality and measured length individual segments or proximal diameter of the coronary arteries between both protocols (P=1). Both anesthetic protocols and the standardized bolus volume allow for diagnostic quality coronary 64-MDCT-CA exams. PMID:25065815

  1. Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings.

    PubMed

    Yoon, Kibo; Song, Soon Young; Lee, Chang Hwa; Ko, Byung Hee; Lee, Seunghun; Kang, Bo Kyeong; Kim, Mi Mi

    2017-04-01

    The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate < 60 mL/min/1.73 m² or to end-stage renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR.

  2. Spontaneous Renal Artery Dissection as a Cause of Acute Renal Infarction: Clinical and MDCT Findings

    PubMed Central

    2017-01-01

    The purpose of this study was to assess the incidence of spontaneous renal artery dissection (SRAD) as a cause of acute renal infarction, and to evaluate the clinical and multidetector computed tomography (MDCT) findings of SRAD. From November 2011 to January 2014, 35 patients who were diagnosed with acute renal infarction by MDCT were included. We analyzed the 35 MDCT data sets and medical records retrospectively, and compared clinical and imaging features of SRAD with an embolism, using Fisher's exact test and the Mann-Whitney test. The most common cause of acute renal infarction was an embolism, and SRAD was the second most common cause. SRAD patients had new-onset hypertension more frequently than embolic patients. Embolic patients were found to have increased C-reactive protein (CRP) more often than SRAD patients. Laboratory results, including tests for lactate dehydrogenase (LDH) and blood urea nitrogen (BUN), and the BUN/creatinine ratio (BCR) were significantly higher in embolic patients than SRAD patients. Bilateral renal involvement was detected in embolic patients more often than in SRAD patients. MDCT images of SRAD patients showed the stenosis of the true lumen, due to compression by a thrombosed false lumen. None of SRAD patients progressed to an estimated glomerular filtration rate < 60 mL/min/1.73 m2 or to end-stage renal disease during the follow-up period. SRAD is not a rare cause of acute renal infarction, and it has a benign clinical course. It should be considered in a differential diagnosis of acute renal infarction, particularly in patients with new-onset hypertension, unilateral renal involvement, and normal ranges of CRP, LDH, BUN, and BCR. PMID:28244286

  3. Managing patient dose in multi-detector computed tomography(MDCT). ICRP Publication 102.

    PubMed

    Valentin, J

    2007-01-01

    Computed tomography (CT) technology has changed considerably in recent years with the introduction of increasing numbers of multiple detector arrays. There are several parameters specific to multi-detector computed tomography (MDCT) scanners that increase or decrease patient dose systematically compared to older single detector computed tomography (SDCT) scanners. This document briefly reviews the MDCT technology, radiation dose in MDCT, including differences from SDCT and factors that affect dose, radiation risks, and the responsibilities for patient dose management. The document recommends that users need to understand the relationship between patient dose and image quality and be aware that image quality in CT is often higher than that necessary for diagnostic confidence. Automatic exposure control (AEC) does not totally free the operator from selection of scan parameters, and awareness of individual systems is important. Scanning protocols cannot simply be transferred between scanners from different manufacturers and should be determined for each MDCT. If the image quality is appropriately specified by the user, and suited to the clinical task, there will be a reduction in patient dose for most patients. Understanding of some parameters is not intuitive and the selection of image quality parameter values in AEC systems is not straightforward. Examples of some clinical situation shave been included to demonstrate dose management, e.g. CT examinations of the chest, the heart for coronary calcium quantification and non-invasive coronary angiography, colonography, the urinary tract, children, pregnant patients, trauma cases, and CT guided interventions. CT is increasingly being used to replace conventional x-ray studies and it is important that patient dose is given careful consideration, particularly with repeated or multiple examinations.

  4. Beak-Like Extension of the Pancreatic Uncinate Process on MDCT: Is It Hyperplasia or Movement?

    PubMed

    Omeri, Ahmad Khalid; Matsumoto, Shunro; Kiyonaga, Maki; Takaji, Ryo; Yamada, Yasunari; Mori, Hiromu

    2016-01-01

    We aimed to evaluate the pancreatic uncinate process with a beak-like extension (BLE) beyond the left border of the superior mesenteric artery, to define the cause of BLE, and to differentiate BLE from hyperplasia. We retrospectively reviewed 1042 triple-phase contrast-enhanced multidetector-row computed tomography (3P-CE-MDCT) examinations of 500 patients. Finally, 38 patients (28 men, 10 women; mean age, 66 years) with 140 3P-CE-MDCT images showing BLE were studied regarding BLE size, contour, and cause. The superior mesenteric artery position was also evaluated. Beak-like extensions were found in 7.6% of patients. Most were caused by movement of the small bowel mesentery (n = 21, 55%), with deviation of mesenteric vessels or mass effect from expanded adjacent organs (n = 3, 8%). Seven patients (18.5%) had true hyperplasia. Beak-like extension is caused by movement of the small bowel mesentery with deviation of mesenteric vessels or by adjacent organ expansion. Beak-like extension closely mimics other pathology on nonenhanced MDCT.

  5. Conventional and reduced radiation dose of 16-MDCT for detection of nephrolithiasis and ureterolithiasis.

    PubMed

    Paulson, Erik K; Weaver, Carolyn; Ho, Lisa M; Martin, Lucie; Li, Jianying; Darsie, James; Frush, Donald P

    2008-01-01

    Our purpose was to prospectively compare the reader compatibility and acceptability of a range of reduced-dose 16-MDCT images with standard-dose 16-MDCT images for the detection of nephroureterolithiasis using a dose reduction simulation technique. The study was HIPAA compliant and institutional review board approved. Fifty consecutive patients with suspected nephrolithiasis were recruited to undergo conventional renal stone unenhanced 16-MDCT with at least 160 mA. Noise was then artificially introduced to simulate levels of 70, 100, and 130 mA. Three blinded independent readers interpreted the original and simulated-dose scans for the location and number of renal and ureteral calculi and secondary signs of obstruction using a 5-point confidence scale. Reader acceptability of scans was inversely related to noise. There was no significant reduction in readers' confidence in detection or exclusion of renal collecting system calculi with simulated reduction of mA of 70, 100, and 130 compared with the standard-dose study. However, for ureteral calcifications, there was a decrease in confidence for the detection or exclusion of ureterolithiasis at an mA of 70 (35 mAs). An mA as low as 70 (35 mAs) is acceptable for evaluation of nephrolithiasis. However, the evaluation of ureterolithiasis is compromised with an mA of 70.

  6. Spectrum of imaging findings on MDCT enterography in patients with small bowel tuberculosis.

    PubMed

    Kalra, N; Agrawal, P; Mittal, V; Kochhar, R; Gupta, V; Nada, R; Singh, R; Khandelwal, N

    2014-03-01

    Abdominal tuberculosis (TB) is the sixth most common extrapulmonary site of involvement. The sites of involvement in abdominal tuberculosis, in descending order of frequency, are lymph nodes, genitourinary tract, peritoneal cavity, and gastrointestinal tract. The radiological armamentarium for evaluating tuberculosis of the small bowel (SBTB) includes barium studies (small bowel follow-through, SBFT), CT (multidetector CT, CT enterography, and CT enteroclysis), ultrasound (sonoenteroclysis), and magnetic resonance imaging (MRI; enterography and enteroclysis). In this review, we illustrate the abnormalities at MDCT enterography in 20 consecutive patients with SB TB and also describe extraluminal findings in these patients. MDCT enterography allows non-invasive good-quality assessment of well-distended bowel loops and the adjacent soft tissues. It displays the thickness and enhancement of the entire bowel wall in all three planes and allows examination of all bowel loops, especially the ileal loops, which are mostly superimposed. The terminal ileum and ileocaecal junction are the most common sites of small bowel involvement in intestinal TB. The most common abnormality is short-segment strictures with symmetrical concentric mural thickening and homogeneous mural enhancement. Other findings include lymphadenopathy, ascites, enteroliths, peritoneal thickening, and enhancement. In conclusion, MDCT enterography is a comprehensive technique for the evaluation of SB TB.

  7. How reliable are 40 MHz IVUS and 64-slice MDCT in characterizing coronary plaque composition? An ex vivo study with histopathological comparison.

    PubMed

    Chopard, Romain; Boussel, Loic; Motreff, Pascal; Rioufol, Gilles; Tabib, Alain; Douek, Philippe; Meyronet, David; Revel, Didier; Finet, Gérard

    2010-04-01

    The present study investigated whether IVUS could serve as a reliable reference in validating MDCT characterization of coronary plaque against a histological gold standard. Twenty-one specimens were postmortem human coronary arteries. Coronary cross-sections were imaged by 40 MHz IVUS and by 64-slice MDCT and characterized histologically as presenting calcified, fibrous or lipid-rich plaques. Plaque composition was analyzed visually and intra-plaque MDCT attenuation was measured in Hounsfield Units (HU). 83 atherosclerotic plaques were identified. IVUS failed to characterize calcified plaque accurately, with a positive predictive value (ppv) of 75% versus 100% for MDCT. Lipid-rich plaque was even less accurately characterized, with ppv of 60 and 68% for IVUS and MDCT respectively. Mean MDCT attenuation was 966 +/- 473 HU for calcified plaque, 83 +/- 35 HU for fibrous plaque and 70.92 HU +/- 41 HU for lipid-rich plaque. No significant difference in mean MDCT attenuation was found between fibrous and lipid-rich plaques (P = 0.276). In vivo validation of MDCT against an IVUS reference thus appears to be an unsuitable and unreliable approach: 40 MHz IVUS suffers from acoustic ambiguities in plaque characterization, and 64-slice MDCT fails to analyze plaque morphology and components accurately.

  8. Parents' Underestimations of Child Weight: Implications for Obesity Prevention.

    PubMed

    Howe, Carol J; Alexander, Gina; Stevenson, Jada

    2017-06-16

    Obesity prevention efforts may be ineffective if parents lack awareness of their children's overweight status. This study examined the factors that predicted parents' underestimation of child weight status. Using a cross sectional design, researchers recruited children and parents in a local children's museum. Parents completed a demographic questionnaire, the Newest Vital Sign, and the Child Body Image Scale. Children's height and weight were measured to calculate child BMI. Random effects modeling examined the association between predictor variables (parent race/ethnicity, income, education, and health literacy, and child BMI percentile, gender, and age) and the dependent variable, parent underestimation of child weight status. Participants included 160 parents (213 children aged 7-12years) representing a racially and ethnically diverse sample who were affluent, educated, and with 36.6% of parents assessed with limited health literacy. Although 45.1% of children were overweight/obese, only 7.5% of parents chose this weight status; 80% of parents underestimated the weight of their normal weight children, 96% underestimated their overweight children, and 72% underestimated their obese children. Parents were more likely to underestimate weight of older children and those under 81st percentile of BMI. No other predictors were significant. Parent underestimation of child weight status appears to be a widespread phenomenon in this sample, regardless of race, ethnicity, income, education, and health literacy. The consistent underestimation of child weight suggests that parents' misperception of weight status represents a critical pathway for intervention. Methods to improve parents' perception of child weight need be developed and tested. Update Key words: obesity, weight status, Newest Vital Sign, overweight, parental perception. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Assessment of Gd-EOB-DTPA-enhanced MRI for HCC and dysplastic nodules and comparison of detection sensitivity versus MDCT.

    PubMed

    Inoue, Tatsuo; Kudo, Masatoshi; Komuta, Mina; Hayaishi, Sosuke; Ueda, Taisuke; Takita, Masahiro; Kitai, Satoshi; Hatanaka, Kinuyo; Yada, Norihisa; Hagiwara, Satoru; Chung, Hobyung; Sakurai, Toshiharu; Ueshima, Kazuomi; Sakamoto, Michiie; Maenishi, Osamu; Hyodo, Tomoko; Okada, Masahiro; Kumano, Seishi; Murakami, Takamichi

    2012-09-01

    We aimed to evaluate gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the detection of hepatocellular carcinomas (HCCs) and dysplastic nodules (DNs) compared with dynamic multi-detector row computed tomography (MDCT), and to discriminate between HCCs and DNs. Eighty-six nodules diagnosed as HCC or DNs were retrospectively investigated. Gd-EOB-DTPA-enhanced MRI and dynamic MDCT were compared with respect to their diagnostic ability for hypervascular HCCs and detection sensitivity for hypovascular tumors. The ability of hepatobiliary images of Gd-EOB-DTPA-enhanced MRI to discriminate between these nodules was assessed. We also calculated the EOB enhancement ratio of the tumors. For hypervascular HCCs, the diagnostic ability of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of MDCT for tumors less than 2 cm (p = 0.048). There was no difference in the detection of hypervascular HCCs between hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI (43/45: 96%) and dynamic MDCT (40/45: 89%), whereas the detection sensitivity of hypovascular tumors by Gd-EOB-DTPA-enhanced MRI was significantly higher than that by dynamic MDCT (39/41: 95% vs. 25/41: 61%, p = 0.001). EOB enhancement ratios were decreased in parallel with the degree of differentiation in DNs and HCCs, although there was no difference between DNs and hypovascular well-differentiated HCCs. The diagnostic ability of Gd-EOB-DTPA-enhanced MRI for hypervascular HCCs less than 2 cm was significantly higher than that of MDCT. For hypovascular tumors, the detection sensitivity of hepatobiliary phase images of Gd-EOB-DTPA-enhanced MRI was significantly higher than that of dynamic Gd-EOB-DTPA-enhanced MRI and dynamic MDCT. It was difficult to distinguish between DNs and hypovascular well-differentiated HCCs based on the EOB enhancement ratio.

  10. Parental underestimates of child weight: a meta-analysis.

    PubMed

    Lundahl, Alyssa; Kidwell, Katherine M; Nelson, Timothy D

    2014-03-01

    Parental perceptions of their children's weight play an important role in obesity prevention and treatment. The objective of this study was to determine the proportion of parents worldwide who underestimate their children's weight and moderators of such misperceptions. Original studies published to January 2013 were chosen through literature searches in PUBMED, PSYCHINFO, and CINAHL databases. References of retrieved articles were also searched for relevant studies. Studies were published in English and assessed parental perceptions of children's weight and then compared perceptions to recognized standards for defining overweight based on anthropometric measures. Data were extracted on study-level constructs, child- and parent-characteristics, procedural characteristics, and parental underestimates separately for normal-weight and overweight/obese samples. Pooled effect sizes were calculated using random-effects models and adjusted for publication bias. Moderators were explored using mixed-effect models. A total of 69 articles (representing 78 samples; n = 15,791) were included in the overweight/obese meta-analysis. Adjusted effect sizes revealed that 50.7% (95% confidence interval 31.1%-70.2%) of parents underestimate their overweight/obese children's weight. Significant moderators of this effect included child's age and BMI. A total of 52 articles (representing 59 samples; n = 64,895) were included in the normal-weight meta-analysis. Pooled effect sizes indicated that 14.3% (95% confidence interval 11.7%-17.4%) of parents underestimate their children's normal-weight status. Significant moderators of this effect included child gender, parent weight, and the method (visual versus nonvisual) in which perception was assessed. Half of parents underestimated their children's overweight/obese status and a significant minority underestimated children's normal weight. Pediatricians are well positioned to make efforts to remedy parental underestimates and promote adoption

  11. MR-Imaging of teeth and periodontal apparatus: an experimental study comparing high-resolution MRI with MDCT and CBCT.

    PubMed

    Gaudino, Chiara; Cosgarea, Raluca; Heiland, Sabine; Csernus, Réka; Beomonte Zobel, Bruno; Pham, Mirko; Kim, Ti-Sun; Bendszus, Martin; Rohde, Stefan

    2011-12-01

    The aim of this study was (1) to assess the ability of magnetic resonance imaging (MRI) to visualize dental and periodontal structures and (2) to compare findings with multidetector computed tomography (MDCT) and cone beam CT (CBCT). Four porcine mandibles were examined with (1) 3T-MRI, (2) MDCT and (3) CBCT. Two observers independently reviewed MR, MDCT and CBCT images and assessed image quality of different dental and periodontal structures. To assess quantitatively the accuracy of the different imaging technique, both observers measured burr holes, previously drilled in the mandibles. Dental structures, e.g. teeth roots, pulpa chamber and dentin, were imaged accurately with all imaging sources. Periodontal space and cortical/trabecular bone were better visualized by MRI (p < 0.001). MRI could excellently display the lamina dura, not detectable with MDCT and only inconstant visible with CBCT (p < 0.001). Burr hole measurements were highly precise with all imaging techniques. This experimental study shows the diagnostic feasibility of MRI in visualization of teeth and periodontal anatomy. Detection of periodontal structures was significantly better with MRI than with MDCT or CBCT. Prospective trials have to evaluate further the potential benefit of MRI in a clinical setting.

  12. Clear Cell Renal Cell Carcinoma: Identifying the Loss of the Y Chromosome on Multiphasic MDCT.

    PubMed

    Young, Jonathan R; Coy, Heidi; Douek, Michael; Lo, Pechin; Sayre, James; Pantuck, Allan J; Raman, Steven S

    2017-08-01

    The objective of our study was to investigate whether multiphasic MDCT enhancement can help identify clear cell renal cell carcinomas (RCCs) with the loss of the Y chromosome. We derived a cohort of 43 clear cell RCCs in men who underwent preoperative four-phase renal mass MDCT from October 2000 to August 2013. Each lesion was segmented in its entirety on axial images. A computer-assisted detection algorithm selected a 0.5-cm-diameter region of maximal attenuation within each lesion in each phase. A 0.5-cm-diameter ROI was manually placed on uninvolved renal cortex in each phase. The relative attenuation of each lesion was calculated as follows: [(maximal lesion attenuation - cortex attenuation) / cortex attenuation] × 100. Absolute attenuation and relative attenuation in each phase were compared using t tests. Both clear cell RCCs with the loss of the Y chromosome and clear cell RCCs without the loss of the Y chromosome exhibited peak enhancement in the corticomedullary phase. However, relative nephrographic attenuation of clear cell RCCs with the loss of Y was significantly less than that of clear cell RCCs without the loss of Y (mean, -8.9 vs 8.4 respectively; p = 0.013). A relative nephrographic attenuation threshold of -1.6 identified the loss of Y with an accuracy of 70% (30/43), sensitivity of 73% (16/22), and specificity of 67% (14/21). Multiphasic MDCT enhancement may assist in identifying the loss of the Y chromosome in clear cell RCCs; this result should be validated in a large prospective trial.

  13. MDCT of acute subaxial cervical spine trauma: a mechanism-based approach.

    PubMed

    Raniga, Sameer B; Menon, Venugopal; Al Muzahmi, Khamis S; Butt, Sajid

    2014-06-01

    Injuries to the spinal column are common and road traffic accidents are the commonest cause. Subaxial cervical spine (C3-C7) trauma encompasses a wide spectrum of osseous and ligamentous injuries, in addition to being frequently associated with neurological injury. Multidetector computed tomography (MDCT) is routinely performed to evaluate acute cervical spine trauma, very often as first-line imaging. MDCT provides an insight into the injury morphology, which in turn reflects the mechanics of injury. This article will review the fundamental biomechanical forces underlying the common subaxial spine injuries and resultant injury patterns or "fingerprints" on MDCT. This systematic and focused analysis enables a more accurate and rapid interpretation of cervical spine CT examinations. Mechanical considerations are important in most clinical and surgical decisions to adequately realign the spine, to prevent neurological deterioration and to facilitate appropriate stabilisation. This review will emphasise the variables on CT that affect the surgical management, as well as imaging "pearls" in differentiating "look-alike" lesions with different surgical implications. It will also enable the radiologist in writing clinically relevant CT reports of cervical spine trauma. Teaching Points • Vertebral bodies and disc bear the axial compression forces, while the ligaments bear the distraction forces.• Compressive forces result in fracture and distractive forces result in ligamentous disruption.• Bilateral facet dislocation is the most severe injury of the flexion-distraction spectrum.• Biomechanics-based CT reading will help to rapidly and accurately identify the entire spectrum of injury.• This approach also helps to differentiate look-alike injuries with different clinical implications.

  14. Coronary fly-through or virtual angioscopy using dual-source MDCT data.

    PubMed

    van Ooijen, Peter M A; de Jonge, Gonda; Oudkerk, Matthijs

    2007-11-01

    Coronary fly-through or virtual angioscopy (VA) has been studied ever since its invention in 2000. However, application was limited because it requires an optimal computed tomography (CT) scan and time-consuming post-processing. Recent advances in post-processing software facilitate easy construction of VA, but until now image quality was insufficient in most patients. The introduction of dual-source multidetector CT (MDCT) could enable VA in all patients. Twenty patients were scanned using a dual-source MDCT (Definition, Siemens, Forchheim, Germany) using a standard coronary artery protocol. Post-processing was performed on an Aquarius Workstation (TeraRecon, San Mateo, Calif.). Length travelled per major branch was recorded in millimetres, together with the time required in minutes. VA could be performed in every patient for each of the major coronary arteries. The mean (range) length of the automated fly-through was 80 (32-107) mm for the left anterior descending (LAD), 75 (21-116) mm for the left circumflex artery (LCx), and 109 (21-190) mm for the right coronary artery (RCA). Calcifications and stenoses were visualised, as well as most side branches. The mean time required was 3 min for LAD, 2.5 min for LCx, and 2 min for the RCA. Dual-source MDCT allows for high quality visualisation of the coronary arteries in every patient because scanning with this machine is independent of the heart rate. This is clearly shown by the successful VA in all patients. Potential clinical value of VA should be determined in the near future.

  15. Ileocaecal Intussusception with a Lead Point: Unusual MDCT Findings of Active Crohn's Disease Involving the Appendix

    PubMed Central

    Ozan, Ebru; Atac, Gokce Kaan; Akincioglu, Egemen; Keskin, Mete; Gulpinar, Kamil

    2015-01-01

    Adult intussusception is a rare entity accounting for 1% of all bowel obstructions. Unlike intussusceptions in children, which are idiopathic in 90% of cases, adult intussusceptions have an identifiable cause (lead point) in the majority of cases. Crohn's disease (CD) may affect any part of the gastrointestinal tract, including the appendix. It was shown to be a predisposing factor for intussusception. Here, we report a rare case of adult intussusception with a lead point, emphasizing diagnostic input of multidetector computed tomography (MDCT) in a patient with active CD that involves the appendix. PMID:26558130

  16. Multidetector CT (MD-CT) in the diagnosis of uncertain open globe injuries.

    PubMed

    Hoffstetter, P; Schreyer, A G; Schreyer, C I; Jung, E M; Heiss, P; Zorger, N; Framme, C

    2010-02-01

    To evaluate the significance of multislice CT for the diagnosis of uncertain penetrating globe injuries. Based on a retrospective chart review between 2002 and 2007, we identified 59 patients presenting with severe ocular trauma with uncertain rupture of the globe due to massive subconjunctival and/or anterior chamber hemorrhage. The IOP (intraocular pressure) was within normal range in all patients. High resolution multidetector CT (MD-CT) scans (16 slice scans) with axial and coronar reconstructions were performed in all patients. The affected eye was examined for signs of penetrating injury such as abnormal eye shape, scleral irregularities, lens dislocation or intravitreal hemorrhages. Four experienced radiologists read the CT scans independently. Beside the diagnosis, the relevant morphological criteria and the optimal plane orientation (axial or coronar) were specified. The sensitivity, specificity, and negative and positive predictive value were calculated. Additionally the interobserver variability was determined by applying the Cohen's kappa test. Surgical sclera inspections were performed in all cases as a standard of reference. The evaluations of the CT examination were compared with the surgery reports. 59 patients were evaluated (42 men, 17 women). The mean age was 29 years (range 7 - 91). In 17 patients a rupture of the globe was diagnosed during surgery. 12 of these 17 penetrating injuries (70.6 %) were classified correctly by MDCT, 5 of the 17 (29.4 %) were not detectable. 42 patients did not have an open globe injury. 41 of these patients were diagnosed correctly negative by MDCT, and one patient was classified false positive. This results in a sensitivity of 70 % with a specificity of 98 %. There was high inter-rater agreement with kappa values between 0.89 - 0.96. Most discrepancies were caused by wrong negative findings. The most frequent morphologic criteria for open globe injury were the deformation (n = 10) and the volume reduction (n = 7) of

  17. Rare diagnosis of nodular lymphangitis caused by Mycobacterium marinum: MDCT imaging findings

    PubMed Central

    Pedrosa, Margarita; Soriano, Alex; Zboromyrska, Yuliya; Tudo, Griselda; Garcia, Sebastian; Pomes, Jaime

    2014-01-01

    Mycobacterium marinum is an atypical mycobacterium that usually causes a solitary nodule on the hand (“fish tank granuloma”) or less commonly, secondary erythematous channels and nodules spread along lymphatic drainage of the extremity, mimicking sporothricoid skin lesions of nodular lymphangitis. This report presents a case of this rare entity, a nodular lymphangitis caused by Mycobacterium marinum. Multidetector computed tomography (MDCT) imaging was very useful in determining the morphology (cellulitis with a few small subcutaneous nodules and channels) and the extension of the lesion. PMID:24778804

  18. Diagnostic performance of 64-MDCT and 1.5-T MRI with high-resolution sequences in the T staging of gastric cancer: a comparative analysis with histopathology.

    PubMed

    Anzidei, M; Napoli, A; Zaccagna, F; Di Paolo, P; Zini, C; Cavallo Marincola, B; Geiger, D; Catalano, C; Passariello, R

    2009-10-01

    This study was undertaken to compare the accuracy of magnetic resonance (MR) imaging and 64-slice multidetector computed tomography (64-MDCT) in the T staging of gastric carcinoma in comparison with histopathology. Forty patients with an endoscopic diagnosis of gastric carcinoma underwent preoperative MR imaging and 64-MDCT, both of which were performed after i.v. injection of scopolamine and water distension of the stomach. In the MR imaging protocol, we acquired T2-weighted turbo spin-echo (TSE) sequences, true fast imaging steady-state free precession (true-FISP) and gadolinium-enhanced T1-weighted volumetric interpolated breath-hold examination (VIBE) 3D sequences. Contrastenhanced CT scans were obtained in the arterial and venous phases. Two groups of radiologists independently reviewed the MR and 64-MDCT images. The results were compared with pathology findings. In the evaluation of T stage, 64-MDCT had 82.5% and MR imaging had 80% sensitivity. Accuracy of MR imaging was slightly higher than that of 64-MDCT in identifying T1 lesions (50% vs 37.5%), whereas the accuracy of 64-MDCT was higher in differentiating T2 lesions (81.2% vs 68.7%). The accuracy of MR imaging and 64-MDCT did not differ significantly in the evaluation of T3-T4 lesions (p>0.05). Understaging was observed in 20% of cases with MR imaging and in 17.5% with 64-MDCT. MR imaging and 64-MDCT accuracy levels did not differ in advanced stages of disease, whereas MR imaging was superior in identifying early stages of gastric cancer and can be considered a valid alternative to MDCT in clinical practice.

  19. Esophagobronchial fistulae: Diagnosis by MDCT with oral contrast swallow examination of a benign and a malignant cause

    PubMed Central

    Hegde, Rahul G; Kalekar, Tushar M; Gajbhiye, Meenakshi I; Bandgar, Amol S; Pawar, Shephali S; Khadse, Gopal J

    2013-01-01

    We report two cases of esophagobronchial fistulae diagnosed by Multi-detector computed tomography (MDCT) oral contrast swallow examination. It is helpful to supplement the CT study with an oral contrast swallow as it aids in confirmation of a suspected fistula and also demonstrates the fistula tract better. We present the clinical details and the imaging findings on MDCT of two cases of esophagobronchial fistulae – one secondary to chronic chest tuberculosis and the other secondary to a squamous cell carcinoma of the upper esophagus – followed by discussion of the etiology, pathogenesis, and imaging of these fistulae. PMID:24082484

  20. Factors associated with parental underestimation of child's weight status.

    PubMed

    Warkentin, Sarah; Mais, Laís A; Latorre, Maria do Rosário D O; Carnell, Susan; Taddei, José Augusto A C

    2017-08-18

    The aim of this study was to examine the prevalence of parental misperception of child weight status, and identify socioeconomic, anthropometric, behavioral and dietary factors associated with underestimation. Cross-sectional study. Data was collected in 14 Brazilian private schools. Parents of children aged 2-8 years (n=976) completed a self-reported questionnaire assessing their perception of their child's weight status, and sociodemographic, anthropometric, behavioral and dietary information. To measure the agreement between parental perception about child weight status and actual child weight status, the Kappa coefficient was estimated, and to investigate associations between parental underestimation and independent variables, chi-squared tests were performed, followed by multiple logistic regression, considering p≤0.05 for statistical significance. Overall, 48.05% of the parents incorrectly classified their child's weight. Specifically, 45.08% underestimated their child's weight status, with just 3% of parents overestimating. Children with higher body mass index (OR=2.03; p<0.001) and boys (OR=1.70; p<0.001) were more likely to have their weight status underestimated by parents. Since awareness of weight problems is essential for prevention and treatment, clinical practitioners should help parents at high risk of misperception to correctly evaluate their child's weight status. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

  1. Estimated Patient Dose Indexes in Adult and Pediatric MDCT: Comparison of Automatic Tube Voltage Selection With Fixed Tube Current, Fixed Tube Voltage, and Weight-Based Protocols.

    PubMed

    Baker, Mark E; Karim, Wadih; Bullen, Jennifer A; Primak, Andrew N; Dong, Frank F; Herts, Brian R

    2015-09-01

    The purposes of this study were to determine the differences in estimated volumetric CT dose index (CTDIvol) obtained from the topogram before abdominal and pelvic MDCT in adult and pediatric patients using a scan type-based algorithm for selecting kilovoltage (CARE kV) and a fixed and a weight-based Quality Reference mAs for selecting tube (gmAs) current-exposure time product, in comparison with standard protocols, and to determine the bias and variability of estimated CTDIvol vis-à-vis actual CTDIvol using the standard protocols. During a 14-month period, 312 adult and pediatric patients referred for abdominal and pelvic MDCT were included in the study. For all patients, the estimated CTDIvol based on the topogram was recorded: protocol A, CARE kV on and 210 gmAs; protocol B, CARE kV on and 1 gmAs times patient weight (in pounds); and protocol C (standard protocol), CARE kV off, 120 kVp, and 1 gmAs times patient weight (in pounds). For the pediatric patients, estimated CTDIvol for the standard protocol D was calculated with 120 kVp and 150 gmAs. All patients were scanned with the standard protocols, and the actual CTDIvol was recorded. Linear regression models compared the CTDIvol of the three protocols in adults and the fourth for children. The estimated and actual CTDIvol were compared using a t test. Protocol B yielded the lowest estimated CTDIvol (mean, 13.2 mGy for adults and 3.5 mGy for pediatric patients). The estimated CTDIvol overestimated the actual CTDIvol by, on average, 1.07 mGy for adults and 0.3 mGy for children. CARE kV appears to reduce estimated CTDIvol vis-à-vis standard protocols only when a weight-based gmAs is used. Prescan estimated CTDIvol calculations appear to generally overestimate actual CTDIvol.

  2. Leukemias involving abdominal and pelvic lymph nodes: evaluation with contrast-enhanced MDCT.

    PubMed

    Zhang, Ge; Yang, Zhi-Gang; Bai, Jiao; Li, Yuan; Xu, Hua-Yan; Long, Qi-Hua

    2014-10-01

    To clarify features of lymph nodes associated with leukemia purposing to offer help for imaging diagnosis and differential diagnosis of leukemia. We retrospectively analyzed 47 patients with clinically proven leukemia involving the abdominal and pelvic lymph nodes. Of these 47 patients, 10 had acute myeloid leukemia, 9 had acute lymphocytic leukemia, and 28 had chronic lymphocytic leukemia. MDCT was used to determine lymph node features such as morphology, growth patterns, size, enhancement patterns, anatomical distribution, and manifestations in extramedullary organs. Incidence of leukemia was higher in men than in women. Enlarged lymph nodes were more frequently conglomerated in chronic lymphocytic leukemia (96.4%) than in acute myeloid leukemia (50%) and acute lymphocytic leukemia (55.6%; P < 0.05 for both). Lymph nodes associated with chronic lymphocytic leukemia were larger than those associated with acute myeloid and lymphocytic leukemias (P < 0.05 for both). The enlarged lymph nodes appeared homogeneous (80.9%) and homogeneous mixed with peripheral (19.1%). No statistically significant differences were observed between the three types of leukemias with respect to enhancement patterns (all P > 0.05). The lymph nodes commonly associated with these three leukemias were located in the lesser omentum, upper and lower para-aortic regions, and groin region. Our study showed that contrast-enhanced MDCT could accurately determine the enhancement patterns and anatomical distribution of lymph nodes associated with leukemia. Therefore, it is helpful for imaging diagnosis and differential diagnosis of leukemia.

  3. Effect of Low-Dose MDCT and Iterative Reconstruction on Trabecular Bone Microstructure Assessment

    PubMed Central

    Baum, Thomas; Nasirudin, Radin A.; Mei, Kai; Garcia, Eduardo G.; Burgkart, Rainer; Rummeny, Ernst J.; Kirschke, Jan S.; Noël, Peter B.

    2016-01-01

    We investigated the effects of low-dose multi detector computed tomography (MDCT) in combination with statistical iterative reconstruction algorithms on trabecular bone microstructure parameters. Twelve donated vertebrae were scanned with the routine radiation exposure used in our department (standard-dose) and a low-dose protocol. Reconstructions were performed with filtered backprojection (FBP) and maximum-likelihood based statistical iterative reconstruction (SIR). Trabecular bone microstructure parameters were assessed and statistically compared for each reconstruction. Moreover, fracture loads of the vertebrae were biomechanically determined and correlated to the assessed microstructure parameters. Trabecular bone microstructure parameters based on low-dose MDCT and SIR significantly correlated with vertebral bone strength. There was no significant difference between microstructure parameters calculated on low-dose SIR and standard-dose FBP images. However, the results revealed a strong dependency on the regularization strength applied during SIR. It was observed that stronger regularization might corrupt the microstructure analysis, because the trabecular structure is a very small detail that might get lost during the regularization process. As a consequence, the introduction of SIR for trabecular bone microstructure analysis requires a specific optimization of the regularization parameters. Moreover, in comparison to other approaches, superior noise-resolution trade-offs can be found with the proposed methods. PMID:27447827

  4. MDCT of the liver in obese patients: evaluation of a different method to optimize iodine dose.

    PubMed

    Rengo, Marco; Bellini, Davide; Businaro, Rita; Caruso, Damiano; Azzara, Gabriella; De Santis, Domenico; Picchia, Simona; Biondi, Tommaso; Eid, Marwen; Boschiero, Dario; Laghi, Andrea

    2017-04-27

    To prospectively compare two different approaches for estimating the amount of intravenous contrast media (CM) needed for multiphasic MDCT of the liver in obese patients. This single-center, HIPAA-compliant prospective study was approved by our Institutional Review Board. Ninety-six patients (55 men, 41 women), with a total of 42 hypovascular liver lesions, underwent MDCT of the liver. The amount of contrast medium injected was computed according to the patient's lean body weight which was estimated using either a bioimpedance device (Group A) or the James formula (Group B). The following variables were compared between the two groups: the amount of contrast medium injected (in grams of Iodine, gI), the contrast enhancement index (CEI) and the lesion-to-liver contrast-to-noise ratio. Protocols A and B yielded significant differences in the amount of CM injected (mean values 41.9 ± 4.41 gI in Group A vs. 35.9 ± 5.75 gI in Group B; P = 0.021). The mean CEI value and lesion-to-liver contrast-to-noise ratio measured on the portal phase were significantly higher with protocol A than with protocol B (P < 0.05). Our study shows that the adoption of a bioimpedance device in obese patients improves liver parenchymal enhancement and lesion conspicuity.

  5. Accuracy of Monte Carlo simulations compared to in-vivo MDCT dosimetry

    SciTech Connect

    Bostani, Maryam McMillan, Kyle; Cagnon, Chris H.; McNitt-Gray, Michael F.; Mueller, Jonathon W.; Cody, Dianna D.; DeMarco, John J.

    2015-02-15

    Purpose: The purpose of this study was to assess the accuracy of a Monte Carlo simulation-based method for estimating radiation dose from multidetector computed tomography (MDCT) by comparing simulated doses in ten patients to in-vivo dose measurements. Methods: MD Anderson Cancer Center Institutional Review Board approved the acquisition of in-vivo rectal dose measurements in a pilot study of ten patients undergoing virtual colonoscopy. The dose measurements were obtained by affixing TLD capsules to the inner lumen of rectal catheters. Voxelized patient models were generated from the MDCT images of the ten patients, and the dose to the TLD for all exposures was estimated using Monte Carlo based simulations. The Monte Carlo simulation results were compared to the in-vivo dose measurements to determine accuracy. Results: The calculated mean percent difference between TLD measurements and Monte Carlo simulations was −4.9% with standard deviation of 8.7% and a range of −22.7% to 5.7%. Conclusions: The results of this study demonstrate very good agreement between simulated and measured doses in-vivo. Taken together with previous validation efforts, this work demonstrates that the Monte Carlo simulation methods can provide accurate estimates of radiation dose in patients undergoing CT examinations.

  6. MDCT Findings of Denim-Sandblasting-Induced Silicosis: a cross-sectional study

    PubMed Central

    2010-01-01

    Background Denim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes. We aimed to describe the radiological features of patients exposed to silica during denim sandblasting and define factors related to the development of silicosis. Methods Sixty consecutive men with a history of exposure to silica during denim sandblasting were recruited. All CT examinations were performed using a 64-row multi-detector CT (MDCT). The nodules were qualitatively and semi-quantitatively analyzed by grading nodular profusion (NP) on CT images. Results Silicosis was diagnosed radiologically in 73.3% of patients (44 of 60). The latency period (the time between initial exposure and radiological imaging) and duration of silica exposure was longer in patients diagnosed with silicosis than in those without silicosis (p < 0.05). Nodules were present in all cases with centrilobular type as the commonest (63.6%). All cases of silicosis were clinically classified as accelerated and 11.4% had progressive massive fibrosis (PMF). Mild NP lesions were the most prevalent in all six zones of the lung. The NP score was significantly correlated with the duration of silica exposure, the latency period, presence of PMF, and pleural thickening. Enlarged lymphadenopathy was present in 45.5% of patients. Conclusions The duration of exposure and the latency period are important for development of silicosis in denim sandblasters. MDCT is a useful tool in detecting findings of silicosis in workers who has silica exposure. PMID:20398415

  7. MDCT findings of denim-sandblasting-induced silicosis: a cross-sectional study.

    PubMed

    Ozmen, Cihan Akgul; Nazaroglu, Hasan; Yildiz, Tekin; Bayrak, Aylin Hasanefendioglu; Senturk, Senem; Ates, Gungor; Akyildiz, Levent

    2010-04-17

    Denim sandblasting is as a novel cause of silicosis in Turkey, with reports of a recent increase in cases and fatal outcomes. We aimed to describe the radiological features of patients exposed to silica during denim sandblasting and define factors related to the development of silicosis. Sixty consecutive men with a history of exposure to silica during denim sandblasting were recruited. All CT examinations were performed using a 64-row multi-detector CT (MDCT). The nodules were qualitatively and semi-quantitatively analyzed by grading nodular profusion (NP) on CT images. Silicosis was diagnosed radiologically in 73.3% of patients (44 of 60). The latency period (the time between initial exposure and radiological imaging) and duration of silica exposure was longer in patients diagnosed with silicosis than in those without silicosis (p < 0.05). Nodules were present in all cases with centrilobular type as the commonest (63.6%). All cases of silicosis were clinically classified as accelerated and 11.4% had progressive massive fibrosis (PMF). Mild NP lesions were the most prevalent in all six zones of the lung. The NP score was significantly correlated with the duration of silica exposure, the latency period, presence of PMF, and pleural thickening. Enlarged lymphadenopathy was present in 45.5% of patients. The duration of exposure and the latency period are important for development of silicosis in denim sandblasters. MDCT is a useful tool in detecting findings of silicosis in workers who has silica exposure.

  8. Comparison between a new reconstruction algorithm (OPED) and filtered backprojection (FBP) for MDCT data

    NASA Astrophysics Data System (ADS)

    Renger, Bernhard; No"l, Peter B.; Tischenko, Oleg; Rummeny, Ernst J.; Hoeschen, Christoph

    2012-03-01

    Previously the Orthogonal Polynomial Expansion on the Disk (OPED) algorithm was presented. Further, in prototype experiments in combination with the CT D`or geometry feasibility was demonstrated. In this study we implemented OPED with a clinical Scanner, and evaluated the potential using phantom studies. All studies were acquired on a Siemens Somatom 64 (Erlangen, Germany) scanner, where raw projection data were reconstructed with the conventional FBP reconstruction and the OPED algorithm. OPED allows one to use fan beam geometry directly without any additional procedures such as interpolation or rebinning if using the CT D`or geometry. In particular, OPED describes an approximation of the image function as a sum of polynomials using Chebychev polynomials. For performance evaluation, the Catphan phantom 600 was imaged. OPED Images where reconstructed using C++ and MATLAB® .We measured uniformity, MTF and CNR for different dose levels and compared these to standard FBP images reconstructions with different filter kernels. The integration and interpretation of the MDCT projection data for the OPED algorithm was accomplished. Reconstruction time is about 6 s on Quad-Core 3 GHz Intel Xeon processor. Typical artifacts are reduced when applying OPED. Using OPED the MTF maintains constant over the whole FOV. Uniformity and CNR are equal compared to FBP. Advantages of OPED were demonstrated by applying the algorithm to projections images from a clinical MDCT scanner. In the future, we see OPED applications for low-dose or limited angle geometries to reduce the radiation dose while improving diagnostic quality of the reconstructed slices.

  9. A Subspace Semi-Definite programming-based Underestimation (SSDU) method for stochastic global optimization in protein docking*

    PubMed Central

    Nan, Feng; Moghadasi, Mohammad; Vakili, Pirooz; Vajda, Sandor; Kozakov, Dima; Ch. Paschalidis, Ioannis

    2015-01-01

    We propose a new stochastic global optimization method targeting protein docking problems. The method is based on finding a general convex polynomial underestimator to the binding energy function in a permissive subspace that possesses a funnel-like structure. We use Principal Component Analysis (PCA) to determine such permissive subspaces. The problem of finding the general convex polynomial underestimator is reduced into the problem of ensuring that a certain polynomial is a Sum-of-Squares (SOS), which can be done via semi-definite programming. The underestimator is then used to bias sampling of the energy function in order to recover a deep minimum. We show that the proposed method significantly improves the quality of docked conformations compared to existing methods. PMID:25914440

  10. Data from selective harvests underestimate temporal trends in quantitative traits.

    PubMed

    Pelletier, Fanie; Festa-Bianchet, Marco; Jorgenson, Jon T

    2012-10-23

    Human harvests can select against phenotypes favoured by natural selection, and natural resource managers should evaluate possible artificial selection on wild populations. Because the required genetic data are extremely difficult to gather, however, managers typically rely on harvested animals to document temporal trends. It is usually unknown whether these data are unbiased. We explore our ability to detect a decline in horn size of bighorn sheep (Ovis canadensis) by comparing harvested males with all males in a population where evolutionary changes owing to trophy hunting were previously reported. Hunting records underestimated the temporal decline, partly because of an increasing proportion of rams that could not be harvested because their horns were smaller than the threshold set by hunting regulations. If harvests are selective, temporal trends measured from harvest records will underestimate the magnitude of changes in wild populations.

  11. Pain is an underestimated symptom in cystic fibrosis.

    PubMed

    Masson, Alexandra; Kirszembaum, Maya; Sermet-Gaudelus, Isabelle

    2017-08-12

    Life expectancy is increasing in cystic fibrosis and new aspects of the disease have to be taken into account in cystic fibrosis care. Pain is encountered among 70% of adult and pediatric patients with cystic fibrosis. This symptom is underestimated by the multidisciplinary team. It has been reported as impacting quality of life and adherence to treatments. The location of pain is inconstant among the different studies but the major symptoms are headaches, gastrointestinal, and chest pain. Pain is different for each patient and requires careful evaluation using questionnaires some of which specifically developed for patients with cystic fibrosis. Medical and nonmedical treatment such as ostheopathy or sophrology may relieve pain symptoms but have to be adjusted in the frame of a global personalized care. Pain maybe an underestimated symptom among patients with cystic fibrosis and impacts negatively on quality of life. VIDEO ABSTRACT.

  12. People underestimate the value of persistence for creative performance.

    PubMed

    Lucas, Brian J; Nordgren, Loran F

    2015-08-01

    Across 7 studies, we investigated the prediction that people underestimate the value of persistence for creative performance. Across a range of creative tasks, people consistently underestimated how productive they would be while persisting (Studies 1-3). Study 3 found that the subjectively experienced difficulty, or disfluency, of creative thought accounted for persistence undervaluation. Alternative explanations based on idea quality (Studies 1-2B) and goal setting (Study 4) were considered and ruled out and domain knowledge was explored as a boundary condition (Study 5). In Study 6, the disfluency of creative thought reduced people's willingness to invest in an opportunity to persist, resulting in lower financial performance. This research demonstrates that persistence is a critical determinant of creative performance and that people may undervalue and underutilize persistence in everyday creative problem solving. (c) 2015 APA, all rights reserved.

  13. MDCT evaluation of potential living renal donor, prior to laparoscopic donor nephrectomy: What the transplant surgeon wants to know?

    PubMed

    Ghonge, Nitin P; Gadanayak, Satyabrat; Rajakumari, Vijaya

    2014-10-01

    As Laparoscopic Donor Nephrectomy (LDN) offers several advantages for the donor such as lesser post-operative pain, fewer cosmetic concerns and faster recovery time, there is growing global trend towards LDN as compared to open nephrectomy. Comprehensive pre-LDN donor evaluation includes assessment of renal morphology including pelvi-calyceal and vascular system. Apart from donor selection, evaluation of the regional anatomy allows precise surgical planning. Due to limited visualization during laparoscopic renal harvesting, detailed pre-transplant evaluation of regional anatomy, including the renal venous anatomy is of utmost importance. MDCT is the modality of choice for pre-LDN evaluation of potential renal donors. Apart from appropriate scan protocol and post-processing methods, detailed understanding of surgical techniques is essential for the Radiologist for accurate image interpretation during pre-LDN MDCT evaluation of potential renal donors. This review article describes MDCT evaluation of potential living renal donor, prior to LDN with emphasis on scan protocol, post-processing methods and image interpretation. The article laid special emphasis on surgical perspectives of pre-LDN MDCT evaluation and addresses important points which transplant surgeons want to know.

  14. [MDCT features and anatomic-pathological basis of the diseases in central thoracic-abdominal junctional region].

    PubMed

    Ye, Yilan; Yang, Zhigang; Li, Hua; Deng, Wen; Li, Yuan; Guo, Yingkun

    2012-02-01

    This paper is to determine relationship between MDCT features and anatomic-pathology of the diseases in central thoracic-abdominal junctional region. 3 cadavers were cut transversely and another 3 vertically to observe the anatomy of thoracic-abdominal junctional zone. 93 patients with diseases in central thoracic-abdominal junctional zone were scanned with MDCT. The correlation between MDCT features of the diseases in central thoracic-abdominal junctional region and the anatomic-pathology of the diseases in this region was evaluated. On cadaver sections, central thoracic-abdominal junctional region was an area between anterior chest wall and dorsal spine in vertical direction. The region was separated into upper and lower sections by diaphragm. The upper section mainly contains heart and pericardium, while the lower contains broad ligament and left lobe of liver. The hiatus of diaphragm are vena caval foramen, esophageal foramen and aortic foramen in anterior-posterior turn. In the present study, 23 patients had portal hypertension, 18 had dissection of aorta, 8 got diseases in inferior vena cava, 9 had lymphoma, 12 got diseases in multiple vertebrae, 7 had lower thoracic esophageal carcinoma accompanied with metastasis in upper abdominal lymph nodes, 9 had carcinoma of abdominal esophagus and/or gastric cardia, 4 had esophageal hiatal hernia and 3 patients had neurogenic tumor in posterior mediastinum and/or superior spatium retroperitoneale. The MDCT features and distribution of the diseases in central thoracic-abdominal junctional region influence the anatomic-pathology characteristics in this region.

  15. [Current practice of pediatric MDCT in Japan: survey results of demographics and age-based dose reduction].

    PubMed

    Miyazaki, Osamu; Kitamura, Masayuki; Masaki, Hidekazu; Nosaka, Shunsuke; Miyasaka, Mikiko; Kashima, Kyoko; Okada, Yoshiyuki; Tsutsumi, Yoshiyuki

    2005-07-01

    To assess the current practice of pediatric MDCT in Japan, with particular reference to age-related dose adjustment. During the first three months of 2004, a questionnaire was mailed to 996 institutions, among which listed MDCT users ranged from private hospitals to large university-based hospitals. We received responses from 348 (34.9%) institutions. Fifty-three percent of the respondents had four-detector MDCT units. Approximately 70% of examinations were head and 22% were body. Scanning parameters were determined by full-time radiologists in 40%, and by CT technologists in 28% of respondents. Eighty-nine percent (head CT) and 85% (abdominal CT) of respondents indicated that they changed parameters for children. More than 90% changed tube current for optimization. Change was based on the technologist's experience (56%, head CT; 43%, abdominal CT), and automatic exposure control has been used as a basis of mAs control in 17% of respondents for head CT and in 34% for abdominal CT. Age-related mAs settings for abdominal CT were almost the same as those published in a United States survey. Although Japan has approximately 40% of the world's CT units, optimized pediatric MDCT settings might be moved away from a fixed mA protocol as recommended by the FDA and in conformity with the ALARA (as low as reasonably achievable) concept.

  16. Oxygen utilization rate (OUR) underestimates ocean respiration: A model study

    NASA Astrophysics Data System (ADS)

    Koeve, W.; Kähler, P.

    2016-08-01

    We use a simple 1-D model representing an isolated density surface in the ocean and 3-D global ocean biogeochemical models to evaluate the concept of computing the subsurface oceanic oxygen utilization rate (OUR) from the changes of apparent oxygen utilization (AOU) and water age. The distribution of AOU in the ocean is not only the imprint of respiration in the ocean's interior but is strongly influenced by transport processes and eventually loss at the ocean surface. Since AOU and water age are subject to advection and diffusive mixing, it is only when they are affected both in the same way that OUR represents the correct rate of oxygen consumption. This is the case only when advection prevails or with uniform respiration rates, when the proportions of AOU and age are not changed by transport. In experiments with the 1-D tube model, OUR underestimates respiration when maximum respiration rates occur near the outcrops of isopycnals and overestimates when maxima occur far from the outcrops. Given the distribution of respiration in the ocean, i.e., elevated rates near high-latitude outcrops of isopycnals and low rates below the oligotrophic gyres, underestimates are the rule. Integrating these effects globally in three coupled ocean biogeochemical and circulation models, we find that AOU-over-age based calculations underestimate true model respiration by a factor of 3. Most of this difference is observed in the upper 1000 m of the ocean with the discrepancies increasing toward the surface where OUR underestimates respiration by as much as factor of 4.

  17. Numerosity underestimation with item similarity in dynamic visual display.

    PubMed

    Au, Ricky K C; Watanabe, Katsumi

    2013-01-01

    The estimation of numerosity of a large number of objects in a static visual display is possible even at short durations. Such coarse approximations of numerosity are distinct from subitizing, in which the number of objects can be reported with high precision when a small number of objects are presented simultaneously. The present study examined numerosity estimation of visual objects in dynamic displays and the effect of object similarity on numerosity estimation. In the basic paradigm (Experiment 1), two streams of dots were presented and observers were asked to indicate which of the two streams contained more dots. Streams consisting of dots that were identical in color were judged as containing fewer dots than streams where the dots were different colors. This underestimation effect for identical visual items disappeared when the presentation rate was slower (Experiment 1) or the visual display was static (Experiment 2). In Experiments 3 and 4, in addition to the numerosity judgment task, observers performed an attention-demanding task at fixation. Task difficulty influenced observers' precision in the numerosity judgment task, but the underestimation effect remained evident irrespective of task difficulty. These results suggest that identical or similar visual objects presented in succession might induce substitution among themselves, leading to an illusion that there are few items overall and that exploiting attentional resources does not eliminate the underestimation effect.

  18. Underestimation and undertreatment of pain in HIV disease: multicentre study.

    PubMed Central

    Larue, F.; Fontaine, A.; Colleau, S. M.

    1997-01-01

    OBJECTIVE: To measure the prevalence, severity, and impact of pain on quality of life for HIV patients; to identify factors associated with undertreatment of pain. DESIGN: Multicentre cross sectional survey. SETTINGS: 34 HIV treatment facilities, including inpatient hospital wards, day hospitals, and ambulatory care clinics, in 13 cities throughout France. SUBJECTS: 315 HIV patients at different stages of the disease. MAIN OUTCOME MEASURES: Patients: recorded presence and severity of pain and rated quality of life. Doctors: reported disease status, estimate of pain severity, and analgesic treatment ordered. RESULTS: From 30% (17/56) of outpatients to 62% (73/118) of inpatients reported pain due to HIV disease. Pain severity significantly decreased patients' quality of life. Doctors underestimated pain severity in 52% (70/135) of HIV patients reporting pain. Underestimation of pain severity was more likely for patients who reported moderate (odds ratio 24) or severe pain (165) and less likely for patients whose pain source was identified or who were perceived as more depressed. Of the patients reporting moderate or severe pain, 57% (61/107) did not receive any analgesic treatment; only 22% (23/107) received at least weak opioids. Likelihood of analgesic prescription increased when doctors estimated pain to be more severe and regarded patients as sicker. CONCLUSIONS: Pain is a common and debilitating symptom of HIV disease which is gravely underestimated and undertreated. PMID:9001475

  19. The electron donating capacity of biochar is dramatically underestimated

    PubMed Central

    Prévoteau, Antonin; Ronsse, Frederik; Cid, Inés; Boeckx, Pascal; Rabaey, Korneel

    2016-01-01

    Biochars have gathered considerable interest for agronomic and engineering applications. In addition to their high sorption ability, biochars have been shown to accept or donate considerable amounts of electrons to/from their environment via abiotic or microbial processes. Here, we measured the electron accepting (EAC) and electron donating (EDC) capacities of wood-based biochars pyrolyzed at three different highest treatment temperatures (HTTs: 400, 500, 600 °C) via hydrodynamic electrochemical techniques using a rotating disc electrode. EACs and EDCs varied with HTT in accordance with a previous report with a maximal EAC at 500 °C (0.4 mmol(e−).gchar−1) and a large decrease of EDC with HTT. However, while we monitored similar EAC values than in the preceding study, we show that the EDCs have been underestimated by at least 1 order of magnitude, up to 7 mmol(e−).gchar−1 for a HTT of 400 °C. We attribute this existing underestimation to unnoticed slow kinetics of electron transfer from biochars to the dissolved redox mediators used in the monitoring. The EDC of other soil organic constituents such as humic substances may also have been underestimated. These results imply that the redox properties of biochars may have a much bigger impact on soil biogeochemical processes than previously conjectured. PMID:27628746

  20. The electron donating capacity of biochar is dramatically underestimated

    NASA Astrophysics Data System (ADS)

    Prévoteau, Antonin; Ronsse, Frederik; Cid, Inés; Boeckx, Pascal; Rabaey, Korneel

    2016-09-01

    Biochars have gathered considerable interest for agronomic and engineering applications. In addition to their high sorption ability, biochars have been shown to accept or donate considerable amounts of electrons to/from their environment via abiotic or microbial processes. Here, we measured the electron accepting (EAC) and electron donating (EDC) capacities of wood-based biochars pyrolyzed at three different highest treatment temperatures (HTTs: 400, 500, 600 °C) via hydrodynamic electrochemical techniques using a rotating disc electrode. EACs and EDCs varied with HTT in accordance with a previous report with a maximal EAC at 500 °C (0.4 mmol(e‑).gchar‑1) and a large decrease of EDC with HTT. However, while we monitored similar EAC values than in the preceding study, we show that the EDCs have been underestimated by at least 1 order of magnitude, up to 7 mmol(e‑).gchar‑1 for a HTT of 400 °C. We attribute this existing underestimation to unnoticed slow kinetics of electron transfer from biochars to the dissolved redox mediators used in the monitoring. The EDC of other soil organic constituents such as humic substances may also have been underestimated. These results imply that the redox properties of biochars may have a much bigger impact on soil biogeochemical processes than previously conjectured.

  1. 3D Volumetric Evaluation of Lipiodol Retention in HCC after Chemoembolization: A Quantitative Comparison between CBCT and MDCT

    PubMed Central

    Wang, Zhijun; Lin, MingDe; Lesage, David; Chen, Rongxin; Chapiro, Julius; Gu, Tara; Tacher, Vania; Duran, Rafael; Geschwind, Jean-François

    2014-01-01

    Rationale and Objectives To evaluate the capability of cone-beam computed tomography (CBCT) acquired immediately after transcatheter arterial chemoembolization (TACE) in determining Lipiodol retention quantitatively and volumetrically when compared to 1-day post-procedure unenhanced MDCT. Materials and methods From June to December, 2012, fifteen patients met the inclusion criteria of unresectable hepatocellular carcinoma (HCC) that was treated with conventional TACE (cTACE), and had intra-procedural CBCT and 1-day post-TACE MDCT. Four patients were excluded because the Lipiodol was diffuse throughout the entire liver or Lipiodol deposition was not clear on both CBCT and MDCT. Eleven patients with a total of 31 target lesions were included in the analysis. A quantitative and 3D software was used to assess complete, localized and diffuse lipiodol deposition. Tumor volume, Lipiodol volume in the tumor, % Lipiodol retention, and Lipiodol enhancement in Hounsfield Unit (HU) were calculated and compared between CBCT and MDCT using two-tailed student’s t-test and Bland-Altman plots. Results The mean value of tumor volume, Lipiodol deposited regions, calculated average % Lipiodol retention, and HU value of CBCT were not significantly different from those of MDCT (tumor volume: 9.37±11.35cm3 vs. 9.34±11.44cm3, P=0.991; Lipiodol volume: 7.84±9.34cm3 vs. 7.84±9.60 cm3, P=0.998; % Lipiodol retention: 89.3%±14.7% vs. 90.2% ± 14.9%, P=0.811; HU value: 307.7±160.1 HU vs. 257.2±120.0 HU, P=0.139). Bland-Altman plots showed only minimal difference and high agreement when comparing CBCT to MDCT. Conclusion CBCT has a similar capability, intraprocedurally, to assess Lipiodol deposition in 3D for patients with HCC treated with cTACE when compared to MDCT. PMID:24507426

  2. Comparison of hepatic MDCT, MRI, and DSA to explant pathology for the detection and treatment planning of hepatocellular carcinoma

    PubMed Central

    Ladd, Lauren M.; Tirkes, Temel; Tann, Mark; Agarwal, David M.; Johnson, Matthew S.; Tahir, Bilal; Sandrasegaran, Kumaresan

    2016-01-01

    Background/Aims The diagnosis and treatment plan for hepatocellular carcinoma (HCC) can be made from radiologic imaging. However, lesion detection may vary depending on the imaging modality. This study aims to evaluate the sensitivities of hepatic multidetector computed tomography (MDCT), magnetic resonance imaging (MRI), and digital subtraction angiography (DSA) in the detection of HCC and the consequent management impact on potential liver transplant patients. Methods One hundred and sixteen HCC lesions were analyzed in 41 patients who received an orthotopic liver transplant (OLT). All of the patients underwent pretransplantation hepatic DSA, MDCT, and/or MRI. The imaging results were independently reviewed retrospectively in a blinded fashion by two interventional and two abdominal radiologists. The liver explant pathology was used as the gold standard for assessing each imaging modality. Results The sensitivity for overall HCC detection was higher for cross-sectional imaging using MRI (51.5%, 95% confidence interval [CI]=36.2-58.4%) and MDCT (49.8%, 95% CI=43.7-55.9%) than for DSA (41.7%, 95% CI=36.2-47.3%) (P=0.05). The difference in false-positive rate was not statistically significant between MRI (22%), MDCT (29%), and DSA (29%) (P=0.67). The sensitivity was significantly higher for detecting right lobe lesions than left lobe lesions for all modalities (MRI: 56.1% vs. 43.1%, MDCT: 55.0% vs. 42.0%, and DSA: 46.9% vs. 33.9%; all P<0.01). The sensitivities of the three imaging modalities were also higher for lesions ≥2 cm vs. <2 cm (MRI: 73.4% vs. 32.7%, MDCT: 66.9% vs. 33.8%, and DSA: 62.2% vs. 24.1%; all P<0.01). The interobserver correlation was rated as very good to excellent. Conclusion The sensitivity for detecting HCC is higher for MRI and MDCT than for DSA, and so cross-sectional imaging modalities should be used to evaluate OLT candidacy. PMID:27987537

  3. Application of MPVR and TL-VR with 64-row MDCT in neonates with congenital EA and distal TEF.

    PubMed

    Wen, Yang; Peng, Yun; Zhai, Ren-You; Li, Ying-Zi

    2011-03-28

    To assess the application of multiple planar volume reconstruction (MPVR) and three-dimensional (3D) transparency lung volume rendering (TL-VR) with 64-row multidetector-row computed tomography (MDCT) in neonates with congenital esophageal atresia (EA) and distal tracheoesophageal fistula (TEF). Twenty neonates (17 boys, 3 girls) with EA and distal TEF at a mean age of 4.6 d (range 1-16 d) were enrolled in this study. A helical scan of 64-row MDCT was performed at the 64 mm × 0.625 mm collimation. EA and TEF were reconstructed with MPVR and TL-VR, respectively. Initial diagnosis of EA was made by chest radiography showing the inserted catheter in the proximal blind-ended esophageal pouch. Manifestations of MDCT images were compared with the findings at surgery. MDCT showed the proximal and distal esophageal pouches in 20 cases. No significant difference was observed in gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR. The lengths of gaps between the proximal and distal esophageal pouches detected by MPVR and TL-VR correlated well with the findings at surgery (R = 0.87, P < 0.001). The images of MPVR revealed the orifice of TEF in 13 cases, while TL-VR images showed the orifice of TEF in 4 cases. EA and distal TEF can be reconstructed using MPVR and TL-VR of 64-row MDCT, which is a noninvasive technique to demonstrate the distal esophageal pouches and inter-pouch distance in neonates with EA and distal TEF.

  4. Coronary image quality of 320-MDCT in patients with heart rates above 65 beats per minute: preliminary experience.

    PubMed

    Lee, Allan B; Nandurkar, Dee; Schneider-Kolsky, Michal E; Crossett, Marcus; Seneviratne, Sujith K; Cameron, James D; Troupis, John M

    2011-06-01

    High heart rate may negatively influence the image quality of cardiac CT. The technical advances of 320-MDCT may overcome issues with poor image quality associated with high heart rate. This study aimed to evaluate the coronary image quality of 320-MDCT in patients with heart rates above 65 beats/min. Patients who presented for cardiac CT were divided into two groups according to heart rate, either greater than 65 beats/min or less than or equal to 65 beats/min. Two radiologists were blinded to the patient groups and evaluated images of 15 coronary artery segments per patient using 320-MDCT with consensus agreement. The image quality was scored subjectively as 1 or 2 (diagnostic quality) or 3 (poor quality and nondiagnostic). There were no statistically significant differences between the two groups in terms of age, sex, and body mass index (p > 0.05). The median heart rate was 70 beats/min (range, 67-110 beats/min) for the group with heart rate greater than 65 beats/min and 60 beats/min (range, 48-65 beats/min) for the group with heart rate less than or equal to 65 beats/min (p < 0.001). In patients with heart rates greater than 65 beats/min, diagnostic quality images (scores of 1 or 2) were obtained in 95.6% of the analyzed segments, compared with 96.9% in the group with heart rate less than or equal to 65 beats/min (p = 0.7). Our initial evaluation suggests that coronary artery images of diagnostic quality can be obtained using 320-MDCT in most patients with heart rates greater than 65 beats/min, in percentages similar to those for patients with heart rates less than or equal to 65 beats/min. This finding may be the result of the inherent image acquisition and reconstruction technique of 320-MDCT.

  5. Hi-Res scan mode in clinical MDCT systems: Experimental assessment of spatial resolution performance

    PubMed Central

    Cruz-Bastida, Juan P.; Gomez-Cardona, Daniel; Li, Ke; Sun, Heyi; Hsieh, Jiang; Szczykutowicz, Timothy P.; Chen, Guang-Hong

    2016-01-01

    Purpose: The introduction of a High-Resolution (Hi-Res) scan mode and another associated option that combines Hi-Res mode with the so-called High Definition (HD) reconstruction kernels (referred to as a Hi-Res/HD mode in this paper) in some multi-detector CT (MDCT) systems offers new opportunities to increase spatial resolution for some clinical applications that demand high spatial resolution. The purpose of this work was to quantify the in-plane spatial resolution along both the radial direction and tangential direction for the Hi-Res and Hi-Res/HD scan modes at different off-center positions. Methods: A technique was introduced and validated to address the signal saturation problem encountered in the attempt to quantify spatial resolution for the Hi-Res and Hi-Res/HD scan modes. Using the proposed method, the modulation transfer functions (MTFs) of a 64-slice MDCT system (Discovery CT750 HD, GE Healthcare) equipped with both Hi-Res and Hi-Res/HD modes were measured using a metal bead at nine different off-centered positions (0–16 cm with a step size of 2 cm); at each position, both conventional scans and Hi-Res scans were performed. For each type of scan and position, 80 repeated acquisitions were performed to reduce noise induced uncertainties in the MTF measurements. A total of 15 reconstruction kernels, including eight conventional kernels and seven HD kernels, were used to reconstruct CT images of the bead. An ex vivo animal study consisting of a bone fracture model was performed to corroborate the MTF results, as the detection of this high-contrast and high frequency task is predominantly determined by spatial resolution. Images of this animal model generated by different scan modes and reconstruction kernels were qualitatively compared with the MTF results. Results: At the centered position, the use of Hi-Res mode resulted in a slight improvement in the MTF; each HD kernel generated higher spatial resolution than its counterpart conventional kernel

  6. Impact of Aortic Valve Calcification, as Measured by MDCT, on Survival in Patients With Aortic Stenosis

    PubMed Central

    Clavel, Marie-Annick; Pibarot, Philippe; Messika-Zeitoun, David; Capoulade, Romain; Malouf, Joseph; Aggarval, Shivani; Araoz, Phillip A.; Michelena, Hector I.; Cueff, Caroline; Larose, Eric; Miller, Jordan D.; Vahanian, Alec; Enriquez-Sarano, Maurice

    2014-01-01

    BACKGROUND Aortic valve calcification (AVC) load measures lesion severity in aortic stenosis (AS) and is useful for diagnostic purposes. Whether AVC predicts survival after diagnosis, independent of clinical and Doppler echocardiographic AS characteristics, has not been studied. OBJECTIVES This study evaluated the impact of AVC load, absolute and relative to aortic annulus size (AVCdensity), on overall mortality in patients with AS under conservative treatment and without regard to treatment. METHODS In 3 academic centers, we enrolled 794 patients (mean age, 73 ± 12 years; 274 women) diagnosed with AS by Doppler echocardiography who underwent multidetector computed tomography (MDCT) within the same episode of care. Absolute AVC load and AVCdensity (ratio of absolute AVC to cross-sectional area of aortic annulus) were measured, and severe AVC was separately defined in men and women. RESULTS During follow-up, there were 440 aortic valve implantations (AVIs) and 194 deaths (115 under medical treatment). Univariate analysis showed strong association of absolute AVC and AVCdensity with survival (both, p < 0.0001) with a spline curve analysis pattern of threshold and plateau of risk. After adjustment for age, sex, coronary artery disease, diabetes, symptoms, AS severity on hemodynamic assessment, and LV ejection fraction, severe absolute AVC (adjusted hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.04 to 2.92; p = 0.03) or severe AVCdensity (adjusted HR: 2.44; 95% CI: 1.37 to 4.37; p = 0.002) independently predicted mortality under medical treatment, with additive model predictive value (all, p ≤ 0.04) and a net reclassification index of 12.5% (p = 0.04). Severe absolute AVC (adjusted HR: 1.71; 95% CI: 1.12 to 2.62; p = 0.01) and severe AVCdensity (adjusted HR: 2.22; 95% CI: 1.40 to 3.52; p = 0.001) also independently predicted overall mortality, even with adjustment for time-dependent AVI. CONCLUSIONS This large-scale, multicenter outcomes study of

  7. Hi-Res scan mode in clinical MDCT systems: Experimental assessment of spatial resolution performance.

    PubMed

    Cruz-Bastida, Juan P; Gomez-Cardona, Daniel; Li, Ke; Sun, Heyi; Hsieh, Jiang; Szczykutowicz, Timothy P; Chen, Guang-Hong

    2016-05-01

    The introduction of a High-Resolution (Hi-Res) scan mode and another associated option that combines Hi-Res mode with the so-called High Definition (HD) reconstruction kernels (referred to as a Hi-Res/HD mode in this paper) in some multi-detector CT (MDCT) systems offers new opportunities to increase spatial resolution for some clinical applications that demand high spatial resolution. The purpose of this work was to quantify the in-plane spatial resolution along both the radial direction and tangential direction for the Hi-Res and Hi-Res/HD scan modes at different off-center positions. A technique was introduced and validated to address the signal saturation problem encountered in the attempt to quantify spatial resolution for the Hi-Res and Hi-Res/HD scan modes. Using the proposed method, the modulation transfer functions (MTFs) of a 64-slice MDCT system (Discovery CT750 HD, GE Healthcare) equipped with both Hi-Res and Hi-Res/HD modes were measured using a metal bead at nine different off-centered positions (0-16 cm with a step size of 2 cm); at each position, both conventional scans and Hi-Res scans were performed. For each type of scan and position, 80 repeated acquisitions were performed to reduce noise induced uncertainties in the MTF measurements. A total of 15 reconstruction kernels, including eight conventional kernels and seven HD kernels, were used to reconstruct CT images of the bead. An ex vivo animal study consisting of a bone fracture model was performed to corroborate the MTF results, as the detection of this high-contrast and high frequency task is predominantly determined by spatial resolution. Images of this animal model generated by different scan modes and reconstruction kernels were qualitatively compared with the MTF results. At the centered position, the use of Hi-Res mode resulted in a slight improvement in the MTF; each HD kernel generated higher spatial resolution than its counterpart conventional kernel. However, the MTF along the

  8. Chest pain evaluation in the emergency department: can MDCT provide a comprehensive evaluation?

    PubMed

    White, Charles S; Kuo, Dick; Kelemen, Mark; Jain, Vineet; Musk, Amy; Zaidi, Eram; Read, Katrina; Sliker, Clint; Prasad, Rajnish

    2005-08-01

    The purpose of our study was to determine whether MDCT can provide a comprehensive assessment of cardiac and noncardiac causes of chest pain in stable emergency department patients. Patients with chest pain who presented to the emergency department without definitive findings of acute myocardial infarction based on history, physical examination, and ECG were recruited immediately after the initial clinical assessment. For each patient, the emergency department physician was asked whether a CT scan would normally have been ordered on clinical grounds (e.g., to exclude pulmonary embolism). Each consenting patient underwent enhanced ECG-gated 16-MDCT. Ten cardiac phases were reconstructed. The images were evaluated for cardiac (coronary calcium and stenosis, ejection fraction, and wall motion and perfusion) and significant noncardiac (pulmonary embolism, dissection, pneumonia, and so forth) causes of chest pain. Correlation was made between the presence of significant cardiac and noncardiac findings on CT and the final clinical diagnosis based on history, examination, and any subsequent cardiac workup at the 1-month follow-up by a consensus of three physicians. Sixty-nine patients met all criteria for enrollment in the study, of whom 45 (65%) would not otherwise have undergone CT. Fifty-two patients (75%) had no significant CT findings and a final diagnosis of clinically insignificant chest pain. Thirteen patients (19%) had significant CT findings (cardiac, 10; noncardiac, 3) concordant with the final diagnosis. CT failed to suggest a diagnosis in two patients (3%), both of whom proved to have clinically significant coronary artery stenoses. In two patients (3%), CT overdiagnosed a coronary stenosis. Sensitivity and specificity for the establishment of a cardiac cause of chest pain were 83% and 96%, respectively. Overall sensitivity and specificity for all other cardiac and noncardiac causes were 87% and 96%, respectively. ECG-gated MDCT appears to be logistically

  9. Impact of bowtie filter and object position on the two-dimensional noise power spectrum of a clinical MDCT system

    PubMed Central

    Gomez-Cardona, Daniel; Cruz-Bastida, Juan Pablo; Li, Ke; Budde, Adam; Hsieh, Jiang; Chen, Guang-Hong

    2016-01-01

    Purpose: Noise characteristics of clinical multidetector CT (MDCT) systems can be quantified by the noise power spectrum (NPS). Although the NPS of CT has been extensively studied in the past few decades, the joint impact of the bowtie filter and object position on the NPS has not been systematically investigated. This work studies the interplay of these two factors on the two dimensional (2D) local NPS of a clinical CT system that uses the filtered backprojection algorithm for image reconstruction. Methods: A generalized NPS model was developed to account for the impact of the bowtie filter and image object location in the scan field-of-view (SFOV). For a given bowtie filter, image object, and its location in the SFOV, the shape and rotational symmetries of the 2D local NPS were directly computed from the NPS model without going through the image reconstruction process. The obtained NPS was then compared with the measured NPSs from the reconstructed noise-only CT images in both numerical phantom simulation studies and experimental phantom studies using a clinical MDCT scanner. The shape and the associated symmetry of the 2D NPS were classified by borrowing the well-known atomic spectral symbols s, p, and d, which correspond to circular, dumbbell, and cloverleaf symmetries, respectively, of the wave function of electrons in an atom. Finally, simulated bar patterns were embedded into experimentally acquired noise backgrounds to demonstrate the impact of different NPS symmetries on the visual perception of the object. Results: (1) For a central region in a centered cylindrical object, an s-wave symmetry was always present in the NPS, no matter whether the bowtie filter was present or not. In contrast, for a peripheral region in a centered object, the symmetry of its NPS was highly dependent on the bowtie filter, and both p-wave symmetry and d-wave symmetry were observed in the NPS. (2) For a centered region-ofinterest (ROI) in an off-centered object, the symmetry of

  10. Data compression in wireless sensors network using MDCT and embedded harmonic coding.

    PubMed

    Alsalaet, Jaafar K; Ali, Abduladhem A

    2015-05-01

    One of the major applications of wireless sensors networks (WSNs) is vibration measurement for the purpose of structural health monitoring and machinery fault diagnosis. WSNs have many advantages over the wired networks such as low cost and reduced setup time. However, the useful bandwidth is limited, as compared to wired networks, resulting in relatively low sampling. One solution to this problem is data compression which, in addition to enhancing sampling rate, saves valuable power of the wireless nodes. In this work, a data compression scheme, based on Modified Discrete Cosine Transform (MDCT) followed by Embedded Harmonic Components Coding (EHCC) is proposed to compress vibration signals. The EHCC is applied to exploit harmonic redundancy present is most vibration signals resulting in improved compression ratio. This scheme is made suitable for the tiny hardware of wireless nodes and it is proved to be fast and effective. The efficiency of the proposed scheme is investigated by conducting several experimental tests.

  11. A Rare Presentation of an Entrapment in a Liver Transplant Candidate Depicted by MDCT Angiography

    PubMed Central

    Kantarci, Mecit; Aydin, Unal; Doganay, Selim; Aydinli, Bulent; Yuce, Ihsan; Polat, Kamil Yalcin

    2010-01-01

    Hypertrophic caudate lobe veins can mimic a normal venous configuration. In cases of multiple vascular collaterals, Doppler evaluations must be conducted, and the flow direction of these veins as well as the IVC should be evaluated. If the flow in the IVC is reversed, Budd-Chiari syndrome should be suspected; moreover, at the supra diaphragmatic level, which may be considered a blind spot, particularly for radiologists, a web should be searched for in the area where the IVC opens into the right atrium. In this study, we present the unique findings of multidetector computed tomography (MDCT) angiography for a liver transplant candidate with Budd-Chiari syndrome caused by a web in the proximal IVC. PMID:25610132

  12. Multiphase contrast-saline mixture injection with dual-flow in 64-row MDCT coronary CTA.

    PubMed

    Cao, Lizhen; Du, Xiangying; Li, Pengyu; Liu, Yaou; Li, Kuncheng

    2009-03-01

    To explore the feasibility of multiphase contrast-saline mixture with dual-flow injection technique for visualization of right ventricular (RV) cavity and interventricular septum (IVS) in 64-row multidetector computed tomography (MDCT) coronary angiography. Twenty-four patients underwent coronary CT angiography (CTA) imaging with 64-row MDCT. In twelve patients (group A), 60 ml contrast medium (CM) bolus was followed by 40 ml saline, and in the other twelve patients (group B), 50 ml CM bolus was followed by 50 ml contrast-saline mixture at 60:40 ratio. The CM, saline and contrast-saline mixture flow rate were all 5.0 ml/s. Two experienced radiologists measured the CT values of ascending aorta, descending aorta, pulmonary artery and RV, rated the uniformity of RV cavity, the visualization of coronary arteries and IVS independently. By Kappa test, agreement between the two radiologists was 0.93 and 0.86 concerning the CT value measurements and the grades of the three indexes, respectively. By t-test, the mean CT values of ascending aorta and descending aorta of the two groups had no statistical difference (t=1.459, P>0.05; t=1.619, P>0.05); while the mean CT values of pulmonary artery and RV cavity had statistical differences (t=8.316, P<0.05; t=10.372, P<0.05). By two-related rank sum test, according to the visualization of coronary arteries and the uniformity of RV cavity, there were no statistical differences (U=66.00, P>0.05; U=54.00, P>0.05); while according to the visualization of IVS, group B was better than group A (U=8.00, P<0.05). In coronary CTA, a contrast-saline mixture after CM bolus can provide clear visualization of RV and IVS and LV without impairing coronary CTA image.

  13. MDCT for automated detection and measurement of pneumothoraces in trauma patients.

    PubMed

    Cai, Wenli; Tabbara, Malek; Takata, Noboru; Yoshida, Hiroyuki; Harris, Gordon J; Novelline, Robert A; de Moya, Marc

    2009-03-01

    The size of a pneumothorax is an important index to guide the emergency treatment of trauma patients--chest tube drainage. The purpose of this study was to develop and validate an automated computer-aided volumetry scheme for detection and measurement of pneumothoraces for trauma patients imaged with MDCT. Three pigs and 68 trauma patients with at least one diagnosed occult pneumothorax (23 women and 45 men; age range, 14-89 years; mean age, 41 +/- 19 years) were selected for the development and validation of our computer-aided volumetry scheme for pneumothorax. Computer-aided volumetry of pneumothorax consisted of five automated steps: extraction of pleural region, detection of pneumothorax candidates, delineation of the detected pneumothorax candidates, reduction of false-positive findings, and report of the volumetric measurement of pneumothoraces. In the animal study, our computer-aided volumetry scheme yielded a mean value of 24.27 +/- 0.64 mL (SD) compared with 25 mL of air volume manually injected in each scan. The correlation coefficients were 0.999 and 0.997 for the in vivo and ex vivo comparison, respectively. In the patient study, the sensitivity of our computer-aided volumetry scheme was 100% with a false-positive rate of 0.15 per case for 32 occult pneumothoraces > or = 25 mL. The correlation coefficient was 0.999 for manual volumetry comparison. This automated computer-aided volumetry scheme took approximately 3 minutes to finish the detection and measurement per case. The results show that our computer-aided volumetry scheme provides an automated method for accurate and efficient detection and measurement of pneumothoraces in MDCT images of trauma patients.

  14. Diagnostic Value and Interreader Agreement of the Pancreaticolienal Gap in Pancreatic Cancer on MDCT

    PubMed Central

    Schawkat, Khoschy; Kühn, Wolfgang; Inderbitzin, Daniel; Gloor, Beat; Heverhagen, Johannes T.; Runge, Val Murray; Christe, Andreas

    2016-01-01

    Objective The aim of this retrospective study was to evaluate the diagnostic value and measure interreader agreement of the pancreaticolienal gap (PLG) in the assessment of imaging features of pancreatic carcinoma (PC) on contrast-enhanced multi-detector computed tomography (CE-MDCT). Materials and Methods CE-MDCT studies in the portal venous phase were retrospectively reviewed for 66 patients with PC. The age- and gender-matched control group comprised 103 healthy individuals. Three radiologists with different levels of experience independently measured the PLG (the minimum distance of the pancreatic tail to the nearest border of the spleen) in the axial plane. The interreader agreement of the PLG and the receiver operating characteristic (ROC) curve was used to calculate the accuracy of the technique. Results While the control group (n = 103) showed a median PLG of 3 mm (Range: 0 – 39mm) the PC patients had a significantly larger PLG of 15mm (Range: 0 – 53mm)(p < 0.0001). A ROC curve demonstrated a cutoff-value of >12 mm for PC, with a sensitivity of 58.2% (95% CI = 45.5–70.1), specificity of 84.0% (95% CI = 75.6–90.4) and an area under the ROC curve of 0.714 (95% CI = 0.641 to 0.780). The mean interreader agreement showed correlation coefficient r of 0.9159. The extent of the PLG did not correlate with tumor stage but did correlate with pancreatic density (fatty involution) and age, the density decreased by 4.1 HU and the PLG increased by 0.8 mm within every 10 y. Conclusion The significant interreader agreement supports the use of the PLG as a characterizing feature of pancreatic cancer independent of the tumor stage on an axial plane. The increase in the PLG with age may represent physiological atrophy of the pancreatic tail. PMID:27893776

  15. Priapism and glucose-6-phosphate dehydrogenase deficiency: An underestimated correlation?

    PubMed

    De Rose, Aldo Franco; Mantica, Guglielmo; Tosi, Mattia; Bovio, Giulio; Terrone, Carlo

    2016-10-05

    Priapism is a rare clinical condition characterized by a persistent erection unrelated to sexual excitement. Often the etiology is idiopathic. Three cases of priapism in glucose-6-phosphate dehydrogenase (G6PD) deficiency patients have been described in literature. We present the case of a 39-year-old man with glucose- 6-phosphate dehydrogenase deficiency, who reached out to our department for the arising of a non-ischemic priapism without arteriolacunar fistula. We suggest that the glucose-6-phosphate dehydrogenase deficiency could be an underestimated risk factor for priapism.

  16. Multidetector CT in emergency radiology: acute and generalized non-traumatic abdominal pain

    PubMed Central

    Paolantonio, Pasquale; Rengo, Marco; Ferrari, Riccardo

    2016-01-01

    Multidetector CT (MDCT) is an imaging technique that provides otherwise unobtainable information in the diagnostic work-up of patients presenting with acute abdominal pain. A correct working diagnosis depends essentially on understanding the individual patient's clinical data and laboratory findings. In haemodynamically stable patients with acute severe and generalized abdominal pain, MDCT is now the preferred imaging test and gives invaluable diagnostic information, also in unstable patients after stabilization. In this descriptive review, we focus our attention on acute, severe and generalized or undifferentiated non-traumatic abdominal pain. The main differential diagnoses are acute pancreatitis, gastrointestinal perforation, ruptured abdominal aneurysm and acute mesenteric ischaemia. We will provide radiologist readers with a technical guide to optimize MDCT imaging protocols and list the major CT signs essential to reach a correct diagnosis and guide the best treatment. PMID:26689097

  17. Consequences of Underestimating Impalement Bicycle Handlebar Injuries in Children.

    PubMed

    Ramos-Irizarry, Carmen T; Swain, Shakeva; Troncoso-Munoz, Samantha; Duncan, Malvina

    Impalement bicycle handlebar trauma injuries are rare; however, on initial assessment, they have the potential of being underestimated. We reviewed our prospective trauma database of 3,894 patients for all bicycle injuries from January 2010 to May 2015. Isolated pedal bike injuries were reported in 2.6% (N = 101) of the patients who were admitted to the trauma service. Fifteen patients suffered direct handlebar trauma. Patients were grouped into blunt trauma (n = 12) and impalement trauma (n = 3). We examined gender, age, injury severity score (ISS), Glasgow Coma Scale score, use of protective devices, need for surgical intervention, need for intensive care (ICU), and hospital length of stay. Mean age was 9.6 years. All children with penetrating injuries were males. Mean ISS was less than 9 in both groups. None of the children were wearing bicycle helmets. Three patients who sustained blunt injuries required ICU care due to associated injuries. All of the children with impalement injuries required several surgical interventions. These injuries included a traumatic direct inguinal hernia, a medial groin and thigh laceration with resultant femoral hernia, and a lateral deep thigh laceration. Impalement bicycle handlebar injuries must be thoroughly evaluated, with a similar importance given to blunt injuries. A high index of suspicion must be maintained when examining children with handlebar impalement injuries, as they are at risk for missed or underestimation of their injuries.

  18. Does WISC-IV Underestimate the Intelligence of Autistic Children?

    PubMed

    Nader, Anne-Marie; Courchesne, Valérie; Dawson, Michelle; Soulières, Isabelle

    2016-05-01

    Wechsler Intelligence Scale for Children (WISC) is widely used to estimate autistic intelligence (Joseph in The neuropsychology of autism. Oxford University Press, Oxford, 2011; Goldstein et al. in Assessment of autism spectrum disorders. Guilford Press, New York, 2008; Mottron in J Autism Dev Disord 34(1):19-27, 2004). However, previous studies suggest that while WISC-III and Raven's Progressive Matrices (RPM) provide similar estimates of non-autistic intelligence, autistic children perform significantly better on RPM (Dawson et al. in Psychol Sci 18(8):657-662, doi: 10.1111/j.1467-9280.2007.01954.x , 2007). The latest WISC version introduces substantial changes in subtests and index scores; thus, we asked whether WISC-IV still underestimates autistic intelligence. Twenty-five autistic and 22 typical children completed WISC-IV and RPM. Autistic children's RPM scores were significantly higher than their WISC-IV FSIQ, but there was no significant difference in typical children. Further, autistic children showed a distinctively uneven WISC-IV index profile, with a "peak" in the new Perceptual Reasoning Index. In spite of major changes, WISC-IV FSIQ continues to underestimate autistic intelligence.

  19. Underestimating the frequency, strength and cost of antipredator responses with data from GPS collars: an example with wolves and elk

    PubMed Central

    Creel, Scott; Winnie, John A; Christianson, David

    2013-01-01

    Field studies that rely on fixes from GPS-collared predators to identify encounters with prey will often underestimate the frequency and strength of antipredator responses. These underestimation biases have several mechanistic causes. (1) Step bias: The distance between successive GPS fixes can be large, and encounters that occur during these intervals go undetected. This bias will generally be strongest for cursorial hunters that can rapidly cover large distances (e.g., wolves and African wild dogs) and when the interval between GPS fixes is long relative to the duration of a hunt. Step bias is amplified as the path travelled between successive GPS fixes deviates from a straight line. (2) Scatter bias: Only a small fraction of the predators in a population typically carry GPS collars, and prey encounters with uncollared predators go undetected unless a collared group-mate is present. This bias will generally be stronger for fission–fusion hunters (e.g., spotted hyenas, wolves, and lions) than for highly cohesive hunters (e.g., African wild dogs), particularly when their group sizes are large. Step bias and scatter bias both cause underestimation of the frequency of antipredator responses. (3) Strength bias: Observations of prey in the absence of GPS fix from a collared predator will generally include a mixture of cases in which predators were truly absent and cases in which predators were present but not detected, which causes underestimation of the strength of antipredator responses. We quantified these biases with data from wolves and African wild dogs and found that fixes from GPS collars at 3-h intervals underestimated the frequency and strength of antipredator responses by a factor >10. We reexamined the results of a recent study of the nonconsumptive effects of wolves on elk in light of these results and confirmed that predation risk has strong effects on elk dynamics by reducing the pregnancy rate. PMID:24455148

  20. Underestimating the frequency, strength and cost of antipredator responses with data from GPS collars: an example with wolves and elk.

    PubMed

    Creel, Scott; Winnie, John A; Christianson, David

    2013-12-01

    Field studies that rely on fixes from GPS-collared predators to identify encounters with prey will often underestimate the frequency and strength of antipredator responses. These underestimation biases have several mechanistic causes. (1) Step bias: The distance between successive GPS fixes can be large, and encounters that occur during these intervals go undetected. This bias will generally be strongest for cursorial hunters that can rapidly cover large distances (e.g., wolves and African wild dogs) and when the interval between GPS fixes is long relative to the duration of a hunt. Step bias is amplified as the path travelled between successive GPS fixes deviates from a straight line. (2) Scatter bias: Only a small fraction of the predators in a population typically carry GPS collars, and prey encounters with uncollared predators go undetected unless a collared group-mate is present. This bias will generally be stronger for fission-fusion hunters (e.g., spotted hyenas, wolves, and lions) than for highly cohesive hunters (e.g., African wild dogs), particularly when their group sizes are large. Step bias and scatter bias both cause underestimation of the frequency of antipredator responses. (3) Strength bias: Observations of prey in the absence of GPS fix from a collared predator will generally include a mixture of cases in which predators were truly absent and cases in which predators were present but not detected, which causes underestimation of the strength of antipredator responses. We quantified these biases with data from wolves and African wild dogs and found that fixes from GPS collars at 3-h intervals underestimated the frequency and strength of antipredator responses by a factor >10. We reexamined the results of a recent study of the nonconsumptive effects of wolves on elk in light of these results and confirmed that predation risk has strong effects on elk dynamics by reducing the pregnancy rate.

  1. Is rosmarinic acid underestimated as an experimental cardiovascular drug?

    PubMed

    Ferreira, Luciana Garros; Celotto, Andrea Carla; Capellini, Verena Kise; Albuquerque, Agnes Afrodite Sumarelli; Nadai, Tales Rubens de; Carvalho, Marco Tulio Menezes de; Evora, Paulo Roberto Barbosa

    2013-01-01

    The rationale of the present review is to analize the activity of Rosmarinus officinalis in the the cardiovascular system A MEDLINE database search (from January 1970 to December 2011) using only rosmarinic acid as searched term. The references search revealed 509 references about rosmarinic acid in 40 years (the first reference is from 1970). There is a powerful prevalence of antioxidant and cancer studies. Other diseases are few cited, as inflammation, brain (Alzheimer and Parkinson disease) and, memory; allergy; diabetes; atherosclerosis, and; hypertension. It is necessary to consider the complete absence of studies on coronary artery disease, myocardial ischemia, heart failure or ischemia/reperfusion injury. Rosmarinic acid is underestimated as an experimental cardiovascular drug and deserves more attention.

  2. The underestimated potential of solar energy to mitigate climate change

    NASA Astrophysics Data System (ADS)

    Creutzig, Felix; Agoston, Peter; Goldschmidt, Jan Christoph; Luderer, Gunnar; Nemet, Gregory; Pietzcker, Robert C.

    2017-09-01

    The Intergovernmental Panel on Climate Change's fifth assessment report emphasizes the importance of bioenergy and carbon capture and storage for achieving climate goals, but it does not identify solar energy as a strategically important technology option. That is surprising given the strong growth, large resource, and low environmental footprint of photovoltaics (PV). Here we explore how models have consistently underestimated PV deployment and identify the reasons for underlying bias in models. Our analysis reveals that rapid technological learning and technology-specific policy support were crucial to PV deployment in the past, but that future success will depend on adequate financing instruments and the management of system integration. We propose that with coordinated advances in multiple components of the energy system, PV could supply 30-50% of electricity in competitive markets.

  3. Underestimation of Monostatic Sodar Measurements in Complex Terrain

    NASA Astrophysics Data System (ADS)

    Behrens, Paul; O'Sullivan, J.; Archer, R.; Bradley, S.

    2012-04-01

    Recent investigations in complex terrain have found that remote sensing instrumentation commonly finds mean wind-speed differences when compared to cup anemometery. In many cases the difference is found to be an underestimation and varies from 2 to 9% depending on topology. We describe these differences in a theoretical sense for a five-beam sodar. An investigation is conducted on a New Zealand ridge with a five-beam sodar and three computational models, consisting of a potential flow model and two computational fluid dynamical simulations, OpenFOAM and the industry standard software WindSim. All models predict the difference to within 0.1-2.5%. A comparative assessment is made and it is found that, given the computing overheads, the potential flow model provides a good compromise in the prediction of mean wind-speed difference.

  4. Underestimating our influence over others' unethical behavior and decisions.

    PubMed

    Bohns, Vanessa K; Roghanizad, M Mahdi; Xu, Amy Z

    2014-03-01

    We examined the psychology of "instigators," people who surround an unethical act and influence the wrongdoer (the "actor") without directly committing the act themselves. In four studies, we found that instigators of unethical acts underestimated their influence over actors. In Studies 1 and 2, university students enlisted other students to commit a "white lie" (Study 1) or commit a small act of vandalism (Study 2) after making predictions about how easy it would be to get their fellow students to do so. In Studies 3 and 4, online samples of participants responded to hypothetical vignettes, for example, about buying children alcohol and taking office supplies home for personal use. In all four studies, instigators failed to recognize the social pressure they levied on actors through simple unethical suggestions, that is, the discomfort actors would experience by making a decision that was inconsistent with the instigator's suggestion.

  5. Glycerol, an underestimated flavor precursor in the Maillard reaction.

    PubMed

    Smarrito-Menozzi, Candice; Matthey-Doret, Walter; Devaud-Goumoens, Stéphanie; Viton, Florian

    2013-10-30

    The objective of the present work was to investigate in depth the role of glycerol in Maillard reactions and its potential to act as an active flavor precursor. Reactions using isotopically labeled compounds (various reducing sugars, proline, and glycerol) unambiguously demonstrated that, in addition to its role of solvent, glycerol actively contributes to the formation of proline-specific compounds in Maillard model systems. Additionally, rhamnose and fucose/proline/glycerol systems generated the 2-propionyl-1(3),4,5,6-tetrahydropyridines, known for their roasty, popcorn aroma. Their formation from such systems is unprecedented. The results presented here have direct implications for flavor generation during thermal processing of foods containing glycerol, which is a ubiquitous food ingredient and an underestimated flavor precursor.

  6. Climate change velocity underestimates climate change exposure in mountainous regions

    NASA Astrophysics Data System (ADS)

    Dobrowski, Solomon Z.; Parks, Sean A.

    2016-08-01

    Climate change velocity is a vector depiction of the rate of climate displacement used for assessing climate change impacts. Interpreting velocity requires an assumption that climate trajectory length is proportional to climate change exposure; longer paths suggest greater exposure. However, distance is an imperfect measure of exposure because it does not quantify the extent to which trajectories traverse areas of dissimilar climate. Here we calculate velocity and minimum cumulative exposure (MCE) in degrees Celsius along climate trajectories for North America. We find that velocity is weakly related to MCE; each metric identifies contrasting areas of vulnerability to climate change. Notably, velocity underestimates exposure in mountainous regions where climate trajectories traverse dissimilar climates, resulting in high MCE. In contrast, in flat regions velocity is high where MCE is low, as these areas have negligible climatic resistance to movement. Our results suggest that mountainous regions are more climatically isolated than previously reported.

  7. Climate change velocity underestimates climate change exposure in mountainous regions.

    PubMed

    Dobrowski, Solomon Z; Parks, Sean A

    2016-08-01

    Climate change velocity is a vector depiction of the rate of climate displacement used for assessing climate change impacts. Interpreting velocity requires an assumption that climate trajectory length is proportional to climate change exposure; longer paths suggest greater exposure. However, distance is an imperfect measure of exposure because it does not quantify the extent to which trajectories traverse areas of dissimilar climate. Here we calculate velocity and minimum cumulative exposure (MCE) in degrees Celsius along climate trajectories for North America. We find that velocity is weakly related to MCE; each metric identifies contrasting areas of vulnerability to climate change. Notably, velocity underestimates exposure in mountainous regions where climate trajectories traverse dissimilar climates, resulting in high MCE. In contrast, in flat regions velocity is high where MCE is low, as these areas have negligible climatic resistance to movement. Our results suggest that mountainous regions are more climatically isolated than previously reported.

  8. Climate change velocity underestimates climate change exposure in mountainous regions

    PubMed Central

    Dobrowski, Solomon Z.; Parks, Sean A.

    2016-01-01

    Climate change velocity is a vector depiction of the rate of climate displacement used for assessing climate change impacts. Interpreting velocity requires an assumption that climate trajectory length is proportional to climate change exposure; longer paths suggest greater exposure. However, distance is an imperfect measure of exposure because it does not quantify the extent to which trajectories traverse areas of dissimilar climate. Here we calculate velocity and minimum cumulative exposure (MCE) in degrees Celsius along climate trajectories for North America. We find that velocity is weakly related to MCE; each metric identifies contrasting areas of vulnerability to climate change. Notably, velocity underestimates exposure in mountainous regions where climate trajectories traverse dissimilar climates, resulting in high MCE. In contrast, in flat regions velocity is high where MCE is low, as these areas have negligible climatic resistance to movement. Our results suggest that mountainous regions are more climatically isolated than previously reported. PMID:27476545

  9. Use of Preprocedural MDCT for Cardiac Implantable Electric Device Lead Extraction: Frequency of Findings That Change Management.

    PubMed

    Ehieli, Wendy L; Boll, Daniel T; Marin, Daniele; Lewis, Robert; Piccini, Jonathan P; Hurwitz, Lynne M

    2017-04-01

    Five percent of cardiac implantable electric devices (CIEDs) are removed each year. Percutaneous extraction is preferred but can be complicated if the leads adhere to the vasculature or perforate. The goal of this study is to assess the frequency of findings on dedicated MDCT that alter preprocedural planning for percutaneous CIED extraction. One hundred patients with CIEDs who underwent MDCT before percutaneous lead extraction were analyzed. Major findings that could preclude percutaneous removal, including lead course and termination, were distinguished from moderately significant findings that could alter but not preclude percutaneous removal, including endofibrosis of leads to the vasculature, lead termination abnormalities, central vein stenosis, or thrombus. Incidental findings were characterized separately. Findings were correlated with preprocedural decisions, the extraction procedure performed, and procedural outcomes. Twenty-six women and 74 men with 125 right ventricular leads, 84 right atrial leads, and 26 coronary venous leads were evaluated. Major findings were present in 7% of patients, including six patients with lead perforation and one with a lead coursing outside a tricuspid annuloplasty ring. Moderately significant findings of endothelial fibrosis were found in 78% of patients. The central veins were narrowed or occluded in 42% of patients, and thrombus was present in 2% of patients. Thirty-six percent of patients had incidental findings, and 4% of patients had unexpected findings requiring immediate inpatient attention. MDCT performed before CIED lead extraction is able to identify major and moderately significant findings that can alter either percutaneous extraction or preprocedural planning. The use of dedicated preprocedural MDCT can help to stratify patient risk, guide decision making by the proceduralist, and identify non-catheter-related findings that affect patient management.

  10. Evaluation of a single-pass continuous whole-body 16-MDCT protocol for patients with polytrauma.

    PubMed

    Nguyen, Duy; Platon, Alexandra; Shanmuganathan, Kathirkamanathan; Mirvis, Stuart E; Becker, Christoph D; Poletti, Pierre-Alexandre

    2009-01-01

    The purpose of this study was to compare a conventional multiregional MDCT protocol with two continuous single-pass whole-body MDCT protocols in imaging of patients with polytrauma. Ninety patients with polytrauma underwent whole-body 16-MDCT with a conventional (n=30) or one of two single-pass (n=60) protocols. The conventional protocol included unenhanced scans of the head and cervical spine and contrast-enhanced helical scans (140 mL, 4 mL/s, 300 mg I/mL) of the thorax and abdomen. The single-pass protocols consisted of unenhanced scans of the head followed by one-sweep acquisition from the circle of Willis through the pubic symphysis with a biphasic (150 mL, 6 and 4 mL/s, 300 mg I/mL) or monophasic (110 mL, 4 mL/s, 400 mg I/mL) injection. Acquisition times and interval delays between head, chest, and abdominal scans were recorded. Contrast enhancement was measured in the aortic arch, liver, spleen, and kidney. Diagnostic image quality in the same areas was assessed on a 4-point scale. Median acquisition times for the single-pass protocols were significantly shorter (-42.5%) than the acquisition time for the conventional protocol. No significant differences were found in mean enhancement values in the aorta, liver, spleen, and kidney for the three protocols. The image quality with both single-pass protocols was better than that with the conventional protocol in assessment of the mediastinum and cervical spine (p<0.05). There was no significant difference between the single-pass protocols. Use of single-pass continuous whole-body MDCT protocols can significantly decrease examination time for patients with polytrauma and improve image quality compared with a conventional serial scan protocol. Monophasic injection with highly concentrated contrast medium can reduce injection flow rate and should therefore be preferred to a biphasic injection technique.

  11. Accuracy of water-enema multidetector computed tomography (WE-MDCT) in colon cancer staging: a prospective study.

    PubMed

    Sibileau, E; Ridereau-Zins, Catherine; Vanel, D; Pavageau, A H; Bertrais, S; Metivier-Cesbron, E; Venara, A; Aubé, C

    2014-10-01

    To assess the accuracy of water-enema multidetector computed tomography (WE-MDCT) in extra-rectal colon cancer staging. Fifty-three patients (mean age 70 years) with extra-rectal colon cancer proven by colonoscopy and biopsy were prospectively evaluated by preoperative WE-MDCT. CT scans were both intraluminal (water enema or WE) and intravenous (iodinated) contrast enhanced (CE). All patients underwent surgery. Tumors were classified with the TNM staging system. Noted CT features were: tumor size and location; tumor form and edges; spread to the pericolic fat or neighboring organs; thickening of retroperitoneal fascia; number, size, and enhancement of the peritumoral lymph nodes. Tumors were classified on CT into 3 T-stage groups: T1/T2, T3, and T4. Lymph nodes were classified by their density after injection [positive over 100 Hounsfield units (HU)]. Tumor localization to the specific colon segment was correct in all the cases. The agreement between WE-MDCT staging and histopathology staging was good (k = 0.64). An irregular and bowl-shaped aspect of the external edges of tumor provided excellent sensitivity for T3/T4 inclusion (Se 97.7%, NPV 85.7%). Thickening of a fascia or the abdominal wall provided good specificity for T4 stage (Sp 88.1%, NPV 94.9%). Enhancement over 100 HU of at least one peritumoral lymph node was the best criterion of N+ staging (Sp 67.7%, NPV 87.5%). WE-MDCT permits good staging of colon cancer based on objective features.

  12. Trauma whole-body MDCT: an assessment of image quality in conventional dual-phase and modified biphasic injection.

    PubMed

    Hakim, Wasim; Kamanahalli, Raghavendra; Dick, Elizabeth; Bharwani, Nishat; Fetherston, Shirley; Kashef, Elika

    2016-07-01

    To compare the image quality of conventional arterial and portal venous (PV) phase multidetector CT (MDCT) with two biphasic injection protocols in polytrauma patients. 60 consecutive patients with polytrauma underwent body 256-slice MDCT with a conventional protocol or 1 of 2 single-pass biphasic protocols: Group A, arterial (30 s) and PV (60 s) phase acquisitions; Group B, "biphasic" contrast injection with a single acquisition at 60 s; and Group C, "modified biphasic" injection with a single acquisition at a 70-s delay. Images were analyzed for arterial, venous and parenchymal attenuation profiles with regions of interest in the major arteries, veins and solid abdominal organs. A 5-point scoring system was used to assess the image quality, with 5 representing excellent arterial, venous and parenchymal opacification and <3 representing non-diagnostic opacification. In addition, the effective dose (millisieverts) was compared between the groups. In 93% of patients, image quality was scored as good or excellent (≥4). All studies were of satisfactory diagnostic quality. Overall, venous and arterial attenuation profiles were comparable. Attenuation profiles in the solid abdominal viscera were significantly higher (p < 0.01) using both biphasic protocols than with arterial or PV phase of conventional protocols. Effective doses were higher in Group A. Comparable image quality can be achieved using a biphasic i.v. contrast injection protocol with single MDCT acquisition with less radiation and reduction in acquisition time. For these particular biphasic injection protocols, we have shown that image quality is comparable with a conventional protocol. This has been achieved by comparing enhanced densities of specific structures, as well as gestalt scoring by assessors, on a 256-slice MDCT.

  13. [Dose reduction and image quality in MDCT of the upper abdomen: potential of an adaptive post-processing filter].

    PubMed

    Kröpil, P; Lanzman, R S; Walther, C; Röhlen, S; Godehardt, E; Mödder, U; Cohnen, M

    2010-03-01

    To evaluate the effects of a 2D non-linear adaptive post-processing filter (2D-NLAF) on image quality in dose-reduced multi-detector CT (MDCT) of the upper abdomen. MDCT of the upper abdomen was simulated on a 64-slice scanner using a multi-modal anthropomorphic phantom (CIRS, Norfolk, USA). While keeping the collimation (64 x 0.6 mm) and pitch (p = 1) unchanged, the tube current (100 - 500 mAs) and tube potential (80 - 140 kVp) were varied to perform MDCT as high dose (CTDI > 20), middle dose (CTDI 10 - 20) and low dose (CTDI < 10) level protocols. Four independent blinded radiologists evaluated axial images with a thickness of 7 and 3 mm with respect to the presentation of "mesenteric low contrast lesions", "liver veins", "liver cysts", "renal cysts" and "big vessels". The subjective image quality of original data and post-processed images using a 2D-NLAF (SharpViewCT, Linköping, Sweden) was graded on a 5-point scale (from "1" not visible to "5" excellent) and statistically analyzed. The effective dose (E) was estimated using commercial software (CT-EXPO). For all protocol groups, 2D-NLAF led to a significant improvement in subjective image quality for all examined lesions (p < 0.01), particularly at the protocols of middle dose (E: 5 - 8 mSv) and low dose level (E: 1 - 5 mSv). A maximum effect was seen in middle dose protocols for "low contrast lesions" (score "3.3" with filter versus "2.5" without) and "liver veins" ("4.5" versus "3.9"). The phantom study indicates a potential dose reduction of up to 50 % in MDCT of the upper abdomen by use of a 2D-NLAF, which should be further examined in clinical trails. Georg Thieme Verlag KG Stuttgart New York.

  14. Emergency radiology: straightening of the cervical spine in MDCT after trauma—a sign of injury or normal variant?

    PubMed Central

    Deak, Zsuszsanna; Krtakovska, Aina; Ruschi, Francesco; Kammer, Nora; Wirth, Stefan; Reiser, Maximilian; Geyer, Lucas

    2016-01-01

    Objective: To evaluate whether straightening of the cervical spine (C-spine) alignment after trauma can be considered a significant multidetector CT (MDCT) finding. Methods: 160 consecutive patients after C-spine trauma admitted to a Level 1 trauma centre received MDCT according to Canadian Cervical Spine Rule and National Emergency X-Radiography Utilization Study indication rule; subgroups with and without cervical collar immobilization (CCI +/−) were compared with a control group (n = 20) of non-traumatized patients. Two independent readers evaluated retrospectively the alignment, determined the absolute rotational angle of the posterior surface of C2 and C7 (ARA C2–7) and grouped the results for lordosis (<−13°), straight (−13 to +6°) and kyphosis (>+6°). Results: In the two CCI−/CCI+ study groups, the straight or kyphotic alignment significantly (p = 0.001) predominated over lordosis. The number of patients with straight C-spine alignment was higher in the CCI+ group (CCI+ 69% vs CCI− 49%, p = 0.05). A comparison of the CCI+ group vs the CCI− group revealed a slightly smaller number of kyphotic (10% vs 18%, p = 0.34) and lordotic (21% vs 33%, p = 0.33) alignments. Statistically, however, the differences were of no significance. The control group revealed no significant differences. Conclusion: Straightening of the C-spine alone is not a definitive sign of injury but is a biomechanical variation due to CCI and neck positioning during MDCT or active patient control. Advances in knowledge: Straightening of the C-spine alignment in MDCT alone is not a definitive sign of injury. Straightening of the C-spine alignment is related to neck positioning and active patient control. CCI has a straightening effect on the cervical alignment. PMID:26764283

  15. [Evaluation of left ventricular function with a 16-slice multidetector tomograph (MDCT-16): correlation with cardiovascular magnetic resonance imaging].

    PubMed

    de la Peña-Almaguer, Erasmo; Azpiri López, José Ramón; González-Camid, Felipe de Jesús; Ponce de León, Enrique; Flores-Ramírez, Ramiro; Zamarripa, Rafael; Loera, Javier; Rodríguez, Daniel; González Quijano, Rafael; Azpiri-Magallanes, Marcela; Jaramillo Estrada, Samuel; Assad Morell, José Luis

    2005-01-01

    The evaluation of Left ventricular function has both prognostic as well as therapeutic implications in patients with heart disease. Non-invasive coronary angiography with computed tomography using 16 slices (MDCT-16) allows to obtain images of the coronary anatomy due to its high spatial and temporal resolution, and also, to obtain data regarding Left ventricular function. The objective of this study was to correlate the use of MDCT-16 for the evaluation of the Left ventricular parameters using MRI as the Standard of reference. MRI: Se A 1.5 Tesla GE CvI Scanner optimized for cardiovascular applications was used. Using an ECG gated steady state fast precession sequence (SSFP, Thickness 10 mm, Flip Angle 45, FOV 36 cm. NEX 1, Frequency 256, Phase 128, Partial FOV 0.75, 16VPS), 6 to 8 short axis images of from base to apex of the left ventricle were obtained. Tomography: Using a 16 slice Multidetector tomograph (GE Lightspeed) and using ECG synchronization, images of the heart were obtained after the administration of 80 mls. of no-ionic contrast. The images were reconstructed off-line to obtain from 6 to 8 slices in a similar fashion to that of MR. Both studies were independently analyzed by 2 operators who obtained the ventricular function data. Linear correlation and a Paired T Student test was used to analyze the data and was considered significant when p < 0.05. 20 consecutive patients were evaluated with MDCT-16 and MRI, 18 males, mean age 52 +/- 15 years. There was no significant difference among the measurements for cardiac CT and MRI of the end-diastolic volume (EDV) and end-sistolic volume (ESV), stroke volume (SV), LV Mass or LV ejection fraction (LVEF). This results show a high correlation among the clinically relevant ventricular function parameters evaluated by cardiovascular CT and MRI. This findings suggest that ventricular function can be successfully evaluated along with the coronary anatomy using MDCT-16.

  16. Printed MDCT 3D models for prediction of Left Atrial Appendage (LAA) occluder device size - A feasibility study.

    PubMed

    Goitein, Orly; Fink, Noam; Guetta, Victor; Beinart, Roy; Brodov, Yafim; Konen, Eli; Goitein, David; Di Segni, Elio; Grupper, Avishay; Glikson, Michael

    2017-05-16

    Trans-esophageal echocardiography (TEE) and MDCT currently serve as imaging modalities for left atrial appendage (LAA) occlusion pre-procedural planning. We assessed the feasibility of multi-detector CT (MDCT) based models to predict the correct size of device for LAA occlusion procedures. Patients planned for LAA occlusion underwent MDCT before implantation, which was used for creating and printing 3D LAA models. Three cardiologists evaluated the 3D models and predicted the correct size of the device by manual manipulation, these predictions were compared with the actual device implanted during the procedure. Twenty nine patients were included in this study. Amplatzer™ and Watchman™ devices were deployed in 12 and 17 patients, respectively. Two procedures were aborted due to failure of occlusion, all three physicians predicted it. There was good correlation between the 3D models and the inserted device for Amplatzer™ devices with concordance correlation coefficient 0.778 (P=0.001) and poor agreement for Watchman™ devices - concordance correlation coefficient of 0.315 (P=0.203). Agreement between the three physicians for Amplatzer ™ and Watchman™ devices were excellent with a calculated average intra-class correlation of 0.915 and 0.816 respectively. We found LAA printed 3D models to be accurate for prediction of LAA occluder device size for Amplatzer™ device but not for Watchman™ device.

  17. Extramural venous invasion detected by MDCT as an adverse imaging feature for predicting synchronous metastases in T4 gastric cancer.

    PubMed

    Cheng, Jin; Wu, Jing; Ye, Yingjiang; Zhang, Chunfang; Zhang, Yinli; Wang, Yi

    2017-04-01

    Background Extramural venous invasion (EMVI) is defined histologically as the active invasion of tumor cells to the lumens of mesenteric vessels beyond the muscularis propria in advanced gastrointestinal cancer, resulting in distant metastases. Purpose To determine the association between synchronous metastatic disease in patients with T4 gastric cancer and EMVI detected on contrast-enhanced multiple-row detector computed tomography (MDCT). Material and Methods A total of 152 patients with T4 gastric carcinoma were retrospectively reviewed and divided into EMVI-positive and EMVI-negative groups where EMVI, as detected on MDCT, was defined as a tubular or nodular soft tissue thickening extending from the tumor along the vessels of the mesentery. Synchronous metastases were detected by MDCT and/or confirmed by postoperative diagnosis. Logistic regression analyses were performed to analyze the predictive factors of synchronous metastases in gastric cancer. Results Synchronous metastases were found in 47 of 152 (30.9%) patients with T4 gastric cancer. Thirty-one of 77 (40.3%) patients in the EMVI-positive group had evidence of metastases compared to 16 (21.3%) of 75 patients in the EMVI-negative group ( P = 0.019). Synchronous metastases were significantly associated with EMVI with an odds ratio (OR) of 2.250 (95% CI, 1.072-4.724). Conclusion EMVI-positive tumors, as an adverse imaging feature, were significantly associated with synchronous metastases in patients with T4 gastric cancer.

  18. MDCT Linear and Volumetric Analysis of Adrenal Glands: Normative Data and Multiparametric Assessment.

    PubMed

    Carsin-Vu, Aline; Oubaya, Nadia; Mulé, Sébastien; Janvier, Annaëlle; Delemer, Brigitte; Soyer, Philippe; Hoeffel, Christine

    2016-08-01

    To study linear and volumetric adrenal measurements, their reproducibility, and correlations between total adrenal volume (TAV) and adrenal micronodularity, age, gender, body mass index (BMI), visceral (VAAT) and subcutaneous adipose tissue volume (SAAT), presence of diabetes, chronic alcoholic abuse and chronic inflammatory disease (CID). We included 154 patients (M/F, 65/89; mean age, 57 years) undergoing abdominal multidetector row computed tomography (MDCT). Two radiologists prospectively independently performed adrenal linear and volumetric measurements with semi-automatic software. Inter-observer reliability was studied using inter-observer correlation coefficient (ICC). Relationships between TAV and associated factors were studied using bivariate and multivariable analysis. Mean TAV was 8.4 ± 2.7 cm(3) (3.3-18.7 cm(3)). ICC was excellent for TAV (0.97; 95 % CI: 0.96-0.98) and moderate to good for linear measurements. TAV was significantly greater in men (p < 0.0001), alcoholics (p = 0.04), diabetics (p = 0.0003) and those with micronodular glands (p = 0.001). TAV was lower in CID patients (p = 0.0001). TAV correlated positively with VAAT (r = 0.53, p < 0.0001), BMI (r = 0.42, p < 0.0001), SAAT (r = 0.29, p = 0.0003) and age (r = 0.23, p = 0.005). Multivariable analysis revealed gender, micronodularity, diabetes, age and BMI as independent factors influencing TAV. Adrenal gland MDCT-based volumetric measurements are more reproducible than linear measurements. Gender, micronodularity, age, BMI and diabetes independently influence TAV. • Volumetric measurements are more reproducible than linear measurements for adrenal glands. • Inter-observer reproducibility of adrenal gland volume is excellent using semiautomatic software. • Gender, age, BMI, and diabetes independently influence total adrenal gland volume. • Adrenal micronodularity is associated with increased total adrenal gland volume.

  19. STATIC VS PROSPECTIVE GATED, NON-BREATH HOLD VOLUMETRIC MDCT IMAGING OF THE LUNGS

    PubMed Central

    Saba, Osama I.; Chon, Deokiee; Beck, Kenneth; McLennan, Geoffrey; Sieren, Jered; Reinhardt, Joseph; Hoffman, Eric A.

    2005-01-01

    Rationale and Objectives: We seek to establish lung imaging methods which provide for the ability to image the lung under dynamic, non-breath hold conditions while providing “virtual breath hold,” quantifiable volumetric image data sets. We use static, breath hold images as the gold standard for evaluating these virtual breath hold images in both a phantom and sheep. Materials and Methods: We have developed axial methods for gating image acquisition to multiple points in the respiratory cycle interleaved with incremental table stepping during multidetector-row CT (MDCT) scanning. Datasets are generated over multiple breaths, providing volume images representative of multiple points within a respiratory cycle. To determine the reproducibility and accuracy of the methods , 6 anesthetized sheep were studied by MDCT in non-gated and airway-pressure (Pawy)-gated modes where Pawy was 0, 7 and 15 cmH2O. Results: No significant differences were found between the coefficient of variation in air volume measured from repeated static scans (1.74±1.78%), gated scans: Inspiratory gated (1.2±0.44%) or expiratory-gated (1.39±0.98%), or between static (1.74±1.78%) and gated (1.39+/-0.98%) scanning at similar Pawy (p>0.1). Measured air volumes were larger from static vs. gated scans by 5.85±3.77% at 7cmH2O and 4.45±3.6% at 15cmHL2O Pawy (p<0.05) consistent with hysteresis. Differences between air volumes at 7 and 15 cmH2O measured from either static or gated scans or that delivered by a supersyringe were insignificant (p<0.05). Visual accuracy of 3D anatomic geometry was achieved, and landmark certainty was within 1mm across respiratory cycles. Conclusion: A method has been demonstrated which provides for accurate gating to respiratory signals during axial scanning. High resolution volumetric image datasets are achievable while the scanned subject is breathing.Images are quantitatively similar to breath hold images with differences likely explained by known P-V hysteresis

  20. Reducing radiation dose to selected organs by selecting the tube start angle in MDCT helical scans: A Monte Carlo based study

    SciTech Connect

    Zhang Di; Zankl, Maria; DeMarco, John J.; Cagnon, Chris H.; Angel, Erin; Turner, Adam C.; McNitt-Gray, Michael F.

    2009-12-15

    Purpose: Previous work has demonstrated that there are significant dose variations with a sinusoidal pattern on the peripheral of a CTDI 32 cm phantom or on the surface of an anthropomorphic phantom when helical CT scanning is performed, resulting in the creation of ''hot'' spots or ''cold'' spots. The purpose of this work was to perform preliminary investigations into the feasibility of exploiting these variations to reduce dose to selected radiosensitive organs solely by varying the tube start angle in CT scans. Methods: Radiation dose to several radiosensitive organs (including breasts, thyroid, uterus, gonads, and eye lenses) resulting from MDCT scans were estimated using Monte Carlo simulation methods on voxelized patient models, including GSF's Baby, Child, and Irene. Dose to fetus was also estimated using four pregnant female models based on CT images of the pregnant patients. Whole-body scans were simulated using 120 kVp, 300 mAs, both 28.8 and 40 mm nominal collimations, and pitch values of 1.5, 1.0, and 0.75 under a wide range of start angles (0 deg. - 340 deg. in 20 deg. increments). The relationship between tube start angle and organ dose was examined for each organ, and the potential dose reduction was calculated. Results: Some organs exhibit a strong dose variation, depending on the tube start angle. For small peripheral organs (e.g., the eye lenses of the Baby phantom at pitch 1.5 with 40 mm collimation), the minimum dose can be 41% lower than the maximum dose, depending on the tube start angle. In general, larger dose reductions occur for smaller peripheral organs in smaller patients when wider collimation is used. Pitch 1.5 and pitch 0.75 have different mechanisms of dose reduction. For pitch 1.5 scans, the dose is usually lowest when the tube start angle is such that the x-ray tube is posterior to the patient when it passes the longitudinal location of the organ. For pitch 0.75 scans, the dose is lowest when the tube start angle is such that the x

  1. Feasibility of using single-slice MDCT to evaluate visceral abdominal fat in an urban pediatric population.

    PubMed

    Blitman, Netta M; Baron, Lindsay Stanton; Berkenblit, Robert G; Schoenfeld, Alan H; Markowitz, Morri; Freeman, Katherine

    2011-08-01

    Obesity is a growing clinical problem, especially among children of low socioeconomic status. Increased visceral abdominal fat is implicated in the metabolic syndrome and its health consequences. The purpose of this study is to validate measurement of a single MDCT slice as a predictor of total visceral abdominal fat and to correlate over a wide range of body mass indexes (BMIs). A two-phase retrospective analysis was performed. For validation, MDCTs of 21 consecutive healthy children (8-14 years old) were reviewed. In these cases, visceral abdominal fat and subcutaneous abdominal fat area were calculated using a body fat analysis function from single 0.625-mm MDCT slices at the umbilicus and were compared with total visceral abdominal fat area as measured from T11 to the coccyx. Subsequently, visceral abdominal fat area was obtained from single slices at the umbilicus from abdominal MDCT scans of 146 consecutive healthy children (age range, 6-14 years; 80 boys and 66 girls; 77 Hispanic, 41 African American, 15 white, and 13 multiracial or other race) for whom BMI was available. Associations between visceral abdominal fat area and sex, race, and BMI were determined. Effective radiation dose for a 1.25-mm axial MDCT slice was calculated using a mathematic model that uses derived scaling factors for pediatric patients. Visceral abdominal fat area obtained from a 0.625-mm slice at the umbilicus was highly correlated with total visceral abdominal fat area (r = 0.96; p < 0.0001). Visceral abdominal fat area from single slices at the umbilicus was significantly correlated with BMI (r = 0.72; p < 0.0001). Umbilical visceral abdominal fat area was significantly lower in African American children compared with others (median, 14 vs 22 cm(2); p = 0.02) and was not associated with sex. In our population, the effective radiation dose from the smallest obtainable slice was 0.015-0.019 mSv/37-54 kg of patient weight. Visceral abdominal fat area calculated from a single abdominal

  2. Morphological and functional MDCT: problem-solving tool and surrogate biomarker for hepatic disease clinical care and drug discovery in the era of personalized medicine.

    PubMed

    Wang, Liang

    2010-08-17

    This article explains the significant role of morphological and functional multidetector computer tomography (MDCT) in combination with imaging postprocessing algorithms served as a problem-solving tool and noninvasive surrogate biomarker to effectively improve hepatic diseases characterization, detection, tumor staging and prognosis, therapy response assessment, and novel drug discovery programs, partial liver resection and transplantation, and MDCT-guided interventions in the era of personalized medicine. State-of-the-art MDCT depicts and quantifies hepatic disease over conventional CT for not only depicting lesion location, size, and extent but also detecting changes in tumor biologic behavior caused by therapy or tumor progression before morphologic changes. Color-encoded parameter display provides important functional information on blood flow, permeability, leakage space, and blood volume. Together with other relevant biomarkers and genomics, the imaging modality is being developed and validated as a biomarker to early response to novel, targeted anti-VEGF(R)/PDGFR or antivascular/angiogenesis agents as its parameters correlate with immunohistochemical surrogates of tumor angiogenesis and molecular features of malignancies. MDCT holds incremental value to World Health Organization response criteria and Response Evaluation Criteria in Solid Tumors in liver disease management. MDCT volumetric measurement of future remnant liver is the most important factor influencing the outcome of patients who underwent partial liver resection and transplantation. MDCT-guided interventional methods deliver personalized therapies locally in the human body. MDCT will hold more scientific impact when it is fused with other imaging probes to yield comprehensive information regarding changes in liver disease at different levels (anatomic, metabolic, molecular, histologic, and other levels).

  3. Empathy gaps for social pain: why people underestimate the pain of social suffering.

    PubMed

    Nordgren, Loran F; Banas, Kasia; MacDonald, Geoff

    2011-01-01

    In 5 studies, the authors examined the hypothesis that people have systematically distorted beliefs about the pain of social suffering. By integrating research on empathy gaps for physical pain (Loewenstein, 1996) with social pain theory (MacDonald & Leary, 2005), the authors generated the hypothesis that people generally underestimate the severity of social pain (ostracism, shame, etc.)--a biased judgment that is only corrected when people actively experience social pain for themselves. Using a social exclusion manipulation, Studies 1-4 found that nonexcluded participants consistently underestimated the severity of social pain compared with excluded participants, who had a heightened appreciation for social pain. This empathy gap for social pain occurred when participants evaluated both the pain of others (interpersonal empathy gap) as well as the pain participants themselves experienced in the past (intrapersonal empathy gap). The authors argue that beliefs about social pain are important because they govern how people react to socially distressing events. In Study 5, middle school teachers were asked to evaluate policies regarding emotional bullying at school. This revealed that actively experiencing social pain heightened the estimated pain of emotional bullying, which in turn led teachers to recommend both more comprehensive treatment for bullied students and greater punishment for students who bully.

  4. Brighter galaxy bias: underestimating the velocity dispersions of galaxy clusters

    NASA Astrophysics Data System (ADS)

    Old, L.; Gray, M. E.; Pearce, F. R.

    2013-09-01

    We study the systematic bias introduced when selecting the spectroscopic redshifts of brighter cluster galaxies to estimate the velocity dispersion of galaxy clusters from both simulated and observational galaxy catalogues. We select clusters with Ngal ≥ 50 at five low-redshift snapshots from the publicly available De Lucia & Blaziot semi-analytic model galaxy catalogue. Clusters are also selected from the Tempel Sloan Digital Sky Survey Data Release 8 groups and clusters catalogue across the redshift range 0.021 ≤ z ≤ 0.098. We employ various selection techniques to explore whether the velocity dispersion bias is simply due to a lack of dynamical information or is the result of an underlying physical process occurring in the cluster, for example, dynamical friction experienced by the brighter cluster members. The velocity dispersions of the parent dark matter (DM) haloes are compared to the galaxy cluster dispersions and the stacked distribution of DM particle velocities is examined alongside the corresponding galaxy velocity distribution. We find a clear bias between the halo and the semi-analytic galaxy cluster velocity dispersion on the order of σgal/σDM ˜ 0.87-0.95 and a distinct difference in the stacked galaxy and DM particle velocities distribution. We identify a systematic underestimation of the velocity dispersions when imposing increasing absolute I-band magnitude limits. This underestimation is enhanced when using only the brighter cluster members for dynamical analysis on the order of 5-35 per cent, indicating that dynamical friction is a serious source of bias when using galaxy velocities as tracers of the underlying gravitational potential. In contrast to the literature we find that the resulting bias is not only halo mass dependent but also that the nature of the dependence changes according to the galaxy selection strategy. We make a recommendation that, in the realistic case of limited availability of spectral observations, a strictly

  5. Correlation between epicardial adipose tissue and severity of coronary artery stenosis evaluated by 64-MDCT.

    PubMed

    Yang, Chunying; Li, Liang; Zha, Yunfei; Peng, Zhoufeng

    2016-01-01

    The purpose was to investigate the correlation between epicardial adipose tissue (EAT) thickness, EAT volume, and severity of coronary artery stenosis. We retrospectively enrolled 188 patients that underwent coronary computed tomography (CT) angiography for clinically suspected coronary artery disease using 64-MDCT. Images were reconstructed using a retrospective electrocardiogram-gated algorithm with 0.625-mm-thick sections. EAT thickness and volume were calculated. The coronary CT angiography showed 106 patients who had coronary artery pathology (178 lesions), 21 patients with moderate stenosis (27 lesions), 12 patients with severe stenosis (18 lesions), and 6 patients with complete occlusion (8 lesions). EAT thickness, EAT volume, and Gensini score were statistically different among groups (FT=32.306, FV=27.743, F=110.483, P=.000). Pearson correlation analysis showed that Gensini score had significantly positive correlation with EAT thickness and volume, respectively. EAT thickness and volume demonstrated a positive correlation with severity of coronary artery stenosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. A Numerical Study of Water Loss Rate Distributions in MDCT-based Human Airway Models

    PubMed Central

    Wu, Dan; Miyawaki, Shinjiro; Tawhai, Merryn H.; Hoffman, Eric A.; Lin, Ching-Long

    2015-01-01

    Both three-dimensional (3D) and one-dimensional (1D) computational fluid dynamics (CFD) methods are applied to study regional water loss in three multi-detector row computed-tomography (MDCT)-based human airway models at the minute ventilations of 6, 15 and 30 L/min. The overall water losses predicted by both 3D and 1D models in the entire respiratory tract agree with available experimental measurements. However, 3D and 1D models reveal different regional water loss rate distributions due to the 3D secondary flows formed at bifurcations. The secondary flows cause local skewed temperature and humidity distributions on inspiration acting to elevate the local water loss rate; and the secondary flow at the carina tends to distribute more cold air to the lower lobes. As a result, the 3D model predicts that the water loss rate first increases with increasing airway generation, and then decreases as the air approaches saturation, while the 1D model predicts a monotonic decrease of water loss rate with increasing airway generation. Moreover, the 3D (or 1D) model predicts relatively higher water loss rates in lower (or upper) lobes. The regional water loss rate can be related to the non-dimensional wall shear stress (τ*) by the non-dimensional mass transfer coefficient (h0*) as h0* = 1.15 τ*0.272, R = 0.842. PMID:25869455

  7. Accuracy of gantry rotation time of less than 300 ms for modern MDCT systems.

    PubMed

    Fukuda, Atsushi; Lin, Pei-Jan Paul; Matsubara, Kosuke; Miyati, Tosiaki

    2015-01-01

    The accuracy of gantry rotation times of less than 300 ms has been assessed for two "state-of-the art" MDCT systems. The rotation time was measured at selected nominal rotation times (275 and 280 ms) with a solid-state detector; Unfors Xi probe. The detector was positioned on the inner bottom of the gantry bore. Because a pair of two successive radiation peaks is necessary for determination of the rotation time, the radiation detection was performed with the helical scan mode of operation. Upon completion of the data acquisition, we determined the peak times with the Unfors Xi View software program to obtain the rotation time. The means and standard deviations of the measured rotation times were 275.3 ± 0.5 and 285.1 ± 0.4 ms, respectively. The inaccuracy of the rotation time was approximately 5 ms at most, which was comparable to that previously reported for slower rotation times.

  8. Massive yet grossly underestimated global costs of invasive insects

    PubMed Central

    Bradshaw, Corey J. A.; Leroy, Boris; Bellard, Céline; Roiz, David; Albert, Céline; Fournier, Alice; Barbet-Massin, Morgane; Salles, Jean-Michel; Simard, Frédéric; Courchamp, Franck

    2016-01-01

    Insects have presented human society with some of its greatest development challenges by spreading diseases, consuming crops and damaging infrastructure. Despite the massive human and financial toll of invasive insects, cost estimates of their impacts remain sporadic, spatially incomplete and of questionable quality. Here we compile a comprehensive database of economic costs of invasive insects. Taking all reported goods and service estimates, invasive insects cost a minimum of US$70.0 billion per year globally, while associated health costs exceed US$6.9 billion per year. Total costs rise as the number of estimate increases, although many of the worst costs have already been estimated (especially those related to human health). A lack of dedicated studies, especially for reproducible goods and service estimates, implies gross underestimation of global costs. Global warming as a consequence of climate change, rising human population densities and intensifying international trade will allow these costly insects to spread into new areas, but substantial savings could be achieved by increasing surveillance, containment and public awareness. PMID:27698460

  9. Massive yet grossly underestimated global costs of invasive insects

    NASA Astrophysics Data System (ADS)

    Bradshaw, Corey J. A.; Leroy, Boris; Bellard, Céline; Roiz, David; Albert, Céline; Fournier, Alice; Barbet-Massin, Morgane; Salles, Jean-Michel; Simard, Frédéric; Courchamp, Franck

    2016-10-01

    Insects have presented human society with some of its greatest development challenges by spreading diseases, consuming crops and damaging infrastructure. Despite the massive human and financial toll of invasive insects, cost estimates of their impacts remain sporadic, spatially incomplete and of questionable quality. Here we compile a comprehensive database of economic costs of invasive insects. Taking all reported goods and service estimates, invasive insects cost a minimum of US$70.0 billion per year globally, while associated health costs exceed US$6.9 billion per year. Total costs rise as the number of estimate increases, although many of the worst costs have already been estimated (especially those related to human health). A lack of dedicated studies, especially for reproducible goods and service estimates, implies gross underestimation of global costs. Global warming as a consequence of climate change, rising human population densities and intensifying international trade will allow these costly insects to spread into new areas, but substantial savings could be achieved by increasing surveillance, containment and public awareness.

  10. The risk of sustained sexual transmission of Zika is underestimated.

    PubMed

    Allard, Antoine; Althouse, Benjamin M; Hébert-Dufresne, Laurent; Scarpino, Samuel V

    2017-09-01

    Pathogens often follow more than one transmission route during outbreaks-from needle sharing plus sexual transmission of HIV to small droplet aerosol plus fomite transmission of influenza. Thus, controlling an infectious disease outbreak often requires characterizing the risk associated with multiple mechanisms of transmission. For example, during the Ebola virus outbreak in West Africa, weighing the relative importance of funeral versus health care worker transmission was essential to stopping disease spread. As a result, strategic policy decisions regarding interventions must rely on accurately characterizing risks associated with multiple transmission routes. The ongoing Zika virus (ZIKV) outbreak challenges our conventional methodologies for translating case-counts into route-specific transmission risk. Critically, most approaches will fail to accurately estimate the risk of sustained sexual transmission of a pathogen that is primarily vectored by a mosquito-such as the risk of sustained sexual transmission of ZIKV. By computationally investigating a novel mathematical approach for multi-route pathogens, our results suggest that previous epidemic threshold estimates could under-estimate the risk of sustained sexual transmission by at least an order of magnitude. This result, coupled with emerging clinical, epidemiological, and experimental evidence for an increased risk of sexual transmission, would strongly support recent calls to classify ZIKV as a sexually transmitted infection.

  11. [Venous Paravasation After Augmentation of Pedicle Screws - An Underestimated Risk].

    PubMed

    Prokop, Axel; Sagerer, Manuela; Rupp, Wolfgang; Chmielnicki, Marc

    2017-06-30

    Cement-augmented pedicle screws can increase the stability of fixators for unstable vertebral fractures in the elderly. Fixators can be inserted quickly and with minimally invasive techniques, reducing surgical risks. From March 2012 until July 2014, we treated 40 patients with percutaneous augmented fixators for unstable vertebral fractures. Average age was 77.5 years. During the six month observation period, no patients died. There were no neurological deficits. On VAS, average pain decreased from 8.5 to 4.1 points postoperatively. The average Cobb angle of 4.1° was improved after surgery. After 6 months, bony consolidation yielded angles of 1 to 4°, average 2.6°. There was often venous extravasation of cement leaking from the augmented vertebrae, even extending to pulmonary embolism. The emboli were usually asymptomatic. We report a case where the patient required resuscitation immediately after cement application because of pulmonary emboli. The patient survived because of the immediately implemented critical care measures. Little has been published about this risk, which is underestimated despite increasing numbers of augmented fixator operations. The risk can be reduced with slower cement injection, smaller cement applicators, and short term positive pressure ventilation with PEEP. Georg Thieme Verlag KG Stuttgart · New York.

  12. Awareness, overestimation, and underestimation of cognitive functions in epilepsy.

    PubMed

    Giovagnoli, Anna Rita

    2013-01-01

    This study estimated cognitive awareness and the predictors of self-rating in patients with epilepsy (PWE). The Multiple Ability Self-Report Questionnaire (MASQ), State-Trait Anxiety Inventory, and Beck Depression Inventory were used for self-evaluation. Neuropsychological assessment yielded five single-domain scores (Long-Term Memory, Mental Speed, Working Memory, Set Shifting, and Visuospatial Matching) and a total composite score. Awareness was computed as the concordance between the neuropsychological and MASQ scores. In 37 patients with full awareness, self-ratings were predicted by Long-Term Memory, Working Memory, and Mental Speed. In 58 patients with incomplete or no awareness, self-ratings related to depression and seizure frequency. Compared with overestimation, underestimation was associated with higher test scores, better education, and younger age. Brain lesion and the type of epilepsy showed no effect. Therefore, PWE may appear unaware of their cognitive abilities due to negative affect and clinical burden. Understanding patients' awareness of their cognitive deficits can help clarify the clinical pattern provoked by epilepsy, as well as patients' compliance with treatment for seizures or cognitive difficulties. Copyright © 2012. Published by Elsevier Inc.

  13. Massive yet grossly underestimated global costs of invasive insects.

    PubMed

    Bradshaw, Corey J A; Leroy, Boris; Bellard, Céline; Roiz, David; Albert, Céline; Fournier, Alice; Barbet-Massin, Morgane; Salles, Jean-Michel; Simard, Frédéric; Courchamp, Franck

    2016-10-04

    Insects have presented human society with some of its greatest development challenges by spreading diseases, consuming crops and damaging infrastructure. Despite the massive human and financial toll of invasive insects, cost estimates of their impacts remain sporadic, spatially incomplete and of questionable quality. Here we compile a comprehensive database of economic costs of invasive insects. Taking all reported goods and service estimates, invasive insects cost a minimum of US$70.0 billion per year globally, while associated health costs exceed US$6.9 billion per year. Total costs rise as the number of estimate increases, although many of the worst costs have already been estimated (especially those related to human health). A lack of dedicated studies, especially for reproducible goods and service estimates, implies gross underestimation of global costs. Global warming as a consequence of climate change, rising human population densities and intensifying international trade will allow these costly insects to spread into new areas, but substantial savings could be achieved by increasing surveillance, containment and public awareness.

  14. Ammonia emissions may be substantially underestimated in China.

    PubMed

    Zhang, Xiuming; Wu, Yiyun; Liu, Xuejun; Reis, Stefan; Jin, Jiaxin; Dragosits, Ulrike; Van Damme, Martin; Clarisse, Lieven; Whitburn, Simon; Coheur, Pierre-Francois; Gu, Baojing

    2017-10-06

    China is a global hotspot of atmospheric ammonia (NH3) emissions and, as a consequence, very high nitrogen (N) deposition levels are documented. However, previous estimates of total NH3 emissions in China were much lower than inference from observed deposition values would suggest, highlighting the need for further investigation. Here, we reevaluated NH3 emissions based on a mass balance approach, validated by N deposition monitoring and satellite observations, for China for the period of 2000 to 2015. Total NH3 emissions in China increased from 12.1±0.8 Tg N yr-1 in 2000 to 15.6±0.9 Tg N yr-1 in 2015 at an annual rate of 1.9%, which is approximately 40% higher than existing studies suggested. This difference is mainly due to more emission sources now having been included and NH3 emission rates from mineral fertilizer application and livestock having been underestimated previously. Our estimated NH3 emission levels are consistent with the measured deposition of NHx (including NH4+ and NH3) on land (11-14 Tg N yr-1) and the substantial increases in NH3 concentrations observed by satellite measurements over China. These findings substantially improve our understanding on NH3 emissions, implying that future air pollution control strategies have to consider the potentials of reducing NH3 emission in China.

  15. Satellite methods underestimate indirect climate forcing by aerosols

    PubMed Central

    Penner, Joyce E.; Xu, Li; Wang, Minghuai

    2011-01-01

    Satellite-based estimates of the aerosol indirect effect (AIE) are consistently smaller than the estimates from global aerosol models, and, partly as a result of these differences, the assessment of this climate forcing includes large uncertainties. Satellite estimates typically use the present-day (PD) relationship between observed cloud drop number concentrations (Nc) and aerosol optical depths (AODs) to determine the preindustrial (PI) values of Nc. These values are then used to determine the PD and PI cloud albedos and, thus, the effect of anthropogenic aerosols on top of the atmosphere radiative fluxes. Here, we use a model with realistic aerosol and cloud processes to show that empirical relationships for ln(Nc) versus ln(AOD) derived from PD results do not represent the atmospheric perturbation caused by the addition of anthropogenic aerosols to the preindustrial atmosphere. As a result, the model estimates based on satellite methods of the AIE are between a factor of 3 to more than a factor of 6 smaller than model estimates based on actual PD and PI values for Nc. Using ln(Nc) versus ln(AI) (Aerosol Index, or the optical depth times angstrom exponent) to estimate preindustrial values for Nc provides estimates for Nc and forcing that are closer to the values predicted by the model. Nevertheless, the AIE using ln(Nc) versus ln(AI) may be substantially incorrect on a regional basis and may underestimate or overestimate the global average forcing by 25 to 35%. PMID:21808047

  16. Quantifying Greenland freshwater flux underestimates in climate models

    NASA Astrophysics Data System (ADS)

    Little, Christopher M.; Piecuch, Christopher G.; Chaudhuri, Ayan H.

    2016-05-01

    Key processes regulating the mass balance of the Greenland Ice Sheet (GIS) are not represented in current-generation climate models. Here using output from 19 different climate models forced with a high-end business-as-usual emissions pathway, we compare modeled freshwater fluxes (FWF) to a parameterization based on midtropospheric temperature. By the mid 21st century, parameterized GIS FWF is 478 ± 215 km3 yr-1 larger than modeled—over 3 times the 1992-2011 rate of GIS mass loss. By the late 21st century, ensemble mean parameterized GIS FWF anomalies are comparable to FWF anomalies over the northern North Atlantic Ocean, equivalent to approximately 11 cm of global mean sea level rise. The magnitude and spread of these underestimates underscores the need for assessments of the coupled response of the ocean to increased FWF that recognize: (1) the widely varying freshwater budgets of each model and (2) uncertainty in the relationship between GIS FWF and atmospheric temperature.

  17. The underestimation of egocentric distance: evidence from frontal matching tasks

    PubMed Central

    Li, Zhi; Phillips, John

    2011-01-01

    There is controversy over the existence, nature, and cause of error in egocentric distance judgments. One proposal is that the systematic biases often found in explicit judgments of egocentric distance along the ground may be related to recently observed biases in the perceived declination of gaze (Durgin & Li, Attention, Perception, & Psychophysics, in press), To measure perceived egocentric distance nonverbally, observers in a field were asked to position themselves so that their distance from one of two experimenters was equal to the frontal distance between the experimenters. Observers placed themselves too far away, consistent with egocentric distance underestimation. A similar experiment was conducted with vertical frontal extents. Both experiments were replicated in panoramic virtual reality. Perceived egocentric distance was quantitatively consistent with angular bias in perceived gaze declination (1.5 gain). Finally, an exocentric distance-matching task was contrasted with a variant of the egocentric matching task. The egocentric matching data approximate a constant compression of perceived egocentric distance with a power function exponent of nearly 1; exocentric matches had an exponent of about 0.67. The divergent pattern between egocentric and exocentric matches suggests that they depend on different visual cues. PMID:21735313

  18. The underestimation of egocentric distance: evidence from frontal matching tasks.

    PubMed

    Li, Zhi; Phillips, John; Durgin, Frank H

    2011-10-01

    There is controversy over the existence, nature, and cause of error in egocentric distance judgments. One proposal is that the systematic biases often found in explicit judgments of egocentric distance along the ground may be related to recently observed biases in the perceived declination of gaze (Durgin & Li, Attention, Perception, & Psychophysics, in press), To measure perceived egocentric distance nonverbally, observers in a field were asked to position themselves so that their distance from one of two experimenters was equal to the frontal distance between the experimenters. Observers placed themselves too far away, consistent with egocentric distance underestimation. A similar experiment was conducted with vertical frontal extents. Both experiments were replicated in panoramic virtual reality. Perceived egocentric distance was quantitatively consistent with angular bias in perceived gaze declination (1.5 gain). Finally, an exocentric distance-matching task was contrasted with a variant of the egocentric matching task. The egocentric matching data approximate a constant compression of perceived egocentric distance with a power function exponent of nearly 1; exocentric matches had an exponent of about 0.67. The divergent pattern between egocentric and exocentric matches suggests that they depend on different visual cues.

  19. [Postoperative 30-day mortality may underestimate the risk of esophagectomy].

    PubMed

    Huang, Chuan; Yang, Yongbo; Yan, Wanpu; Dai, Liang; Kang, Xiaozheng; Chen, Keneng

    2015-09-01

    To summarize the mortality of esophagectomy in our series and compare the different mortalities based on 30-day deaths and 90-day deaths postoperatively. A total of 954 patients undergoing esophagectomy by single-surgeon-team between January 2000 and December 2012 from our prospective database were enrolled. The mortalities based on 30-day and 90-day deaths postoperatively were compared, and the causes of deaths within 30 days and 90 days were analyzed. Among all these 954 patients, a total of 20 postoperative deaths(2.1%) were observed: 11 within 30 days(1.1%) and 9 between 30 and 90 days after surgery(1.0%). The reasons for deaths within 30 days were as follows: 3 for respiratory failure related to anastomotic leakage,1 for bleeding after stenting due to anastomotic fistula, 1 for sepsis, 3 for respiratory failure from presenting preoperative respiratory morbidities, 2 for cardiac arrest caused by preoperative heart disorder, and 1 for multiple organ failure caused by early adjuvant chemotoxicity. The reasons for deaths between 30 and 90 days were as follows: 1 for respiratory failure related to anastomotic leakage, 1 for cardiac arrest from preoperative heart disorder, 1 for cerebrovascular accident, 1 for liver failure from liver cirrhosis presenting preoperatively, 1 for renal failure after operation, 1 for tumor progression and 2 for unknown reasons. Since postoperative mortality calculated based on 30 days deaths postoperatively may underestimate the risk of esophagectomy, mortality calculated based on 90 days may be a better option.

  20. Care Received by Elderly US Stroke Survivors May Be Underestimated.

    PubMed

    Skolarus, Lesli E; Freedman, Vicki A; Feng, Chunyang; Wing, Jeffrey J; Burke, James F

    2016-08-01

    Previous studies exploring stroke-related caregiving focused solely on informal caregiving and a relatively limited set of activities. We sought to determine whether, and at what cost, stroke survivors receive more care than matched controls using an expanded definition of caregiving and inclusion of paid caregivers. Data were drawn from the National Health and Aging Trends Study (NHATS), a nationally representative survey of Medicare beneficiaries. NHATS personnel conducted in-person interviews with respondents or proxies to determine the weekly hours of care received. We compared hours of assistance received between self-reported stroke survivors (n=892) and demography- and comorbidity-matched nonstroke controls (n=892). The annual cost of stroke caregiving was estimated using reported paid caregiving data and estimates of unpaid caregiving costs. Of community-dwelling elderly stroke survivors, 51.4% received help from a caregiver. Stroke survivors received an average of 10 hours of additional care per week compared with demography- and comorbidity-matched controls (22.3 hours versus 11.8 hours; P<0.01). We estimate that the average annual cost for caregiving for an elderly stroke survivor is ≈$11 300 or ≈$40 billion annually, for all elderly stroke survivors, of which $5000 per person, or $18.2 billion annually, is specific to stroke. Although stroke survivors are known to require considerable caregiving resources, our findings suggest that previous assessments may underestimate hours of care received and hence costs. © 2016 American Heart Association, Inc.

  1. Utility of Postmortem Autopsy via Whole-Body Imaging: Initial Observations Comparing MDCT and 3.0T MRI Findings with Autopsy Findings

    PubMed Central

    Cha, Jang Gyu; Kim, Dong Hun; Kim, Dae Ho; Paik, Sang Hyun; Park, Jai Soung; Park, Seong Jin; Lee, Hae Kyung; Hong, Hyun Sook; Choi, Duek Lin; Chung, Nak Eun; Lee, Bong Woo; Seo, Joong Seok

    2010-01-01

    Objective We prospectively compared whole-body multidetector computed tomography (MDCT) and 3.0T magnetic resonance (MR) images with autopsy findings. Materials and Methods Five cadavers were subjected to whole-body, 16-channel MDCT and 3.0T MR imaging within two hours before an autopsy. A radiologist classified the MDCT and 3.0T MRI findings into major and minor findings, which were compared with autopsy findings. Results Most of the imaging findings, pertaining to head and neck, heart and vascular, chest, abdomen, spine, and musculoskeletal lesions, corresponded to autopsy findings. The causes of death that were determined on the bases of MDCT and 3.0T MRI findings were consistent with the autopsy findings in four of five cases. CT was useful in diagnosing fatal hemorrhage and pneumothorax, as well as determining the shapes and characteristics of the fractures and the direction of external force. MRI was effective in evaluating and tracing the route of a metallic object, soft tissue lesions, chronicity of hemorrhage, and bone bruises. Conclusion A postmortem MDCT combined with MRI is a potentially powerful tool, providing noninvasive and objective measurements for forensic investigations. PMID:20592923

  2. Dynamic left ventricular outflow tract obstruction: underestimated cause of hypotension and hemodynamic instability

    PubMed Central

    2014-01-01

    Left ventricular outflow tract obstruction, which is typically associated with hypertrophic cardiomyopathy, is the third most frequent cause of unexplained hypotension. This underestimated problem may temporarily accompany various diseases (it is found in even <1% of patients with no tangible cardiac disease) and clinical situations (hypovolemia, general anesthesia). It is currently assumed that left ventricular outflow tract obstruction is a dynamic phenomenon, the occurrence of which requires the coexistence of predisposing anatomic factors and a physiological condition that induces it. The diagnosis of left ventricular outflow tract obstruction should entail immediate implementation of the therapy to eliminate the factors that can potentially intensify the obstruction. Echocardiography is the basic modality in the diagnosis and treatment of left ventricular outflow tract obstruction. This paper presents four patients in whom the immediate implementation of bedside echocardiography enabled a rapid diagnosis of left ventricular outflow tract obstruction and implementation of proper treatment. PMID:26674265

  3. Correcting eddy-covariance flux underestimates over a grassland.

    SciTech Connect

    Twine, T. E.; Kustas, W. P.; Norman, J. M.; Cook, D. R.; Houser, P. R.; Meyers, T. P.; Prueger, J. H.; Starks, P. J.; Wesely, M. L.; Environmental Research; Univ. of Wisconsin at Madison; DOE; National Aeronautics and Space Administration; National Oceanic and Atmospheric Administrationoratory

    2000-06-08

    Independent measurements of the major energy balance flux components are not often consistent with the principle of conservation of energy. This is referred to as a lack of closure of the surface energy balance. Most results in the literature have shown the sum of sensible and latent heat fluxes measured by eddy covariance to be less than the difference between net radiation and soil heat fluxes. This under-measurement of sensible and latent heat fluxes by eddy-covariance instruments has occurred in numerous field experiments and among many different manufacturers of instruments. Four eddy-covariance systems consisting of the same models of instruments were set up side-by-side during the Southern Great Plains 1997 Hydrology Experiment and all systems under-measured fluxes by similar amounts. One of these eddy-covariance systems was collocated with three other types of eddy-covariance systems at different sites; all of these systems under-measured the sensible and latent-heat fluxes. The net radiometers and soil heat flux plates used in conjunction with the eddy-covariance systems were calibrated independently and measurements of net radiation and soil heat flux showed little scatter for various sites. The 10% absolute uncertainty in available energy measurements was considerably smaller than the systematic closure problem in the surface energy budget, which varied from 10 to 30%. When available-energy measurement errors are known and modest, eddy-covariance measurements of sensible and latent heat fluxes should be adjusted for closure. Although the preferred method of energy balance closure is to maintain the Bowen-ratio, the method for obtaining closure appears to be less important than assuring that eddy-covariance measurements are consistent with conservation of energy. Based on numerous measurements over a sorghum canopy, carbon dioxide fluxes, which are measured by eddy covariance, are underestimated by the same factor as eddy covariance evaporation

  4. Managing the underestimated risk of statin-associated myopathy.

    PubMed

    Rallidis, Loukianos S; Fountoulaki, Katerina; Anastasiou-Nana, Maria

    2012-09-06

    In clinical practice 5-10% of patients receiving statins develop myopathy, a side effect that had been systematically underestimated in the randomized controlled trials with statins. The most common manifestation of myopathy is muscle pain (usually symmetrical, involving proximal muscles) without creatinine kinase (CK) elevation or less frequently with mild CK elevation. Clinically significant rhabdomyolysis (muscle symptoms with CK elevation >10 times the upper limit of normal and with creatinine elevation) is extremely rare. Myopathy complicates the use of all statins (class effect) and is dose-dependent. The pathophysiologic mechanism of statin-associated myopathy is unknown and probably multifactorial. The risk of statin-associated myopathy can be minimized by identifying vulnerable patients (i.e. patients with impaired renal or liver function, advanced age, hypothyroidism, etc.) and/or by eliminating-avoiding statin interactions with specific drugs (cytochrome P-450 3A4 inhibitors, gemfibrozil, etc.). In symptomatic patients, the severity of symptoms, the magnitude of CK elevation and the risk/benefit ratio of statin continuation should be considered before statin treatment is discontinued. Potential strategies are the use of the same statin at a lower dose and if symptoms recur the initiation of fluvastatin XL 80 mg daily or rosuvastatin intermittently in low dose (5-10mg), combined usually with ezetimibe 10mg daily. Failure of these approaches necessitates the use of non-statin lipid lowering drugs (ezetimibe, colesevelam). In order to provide evidence based recommendations for the appropriate management of statin-intolerant patients we need randomized clinical trials directly comparing the myopathic potential of different lipid-lowering medications at comparable doses.

  5. Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan

    PubMed Central

    Kobayashi, Taiichiro; Yano, Hideaki; Murata, Yukinori; Igari, Toru; Nakada-Tsukui, Kumiko; Yagita, Kenji; Nozaki, Tomoyoshi; Kaku, Mitsuo; Tsukada, Kunihisa; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Oka, Shinichi

    2016-01-01

    ABSTRACT Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis. PMID:27847377

  6. Underestimated Amoebic Appendicitis among HIV-1-Infected Individuals in Japan.

    PubMed

    Kobayashi, Taiichiro; Watanabe, Koji; Yano, Hideaki; Murata, Yukinori; Igari, Toru; Nakada-Tsukui, Kumiko; Yagita, Kenji; Nozaki, Tomoyoshi; Kaku, Mitsuo; Tsukada, Kunihisa; Gatanaga, Hiroyuki; Kikuchi, Yoshimi; Oka, Shinichi

    2017-01-01

    Entamoeba histolytica is not a common causative agent of acute appendicitis. However, amoebic appendicitis can sometimes be severe and life threatening, mainly due to a lack of awareness. Also, its frequency, clinical features, and pathogenesis remain unclear. The study subjects were HIV-1-infected individuals who presented with acute appendicitis and later underwent appendectomy at our hospital between 1996 and 2014. Formalin-fixed paraffin-embedded preserved appendix specimens were reexamined by periodic acid-Schiff (PAS) staining and PCR to identify undiagnosed amoebic appendicitis. Appendectomies were performed in 57 patients with acute appendicitis. The seroprevalence of E. histolytica was 33% (14/43) from the available stored sera. Based on the medical records, only 3 cases were clinically diagnosed as amoebic appendicitis, including 2 diagnosed at the time of appendectomy and 1 case diagnosed by rereview of the appendix after the development of postoperative complications. Retrospective analyses using PAS staining and PCR identified 3 and 3 more cases, respectively. Thus, E. histolytica infection was confirmed in 9 cases (15.8%) in the present study. Apart from a significantly higher leukocyte count in E. histolytica-positive patients than in negative patients (median, 13,760 versus 10,385 cells/μl, respectively, P = 0.02), there were no other differences in the clinical features of the PCR-positive and -negative groups. In conclusion, E. histolytica infection was confirmed in 9 (15.8%) of the appendicitis cases. However, only 3, including one diagnosed after intestinal perforation, were diagnosed before the present analyses. These results strongly suggest there is frequently a failure to detect trophozoites in routine examination, resulting in an underestimation of the incidence of amoebic appendicitis. Copyright © 2016 Kobayashi et al.

  7. Body Mass Index Underestimates Adiposity in Persons With Multiple Sclerosis.

    PubMed

    Pilutti, Lara A; Motl, Robert W

    2016-03-01

    To examine the relation between body mass index (BMI) and adiposity assessed by dual-energy x-ray absorptiometry in persons with multiple sclerosis (MS) and non-MS controls as well as to determine the accuracy of standard and alternate BMI thresholds for obesity. Cross-sectional. University research laboratory. The sample included persons with MS (n=235) and controls (n=53) (N=288). Not applicable. Main outcome measures included BMI, whole body soft tissue composition (ie, percent body fat [%BF], fat mass, and lean soft tissue mass), bone mineral content, and bone mineral density. We observed significant strong associations between BMI and sex-specific %BF in persons with MS and non-MS controls, and BMI explained ∼40% of the variance in %BF in both MS and control samples. Receiver operating characteristic curve analyses indicated that the standard BMI threshold for obesity (ie, 30kg/m(2)) had excellent specificity (93%-100%) but poor sensitivity (37%-44%) in persons with MS and non-MS controls. The BMI threshold that best identified %BF-defined obesity was 24.7kg/m(2) in the MS sample and 25.1kg/m(2) in the control sample. We determined a strong association between BMI and adiposity; however, the current BMI threshold for classifying obesity underestimates true adiposity in persons with MS. A similar relation was observed between BMI and obesity in non-MS controls. The non-MS sample included primarily middle-aged women, and similar BMI-%BF misclassifications have been reported in these samples. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Do general circulation models underestimate the natural variability in the artic climate?

    SciTech Connect

    Battisti, D.S.; Bitz, C.M.; Moritz, R.E.

    1997-08-01

    The authors examine the natural variability of the arctic climate system simulated by two very different models: the Geophysical Fluid Dynamics Laboratory (GFDL) global climate model, and an area-averaged model of the arctic atmosphere-sea ice-upper-ocean system called the polar cap climate model, the PCCM. A 1000-yr integration of the PCCM is performed in which the model is driven by a prescribed, stochastic atmospheric energy flux convergence (D), which has spectral characteristics that are identical to the spectra of the observed D. The standard deviation of the yearly mean sea ice thickness from this model is 0.85 m; the mean sea ice thickness is 3.1 m. In contrast, the standard deviation of the yearly averaged sea ice thickness in the GFDL climate model is found to be about 6% of the climatological mean thickness and only 24% of that simulated by the PCCM. A series of experiments is presented to determine the cause of these disparate results. First, after changing the treatment of sea ice and snow albedo in the (standard) PCCM model to be identical thermodynamically to that in the GFDL model, the PCCM is driven with D from the GFDL control integration to demonstrate that the PCCM model produces an arctic climate similar to that of the GFDL model. Integrations of the PCCM are then examined in which the different prescriptions of the sea ice treatment (GFDL vs standard PCCM) and D (GFDL vs observed) are permutated. The authors present calculations that indicate the variability in the sea ice thickness is extremely sensitive to the spectrum of the atmospheric energy flux convergence. A conservative best estimate for the amplitude of the natural variability in the arctic sea ice volume is presented.The results suggest that most of the global climate models that have been used to evaluate climate change may also have artificially quiescent variability in the Arctic. 24 refs., 6 figs., 3 tabs.

  9. VARIANCES MAY BE UNDERESTIMATED USING AVAILABLE SOFTWARE FOR GENERALIZED ADDITIVE MODELS. (R829213)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  10. VARIANCES MAY BE UNDERESTIMATED USING AVAILABLE SOFTWARE FOR GENERALIZED ADDITIVE MODELS. (R829213)

    EPA Science Inventory

    The perspectives, information and conclusions conveyed in research project abstracts, progress reports, final reports, journal abstracts and journal publications convey the viewpoints of the principal investigator and may not represent the views and policies of ORD and EPA. Concl...

  11. MDCT arthrography of the hip: value of the adaptive statistical iterative reconstruction technique and potential for radiation dose reduction.

    PubMed

    Tobalem, Frank; Dugert, Eric; Verdun, Francis R; Dunet, Vincent; Ott, Julien G; Rudiger, Hannes A; Cherix, Stephane; Meuli, Reto; Becce, Fabio

    2014-12-01

    The purpose of this article is to assess the effect of the adaptive statistical iterative reconstruction (ASIR) technique on image quality in hip MDCT arthrography and to evaluate its potential for reducing radiation dose. Thirty-seven patients examined with hip MDCT arthrography were prospectively randomized into three different protocols: one with a regular dose (volume CT dose index [CTDIvol], 38.4 mGy) and two with a reduced dose (CTDIvol, 24.6 or 15.4 mGy). Images were reconstructed using filtered back projection (FBP) and four increasing percentages of ASIR (30%, 50%, 70%, and 90%). Image noise and contrast-to-noise ratio (CNR) were measured. Two musculoskeletal radiologists independently evaluated several anatomic structures and image quality parameters using a 4-point scale. They also jointly assessed acetabular labrum tears and articular cartilage lesions. With decreasing radiation dose level, image noise statistically significantly increased (p=0.0009) and CNR statistically significantly decreased (p=0.001). We also found a statistically significant reduction in noise (p=0.0001) and increase in CNR (p≤0.003) with increasing percentage of ASIR; in addition, we noted statistically significant increases in image quality scores for the labrum and cartilage, subchondral bone, overall diagnostic quality (up to 50% ASIR), and subjective noise (p≤0.04), and statistically significant reductions for the trabecular bone and muscles (p≤0.03). Regardless of the radiation dose level, there were no statistically significant differences in the detection and characterization of labral tears (n=24; p=1) and cartilage lesions (n=40; p≥0.89) depending on the ASIR percentage. The use of up to 50% ASIR in hip MDCT arthrography helps to reduce radiation dose by approximately 35-60%, while maintaining diagnostic image quality comparable to that of a regular-dose protocol using FBP.

  12. Vascular Injuries to the Neck After Penetrating Trauma: Diagnostic Performance of 40- and 64-MDCT Angiography.

    PubMed

    Bodanapally, Uttam K; Dreizin, David; Sliker, Clint W; Boscak, Alexis R; Reddy, Ramachandra P

    2015-10-01

    The purposes of this study were to assess the diagnostic performance of 40- and 64-MDCT angiography with digital subtraction angiography as the reference standard in the detection of arterial injuries in patients at high risk after penetrating neck trauma and to perform a separate analysis of injuries to the external carotid artery. In a retrospective evaluation of 53 sets of angiograms from 51 patients with penetrating neck injury, three reviewers unaware of the digital subtraction angiographic findings reviewed the CT angiographic (CTA) images to discern the presence or absence of arterial injuries. Sensitivity and specificity of CTA were calculated per injury, and a separate analysis of external carotid artery injuries was performed. Sensitivity of CTA for detecting arterial injuries ranged from 75.7% (95% CI, 62.3-86.9%) to 82.2% (95% CI, 69.5-92.1%). Specificity ranged from 96.4% (95% CI, 94.0-98.4%) to 98.4% (95% CI, 96.0-100%). CTA was highly sensitive for detection of the subgroup of injuries involving the large-caliber vessels that contribute to cerebral circulation. These sensitivities ranged from 92.8% (95% CI, 66-98.8%) to 100% (95% CI, 76.6-100%) for internal carotid artery injuries and from 88.9% (95% CI, 65.2-98.3%) to 94.4% (95% CI, 72.6-99.0%) for vertebral artery injuries. In contrast, sensitivity of CTA was limited for external carotid artery injuries, ranging from 63.4% (95% CI, 45.5-79.5%) to 70.0% (95% CI, 52.0-85.0%). CTA can be used for initial evaluation and may help guide management decisions if an external carotid artery injury is detected. Negative findings should not preclude close clinical follow-up, repeat CTA evaluation, or, in the presence of high suspicion of arterial injury due to clinical findings or wound trajectory, evaluation with digital subtraction angiography.

  13. Noninvasive detection of cardiac amyloidosis using delayed enhanced MDCT: a pilot study.

    PubMed

    Deux, Jean-François; Mihalache, Cristian-Ionut; Legou, François; Damy, Thibaud; Mayer, Julie; Rappeneau, Stéphane; Planté-Bordeneuve, Violaine; Luciani, Alain; Kobeiter, Hicham; Rahmouni, Alain

    2015-08-01

    To evaluate myocardial enhancement of patients with cardiac amyloidosis (CA) using computed tomography (CT). Thirteen patients with CA and 11 control patients were examined with first-pass and delayed CT acquisition. A qualitative and quantitative analysis of images was performed. Myocardial attenuation, myocardial signal-to-noise ratio (SNRmyoc), blood pool SNR (SNRblood), contrast-to-noise ratio between blood pool and myocardium (CNRblood-myoc) and relative attenuation index (RAI) defined as variation of myocardial attenuation between delayed and first-pass acquisitions were calculated. Two false negative cases (15 %) and three false positive cases (27 %) were detected on qualitative analysis. SNRmyoc of patients with CA was significantly (p < 0.05) lower on first-pass (4.08 ± 1.9) and higher on delayed acquisition (7.10 ± 2.7) than control patients (6.1 ± 2.2 and 5.03 ± 1.8, respectively). Myocardial attenuation was higher in CA (121 ± 39 HU) than control patients (81 ± 17 HU) on delayed acquisition. CNRblood-myoc was significantly (p < 0.05) lower in CA (1.51 ± 0.7) than control patients (2.85 ± 1.2) on delayed acquisition. The RAI was significantly (p < 0.05) higher in CA (0.12 ± 0.25) than in control patients (-0.56 ± 0.21). Dual phase MDCT can detect abnormal myocardial enhancement in patients with CA. • CT can detect abnormal first-pass and delayed enhancement in cardiac amyloidosis. • Measurement of relative myocardial enhancement between acquisitions helps to detect cardiac amyloidosis. • CT may provide useful data to diagnose cardiac amyloidosis.

  14. A Numerical Study of Heat and Water Vapor Transfer in MDCT-Based Human Airway Models

    PubMed Central

    Wu, Dan; Tawhai, Merryn H.; Hoffman, Eric A.; Lin, Ching-Long

    2014-01-01

    A three-dimensional (3D) thermo-fluid model is developed to study regional distributions of temperature and water vapor in three multi-detector row computed-tomography (MDCT)-basedhuman airwayswith minute ventilations of 6, 15 and 30 L/min. A one-dimensional (1D) model is also solved to provide necessary initial and boundary conditionsforthe 3D model. Both 3D and 1D predicted temperature distributions agree well with available in vivo measurement data. On inspiration, the 3D cold high-speed air stream is split at the bifurcation to form secondary flows, with its cold regions biased toward the inner wall. The cold air flowing along the wall is warmed up more rapidly than the air in the lumen center. The repeated splitting pattern of air streams caused by bifurcations acts as an effective mechanism for rapid heat and mass transfer in 3D. This provides a key difference from the 1D model, where heating relies largely on diffusion in the radial direction, thus significantly affecting gradient-dependent variables, such as energy flux and water loss rate. We then propose the correlations for respective heat and mass transfer in the airways of up to 6 generations: Nu=3.504(ReDaDt)0.277, R = 0.841 and Sh=3.652(ReDaDt)0.268, R = 0.825, where Nu is the Nusselt number, Sh is the Sherwood number, Re is the branch Reynolds number, Da is the airway equivalent diameter, and Dt is the tracheal equivalentdiameter. PMID:25081386

  15. MDCT in the assessment of laryngeal trauma: value of 2D multiplanar and 3D reconstructions.

    PubMed

    Becker, Minerva; Duboé, Pier-Olivier; Platon, Alexandra; Kohler, Romain; Tasu, Jean-Pierre; Becker, Christoph D; Poletti, Pierre-Alexandre

    2013-10-01

    The purpose of this study was to analyze fracture patterns and related effects of laryngeal trauma and to assess the value of 2D multiplanar reformation (MPR) and 3D reconstruction. Among 4222 consecutively registered trauma patients who underwent emergency MDCT, 38 patients had presented with laryngeal trauma. Axial, 2D MPR, 3D volume-rendered, and virtual endoscopic images were analyzed retrospectively by two blinded observers according to predefined criteria. Laryngeal fractures, soft-tissue injuries, and airway compromise were evaluated and correlated with clinical, endoscopic, surgical, and follow-up findings. Fifty-nine fractures (37 thyroid, 13 cricoid, nine arytenoid) were present in 38 patients. They were isolated in 21 (55%) patients. The other 17 (45%) patients had additional injuries to the neck, face, brain, chest, or abdomen. Laryngeal fractures were bilateral in 31 (82%) patients and were associated with hyoid bone fractures in nine (24%) patients. Arytenoid luxation was present in eight cartilages. Axial imaging missed 7 of 59 (12%) laryngeal fractures, six of eight (75%) arytenoid luxations, and four of nine (44%) hyoid bone fractures. Additional 2D MPR imaging missed 5 of 59 (8%) laryngeal fractures, five of eight (62.5%) arytenoid luxations, and two of nine (22%) hyoid bone fractures, whereas 3D volume-rendered images depicted them all. Virtual endoscopy and 3D volume rendering added diagnostic accuracy with respect to the length, width, shape, and spatial orientation of fractures in 22 of 38 (58%) patients; arytenoid luxation in six of eight (75%) luxations; and the evaluation of airway narrowing in 19 of 38 (50%) patients. Three-dimensional volume rendering was not of additional value in evaluation of the cricoid cartilage. The use of 2D MPR and 3D volume rendering with or without virtual endoscopy improved assessment of thyroid and hyoid bone fractures, arytenoid luxations, and laryngotracheal narrowing, providing helpful data for optimal

  16. A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

    SciTech Connect

    Yin, Youbing; Choi, Jiwoong; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

    2013-07-01

    A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C{sub 1} continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung.

  17. A multiscale MDCT image-based breathing lung model with time-varying regional ventilation

    NASA Astrophysics Data System (ADS)

    Yin, Youbing; Choi, Jiwoong; Hoffman, Eric A.; Tawhai, Merryn H.; Lin, Ching-Long

    2013-07-01

    A novel algorithm is presented that links local structural variables (regional ventilation and deforming central airways) to global function (total lung volume) in the lung over three imaged lung volumes, to derive a breathing lung model for computational fluid dynamics simulation. The algorithm constitutes the core of an integrative, image-based computational framework for subject-specific simulation of the breathing lung. For the first time, the algorithm is applied to three multi-detector row computed tomography (MDCT) volumetric lung images of the same individual. A key technique in linking global and local variables over multiple images is an in-house mass-preserving image registration method. Throughout breathing cycles, cubic interpolation is employed to ensure C1 continuity in constructing time-varying regional ventilation at the whole lung level, flow rate fractions exiting the terminal airways, and airway deformation. The imaged exit airway flow rate fractions are derived from regional ventilation with the aid of a three-dimensional (3D) and one-dimensional (1D) coupled airway tree that connects the airways to the alveolar tissue. An in-house parallel large-eddy simulation (LES) technique is adopted to capture turbulent-transitional-laminar flows in both normal and deep breathing conditions. The results obtained by the proposed algorithm when using three lung volume images are compared with those using only one or two volume images. The three-volume-based lung model produces physiologically-consistent time-varying pressure and ventilation distribution. The one-volume-based lung model under-predicts pressure drop and yields un-physiological lobar ventilation. The two-volume-based model can account for airway deformation and non-uniform regional ventilation to some extent, but does not capture the non-linear features of the lung.

  18. Gleason underestimation is predicted by prostate biopsy core length.

    PubMed

    Reis, Leonardo O; Sanches, Brunno C F; de Mendonça, Gustavo Borges; Silva, Daniel M; Aguiar, Tiago; Menezes, Ocivaldo P; Billis, Athanase

    2015-06-01

    To evaluate whether core length impacts biopsy accuracy and Gleason score underestimation compared to radical prostatectomy (RP) specimens. From 2010 to 2011, 8,928 cores were trans-rectal obtained from 744 consecutive patients (178 RP, 24%), 557 by an experienced performer (>250/year) and 187 (25%) by in-training urology residents. Prospectively analyzed variables were core length, age, prostate volume, free and total prostate-specific antigen (PSA), PSA density and free/total PSA ratio. Mean core length for Gleason upgrading on RP (42.7%, n = 76) was 11.61 (±2.5, median 11.40) compared to 13.52 (±3.2, median 13.70), p < 0.001 for perfect biopsy-RP Gleason agreement (57.3%, n = 102). In multivariate analysis, for each unit of core length increment in millimeter, the Gleason upgrading risk decreased 89.9%, p = 0.049 [odds ratio (OR) 0.10, 95% confidence interval (CI) 0.01-0.99]. Biopsy positivity between experienced (35.5%) and in-training performer (30.1%) was not significantly different (p = 0.20), with comparable mean patient age (65.1 vs. 64.1), prostate volume (52.3 vs. 50.7) and median PSA (5.2 vs. 5.1), respectively. Denoting wider variability in terms of core length, in-training performers obtained significantly larger cores for positive biopsies (11.33 ± 3.42 vs. 10.83 ± 3.68), p = 0.043, compared to experienced performer (11.39 ± 3.36 vs. 11.37 ± 3.64), p = 0.30. In multivariate analysis, PSA density (OR 1.14, 95% CI 1.02-1.28) and age (OR 1.04, 95% CI 1.01-1.07) were significantly associated with biopsy positivity, p = 0.021 and p = 0.011, respectively. While core length on trans-rectal biopsy independently affects Gleason upgrading on RP specimens, performer experience has minor impact on Gleason discordance or biopsy positivity due to a sharp learning curve.

  19. METABOLIC ACIDOSIS--AN UNDERESTIMATED PROBLEM AFTER KIDNEY TRANSPLANTATION?.

    PubMed

    Katalinić, Lea; Blaslov, Kristina; Đanić-Hadžibegović, Ana; Gellineo, Lana; Kes, Petar; Jelaković, Bojan; Basić-Jukić, Nikolina

    2015-12-01

    acidosis to be linked with significantly higher creatinine and urea levels, decreased creatinine clearance and lower calcium levels. Nevertheless, metabolic acidosis still stays a highly underestimated problem among nephrologists dealing with transplant recipients. We suggest regular determination of the acid-base status in renal transplant recipients.

  20. What Pacific tsunamis tell us about underestimating hazard and risk

    NASA Astrophysics Data System (ADS)

    Goff, J. R.

    2011-12-01

    occurred in prehistory than have occurred in historic time. Larger events have occurred in prehistory than have been modelled in any probabilistic tsunami hazard assessment. This talk presents work that draws together much of the geological, TEK and archaeological evidence for such events and makes one key point - palaeotsunamis have had significant impact upon prehistoric coastal settlements and culture. We are currently underestimating the hazard and this does little to help in our assessment of the risk.

  1. Hydatid of Morgagni: a possible underestimated cause of unexplained infertility.

    PubMed

    Rasheed, Salah M; Abdelmonem, Allam M

    2011-09-01

    To evaluate the possible role of hydatid of Morgagni in patients with unexplained infertility. This was a non-randomized controlled trial conducted at the Department of Obstetrics and Gynecology of Sohag University, Egypt. Two hundred and thirteen patients with unexplained infertility and hydatid of Morgagni diagnosed at laparoscopy were included. The laterality (bilateral vs unilateral), location (fimbrial vs juxta-fimbrial), number (single vs multiple) and diameter of the hydatids of Morgagni were recorded. Patients were allocated to a study group (n=127) who underwent laparoscopic excision of hydatid of Morgagni and a control group (n=86) who underwent no intervention. Patients were followed for six months without any infertility or hormonal treatment to detect spontaneous pregnancy. Patients missed during the follow-up or who received infertility treatment were excluded. Statistical analysis was done using Chi-square test and Student's t-test. To find the most important character of hydatid of Morgagni which impedes pregnancy, logistic regression analysis of the dependent variable (no pregnancy) and independent variables (different characters of hydatid of Morgagni) was carried out in the control group. Hydatid of Morgagni was detected in 52.1% of patients with unexplained infertility compared to 25.6% of those with explained infertility (p<0.001). The pregnancy rate was higher in the study group than the control group (58.7% vs 20.6%, p<0.001). The pregnancy rate was significantly higher in the study group than the control group if the hydatid cyst was bilateral (85.7% vs 5.3%, p<0.001), fimbrial (85.6% and 9.1%, p<0.001), single (57.6% and 30.3%, p<0.001) or 1-2 cm in diameter (58.1% and 25.5%, p<0.001). Logistic analysis showed that the bilaterality and fimbrial location of the hydatid of Morgagni were the most significant characteristics impeding pregnancy (odds ratio=7.27 and 3.67 respectively). Hydatid of Morgagni is a possible underestimated cause of

  2. Synchronous infection of the aorta and the testis: emphysematous epididymo-orchitis, abdominal aortic mycotic aneurysm, and testicular artery pseudoaneurysm diagnosed by use of MDCT.

    PubMed

    Hegde, Rahul G; Balani, Ankit; Merchant, Suleman A; Joshi, Anagha R

    2014-07-01

    We report clinical details and imaging findings for a case of emphysematous epididymo-orchitis with co-existing mycotic abdominal aortic aneurysm and a testicular artery pseudoaneurysm in a diabetic 65-year-old male. We report imaging findings from ultrasonography (USG) and contrast-enhanced multidetector computed tomography (MDCT). Use of MDCT to identify, confirm, and define the extent of the disease, and its utility in understanding the pathogenesis of this rare condition are highlighted. For such lethal infections, early diagnosis and intervention can be lifesaving; imaging can be of crucial importance in this.

  3. Consumption with Large Sip Sizes Increases Food Intake and Leads to Underestimation of the Amount Consumed

    PubMed Central

    Bolhuis, Dieuwerke P.; Lakemond, Catriona M. M.; de Wijk, Rene A.; Luning, Pieternel A.; de Graaf, Cees

    2013-01-01

    Background A number of studies have shown that bite and sip sizes influence the amount of food intake. Consuming with small sips instead of large sips means relatively more sips for the same amount of food to be consumed; people may believe that intake is higher which leads to faster satiation. This effect may be disturbed when people are distracted. Objective The objective of the study is to assess the effects of sip size in a focused state and a distracted state on ad libitum intake and on the estimated amount consumed. Design In this 3×2 cross-over design, 53 healthy subjects consumed ad libitum soup with small sips (5 g, 60 g/min), large sips (15 g, 60 g/min), and free sips (where sip size was determined by subjects themselves), in both a distracted and focused state. Sips were administered via a pump. There were no visual cues toward consumption. Subjects then estimated how much they had consumed by filling soup in soup bowls. Results Intake in the small-sip condition was ∼30% lower than in both the large-sip and free-sip conditions (P<0.001). In addition, subjects underestimated how much they had consumed in the large-sip and free-sip conditions (P<0.03). Distraction led to a general increase in food intake (P = 0.003), independent of sip size. Distraction did not influence sip size or estimations. Conclusions Consumption with large sips led to higher food intake, as expected. Large sips, that were either fixed or chosen by subjects themselves led to underestimations of the amount consumed. This may be a risk factor for over-consumption. Reducing sip or bite sizes may successfully lower food intake, even in a distracted state. PMID:23372657

  4. The impacts of open-mouth breathing on upper airway space in obstructive sleep apnea: 3-D MDCT analysis.

    PubMed

    Kim, Eun Joong; Choi, Ji Ho; Kim, Kang Woo; Kim, Tae Hoon; Lee, Sang Hag; Lee, Heung Man; Shin, Chol; Lee, Ki Yeol; Lee, Seung Hoon

    2011-04-01

    Open-mouth breathing during sleep is a risk factor for obstructive sleep apnea (OSA) and is associated with increased disease severity and upper airway collapsibility. The aim of this study was to investigate the effect of open-mouth breathing on the upper airway space in patients with OSA using three-dimensional multi-detector computed tomography (3-D MDCT). The study design included a case-control study with planned data collection. The study was performed at a tertiary medical center. 3-D MDCT analysis was conducted on 52 patients with OSA under two experimental conditions: mouth closed and mouth open. Under these conditions, we measured the minimal cross-sectional area of the retropalatal and retroglossal regions (mXSA-RP, mXSA-RG), as well as the upper airway length (UAL), defined as the vertical dimension from hard palate to hyoid. We also computed the volume of the upper airway space by 3-D reconstruction of both conditions. When the mouth was open, mXSA-RP and mXSA-RG significantly decreased and the UAL significantly increased, irrespective of the severity of OSA. However, between the closed- and open-mouth states, there was no significant change in upper airway volume at any severity of OSA. Results suggest that the more elongated and narrow upper airway during open-mouth breathing may aggravate the collapsibility of the upper airway and, thus, negatively affect OSA severity.

  5. MDCT Anatomic Assessment of Right Inferior Phrenic Artery Origin Related to Potential Supply to Hepatocellular Carcinoma and its Embolization

    SciTech Connect

    Basile, Antonio Tsetis, Dimitrios; Montineri, Arturo; Puleo, Stefano; Massa Saluzzo, Cesare; Runza, Giuseppe; Coppolino, Francesco; Ettorre, Giovanni Carlo; Patti, Maria Teresa

    2008-03-15

    Purpose. To prospectively assess the anatomic variation of the right inferior phrenic artery (RIPA) origin with multidetector computed tomography (MDCT) scans in relation to the technical and angiographic findings during transcatheter arterial embolization of hepatocellular carcinoma (HCC). Methods. Two hundred patients with hepatocellular carcinomas were examined with 16-section CT during the arterial phase. The anatomy of the inferior phrenic arteries was recorded, with particular reference to their origin. All patients with subcapsular HCC located at segments VII and VIII underwent arteriography of the RIPA with subsequent embolization if neoplastic supply was detected. Results. The RIPA origin was detected in all cases (sensitivity 100%), while the left inferior phrenic artery origin was detected in 187 cases (sensitivity 93.5%). RIPAs originated from the aorta (49%), celiac trunk (41%), right renal artery (5.5%), left gastric artery (4%), and proper hepatic artery (0.5%), with 13 types of combinations with the left IPA. Twenty-nine patients showed subcapsular HCCs in segments VII and VIII and all but one underwent RIPA selective angiography, followed by embolization in 7 cases. Conclusion. MDCT assesses well the anatomy of RIPAs, which is fundamental for planning subsequent cannulation and embolization of extrahepatic RIPA supply to HCC.

  6. Medial pathway patterns of the right retromesenteric plane: anatomical investigation using MDCT in patients with acute pancreatitis and pyelonephritis.

    PubMed

    Takaji, Ryo; Mori, Hiromu; Yamada, Yasunari; Kiyonaga, Maki; Matsumoto, Shunro

    2016-01-01

    To investigate the medial pathways of the right retromesenteric plane by reviewing multidetector CT (MDCT) findings in patients with acute pancreatitis and pyelonephritis. 112 patients with acute pancreatitis and 114 patients with pyelonephritis underwent MDCT scans. 64 of the 112 patients with acute pancreatitis and 34 of the 114 patients with pyelonephritis had right retromesenteric plane thickening because of inflammatory extensions. The medial pathways of the right retromesenteric plane were evaluated by two radiologists in consensus. In 18 (28%) of the 64 patients with acute pancreatitis and 10 (29%) of the 34 patients with pyelonephritis, the right retromesenteric plane continued to the central retroperitoneum behind the descending duodenum and pancreatic head (Type 1 pathway). The right retromesenteric plane extended to the right wall of the descending duodenum (Type 2 pathway) in 46 patients (72%) with acute pancreatitis and 24 patients (71%) with pyelonephritis. There was no significant difference in the pathway patterns of the right retromesenteric plane between the acute pancreatitis group and the pyelonephritis group (Type 1 pathway, p = 0.89; Type 2 pathway, p = 0.76). Two patterns were confirmed regarding the medial pathways of the right retromesenteric plane; this anatomical knowledge is important for evaluating the extension of retroperitoneal diseases. Medial aspect of the right retromesenteric plane is thought to have two pathways. The right retromesenteric plane continuing to the right duodenal wall is a common type. Knowledge of these variations is important when evaluating the retroperitoneal diseases.

  7. Medial pathway patterns of the right retromesenteric plane: anatomical investigation using MDCT in patients with acute pancreatitis and pyelonephritis

    PubMed Central

    Mori, Hiromu; Yamada, Yasunari; Kiyonaga, Maki; Matsumoto, Shunro

    2016-01-01

    Objective: To investigate the medial pathways of the right retromesenteric plane by reviewing multidetector CT (MDCT) findings in patients with acute pancreatitis and pyelonephritis. Methods: 112 patients with acute pancreatitis and 114 patients with pyelonephritis underwent MDCT scans. 64 of the 112 patients with acute pancreatitis and 34 of the 114 patients with pyelonephritis had right retromesenteric plane thickening because of inflammatory extensions. The medial pathways of the right retromesenteric plane were evaluated by two radiologists in consensus. Results: In 18 (28%) of the 64 patients with acute pancreatitis and 10 (29%) of the 34 patients with pyelonephritis, the right retromesenteric plane continued to the central retroperitoneum behind the descending duodenum and pancreatic head (Type 1 pathway). The right retromesenteric plane extended to the right wall of the descending duodenum (Type 2 pathway) in 46 patients (72%) with acute pancreatitis and 24 patients (71%) with pyelonephritis. There was no significant difference in the pathway patterns of the right retromesenteric plane between the acute pancreatitis group and the pyelonephritis group (Type 1 pathway, p = 0.89; Type 2 pathway, p = 0.76). Conclusion: Two patterns were confirmed regarding the medial pathways of the right retromesenteric plane; this anatomical knowledge is important for evaluating the extension of retroperitoneal diseases. Advances in knowledge: Medial aspect of the right retromesenteric plane is thought to have two pathways. The right retromesenteric plane continuing to the right duodenal wall is a common type. Knowledge of these variations is important when evaluating the retroperitoneal diseases. PMID:26694254

  8. MDCT quantification is the dominant parameter in decision–making regarding chest tube drainage for stable patients with traumatic pneumothorax

    PubMed Central

    Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

    2013-01-01

    It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. PMID:22560899

  9. Morbid obesity and postoperative pulmonary atelectasis: an underestimated problem.

    PubMed

    Eichenberger, A- S; Proietti, S; Wicky, S; Frascarolo, P; Suter, M; Spahn, D R; Magnusson, L

    2002-12-01

    Perturbation of respiratory mechanics produced by general anesthesia and surgery is more pronounced in morbidly obese (MO) patients. Because general anesthesia induces pulmonary atelectasis in nonobese patients, we hypothesized that atelectasis formation would be particularly significant in MO patients. We investigated the importance and resorption of atelectasis after general anesthesia in MO and nonobese patients. Twenty MO patients were anesthetized for laparoscopic gastroplasty and 10 nonobese patients for laparoscopic cholecystectomy. We assessed pulmonary atelectasis by computed tomography at three different periods: before the induction of general anesthesia, immediately after tracheal extubation, and 24 h later. Already before the induction of anesthesia, MO patients had more atelectasis, expressed in the percentage of the total lung area, than nonobese patients (2.1% versus 1.0%, respectively; P < 0.01). After tracheal extubation, atelectasis had increased in both groups but remained significantly more so in the MO group (7.6% for MO patients versus 2.8% for the nonobese; P < 0.05). Twenty-four hours later, the amount of atelectasis remained unchanged in the MO patients, but we observed a complete resorption in nonobese patients (9.7% versus 1.9%, respectively; P < 0.01). General anesthesia in MO patients generated much more atelectasis than in nonobese patients. Moreover, atelectasis remained unchanged for at least 24 h in MO patients, whereas atelectasis disappeared in the nonobese. We compared the resolution over time of pulmonary atelectasis after a laparoscopic procedure by performing computed tomography scans in two different groups of patients: 1 group had 10 nonobese patients, and in the other group there were 20 morbidly obese patients.

  10. Uniform slip model underestimates tsunami hazard for probabilistic assessment: results from a case study in the South China Sea

    NASA Astrophysics Data System (ADS)

    Li, L.; Switzer, A.; Chan, C. H.; Wang, Y.; Weiss, R.; Qiu, Q.

    2015-12-01

    It has long been recognized that rupture complexity, typically in the form of heterogeneous slip distribution pattern, has a significant effect on tsunami wave field. However, the effect of heterogeneous slip distributions is not commonly considered in probabilistic tsunami hazard assessment (PTHA) primarily due to its computational expense. To investigate the effect of heterogeneous slip distribution on PTHAs, we incorporate a stochastic source model into a Monte Carlo-type method for PTHA. Using a hybrid kinematic k-squared source model, we generate a broad range of slip distribution patterns for large numbers of synthetic earthquake events and assess tsunami hazard, as an example, for the South China Sea (SCS). Our result suggests, for a relatively small and confined region like the SCS, the commonly used approach based on the uniform slip distribution fault models could significantly underestimate tsunami hazard, especially on a longer time period. For 500-year return periods, the expected wave height along the coast of west Luzon, Taiwan, southeast China, east Vietnam is generally underestimated by 20-50 %. Notably, the underestimation is more pronounced (some locations reach >50%) for the expected tsunami wave height with a 1000-year return period. Also of note the probability of experiencing 1m tsunami wave in the next 100 years is underestimated by more than 40% in many coastal sites in southeast China and east Vietnam. As the results of PTHA commonly serve as the foundation for further risk assessments, this case study emphasizes how crucial it is to take the effect of rupture complexity into account.

  11. Influence of radiation dose and reconstruction algorithm in MDCT assessment of airway wall thickness: A phantom study

    SciTech Connect

    Gomez-Cardona, Daniel; Nagle, Scott K.; Li, Ke; Chen, Guang-Hong; Robinson, Terry E.

    2015-10-15

    Purpose: Wall thickness (WT) is an airway feature of great interest for the assessment of morphological changes in the lung parenchyma. Multidetector computed tomography (MDCT) has recently been used to evaluate airway WT, but the potential risk of radiation-induced carcinogenesis—particularly in younger patients—might limit a wider use of this imaging method in clinical practice. The recent commercial implementation of the statistical model-based iterative reconstruction (MBIR) algorithm, instead of the conventional filtered back projection (FBP) algorithm, has enabled considerable radiation dose reduction in many other clinical applications of MDCT. The purpose of this work was to study the impact of radiation dose and MBIR in the MDCT assessment of airway WT. Methods: An airway phantom was scanned using a clinical MDCT system (Discovery CT750 HD, GE Healthcare) at 4 kV levels and 5 mAs levels. Both FBP and a commercial implementation of MBIR (Veo{sup TM}, GE Healthcare) were used to reconstruct CT images of the airways. For each kV–mAs combination and each reconstruction algorithm, the contrast-to-noise ratio (CNR) of the airways was measured, and the WT of each airway was measured and compared with the nominal value; the relative bias and the angular standard deviation in the measured WT were calculated. For each airway and reconstruction algorithm, the overall performance of WT quantification across all of the 20 kV–mAs combinations was quantified by the sum of squares (SSQs) of the difference between the measured and nominal WT values. Finally, the particular kV–mAs combination and reconstruction algorithm that minimized radiation dose while still achieving a reference WT quantification accuracy level was chosen as the optimal acquisition and reconstruction settings. Results: The wall thicknesses of seven airways of different sizes were analyzed in the study. Compared with FBP, MBIR improved the CNR of the airways, particularly at low radiation dose

  12. Shading correction for on-board cone-beam CT in radiation therapy using planning MDCT images.

    PubMed

    Niu, Tianye; Sun, Mingshan; Star-Lack, Josh; Gao, Hewei; Fan, Qiyong; Zhu, Lei

    2010-10-01

    Applications of cone-beam CT (CBCT) to image-guided radiationtherapy (IGRT) are hampered by shading artifacts in the reconstructed images. These artifacts are mainly due to scatter contamination in the projections but also can result from uncorrected beam hardening effects as well as nonlinearities in responses of the amorphous silicon flat panel detectors. While currently, CBCT is mainly used to provide patient geometry information for treatment setup, more demanding applications requiring high-quality CBCT images are under investigation. To tackle these challenges, many CBCT correction algorithms have been proposed; yet, a standard approach still remains unclear. In this work, we propose a shading correction method for CBCT that addresses artifacts from low-frequency projection errors. The method is consistent with the current workflow of radiation therapy. With much smaller inherent scatter signals and more accurate detectors, diagnostic multidetector CT (MDCT) provides high quality CT images that are routinely used for radiation treatment planning. Using the MDCT image as "free" prior information, we first estimate the primary projections in the CBCT scan via forward projection of the spatially registered MDCT data. Since most of the CBCT shading artifacts stem from low-frequency errors in the projections such as scatter, these errors can be accurately estimated by low-pass filtering the difference between the estimated and raw CBCT projections. The error estimates are then subtracted from the raw CBCT projections. Our method is distinct from other published correction methods that use the MDCT image as a prior because it is projection-based and uses limited patient anatomical information from the MDCT image. The merit of CBCT-based treatment monitoring is therefore retained. The proposed method is evaluated using two phantom studies on tabletop systems. On the Catphan 600 phantom, our approach reduces the reconstruction error from 348 Hounsfield unit (HU

  13. Shading correction for on-board cone-beam CT in radiation therapy using planning MDCT images

    SciTech Connect

    Niu Tianye; Sun, Mingshan; Star-Lack, Josh; Gao Hewei; Fan Qiyong; Zhu Lei

    2010-10-15

    Purpose: Applications of cone-beam CT (CBCT) to image-guided radiation therapy (IGRT) are hampered by shading artifacts in the reconstructed images. These artifacts are mainly due to scatter contamination in the projections but also can result from uncorrected beam hardening effects as well as nonlinearities in responses of the amorphous silicon flat panel detectors. While currently, CBCT is mainly used to provide patient geometry information for treatment setup, more demanding applications requiring high-quality CBCT images are under investigation. To tackle these challenges, many CBCT correction algorithms have been proposed; yet, a standard approach still remains unclear. In this work, we propose a shading correction method for CBCT that addresses artifacts from low-frequency projection errors. The method is consistent with the current workflow of radiation therapy. Methods: With much smaller inherent scatter signals and more accurate detectors, diagnostic multidetector CT (MDCT) provides high quality CT images that are routinely used for radiation treatment planning. Using the MDCT image as ''free'' prior information, we first estimate the primary projections in the CBCT scan via forward projection of the spatially registered MDCT data. Since most of the CBCT shading artifacts stem from low-frequency errors in the projections such as scatter, these errors can be accurately estimated by low-pass filtering the difference between the estimated and raw CBCT projections. The error estimates are then subtracted from the raw CBCT projections. Our method is distinct from other published correction methods that use the MDCT image as a prior because it is projection-based and uses limited patient anatomical information from the MDCT image. The merit of CBCT-based treatment monitoring is therefore retained. Results: The proposed method is evaluated using two phantom studies on tabletop systems. On the Catphan(c)600 phantom, our approach reduces the reconstruction error

  14. Anomalous Origin of One Pulmonary Artery Branch From the Aorta: Role of MDCT Angiography.

    PubMed

    Liu, Hui; Juan, Yu-Hsiang; Chen, Jimei; Xie, Zhaofeng; Wang, Qiushi; Zhang, Xiaoshen; Liang, Changhong; Huang, Hongfei; Kwong, Raymond Y; Saboo, Sachin S

    2015-05-01

    The purpose of this study was to evaluate the prevalence, MDCT angiography (MDCTA) appearance, associated congenital cardiovascular abnormalities, and prognosis of anomalous origin of one pulmonary artery from the aorta (AOPA) on the basis of MDCTA. We conducted a retrospective search of patients with AOPA from our database in a single center, consisting of 5729 patients referred for MDCTA with known or suspected congenital heart diseases from transthoracic echocardiography. The clinical information, subtypes of AOPA, associated cardiovascular anomalies, and surgical and clinical outcomes were retrospectively collected and analyzed. The MDCTA images were retrospectively processed for analysis, and the MDCTA and echocardiography images were interpreted by radiologist and cardiologist without knowledge of the actual diagnosis or surgical outcome. AOPA was seen in 19 patients (14 males and five females; median age, 3 months; range, 4 days-21 years) showing a prevalence of 0.33%. Anomalous origin of the right pulmonary artery (AORPA, 89%), proximal origin subtype of the AOPA (89%), and ipsilateral aortic wall origin of AOPA (58%) were more commonly seen. In addition to the benefit of preoperative planning, MDCTA also supplemented echocardiography by providing accurate diagnosis of AOPA and other associated cardiovascular anomalies compared with transthoracic echocardiography (TTE). We found a total of four patients (21%) with misdiagnosis by TTE, including three patients with underdiagnosis of AOPA and one patient with misdiagnosis as transposition of the great arteries. In addition, two other patients had AOPA diagnosed, but the associated patent ductus arteriosus (PDA) was not detected. MDCTA revealed 95% association with other congenital cardiovascular anomalies, including PDA (71% of AORPA), and aortic arch anomalies (100% of anomalous origin of the left pulmonary artery, AOLPA). The types of surgery depended on the MDCTA findings, including the sub-type, origin

  15. Colorectal liver metastasis after 90Y radioembolization therapy: pilot study of change in MDCT attenuation as a surrogate marker for future FDG PET response.

    PubMed

    Tochetto, Sandra M; Töre, Hüseyin Gürkan; Chalian, Hamid; Yaghmai, Vahid

    2012-05-01

    The purpose of this study was to investigate whether changes in attenuation and size of liver metastatic lesions of colorectal cancer at MDCT 1 month after (90)Y radioembolization treatment are predictive of response at FDG PET 3 months after treatment. Twenty patients with colorectal liver metastasis consecutively treated with (90)Y radioembolization underwent triphasic MDCT of the liver at baseline and 1 and 3 months after treatment and FDG PET at baseline and 3 months after treatment. Percentage change in tumor attenuation at MDCT (volumetric attenuation), tumor size at MDCT (according to Response Evaluation Criteria in Solid Tumors [RECIST] and World health Organization [WHO] criteria), and volume-weighted maximum standardized uptake value at FDG PET were evaluated. The correlation between FDG PET response 3 months after treatment and response according to RECIST, WHO criteria, and attenuation 1 month after treatment was evaluated. Only 13.3% of patients with FDG PET findings of response 3 months after treatment were identified according to RECIST and WHO criteria 1 month after treatment. According to attenuation criteria at 1 month, however, 53.3% of patients with an FDG PET response at 3 months were identified. A strong association was found between FDG PET response at 3 months and response based on attenuation criteria (odds ratio, 12.4; 95% CI, 0.58-265.3; p = 0.05). Early changes in the attenuation of liver metastatic lesions of colon cancer after (90)Y radioembolization treatment may be predictive of future response at FDG PET.

  16. [Preoperative T stage of non-small cell lung cancer: comparison of the efficacy of 64-MDCT versus 3.0T MR imaging].

    PubMed

    Tang, Wei; Wu, Ning; Ouyang, Han; Huang, Yao; Liu, Li; Li, Meng; Zhou, Lina; Xu, Xiaojuan

    2015-08-01

    To compare the diagnostic efficacies of 64-MDCT and 3.0-T MRI in determining the T stage of non-small cell lung cancer (NSCLC). Approval from the institutional ethics committee and informed consent from patients were obtained before the study started. 40 patients with NSCLC proved by pathology were enrolled in the study. All the 40 patients underwent non-enhanced MRI, enhanced MRI, and enhanced MDCT. Their T stages were preliminarily evaluated according to these imaging manifestations by 3 groups of experienced chest radiologists respectively, and correlated with that of postoperative pathology using the Kappa test. The diagnostic efficacies of these three imaging modalities for determining the T stage of NSCLC were compared using the McNemar test. The preoperative diagnostic accuracy rate for the T stage of NSCLC was 85.0% (34 of 40) by non-enhanced MRI, 87.5% (35 of 40) by enhanced MRI, and 80.0% (32 of 40) by enhanced CT, showing no significant differences between the non-enhanced MRI and enhanced CT, enhanced MRI and enhanced CT, and non-enhanced MRI and enhanced MRI for determining the T stage of NSCLC (P>0.05). Compared with the enhanced MDCT, non-enhanced MRI and enhanced MRI provide slightly superior diagnostic efficacy for the preoperative T staging of NSCLC. For the patients with intolerance to contrast medium on MDCT scan, 3.0T MRI may be an alternative for determining the preoperative T stage of NSCLC.

  17. Abdominal rapid-kVp-switching dual-energy MDCT with reduced IV contrast compared to conventional MDCT with standard weight-based IV contrast: an intra-patient comparison.

    PubMed

    Clark, Zachary E; Bolus, David N; Little, Mark D; Morgan, Desiree E

    2015-04-01

    Perform intra-patient comparison of attenuation values on lower keV dual-energy abdominal CT images using reduced IV contrast dose compared to conventional single energy polychromatic beam abdominal MDCT images using standard IV contrast dose. IRB approved retrospective evaluation of consecutive adults who had both standard IV contrast dosage conventional multiphasic MDCT (SECT) and reduced IV contrast dosage rapid kV-switching dual-energy multiphasic MDCT (rsDECT) of the abdomen. Arterial phase dual-energy 52, 70 and 78 keV simulated monoenergetic HU were compared (t test) to arterial phase SECT HU for: aorta, liver, pancreas, psoas, and hepatic/pancreatic tumors. Contrast to noise ratios (CNR), IV contrast dose reduction and dose-length product (DLP) were recorded. Two blinded independent readers evaluated the CT datasets for subjective image quality based on a five point scale. Twenty-nine scan pairs in 24 subjects (13 M, mean age 64, weight 76.7 kg) were evaluated. Mean reduction in IV contrast dose was 37 %. Mean ± SD HU on 52 keV rsDECT vs. SECT were: aorta 534 ± 138 vs. 271 ± 69; liver 88 ± 24 vs. 67 ± 16; pancreas 140 ± 60 vs. 89 ± 40; psoas 63 ± 15 vs. 50 ± 12 (all p < 0.001). Noise was higher for 52 keV compared to SECT (p < 0.001); CNRs were not significantly different. Mean ± SD DLP for rsDECT was 1421 ± 563 and SECT 1335 ± 562 mGy·cm (p = 0.640). For tumor vs. nontumoral parenchyma, mean absolute contrast difference was 58.4 HU on 52 keV, and 29.0 HU on SECT. Nearly all images were rated as good or excellent and there were no statistically significant differences in image quality between the DECT and SECT images. Statistically significant gains in vascular and parenchymal enhancement without adverse effect on CNR or lesion contrast were observed in this intra-patient comparison using reduced IV contrast dose rsDECT compared to standard weight-based IV dose conventional SECT.

  18. High-pitch computed tomography of the lung in pediatric patients: an intraindividual comparison of image quality and radiation dose to conventional 64-MDCT.

    PubMed

    Tsiflikas, I; Thomas, C; Ketelsen, D; Seitz, G; Warmann, S; Claussen, C D; Schäfer, J F

    2014-06-01

    The aim of this study was to investigate frequencies of typical artifacts in low-dose pediatric lung examinations using high-pitch computed tomography (HPCT) compared to MDCT, and to estimate the effective radiation dose (Eeff). Institutional review board approval for this retrospective study was obtained. 35 patients (17 boys, 18 girls; mean age 112 ± 69 months) were included and underwent MDCT and follow-up scan by HPCT or vice versa (mean follow-up time 87 days), using the same tube voltage and current. The total artifact score (0 - 8) was defined as the sum of artifacts arising from movement, breathing or pulsation of the heart or pulmonary vessels (0 - no; 1 - moderate; 2 - severe artifacts). Eeff was estimated according to the European Guidelines on Quality Criteria for Multislice Computed Tomography. The Mann-Whitney U test was used to analyze differences between the patient groups. The Spearman's rank correlation coefficient was used for correlation of ordinal variables. The scan time was significantly lower for HPCT compared to MDCT (0.72 ± 0.13 s vs. 3.65 ± 0.81s; p < 0.0001). In 28 of 35 (80 %) HPCT examinations no artifacts were visible, whereas in MDCT artifacts occurred in all examinations. The frequency of pulsation artifacts and breathing artifacts was higher in MDCT compared to HPCT (100 % vs. 17 % and 31 % vs. 6 %). The total artifact score significantly correlated with the patient's age in MDCT (r = - 0.42; p = 0.01), but not in HPCT (r = - 0.32; p = 0.07). The estimated Eeff was significantly lower in HPCT than in MDCT (1.29 ± 0.31 vs. 1.47 ± 0.37 mSv; p < 0.0001). Our study indicates that the use of HPCT has advantages for pediatric lung imaging with a reduction of breathing and pulsation artifacts. Moreover, the estimated Eeff was lower. In addition, examinations can be performed without sedation or breath-hold without losing image quality. • Fewer artifacts in pediatric

  19. Underestimation of Leptospirosis Incidence in the French West Indies

    PubMed Central

    Cassadou, Sylvie; Rosine, Jacques; Flamand, Claude; Escher, Martina; Ledrans, Martine; Bourhy, Pascale; Picardeau, Mathieu; Quénel, Philippe

    2016-01-01

    Background Leptospirosis is a neglected zoonosis affecting mainly tropical and subtropical regions worldwide, particularly South America and the Caribbean. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population. Methodology/Principal findings In order to estimate the real incidence of leptospirosis in Guadeloupe and Martinique, a study was performed in 2011 using the three prevailing available biological tests for diagnosis: Microscopic Agglutination Test (MAT), IgM ELISA and PCR. The study investigated inpatients and outpatients and used active case ascertainment from data provided by a general practitioners’ sentinel network. The epidemiology of the disease was also described in terms of severity and demographic characteristics. Leptospirosis incidence was estimated at 69.4 (95%CI 47.6–91.1) and 60.6 (95%CI 36.3–85.0) annual cases per 100 000 inhabitants in Guadeloupe and Martinique, respectively, which was 3 and 4 times higher than previous estimations. Conclusion/Significance Inclusion of PCR and IgM ELISA tests for diagnosis of leptospirosis resulted in improved sensitivity in comparison with MAT alone. Our results highlighted the substantial health burden of the disease in these two territories and the importance of access to appropriate laboratory tests. Based on our results, PCR and IgM ELISA tests have now been included in the list of tests reimbursed by the national system of social security insurance in France. Our results also underline the relevance of implementing an integrated strategy for the surveillance, prevention and control of leptospirosis in the French West Indies. PMID:27128631

  20. Surgeons underestimate their influence on medical students entering surgery.

    PubMed

    Quillin, Ralph C; Pritts, Timothy A; Davis, Bradley R; Hanseman, Dennis; Collins, Jocelyn M; Athota, Krishna P; Edwards, Michael J; Tevar, Amit D

    2012-10-01

    Positive surgical role models influence medical students to pursue a career in surgery. However, the perception by role models of their own effectiveness has yet to be examined. In this study, we evaluated the influence of surgical role models on medical student career choice, and how these role models perceive themselves. We distributed a voluntary and anonymous survey to third-year medical students, general surgery resident applicants, general surgery residents, and attending surgery faculty during the 2010-2011 academic year. We performed statistical analysis using the chi-square and Cochran-Mantel-Haenszel tests (P < 0.05 was significant). Medical students and resident applicants agreed that faculty and residents are important in shaping the career paths of students. The applicants were more likely to agree than were students that clerkship role models (P = 0.0049) and mentors (P = 0.0035) affected their interest in surgery. The applicants were also more likely to agree than the students that attending surgeons (P = 0.0004), senior (P = 0.0019) and junior (P = 0.0028) surgery residents served as positive role models. Although the surgical faculty and residents agreed with the students that each level of the surgical team served as positive role models, they did not agree as strongly with the students that they have an important role in shaping students' career path (P < 0.0001). Surgical faculty and residents serve as positive role models for medical students. They have an essential role in shaping students' career paths and should be more cognizant of their influence, which may draw a student toward or lead them away from the field of surgery. Copyright © 2012 Elsevier Inc. All rights reserved.

  1. Underestimation of Leptospirosis Incidence in the French West Indies.

    PubMed

    Cassadou, Sylvie; Rosine, Jacques; Flamand, Claude; Escher, Martina; Ledrans, Martine; Bourhy, Pascale; Picardeau, Mathieu; Quénel, Philippe

    2016-04-01

    Leptospirosis is a neglected zoonosis affecting mainly tropical and subtropical regions worldwide, particularly South America and the Caribbean. As in many other countries, under-reporting of cases was suspected in the French West Indies because of inadequate access to diagnostic tests for the general population. In order to estimate the real incidence of leptospirosis in Guadeloupe and Martinique, a study was performed in 2011 using the three prevailing available biological tests for diagnosis: Microscopic Agglutination Test (MAT), IgM ELISA and PCR. The study investigated inpatients and outpatients and used active case ascertainment from data provided by a general practitioners' sentinel network. The epidemiology of the disease was also described in terms of severity and demographic characteristics. Leptospirosis incidence was estimated at 69.4 (95%CI 47.6-91.1) and 60.6 (95%CI 36.3-85.0) annual cases per 100,000 inhabitants in Guadeloupe and Martinique, respectively, which was 3 and 4 times higher than previous estimations. Inclusion of PCR and IgM ELISA tests for diagnosis of leptospirosis resulted in improved sensitivity in comparison with MAT alone. Our results highlighted the substantial health burden of the disease in these two territories and the importance of access to appropriate laboratory tests. Based on our results, PCR and IgM ELISA tests have now been included in the list of tests reimbursed by the national system of social security insurance in France. Our results also underline the relevance of implementing an integrated strategy for the surveillance, prevention and control of leptospirosis in the French West Indies.

  2. Pancreatic ductal adenocarcinoma and chronic mass-forming pancreatitis: Differentiation with dual-energy MDCT in spectral imaging mode.

    PubMed

    Yin, Qihua; Zou, Xinnong; Zai, Xiaodong; Wu, Zhiyuan; Wu, Qingyang; Jiang, Xingyu; Chen, Hongwei; Miao, Fei

    2015-12-01

    To investigate the value of dual-energy MDCT in spectral imaging in the differential diagnosis of chronic mass-forming chronic pancreatitis (CMFP) and pancreatic ductal adenocarcinoma (PDAC) during the arterial phase (AP) and the pancreatic parenchymal phase (PP). Thirty five consecutive patients with CMFP (n=15) or PDAC (n=20) underwent dual-energy MDCT in spectral imaging during AP and PP. Iodine concentrations were derived from iodine-based material-decomposition CT images and normalized to the iodine concentration in the aorta. The difference in iodine concentration between the AP and PP, contrast-to-noise ratio (CNR) and the slope K of the spectrum curve were calculated. Normalized iodine concentrations (NICs) in patients with CMFP differed significantly from those in patients with PDAC during two double phases (mean NIC, 0.26±0.04 mg/mL vs. 0.53±0.02 mg/mL, p=0.0001; 0.07±0.02 mg/mL vs. 0.28±0.04 mg/mL, p=0.0002, respectively). There were significant differences in the value of the slope K of the spectrum curve in two groups during AP and PP (K(CMFP)=3.27±0.70 vs. K(PDAC)=1.35±0.41, P=0.001, and K(CMFP)=3.70±0.17 vs. K(PDAC)=2.16±0.70, p=0.003, respectively). CNRs at low energy levels (40-70 keV) were higher than those at high energy levels (80-40 keV). Individual patient CNR-optimized energy level images and the NIC can be used to improve the sensitivity and the specificity for differentiating CMFP from PDAC by use of dual-energy MDCT in spectral imaging with fast tube voltage switching. Copyright © 2015. Published by Elsevier Ireland Ltd.

  3. Pelvic ultrasound immediately following MDCT in female patients with abdominal/pelvic pain: is it always necessary?

    PubMed

    Yitta, Silaja; Mausner, Elizabeth V; Kim, Alice; Kim, Danny; Babb, James S; Hecht, Elizabeth M; Bennett, Genevieve L

    2011-10-01

    To determine the added value of reimaging the female pelvis with ultrasound (US) immediately following multidetector CT (MDCT) in the emergent setting. CT and US exams of 70 patients who underwent MDCT for evaluation of abdominal/pelvic pain followed by pelvic ultrasound within 48 h were retrospectively reviewed by three readers. Initially, only the CT images were reviewed followed by evaluation of CT images in conjunction with US images. Diagnostic confidence was recorded for each reading and an exact Wilcoxon signed rank test was performed to compare the two. Changes in diagnosis based on combined CT and US readings versus CT readings alone were identified. Confidence intervals (95%) were derived for the percentage of times US reimaging can be expected to lead to a change in diagnosis relative to the diagnosis based on CT interpretation alone. Ultrasound changed the diagnosis for the ovaries/adnexa 8.1% of the time (three reader average); the majority being cases of a suspected CT abnormality found to be normal on US. Ultrasound changed the diagnosis for the uterus 11.9% of the time (three reader average); the majority related to the endometrial canal. The 95% confidence intervals for the ovaries/adnexa and uterus were 5-12.5% and 8-17%, respectively. Ten cases of a normal CT were followed by a normal US with 100% agreement across all three readers. Experienced readers correctly diagnosed ruptured ovarian cysts and tubo-ovarian abscesses (TOA) based on CT alone with 100% agreement. US reimaging after MDCT of the abdomen and pelvis is not helpful: (1) following a normal CT of the pelvic organs or (2) when CT findings are diagnostic and/or characteristic of certain entities such as ruptured cysts and TOA. Reimaging with ultrasound is warranted for (1) less-experienced readers to improve diagnostic confidence or when CT findings are not definitive, (2) further evaluation of suspected endometrial abnormalities. A distinction should be made between the need for

  4. Aortic and hepatic contrast enhancement with abdominal 64-MDCT in pediatric patients: effect of body weight and iodine dose.

    PubMed

    Bae, Kyongtae T; Shah, Amisha J; Shang, Sherry S; Wang, Jin Hong; Chang, Samuel; Kanematsu, Masayuki; Hildebolt, Charles F

    2008-11-01

    The purpose of our study was to retrospectively evaluate the effect of body weight and iodine dose on aortic and hepatic contrast enhancement in pediatric patients who underwent 64-MDCT of the abdomen and pelvis. Eighty-seven consecutive pediatric patients (50 boys and 37 girls; median age, 12.1 years; age range, 3.8-17.6 years) underwent standard abdominopelvic CT with a 64-MDCT scanner. Contrast medium (350 mg I/mL) was injected using a power injector at 2 mL/s followed by 15-20 mL of saline flush. According to our CT protocol, the volume of administered contrast medium was approximately 1.8 mL/kg of body weight, up to the maximum volume of 80 mL. CT scanning was initiated 60 seconds after the start of the contrast medium injection. CT attenuations of the aorta and liver were measured. For each patient, the injected contrast medium iodine mass per body weight index (g I/kg) (hereafter, iodine mass body index) was calculated. Linear regression analysis was performed between iodine mass body index and aortic and hepatic attenuations. A wide range of patient weights (19-82 kg; mean, 48.6 kg [95% CI, 45.3-51.9 kg]) and contrast volumes (30-80 mL; median, 80.0 mL) were observed. The median attenuations were 149.0 HU (141.0-160.0 HU) for the aorta and 113.5 HU (109.5-120.0 HU) for the liver. Moderately high correlations were observed between iodine mass body index and aortic (Spearman's rho [r(s)] = 0.60 [0.45-0.72]; p < 0.001) and hepatic (r(s) = 0.60 [0.42-0.70]; p < 0.001) attenuations. The regression formulae for aortic attenuation (58.4 + 176.3 x iodine mass body index [p < 0.001]) and hepatic attenuation (58.7 + 108.5 x iodine mass body index [p < 0.001]) indicate that 1.5 and 1.8 mL/kg (350 mg I/mL) of contrast media are required to achieve 116 and 127 HU, respectively, of contrast-enhanced attenuation in the liver. In our study, using abdominal 64-MDCT in pediatric patients, we found that approximately 1.5 mL/kg, or 0.525 g I/kg, yields 116 HU of hepatic

  5. Centauries as underestimated food additives: antioxidant and antimicrobial potential.

    PubMed

    Siler, Branislav; Zivković, Suzana; Banjanac, Tijana; Cvetković, Jelena; Nestorović Živković, Jasmina; Cirić, Ana; Soković, Marina; Mišić, Danijela

    2014-03-15

    Methanol extracts of aerial parts and roots of five centaury species (Centaurium erythraea, C. tenuiflorum, C. littorale ssp. uliginosum, C. pulchellum, and Schenkia spicata) were analysed for their main secondary metabolites: secoiridoid glycosides, a group of monoterpenoid compounds, and phenolics (xanthones and flavonoids), and further investigated for antioxidant capacity and antimicrobial activity. The results of ABTS, DPPH, and FRAP assays showed that above ground parts generally displayed up to 13 times higher antioxidant activity compared to roots, which should be related to higher phenolics content, especially flavonoids, in green plant organs. Secoiridoid glycosides showed no antioxidant activity. All the tested extracts demonstrated appreciative antibacterial (0.05-0.5 mg ml(-1)) and strong antifungal activity (0.1-0.6 mg ml(-1)). Our results imply that above ground parts of all centaury species studied, could be recommended for human usage as a rich source of natural antioxidants and also in food industry as strong antimicrobial agents for food preservation. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Two underestimated threats in food transportation: mould and acceleration

    PubMed Central

    Janssen, S.; Pankoke, I.; Klus, K.; Schmitt, K.; Stephan, U.; Wöllenstein, J.

    2014-01-01

    Two important parameters are often neglected in the monitoring of perishable goods during transport: mould contamination of fresh food and the influence of acceleration or vibration on the quality of a product. We assert the claim that it is necessary to focus research on these two topics in the context of intelligent logistics in this opinion paper. Further, the technical possibilities for future measurement systems are discussed. By measuring taste deviations, we verified the effect on the quality of beer at different vibration frequencies. The practical importance is shown by examining transport routes and market shares. The general feasibility of a mobile mould detection system is established by examining the measurement resolution of semiconductor sensors for mould-related gases. Furthermore, as an alternative solution, we present a concept for a miniaturized and automated culture-medium-based system. Although there is a lack of related research to date, new efforts can make a vital contribution to the reduction of losses in the logistic chains for several products. PMID:24797139

  7. Archaea associated with human surfaces: not to be underestimated.

    PubMed

    Bang, Corinna; Schmitz, Ruth A

    2015-09-01

    Over 40 years ago, Carl Woese and his colleagues discovered the existence of two distinctly different groups of prokaryotes-Bacteria and Archaea. In the meantime, extensive research revealed that several hundred of bacterial species are intensely associated with humans' health and disease. Archaea, originally identified and described to occur mainly in extreme environments, have been shown to be ubiquitous and to appear frequently and in high numbers as part of human microbiota in recent years. Despite the improvement in methodologies leading to increased detection, archaea are often still not considered in many studies focusing on the interdependency between members of the microbiota and components of the human immune system. As a consequence, the knowledge on functional role(s) of archaeal species within the human body is mainly limited to their contribution to nutrient degradation in the intestine, and evidence for immunogenic properties of archaea as part of the human microbiota is generally rare. In this review, the current knowledge of human mucosa-associated archaeal species, their interaction with the human immune system and their potential contribution to humans' health and disease will be discussed.

  8. Tryptophan hydroxylase 2 in seasonal affective disorder: underestimated perspectives?

    PubMed

    Kulikov, Alexander V; Popova, Nina K

    2015-01-01

    Seasonal affective disorder (SAD) is characterized by recurrent depression occurring generally in fall/winter. Numerous pieces of evidence indicate the association of SAD with decreased brain neurotransmitter serotonin (5-HT) system functioning. Tryptophan hydroxylase 2 (TPH2) is the key and rate-limiting enzyme in 5-HT synthesis in the brain. This paper concentrates on the relationship between TPH2 activity and mood disturbances, the association between human TPH2 gene expression and the risk of affective disorder, application of tryptophan to SAD treatment and the animal models of SAD. The main conclusions of this review are as follows: (i) the brain 5-HT deficiency contributes to the mechanism underlying SAD, (ii) TPH2 is involved in the regulation of some kinds of genetically defined affective disorders and (iii) the activation of 5-HT synthesis with exogenous l-tryptophan alone or in combination with light therapy could be effective in SAD treatment. The synergic effect of these combined treatments will have several advantages compared to light or tryptophan therapy alone. First, it is effective in the treatment of patients resistant to light therapy. Secondly, l-tryptophan treatment prolongs the antidepressant effect of light therapy.

  9. Two underestimated threats in food transportation: mould and acceleration.

    PubMed

    Janssen, S; Pankoke, I; Klus, K; Schmitt, K; Stephan, U; Wöllenstein, J

    2014-06-13

    Two important parameters are often neglected in the monitoring of perishable goods during transport: mould contamination of fresh food and the influence of acceleration or vibration on the quality of a product. We assert the claim that it is necessary to focus research on these two topics in the context of intelligent logistics in this opinion paper. Further, the technical possibilities for future measurement systems are discussed. By measuring taste deviations, we verified the effect on the quality of beer at different vibration frequencies. The practical importance is shown by examining transport routes and market shares. The general feasibility of a mobile mould detection system is established by examining the measurement resolution of semiconductor sensors for mould-related gases. Furthermore, as an alternative solution, we present a concept for a miniaturized and automated culture-medium-based system. Although there is a lack of related research to date, new efforts can make a vital contribution to the reduction of losses in the logistic chains for several products.

  10. Panoramic radiographs underestimate extensions of the anterior loop and mandibular incisive canal

    PubMed Central

    Nejaim, Yuri; de Freitas, Deborah Queiroz; de Oliveira Santos, Christiano

    2016-01-01

    Purpose The purpose of this study was to detect the anterior loop of the mental nerve and the mandibular incisive canal in panoramic radiographs (PAN) and cone-beam computed tomography (CBCT) images, as well as to determine the anterior/mesial extension of these structures in panoramic and cross-sectional reconstructions using PAN and CBCT images. Materials and Methods Images (both PAN and CBCT) from 90 patients were evaluated by 2 independent observers. Detection of the anterior loop and the incisive canal were compared between PAN and CBCT. The anterior/mesial extension of these structures was compared between PAN and both cross-sectional and panoramic CBCT reconstructions. Results In CBCT, the anterior loop and the incisive canal were observed in 7.7% and 24.4% of the hemimandibles, respectively. In PAN, the anterior loop and the incisive canal were detected in 15% and 5.5% of cases, respectively. PAN presented more difficulties in the visualization of structures. The anterior/mesial extensions ranged from 0.0 mm to 19.0 mm on CBCT. PAN underestimated the measurements by approximately 2.0 mm. Conclusion CBCT appears to be a more reliable imaging modality than PAN for preoperative workups of the anterior mandible. Individual variations in the anterior/mesial extensions of the anterior loop of the mental nerve and the mandibular incisive canal mean that is not prudent to rely on a general safe zone for implant placement or bone surgery in the interforaminal region. PMID:27672611

  11. Underestimating the Toxicological Challenges Associated with the Use of Herbal Medicinal Products in Developing Countries

    PubMed Central

    Neergheen-Bhujun, Vidushi S.

    2013-01-01

    Various reports suggest a high contemporaneous prevalence of herb-drug use in both developed and developing countries. The World Health Organisation indicates that 80% of the Asian and African populations rely on traditional medicine as the primary method for their health care needs. Since time immemorial and despite the beneficial and traditional roles of herbs in different communities, the toxicity and herb-drug interactions that emanate from this practice have led to severe adverse effects and fatalities. As a result of the perception that herbal medicinal products have low risk, consumers usually disregard any association between their use and any adverse reactions hence leading to underreporting of adverse reactions. This is particularly common in developing countries and has led to a paucity of scientific data regarding the toxicity and interactions of locally used traditional herbal medicine. Other factors like general lack of compositional and toxicological information of herbs and poor quality of adverse reaction case reports present hurdles which are highly underestimated by the population in the developing world. This review paper addresses these toxicological challenges and calls for natural health product regulations as well as for protocols and guidance documents on safety and toxicity testing of herbal medicinal products. PMID:24163821

  12. Field Measurements Indicate Unexpected, Serious Underestimation of Mussel Heart Rates and Thermal Tolerance by Laboratory Studies

    PubMed Central

    Tagliarolo, Morgana; McQuaid, Christopher D.

    2016-01-01

    Attempts to predict the response of species to long-term environmental change are generally based on extrapolations from laboratory experiments that inevitably simplify the complex interacting effects that occur in the field. We recorded heart rates of two genetic lineages of the brown mussel Perna perna over a full tidal cycle in-situ at two different sites in order to evaluate the cardiac responses of the two genetic lineages present on the South African coast to temperature and the immersion/emersion cycle. “Robomussel” temperature loggers were used to monitor thermal conditions at the two sites over one year. Comparison with live animals showed that robomussels provided a good estimate of mussel body temperatures. A significant difference in estimated body temperatures was observed between the sites and the results showed that, under natural conditions, temperatures regularly approach or exceed the thermal limits of P. perna identified in the laboratory. The two P. perna lineages showed similar tidal and diel patterns of heart rate, with higher cardiac activity during daytime immersion and minimal values during daytime emersion. Comparison of the heart rates measured in the field with data previously measured in the laboratory indicates that laboratory results seriously underestimate heart rate activity, by as much as 75%, especially during immersion. Unexpectedly, field estimates of body temperatures indicated an ability to tolerate temperatures considered lethal on the basis of laboratory measurements. This suggests that the interaction of abiotic conditions in the field does not necessarily raise vulnerability to high temperatures. PMID:26840775

  13. Obesity identified by discharge ICD-9 codes underestimates the true prevalence of obesity in hospitalized children.

    PubMed

    Woo, Jessica G; Zeller, Meg H; Wilson, Kimberly; Inge, Thomas

    2009-03-01

    To define inpatient care of obese children with or without an obesity diagnosis. A total of 29,352 inpatient discharges (18,459 unique inpatients) from a tertiary children's hospital were analyzed. Body mass index (BMI) was calculated from measured height and weight. "Obesity" was defined as BMI >or=95th percentile by using Centers for Disease Control and Prevention 2000 growth charts. "Diagnosed obesity" was defined by primary, secondary or tertiary International Classification of Diseases, Ninth Revision codes for "obesity" or "overweight." Analyses controlled for multiple inpatient records per individual. A total of 5989 discharges from the hospital (20.4%) were associated with obesity, but only 512 discharges (1.7%) indicated obesity as a diagnosis. An obesity diagnosis identified only 5.5% of inpatient days for obese inpatients. Obese patients with an obesity diagnosis (Ob/Dx) had fewer hospital discharges per person and shorter lengths of stay than obese patients without an obesity diagnosis (Ob/No Dx). Patients with Ob/Dx had higher odds of mental health, endocrine, and musculoskeletal disorders than non-obese inpatients, but Ob/No Dx patients generally did not. Inpatient obesity diagnoses underestimate inpatient utilization and misidentify patterns of care for obese children. Extreme caution is warranted when using obesity diagnoses to study healthcare utilization by obese children.

  14. Correlating MDCT Liver Injury Grade and Clinical Outcome in Patients Without Significant Extra-hepatic Injury.

    PubMed

    Kumar, Ravi; Kumar, Atin; Baliyan, Vinit; Gamanagatti, Shivanand; Bhalla, Ashu Seith; Sharma, Raju; Gupta, Amit; Kumar, Subodh; Misra, M C

    2016-08-01

    The aim of the study was to correlate multi-detector computed tomography (MDCT) grading with clinical severity and outcome in liver trauma patients without significant extrahepatic injury. Over a period of 2 years (2011-2013), all patients showing evidence of liver injury on contrast-enhanced CT (CECT) abdomen and without significant extrahepatic trauma were prospectively included in the study. Correlation between the CT injury grade and outcome in terms of mortality, duration of ICU/hospital stay, fluid and blood requirements, need for intervention and complications were assessed. The significance of the difference in mortality, duration of ICU/hospital stay, fluid requirement and blood requirements among the patients with various injury grades was assessed by Kruskal-Wallis test. The significance of the difference in need for intervention and complications among the patients with various injury grades was assessed by Fisher's exact test. A total of 198 patients were found to have evidence of hepatic injury on CECT. Out of 198 patients, 117 had insignificant extrahepatic trauma. The overall mean age for these 117 patients was 25.74 ± 15.53 (age range 2-84 years). Death rates according to AAST grades were 0 % in grades II and III, 6.89 % in grade IV and 9.09 % in grade V (p = 0.053). The mean ICU and total hospital stay for grade II was 1.32 and 5.91 days, for grade III was 1.76 and 8.48, for grade IV was 2.86 and 10.31 days and for grade V was 6.54 and 12 days, respectively (p = 0.0001 for ICU, p = 0.0003 for total stay). Mean input and fluid deficit according to various grades were 8634/2607 ml for grade II, 9535/2555 ml for grade III, 15,549/6242 ml for grade IV and 19,958/8280 ml for grade V (p value input-0.0016, output-input (fluid deficit)-0.0001). Average unit of RBC and sum of the blood products transfused were 1.73 and 2.26 for grade II, 2.18 and 2.72 for grade III, 3.03 and 6.27 for grade IV, 6.85 and 38.12 for grade V

  15. The underestimated role of olfaction in avian reproduction ?

    PubMed Central

    Balthazart, Jacques; Taziaux, Mélanie

    2009-01-01

    Until the second half of the 20th century, it was broadly accepted that most birds are microsmatic if not anosmic and unable to detect and use olfactory information. Exceptions were eventually conceded for species like procellariiforms, vultures or kiwis that detect their food at least in part based on olfactory signals. During the past 20–30 years, many publications have appeared indicating that this view is definitely erroneous. We briefly review here anatomical, electrophysiological and behavioral data demonstrating that birds in general possess a functional olfactory system and are able to use olfactory information in a variety of ethological contexts, including reproduction. Recent work also indicates that brain activation induced by sexual interactions with a female is significantly affected by olfactory deprivation in Japanese quail. Brain activation was measured via immunocytochemical detection of the protein product of the immediate early gene c-fos. Changes observed concerned two brain areas that play a key role in the control of male sexual behavior, the medial preoptic nucleus and the bed nucleus of the stria terminalis therefore suggesting a potential role of olfaction in the control of reproduction. The widespread idea that birds are anosmic or microsmatic is thus not supported by the available experimental data and presumably originates in our anthropomorphic view that leads us to think that birds do not smell because they have a rigid beak and nostrils and do not obviously sniff. Experimental analysis of this phenomenon is thus warranted and should lead to a significant change in our understanding of avian biology. PMID:18804490

  16. Underestimation of mid-Holocene Arctic warming in PMIP simulations

    NASA Astrophysics Data System (ADS)

    Zhang, Qiong; Muschitiello, Francesco

    2016-04-01

    Due to the orbital forcing, Arctic is warmer during mid-Holocene (~ 6 kyr BP) in summer because the region received more insolation and also warmer in winter because of strong feedbacks, leads to an annual mean temperature warming. Existing proxy reconstructions show that the Arctic can be two degrees warmer than pre-industrial. However, not all the climate models can capture the warming, and the amplitude is about 0.5 degree less than that seen from proxy data. One possible reason is that these simulations did not take into account a fact of 'Green Sahara', where the large area of Sahara region is covered by vegetation instead of desert as it is today. By using a fully coupled climate model EC-Earth with about 100 km resolution, we have run a series of sensitivity experiments by changing the surface type, as well as accompanied change in dust emission over the northern Sahara. The results show that a green sahara not only results in local climate response such as the northward extension and strengthening of African monsoon, but also affect the large scale circulation and corresponding meridional heat transport. The combination of green sahara and reduced dust entails a general strengthening of the mid-latitude Westerlies, results in a change to more positive North Atlantic Oscillation-like conditions, and more heat transport from lower latitudes to high latitudes both in atmosphere and ocean, eventually leads to a shift towards warmer conditions over the North Atlantic and Arctic regions. This mechanism would explain the sign of rapid hydro-climatic perturbations recorded in several reconstructions from high northern latitudes after the termination of the African Humid Period around 5.5 - 5.0 kyr BP, suggesting that these regions are sensitive to changes in Saharan land cover during the present interglacial. This is central in the debate surrounding Arctic climate amplification and future projections for subtropical precipitation changes and related surface type

  17. Interobserver agreement for detection of malignant features of intraductal papillary mucinous neoplasms of the pancreas on MDCT.

    PubMed

    Do, Richard K G; Katz, Seth S; Gollub, Marc J; Li, Jian; LaFemina, Jennifer; Zabor, Emily C; Moskowitz, Chaya S; Klimstra, David S; Allen, Peter J

    2014-11-01

    The purpose of this retrospective study was to measure interobserver agreement in the assessment of malignant imaging features of intraductal papillary mucinous neoplasms (IPMNs) on MDCT. Pancreatic protocol CT studies were reviewed for 84 patients with resected IPMNs. Maximal diameter of the dominant cyst, presence of a mural nodule, presence of a solid component, and diameters of the main pancreatic duct (MPD) and common bile duct (CBD) were measured by four radiologists independently. In each patient, the IPMN was classified into one of three types: main duct, branch duct, or mixed IPMN. Interobserver agreement of lesion features was examined using the intraclass correlation coefficient (ICC) for continuous features and Fleiss kappa for categorical features. The final dataset included 55 branch duct IPMNs, nine main duct IPMNs, and 20 mixed IPMNs. Moderate agreement (ĸ = 0.458; 95% CI, 0.345-0.564) was observed in assigning branch duct, main duct, or mixed IPMN subtypes. Measurement agreement was substantial to excellent for dominant cyst (ICC = 0.852; 95% CI, 0.777-0.907), MPD (0.753, 0.655-0.837), and CBD (0.608, 0.463-0.724) but only fair to moderate for the detection of the presence of mural nodule (ĸ = 0.284, 0.125-0.432) or solid component (ĸ = 0.405, 0211-0.577). Substantial to excellent interobserver agreement in the measurement of cyst diameter, MPD, and CBD support their use for characterizing malignant features of IPMN on MDCT. However, the subjective interpretation of the presence of solid components and mural nodules by individual radiologists was more variable.

  18. MDCT quantification is the dominant parameter in decision-making regarding chest tube drainage for stable patients with traumatic pneumothorax.

    PubMed

    Cai, Wenli; Lee, June-Goo; Fikry, Karim; Yoshida, Hiroyuki; Novelline, Robert; de Moya, Marc

    2012-07-01

    It is commonly believed that the size of a pneumothorax is an important determinant of treatment decision, in particular regarding whether chest tube drainage (CTD) is required. However, the volumetric quantification of pneumothoraces has not routinely been performed in clinics. In this paper, we introduced an automated computer-aided volumetry (CAV) scheme for quantification of volume of pneumothoraces in chest multi-detect CT (MDCT) images. Moreover, we investigated the impact of accurate volume of pneumothoraces in the improvement of the performance in decision-making regarding CTD in the management of traumatic pneumothoraces. For this purpose, an occurrence frequency map was calculated for quantitative analysis of the importance of each clinical parameter in the decision-making regarding CTD by a computer simulation of decision-making using a genetic algorithm (GA) and a support vector machine (SVM). A total of 14 clinical parameters, including volume of pneumothorax calculated by our CAV scheme, was collected as parameters available for decision-making. The results showed that volume was the dominant parameter in decision-making regarding CTD, with an occurrence frequency value of 1.00. The results also indicated that the inclusion of volume provided the best performance that was statistically significant compared to the other tests in which volume was excluded from the clinical parameters. This study provides the scientific evidence for the application of CAV scheme in MDCT volumetric quantification of pneumothoraces in the management of clinically stable chest trauma patients with traumatic pneumothorax. Copyright © 2012 Elsevier Ltd. All rights reserved.

  19. Effects of computing parameters and measurement locations on the estimation of 3D NPS in non-stationary MDCT images.

    PubMed

    Miéville, Frédéric A; Bolard, Gregory; Bulling, Shelley; Gudinchet, François; Bochud, François O; Verdun, François R

    2013-11-01

    The goal of this study was to investigate the impact of computing parameters and the location of volumes of interest (VOI) on the calculation of 3D noise power spectrum (NPS) in order to determine an optimal set of computing parameters and propose a robust method for evaluating the noise properties of imaging systems. Noise stationarity in noise volumes acquired with a water phantom on a 128-MDCT and a 320-MDCT scanner were analyzed in the spatial domain in order to define locally stationary VOIs. The influence of the computing parameters in the 3D NPS measurement: the sampling distances bx,y,z and the VOI lengths Lx,y,z, the number of VOIs NVOI and the structured noise were investigated to minimize measurement errors. The effect of the VOI locations on the NPS was also investigated. Results showed that the noise (standard deviation) varies more in the r-direction (phantom radius) than z-direction plane. A 25 × 25 × 40 mm(3) VOI associated with DFOV = 200 mm (Lx,y,z = 64, bx,y = 0.391 mm with 512 × 512 matrix) and a first-order detrending method to reduce structured noise led to an accurate NPS estimation. NPS estimated from off centered small VOIs had a directional dependency contrary to NPS obtained from large VOIs located in the center of the volume or from small VOIs located on a concentric circle. This showed that the VOI size and location play a major role in the determination of NPS when images are not stationary. This study emphasizes the need for consistent measurement methods to assess and compare image quality in CT.

  20. Parental and Child Factors Associated with Under-Estimation of Children with Excess Weight in Spain.

    PubMed

    de Ruiter, Ingrid; Olmedo-Requena, Rocío; Jiménez-Moleón, José Juan

    2017-07-10

    Objective Understanding obesity misperception and associated factors can improve strategies to increase obesity identification and intervention. We investigate underestimation of child excess weight with a broader perspective, incorporating perceptions, views, and psychosocial aspects associated with obesity. Methods This study used cross-sectional data from the Spanish National Health Survey in 2011-2012 for children aged 2-14 years who are overweight or obese. Percentages of parental misperceived excess weight were calculated. Crude and adjusted analyses were performed for both child and parental factors analyzing associations with underestimation. Results Two-five year olds have the highest prevalence of misperceived overweight or obesity around 90%. In the 10-14 year old age group approximately 63% of overweight teens were misperceived as normal weight and 35.7 and 40% of obese males and females. Child gender did not affect underestimation, whereas a younger age did. Aspects of child social and mental health were associated with under-estimation, as was short sleep duration. Exercise, weekend TV and videogames, and food habits had no effect on underestimation. Fathers were more likely to misperceive their child´s weight status; however parent's age had no effect. Smokers and parents with excess weight were less likely to misperceive their child´s weight status. Parents being on a diet also decreased odds of underestimation. Conclusions for practice This study identifies some characteristics of both parents and children which are associated with under-estimation of child excess weight. These characteristics can be used for consideration in primary care, prevention strategies and for further research.

  1. Self-reported versus measured body height and weight in Polish adult men: the risk of underestimating obesity rates.

    PubMed

    Łopuszańska, Monika; Lipowicz, Anna; Kołodziej, Halina; Szklarska, Alicja; Bielicki, Tadeusz

    2015-01-01

    Background: In some epidemiological studies, self-reported height and weight are often used to save time and money. Self-reported height and weight are commonly used to assess the prevalence of obesity. The aim of this study was to assess the differences between self-reported and measured height and weight in adult men, and to determine how the accuracy of self-reported data depended on age and education. The prevalence of obesity was also calculated based both on self-reported and measured data. Material and methods: Data were collected during two population studies carried out in Wroclaw in 2010. One study included 1,194 19-year-old males who reported for the health examination mandated by the National Conscription Board (younger group). The other group included 355 men between 35 and 80 years old who reported for a ten-year follow-up (older group). Data were analyzed separately for both age groups. Results: Both younger and older subjects overestimated their height by 1.4 cm and 1.0 cm (1.4 cm, 95   %CI: 1.26, 1.51, and 1.0 cm, 95   %CI: 0.85, 1.26, respectively). On average, younger subjects overestimated their weight by 0.7 kilograms (95   %CI: 0.55, 0.92), whereas older subjects underestimated their weight by 0.9 kilograms (95   %CI: –1.15, –0.48). The lower the level of education, the more the subjects overestimated their height. Conclusions: Adult men systematically overestimate their height and underestimate their weight. The magnitude of the inaccuracy depends on level of education. When self-reported data are used, the prevalence of obesity is generally underestimated. Using self-reported data to calculate BMI can lead to a substantial underestimation of the proportion of underweight and obese individuals in a population. Finally, using self-reported values for height in studies on social inequality may lead to false conclusions.

  2. Radiological surveillance of formerly asbestos-exposed power industry workers: rates and risk factors of benign changes on chest X-ray and MDCT

    PubMed Central

    2014-01-01

    Background To determine the prevalence of asbestos-related changes on chest X-ray (CXR) and low-dose multidetector-row CT (MDCT) of the thorax in a cohort of formerly asbestos-exposed power industry workers and to assess the importance of common risk factors associated with specific radiological changes. Methods To assess the influence of selected risk factors (age, time since first exposure, exposure duration, cumulative exposure and pack years) on typical asbestos-related radiographic changes, we employed multiple logistic regression and receiver operating characteristic (ROC) analysis. Results On CXR, pleural changes and asbestosis were strongly associated with age, years since first exposure and exposure duration. The MDCT results showed an association between asbestosis and age and between plaques and exposure duration, years since first exposure and cumulative exposure. Parenchymal changes on CXR and MDCT, and diffuse pleural thickening on CXR were both associated with smoking. Using a cut-off of 55 years for age, 17 years for exposure duration and 28 years for latency, benign radiological changes in the cohort with CXR could be predicted with a sensitivity of 82.0% for all of the three variables and a specificity of 47.4%, 39.0% and 40.6%, respectively. Conclusions Participants aged 55 years and older and those with an asbestos exposure of at least 17 years or 28 years since first exposure should be seen as having an increased risk of abnormal radiological findings. For implementing a more focused approach the routine use of low-dose MDCT rather than CXR at least for initial examinations would be justified. PMID:24808921

  3. Risk Analysis of Underestimate Cost Offer to The Project Quality in Aceh Province

    NASA Astrophysics Data System (ADS)

    Rani, Hafnidar A.

    2016-11-01

    The possibility of errors in the process of offer price determination could be enormous, so it can affect the possibility of project underestimate cost which can impact and reduce the profit if being implementing. Government Equipment/Service Procurement Policy Institution (LKPP) assesses that the practices of cheaper price in the government equipment/service procurement are still highly found and can be potential to decrease the project quality. This study aimed to analyze the most dominant factors happened in underestimate cost offer practice, to analyze the relationship of underestimate cost offer risk factors to road construction project quality in Aceh Province and to analyze the most potential factors of underestimate cost offer risk affecting road construction project quality in Aceh Province. Road construction projects observed the projects which have been implemented in Aceh Province since 2013 - 2015. This study conducted by interviewing Government Budget Authority (KPA), and distributing the questionnaire to the road construction contractors with the qualification of K1, K2, K3, M1, M2 and B1. Based on the data from Construction Service Development Institution (LPJK) of Aceh Province on 2016, the populations obtained are 2,717 constructors. By using Slovin Equation, the research samples obtained are 97 contractors. The most dominant factors in underestimate cost offer risk of the road construction projects in Aceh Province is Contingency Cost Factor which the mean is 4.374.

  4. Perceived risk of diabetes seriously underestimates actual diabetes risk: The KORA FF4 study

    PubMed Central

    Stang, Andreas; Bongaerts, Brenda; Kuss, Oliver; Herder, Christian; Roden, Michael; Quante, Anne; Holle, Rolf; Huth, Cornelia; Peters, Annette; Meisinger, Christa

    2017-01-01

    Objective Early detection of diabetes and prediabetic states is beneficial for patients, but may be delayed by patients´ being overly optimistic about their own health. Therefore, we assessed how persons without known diabetes perceive their risk of having or developing diabetes, and we identified factors associated with perception of diabetes risk. Research design and methods 1,953 participants without previously known diabetes from the population-based, German KORA FF4 Study (59.1 years, 47.8% men) had an oral glucose tolerance test. They estimated their probability of having undiagnosed diabetes mellitus (UDM) on a six category scale, and assessed whether they were at risk of developing diabetes in the future. We cross-tabulated glycemic status with risk perception, and fitted robust Poisson regression models to identify determinants of diabetes risk perception. Results 74% (95% CI: 65–82) of persons with UDM believed that their probability of having undetected diabetes was low or very low. 72% (95% CI: 69–75) of persons with prediabetes believed that they were not at risk of developing diabetes. In people with prediabetes, seeing oneself at risk of diabetes was associated with self-rated poor general health (prevalence ratio (PR) = 3.1 (95% CI: 1.4–6.8), parental diabetes (PR = 2.6, 1.9–3.4), high educational level (PR = 1.9 (1.4–2.5)), lower age (PR = 0.7, 0.6–0.8, per 1 standard deviation increase), female sex (PR = 1.2, 0.9–1.5) and obesity (PR = 1.5, 1.2–2.0). Conclusions People with undiagnosed diabetes or prediabetes considerably underestimate their probability of having or developing diabetes. Contrary to associations with actual diabetes risk, perceived diabetes risk was lower in men, lower educated and older persons. PMID:28141837

  5. On the underestimated impact of the gelation temperature on macro- and mesoporosity in monolithic silica.

    PubMed

    Meinusch, Rafael; Ellinghaus, Rüdiger; Hormann, Kristof; Tallarek, Ulrich; Smarsly, Bernd M

    2017-06-07

    The preparation of monolithic SiO2 with bimodal porosity using a special sol-gel procedure ("Nakanishi process") generally shows a pronounced sensitivity towards several physico-chemical parameters of the initial solution (concentrations, precursors, pH, temperature, etc.). Thus, temporal and spatial variations of these parameters during the sol-gel reactions can affect the final meso- and macropore space with respect to the pore size distributions and homogeneity. In this study we thoroughly examine the sol-gel reaction in terms of the impact of temperature accuracy and homogeneity during the gelation and their effect on meso- and macropore space. The in-depth characterization of the macroporosity in monolithic SiO2 rods, prepared by utilizing a highly homogeneous and accurate temperature profile, shows that a decrease of only 1.5 °C during the reaction doubles the mean size of the macropores in the analyzed temperature ranges (22.0-28.0 °C and 33.5-36.5 °C). Rheological measurements of the gelation points and the viscosity of the starting solutions prove that a higher reaction rate is the main reason for this marked temperature-sensitivity. Furthermore, the mesoporosity is affected to a surprising extent by the applied small temperature differences during the gelation reaction. This phenomenon is shown to be mainly caused by the temperature-dependent differences in macropore and skeleton dimensions and an inhomogeneous distribution of mesopore sizes within the skeleton. In essence, our study reveals that the impact of temperature on the formation of meso- and macroscale dimensions during the sol-gel process has been underestimated so far. The impact of a poor temperature homogeneity during monolith synthesis is exemplarily demonstrated by the application of monolithic silica capillary columns in HPLC.

  6. One-dimensional potential of mean force underestimates activation barrier for transport across flexible lipid membranes

    NASA Astrophysics Data System (ADS)

    Kopelevich, Dmitry I.

    2013-10-01

    Transport of a fullerene-like nanoparticle across a lipid bilayer is investigated by coarse-grained molecular dynamics (MD) simulations. Potentials of mean force (PMF) acting on the nanoparticle in a flexible bilayer suspended in water and a bilayer restrained to a flat surface are computed by constrained MD simulations. The rate of the nanoparticle transport into the bilayer interior is predicted using one-dimensional Langevin models based on these PMFs. The predictions are compared with the transport rates obtained from a series of direct (unconstrained) MD simulations of the solute transport into the flexible bilayer. It is observed that the PMF acting on the solute in the flexible membrane underestimates the transport rate by more than an order of magnitude while the PMF acting on the solute in the restrained membrane yields an accurate estimate of the activation energy for transport into the flexible membrane. This paradox is explained by a coexistence of metastable membrane configurations for a range of the solute positions inside and near the flexible membrane. This leads to a significant reduction of the contribution of the transition state to the mean force acting on the solute. Restraining the membrane shape ensures that there is only one stable membrane configuration corresponding to each solute position and thus the transition state is adequately represented in the PMF. This mechanism is quite general and thus this phenomenon is expected to occur in a wide range of interfacial systems. A simple model for the free energy landscape of the coupled solute-membrane system is proposed and validated. This model explicitly accounts for effects of the membrane deformations on the solute transport and yields an accurate prediction of the activation energy for the solute transport.

  7. Seabird Bycatch in Pelagic Longline Fisheries Is Grossly Underestimated when Using Only Haul Data

    PubMed Central

    Brothers, Nigel; Duckworth, Alan R.; Safina, Carl; Gilman, Eric L.

    2010-01-01

    Hundreds of thousands of seabirds are killed each year as bycatch in longline fisheries. Seabirds are predominantly caught during line setting but bycatch is generally recorded during line hauling, many hours after birds are caught. Bird loss during this interval may lead to inaccurate bycatch information. In this 15 year study, seabird bycatch was recorded during both line setting and line hauling from four fishing regions: Indian Ocean, Southern Ocean, Coral Sea and central Pacific Ocean. Over 43,000 albatrosses, petrels and skuas representing over 25 species were counted during line setting of which almost 6,000 seabirds attempted to take the bait. Bait-taking interactions were placed into one of four categories. (i) The majority (57%) of bait-taking attempts were “unsuccessful” involving seabirds that did not take the bait nor get caught or hooked. (ii) One-third of attempts were “successful” with seabirds removing the bait while not getting caught. (iii) One-hundred and seventy-six seabirds (3% of attempts) were observed being “caught” during line setting, with three albatross species – Laysan (Phoebastria immutabilis), black-footed (P. nigripes) and black-browed (Thalassarche melanophrys)– dominating this category. However, of these, only 85 (48%) seabird carcasses were retrieved during line hauling. Most caught seabirds were hooked through the bill. (iv) The remainder of seabird-bait interactions (7%) was not clearly observed, but likely involved more “caught” seabirds. Bait taking attempts and percentage outcome (e.g. successful, caught) varied between seabird species and was not always related to species abundance around fishing vessels. Using only haul data to calculate seabird bycatch grossly underestimates actual bycatch levels, with the level of seabird bycatch from pelagic longline fishing possibly double what was previously thought. PMID:20824163

  8. One-dimensional potential of mean force underestimates activation barrier for transport across flexible lipid membranes.

    PubMed

    Kopelevich, Dmitry I

    2013-10-07

    Transport of a fullerene-like nanoparticle across a lipid bilayer is investigated by coarse-grained molecular dynamics (MD) simulations. Potentials of mean force (PMF) acting on the nanoparticle in a flexible bilayer suspended in water and a bilayer restrained to a flat surface are computed by constrained MD simulations. The rate of the nanoparticle transport into the bilayer interior is predicted using one-dimensional Langevin models based on these PMFs. The predictions are compared with the transport rates obtained from a series of direct (unconstrained) MD simulations of the solute transport into the flexible bilayer. It is observed that the PMF acting on the solute in the flexible membrane underestimates the transport rate by more than an order of magnitude while the PMF acting on the solute in the restrained membrane yields an accurate estimate of the activation energy for transport into the flexible membrane. This paradox is explained by a coexistence of metastable membrane configurations for a range of the solute positions inside and near the flexible membrane. This leads to a significant reduction of the contribution of the transition state to the mean force acting on the solute. Restraining the membrane shape ensures that there is only one stable membrane configuration corresponding to each solute position and thus the transition state is adequately represented in the PMF. This mechanism is quite general and thus this phenomenon is expected to occur in a wide range of interfacial systems. A simple model for the free energy landscape of the coupled solute-membrane system is proposed and validated. This model explicitly accounts for effects of the membrane deformations on the solute transport and yields an accurate prediction of the activation energy for the solute transport.

  9. Seabird bycatch in pelagic longline fisheries is grossly underestimated when using only haul data.

    PubMed

    Brothers, Nigel; Duckworth, Alan R; Safina, Carl; Gilman, Eric L

    2010-08-31

    Hundreds of thousands of seabirds are killed each year as bycatch in longline fisheries. Seabirds are predominantly caught during line setting but bycatch is generally recorded during line hauling, many hours after birds are caught. Bird loss during this interval may lead to inaccurate bycatch information. In this 15 year study, seabird bycatch was recorded during both line setting and line hauling from four fishing regions: Indian Ocean, Southern Ocean, Coral Sea and central Pacific Ocean. Over 43,000 albatrosses, petrels and skuas representing over 25 species were counted during line setting of which almost 6,000 seabirds attempted to take the bait. Bait-taking interactions were placed into one of four categories. (i) The majority (57%) of bait-taking attempts were "unsuccessful" involving seabirds that did not take the bait nor get caught or hooked. (ii) One-third of attempts were "successful" with seabirds removing the bait while not getting caught. (iii) One-hundred and seventy-six seabirds (3% of attempts) were observed being "caught" during line setting, with three albatross species - Laysan (Phoebastria immutabilis), black-footed (P. nigripes) and black-browed (Thalassarche melanophrys)- dominating this category. However, of these, only 85 (48%) seabird carcasses were retrieved during line hauling. Most caught seabirds were hooked through the bill. (iv) The remainder of seabird-bait interactions (7%) was not clearly observed, but likely involved more "caught" seabirds. Bait taking attempts and percentage outcome (e.g. successful, caught) varied between seabird species and was not always related to species abundance around fishing vessels. Using only haul data to calculate seabird bycatch grossly underestimates actual bycatch levels, with the level of seabird bycatch from pelagic longline fishing possibly double what was previously thought.

  10. Is dream recall underestimated by retrospective measures and enhanced by keeping a logbook? A review.

    PubMed

    Aspy, Denholm J; Delfabbro, Paul; Proeve, Michael

    2015-05-01

    There are two methods commonly used to measure dream recall in the home setting. The retrospective method involves asking participants to estimate their dream recall in response to a single question and the logbook method involves keeping a daily record of one's dream recall. Until recently, the implicit assumption has been that these measures are largely equivalent. However, this is challenged by the tendency for retrospective measures to yield significantly lower dream recall rates than logbooks. A common explanation for this is that retrospective measures underestimate dream recall. Another is that keeping a logbook enhances it. If retrospective measures underestimate dream recall and if logbooks enhance it they are both unlikely to reflect typical dream recall rates and may be confounded with variables associated with the underestimation and enhancement effects. To date, this issue has received insufficient attention. The present review addresses this gap in the literature. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Misery has more company than people think: underestimating the prevalence of others' negative emotions.

    PubMed

    Jordan, Alexander H; Monin, Benoît; Dweck, Carol S; Lovett, Benjamin J; John, Oliver P; Gross, James J

    2011-01-01

    Four studies document underestimations of the prevalence of others' negative emotions and suggest causes and correlates of these erroneous perceptions. In Study 1a, participants reported that their negative emotions were more private or hidden than were their positive emotions; in Study 1b, participants underestimated the peer prevalence of common negative, but not positive, experiences described in Study 1a. In Study 2, people underestimated negative emotions and overestimated positive emotions even for well-known peers, and this effect was partially mediated by the degree to which those peers reported suppression of negative (vs. positive) emotions. Study 3 showed that lower estimations of the prevalence of negative emotional experiences predicted greater loneliness and rumination and lower life satisfaction and that higher estimations for positive emotional experiences predicted lower life satisfaction. Taken together, these studies suggest that people may think they are more alone in their emotional difficulties than they really are.

  12. Misery Has More Company Than People Think: Underestimating the Prevalence of Others’ Negative Emotions

    PubMed Central

    Jordan, Alexander H.; Monin, Benoît; Dweck, Carol S.; Lovett, Benjamin J.; John, Oliver P.; Gross, James J.

    2014-01-01

    Four studies document underestimations of the prevalence of others’ negative emotions, and suggest causes and correlates of these erroneous perceptions. In Study 1A, participants reported that their negative emotions were more private or hidden than their positive emotions; in Study 1B, participants underestimated the peer prevalence of common negative, but not positive, experiences described in Study 1A. In Study 2, people underestimated negative emotions and overestimated positive emotions even for well-known peers, and this effect was partially mediated by the degree to which those peers reported suppression of negative (vs. positive) emotions. Study 3 showed that lower estimations of the prevalence of negative emotional experiences predicted greater loneliness and rumination and lower life satisfaction, and that higher estimations for positive emotional experiences predicted lower life satisfaction. Taken together, these studies suggest that people may think they are more alone in their emotional difficulties than they really are. PMID:21177878

  13. Characterization of atypical cystic renal masses with MDCT: comparison of 5-mm axial images and thin multiplanar reconstructed images.

    PubMed

    Bertolotto, Michele; Zappetti, Roberta; Cavallaro, Marco; Perrone, Rosaria; Perretti, Leonardo; Cova, Maria Assunta

    2010-09-01

    The purpose of this study was to investigate whether cystic renal masses are better characterized on thin axial and multiplanar reconstructed MDCT images than on 5-mm images. The records of 70 complex cystic renal masses in 59 patients (45 men, 14 women; mean age, 68 +/- 13 years) who underwent 64-MDCT at two medical centers were studied. Twenty-three of the masses were confirmed on the basis of the histologic findings and 47 in 2-4 years of follow-up. Images were reviewed in two sessions by two radiologists with 12 and 2 years of experience. In the first session, 5-mm axial images were analyzed, and in the second, thin axial images and multiplanar reconstructions. To assess intraobserver variability, analysis was repeated after 1 month. Statistical analysis was performed with Wilcoxon's signed rank test, receiver operating characteristic analysis, and weighted kappa statistics. Radiologists 1 and 2 detected thicker cystic walls (p < 0.001, p < 0.005) and septa (p < 0.03, p < 0.05) and fewer septa (p < 0.005, p < 0.002) on 5-mm axial images and assigned significantly different Bosniak categories than they did in analysis of the volume data (p < 0.04, p < 0.05). Variability was reduced in thin axial and multiplanar views. No significant differences were found in characterization of lesions as benign or malignant in review of 5-mm axial images and volume data sets. The areas under the receiver operating characteristic curve were 0.89 for 5-mm images and 0.96 for volume data sets for radiologist 1 and 0.87 and 0.90 for radiologist 2. Analysis of volume data sets is associated with less intraobserver and interobserver variability than review of 5-mm axial images. Wall thickness and the number and thickness of septa may differ, resulting in assignment of different Bosniak categories. Diagnostic performance in characterizing lesions as benign or malignant, however, is not statistically different for the thick and thin images.

  14. Systems for Lung Volume Standardization during Static and Dynamic MDCT-based Quantitative Assessment of Pulmonary Structure and Function

    PubMed Central

    Fuld, Matthew K.; Grout, Randall; Guo, Junfeng; Morgan, John H.; Hoffman, Eric A.

    2013-01-01

    Rationale and Objectives Multidetector-row Computed Tomography (MDCT) has emerged as a tool for quantitative assessment of parenchymal destruction, air trapping (density metrics) and airway remodeling (metrics relating airway wall and lumen geometry) in chronic obstructive pulmonary disease (COPD) and asthma. Critical to the accuracy and interpretability of these MDCT-derived metrics is the assurance that the lungs are scanned during a breath-hold at a standardized volume. Materials and Methods A computer monitored turbine-based flow meter system was developed to control patient breath-holds and facilitate static imaging at fixed percentages of the vital capacity. Due to calibration challenges with gas density changes during multi-breath xenon-CT an alternative system was required. The design incorporated dual rolling seal pistons. Both systems were tested in a laboratory environment and human subject trials. Results The turbine-based system successfully controlled lung volumes in 32/37 subjects, having a linear relationship for CT measured air volume between repeated scans: for all scans, the mean and confidence interval of the differences (scan1-scan2) was −9 ml (−169, 151); for TLC alone 6 ml (−164, 177); for FRC alone, −23 ml (−172, 126). The dual-piston system successfully controlled lung volume in 31/41 subjects. Study failures related largely to subject non-compliance with verbal instruction and gas leaks around the mouthpiece. Conclusion We demonstrate the successful use of a turbine-based system for static lung volume control and demonstrate its inadequacies for dynamic xenon-CT studies. Implementation of a dual-rolling seal spirometer has been shown to adequately control lung volume for multi-breath wash-in xenon-CT studies. These systems coupled with proper patient coaching provide the tools for the use of CT to quantitate regional lung structure and function. The wash-in xenon-CT method for assessing regional lung function, while not

  15. Calorie Underestimation When Buying High-Calorie Beverages in Fast-Food Contexts.

    PubMed

    Franckle, Rebecca L; Block, Jason P; Roberto, Christina A

    2016-07-01

    We asked 1877 adults and 1178 adolescents visiting 89 fast-food restaurants in New England in 2010 and 2011 to estimate calories purchased. Calorie underestimation was greater among those purchasing a high-calorie beverage than among those who did not (adults: 324 ±698 vs 102 ±591 calories; adolescents: 360 ±602 vs 198 ±509 calories). This difference remained significant for adults but not adolescents after adjusting for total calories purchased. Purchasing high-calorie beverages may uniquely contribute to calorie underestimation among adults.

  16. Radiation dose in a "triple rule-out" coronary CT angiography protocol of emergency department patients using 64-MDCT: the impact of ECG-based tube current modulation on age, sex, and body mass index.

    PubMed

    Takakuwa, Kevin M; Halpern, Ethan J; Gingold, Eric L; Levin, David C; Shofer, Frances S

    2009-04-01

    "Triple rule-out" coronary CT angiography (CTA) using 64-MDCT technology is a new approach for evaluating emergency department patients presenting with symptoms suggestive of acute coronary syndrome (ACS). Our objective was to evaluate the reduction in effective radiation dose through the use of tube current modulation in patients who underwent a triple rule-out coronary CTA evaluation and to document how effective radiation dose was impacted by patient age, sex, and body mass index (BMI). A retrospective analysis of triple rule-out coronary CTA examinations performed on a 64-MDCT scanner was ordered on a prospective cohort of 267 consecutive low- to moderate-risk emergency department patients with suspected ACS from a single university hospital between October 2006 and March 2008. Tube current modulation was generally used in patients with heart rates below 65 beats per minute during the second half of the study period as a way to reduce radiation exposure. We calculated effective radiation exposure using actual patient coronary CTA scanning parameters by age, sex, and BMI. Among the 172 patients evaluated without tube current modulation, effective dose averaged (+/- SD) 18.0 +/- 5.6 mSv (range, 9.9-31.3 mSv). Of the 95 patients who underwent CTA examination with tube current modulation, effective dose was significantly lower at 8.75 +/- 2.64 mSv (range, 5.4-16.6 mSv; p < 0.0001) and image quality was better (p < 0.0001) as compared with examinations without tube current modulation. There were no significant radiation differences by patient age, but tube current modulation decreased radiation exposure by at least half. Among the studies in which tube current modulation was not used, women received less radiation than men (17.0 vs 19.5 mSv, respectively; p < 0.001). For the studies with tube current modulation, there were no radiation differences by sex. Obese patients received significantly more radiation than overweight and normal-weight patients in the non

  17. Tick-borne encephalitis (TBE): an underestimated risk…still: report of the 14th annual meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE).

    PubMed

    Kunze, Ursula

    2012-06-01

    Today, the risk of getting tick-borne encephalitis (TBE) is still underestimated in many parts of Europe and worldwide. Therefore, the 14th meeting of the International Scientific Working Group on Tick-Borne Encephalitis (ISW-TBE) - a group of neurologists, general practitioners, clinicians, travel physicians, virologists, pediatricians, and epidemiologists - was held under the title "Tick-borne encephalitis: an underestimated risk…still". Among the discussed issues were: TBE, an underestimated risk in children, a case report in two Dutch travelers, the very emotional report of a tick victim, an overview of the epidemiological situation, investigations to detect new TBE cases in Italy, TBE virus (TBEV) strains circulation in Northern Europe, TBE Program of the European Centre for Disease Prevention and Control (ECDC), efforts to increase the TBE vaccination rate in the Czech Republic, positioning statement of the World Health Organization (WHO), and TBE in dogs. To answer the question raised above: Yes, the risk of getting TBE is underestimated in children and adults, because awareness is still too low. It is still underestimated in several areas of Europe, where, for a lack of human cases, TBEV is thought to be absent. It is underestimated in travelers, because they still do not know enough about the risk, and diagnostic awareness in non-endemic countries is still low. Copyright © 2012. Published by Elsevier GmbH. All rights reserved.

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

    PubMed

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

    2016-12-01

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

  19. Preferred child body size and parental underestimation of child weight in Mexican-American families

    USDA-ARS?s Scientific Manuscript database

    Objective: To determine whether parents who prefer a heavier child would underestimate their child's weight more than those who prefer a leaner child. Methods: Participants were Mexican-American families (312 mothers, 173 fathers, and 312 children ages 8-10) who were interviewed and had height and w...

  20. Ethnic differences in maternal underestimation of offspring's weight: the ABCD study.

    PubMed

    de Hoog, M L A; Stronks, K; van Eijsden, M; Gemke, R J B J; Vrijkotte, T G M

    2012-01-01

    To determine the ethnic variation in maternal underestimation of their child's weight status and the explanatory role of socio-economic status (SES), acculturation and parental body mass index (BMI). A multi-ethnic sample of 2769 normal or overweight/obese children (underweight children excluded) aged 5-7 years was examined (The Amsterdam Born Child and their Development study), comprising five ethnic subgroups: Dutch (n=1744), African descent (n=184), Turkish (n=86), Moroccan (n=161) and other non-Dutch (n=592). Data on mothers' perception of their child's weight status (5-point scale from 'too low' to 'too high'), SES, acculturation, parental BMI and the children's height and weight were collected. Underestimation was defined by comparing maternal perception with the actual weight status of her child (International Obesity Task Force guidelines). Ethnic differences in underestimation were calculated in the normal weight and overweight/obese categories. Underestimation ranged from 3.6 (Dutch) to 15.7% (Moroccan) in normal-weight children, and from 73.0 (Dutch) to 92.3% (Turkish) in overweight/obese children. After correction for ethnic differences in child's BMI, higher odds ratios (ORs) for underestimation were found in the Turkish (normal weight: OR 6.83; 95% confidence interval (CI) 2.33-20.05 and overweight: OR 2.80; 95% CI 1.12-6.98) and Moroccan (normal weight: OR 11.55; 95% CI 5.28-25.26) groups (reference is the Dutch group). Maternal educational level and immigrant generation largely explained the ethnic differences, with a minor contribution of maternal age. After correction, ORs remained higher in the Moroccan group (OR 4.37; 95% CI 1.79-10.62) among the normal-weight children. Mothers frequently underestimate the actual weight status of their child, especially mothers from Turkish or Moroccan origin. Having a lower SES, being first-generation immigrant and a young mother are important determinants in explaining these differences. As weight perceptions

  1. [Three case reports of breast abscess after nipple piercing: underestimated health problems of a fashion phenomenon].

    PubMed

    Jacobs, V R; Golombeck, K; Jonat, W; Kiechle, M

    2002-07-01

    Piercing is a growing fashion trend among young people. Nipple piercing has shown an increase over the last years. We report about three coincidental cases of breast abscess after nipple piercing within the last months in our clinics and discuss the related problems for health and society. Retrospective analysis of three case reports regarding course of illness and reasons as well as review of literature and internet. Three patients average age 31.9 (28-35) years were hospitalized with breast abscess after nipple piercing (2 x left, 1 x right). The distance piercing to infection was on average 7.7 (5-12) months. In all patients the abscess was incised and the abscess cavity removed, two had an irrigation tubing for a three days, all received i. v. antibiotics postoperatively. Evidence for bacteria was found in case 1: PCR-confirmation of atypical mycobacteria and coagulase negative staphylococcus, case 2: coagulase negative staphylococcus and group B-streptococcus and case 3: green and microaerophilic staphylococcus. The length of hospital stay was on average 8.0 (6-9) days/case, the hospital costs were 3 624,54 e (3 000,26-4 310,58 e) euro;/case. In a follow-up period of 10,0 (5-15) months one relapse occurred which had to be re-operated. Nipple piercing has grown in popularity within the last years and is in general not a stigma of a subculture or lower social classes any more. However, the risk for breast infection is on the one hand underestimated by the women and on the other hand played down by piercing studios. Breast infection after nipple piercing is rarely documented in scientific literature and data bases. Only seven case reports are scientifically published so far. Healing of the wound channel varies and can take up to 6-12 months. The risk for infection is approximately 10-20 %, often in a interval of months after the procedure. Insufficient understanding as well as inconsequent performance of hygienic preparation of the wound beneath other risk

  2. Evaluation of multidecadal variability in CMIP5 surface solar radiation and inferred underestimation of aerosol direct effects over Europe, China, Japan, and India

    NASA Astrophysics Data System (ADS)

    Allen, R. J.; Norris, J. R.; Wild, M.

    2013-06-01

    Observations from the Global Energy Balance Archive indicate regional decreases in all sky surface solar radiation from ˜1950s to 1980s, followed by an increase during the 1990s. These periods are popularly called dimming and brightening, respectively. Removal of the radiative effects of cloud cover variability from all sky surface solar radiation results in a quantity called "clear sky proxy" radiation, in which multidecadal trends can be seen more distinctly, suggesting aerosol radiative forcing as a likely cause. Prior work has shown climate models from the Coupled Model Intercomparison Project 3 (CMIP3) generally underestimate the magnitude of these trends, particularly over China and India. Here we perform a similar analysis with 173 simulations from 42 climate models participating in the new CMIP5. Results show negligible improvement over CMIP3, as CMIP5 dimming trends over four regions—Europe, China, India, and Japan—are all underestimated. This bias is largest for both India and China, where the multimodel mean yields a decrease in clear sky proxy radiation of -1.3±0.3 and -1.2±0.2 W m-2decade-1, respectively, compared to observed decreases of -6.5±0.9 and -8.2±1.3 W m-2decade-1. Similar underestimation of the observed dimming over Japan exists, with the CMIP5 mean dimming ˜20% as large as observed. Moreover, not a single simulation reproduces the magnitude of the observed dimming trend for these three regions. Relative to dimming, CMIP5 models better simulate the observed brightening, but significant underestimation exists for both China and Japan. Overall, no individual model performs particularly well for all four regions. Model biases do not appear to be related to the use of prescribed versus prognostic aerosols or to aerosol indirect effects. However, models exhibit significant correlations between clear sky proxy radiation and several aerosol-related fields, most notably aerosol optical depth (AOD) and absorption AOD. This suggests model

  3. Influence of Contrast Media on Bone Mineral Density (BMD) Measurements from Routine Contrast-Enhanced MDCT Datasets using a Phantom-less BMD Measurement Tool.

    PubMed

    Toelly, Andrea; Bardach, Constanze; Weber, Michael; Gong, Rui; Lai, Yanbo; Wang, Pei; Guo, Yulin; Kirschke, Jan; Baum, Thomas; Gruber, Michael

    2017-06-01

    Aim To evaluate the differences in phantom-less bone mineral density (BMD) measurements in contrast-enhanced routine MDCT scans at different contrast phases, and to develop an algorithm for calculating a reliable BMD value. Materials and Methods 112 postmenopausal women from the age of 40 to 77 years (mean age: 57.31 years; SD 9.61) who underwent a clinically indicated MDCT scan, consisting of an unenhanced, an arterial, and a venous phase, were included. A retrospective analysis of the BMD values of the Th12 to L4 vertebrae in each phase was performed using a commercially available phantom-less measurement tool. Results The mean BMD value in the unenhanced MDCT scans was 79.76 mg/cm³ (SD 31.20), in the arterial phase it was 85.09 mg/cm³ (SD 31.61), and in the venous phase it was 86.18 mg/cm³ (SD 31.30). A significant difference (p < 0.001) was found between BMD values on unenhanced and contrast-enhanced MDCT scans. There was no significant difference between BMD values in the arterial and venous phases (p = 0.228). The following conversion formulas were calculated using linear regression: unenhanced BMD = -2.287 + 0.964 * [arterial BMD value] and -4.517 + 0.978 * [venous BMD value]. The intrarater agreement of BMD measurements was calculated with an intraclass correlation (ICC) of 0.984 and the interobserver reliability was calculated with an ICC of 0.991. Conclusion Phantom-less BMD measurements in contrast-enhanced MDCT scans result in increased mean BMD values, but, with the formulas applied in our study, a reliable BMD value can be calculated. However, the mean BMD values did not differ significantly between the arterial and venous phases. Key points  · BMD can be assessed on routine CT scans using a phantom-less tool.. · i. v. contrast agent significantly elevates BMD values measured on routine CT scans.. · BMD values measured in the arterial and venous phase did not differ significantly.. · Conversion formulas

  4. Evidence for link between modelled trends in Antarctic sea ice and underestimated westerly wind changes.

    PubMed

    Purich, Ariaan; Cai, Wenju; England, Matthew H; Cowan, Tim

    2016-02-04

    Despite global warming, total Antarctic sea ice coverage increased over 1979-2013. However, the majority of Coupled Model Intercomparison Project phase 5 models simulate a decline. Mechanisms causing this discrepancy have so far remained elusive. Here we show that weaker trends in the intensification of the Southern Hemisphere westerly wind jet simulated by the models may contribute to this disparity. During austral summer, a strengthened jet leads to increased upwelling of cooler subsurface water and strengthened equatorward transport, conducive to increased sea ice. As the majority of models underestimate summer jet trends, this cooling process is underestimated compared with observations and is insufficient to offset warming in the models. Through the sea ice-albedo feedback, models produce a high-latitude surface ocean warming and sea ice decline, contrasting the observed net cooling and sea ice increase. A realistic simulation of observed wind changes may be crucial for reproducing the recent observed sea ice increase.

  5. Evidence for link between modelled trends in Antarctic sea ice and underestimated westerly wind changes

    PubMed Central

    Purich, Ariaan; Cai, Wenju; England, Matthew H.; Cowan, Tim

    2016-01-01

    Despite global warming, total Antarctic sea ice coverage increased over 1979–2013. However, the majority of Coupled Model Intercomparison Project phase 5 models simulate a decline. Mechanisms causing this discrepancy have so far remained elusive. Here we show that weaker trends in the intensification of the Southern Hemisphere westerly wind jet simulated by the models may contribute to this disparity. During austral summer, a strengthened jet leads to increased upwelling of cooler subsurface water and strengthened equatorward transport, conducive to increased sea ice. As the majority of models underestimate summer jet trends, this cooling process is underestimated compared with observations and is insufficient to offset warming in the models. Through the sea ice-albedo feedback, models produce a high-latitude surface ocean warming and sea ice decline, contrasting the observed net cooling and sea ice increase. A realistic simulation of observed wind changes may be crucial for reproducing the recent observed sea ice increase. PMID:26842498

  6. The Effect of Swelling Ratio on the Coulter Underestimation of Hydrogel Microsphere Diameters

    PubMed Central

    Pellegrini, Michael; Cherukupalli, Abhimanyu; Medini, Michael; Falkowski, Ron

    2015-01-01

    It has been demonstrated that the diameters of porous particles are underestimated by Coulter measurements. This phenomenon has also been observed in hydrogel particles, but not characterized. Since the Coulter principle uses the displacement of electrolyte to determine particle size, electrolyte contained within the swelled hydrogel microparticles results in an underestimate of actual particle diameters. The increased use of hydrogel microspheres in biomedical applications has led to the increased application of the Coulter principle to evaluate the size distribution of microparticles. A relationship between the swelling ratio of the particles and their reported Coulter diameters will permit calculation of the actual diameters of these particles. Using polyethylene glycol diacrylate hydrogel microspheres, we determined a correction factor that relates the polymer swelling ratio and the reported Coulter diameters to their actual size. PMID:26414785

  7. Inferring Perspective Versus Getting Perspective: Underestimating the Value of Being in Another Person's Shoes.

    PubMed

    Zhou, Haotian; Majka, Elizabeth A; Epley, Nicholas

    2017-04-01

    People use at least two strategies to solve the challenge of understanding another person's mind: inferring that person's perspective by reading his or her behavior (theorization) and getting that person's perspective by experiencing his or her situation (simulation). The five experiments reported here demonstrate a strong tendency for people to underestimate the value of simulation. Predictors estimated a stranger's emotional reactions toward 50 pictures. They could either infer the stranger's perspective by reading his or her facial expressions or simulate the stranger's perspective by watching the pictures he or she viewed. Predictors were substantially more accurate when they got perspective through simulation, but overestimated the accuracy they had achieved by inferring perspective. Predictors' miscalibrated confidence stemmed from overestimating the information revealed through facial expressions and underestimating the similarity in people's reactions to a given situation. People seem to underappreciate a useful strategy for understanding the minds of others, even after they gain firsthand experience with both strategies.

  8. Evidence for link between modelled trends in Antarctic sea ice and underestimated westerly wind changes

    NASA Astrophysics Data System (ADS)

    Purich, Ariaan; Cai, Wenju; England, Matthew H.; Cowan, Tim

    2016-02-01

    Despite global warming, total Antarctic sea ice coverage increased over 1979-2013. However, the majority of Coupled Model Intercomparison Project phase 5 models simulate a decline. Mechanisms causing this discrepancy have so far remained elusive. Here we show that weaker trends in the intensification of the Southern Hemisphere westerly wind jet simulated by the models may contribute to this disparity. During austral summer, a strengthened jet leads to increased upwelling of cooler subsurface water and strengthened equatorward transport, conducive to increased sea ice. As the majority of models underestimate summer jet trends, this cooling process is underestimated compared with observations and is insufficient to offset warming in the models. Through the sea ice-albedo feedback, models produce a high-latitude surface ocean warming and sea ice decline, contrasting the observed net cooling and sea ice increase. A realistic simulation of observed wind changes may be crucial for reproducing the recent observed sea ice increase.

  9. Development of a voxel-matching technique for substantial reduction of subtraction artifacts in temporal subtraction images obtained from thoracic MDCT.

    PubMed

    Itai, Yoshinori; Kim, Hyoungseop; Ishikawa, Seiji; Katsuragawa, Shigehiko; Doi, Kunio

    2010-02-01

    A temporal subtraction image, which is obtained by subtraction of a previous image from a current one, can be used for enhancing interval changes (such as formation of new lesions and changes in existing abnormalities) on medical images by removing most of the normal structures. However, subtraction artifacts are commonly included in temporal subtraction images obtained from thoracic computed tomography and thus tend to reduce its effectiveness in the detection of pulmonary nodules. In this study, we developed a new method for substantially removing the artifacts on temporal subtraction images of lungs obtained from multiple-detector computed tomography (MDCT) by using a voxel-matching technique. Our new method was examined on 20 clinical cases with MDCT images. With this technique, the voxel value in a warped (or nonwarped) previous image is replaced by a voxel value within a kernel, such as a small cube centered at a given location, which would be closest (identical or nearly equal) to the voxel value in the corresponding location in the current image. With the voxel-matching technique, the correspondence not only between the structures but also between the voxel values in the current and the previous images is determined. To evaluate the usefulness of the voxel-matching technique for removal of subtraction artifacts, the magnitude of artifacts remaining in the temporal subtraction images was examined by use of the full width at half maximum and the sum of a histogram of voxel values, which may indicate the average contrast and the total amount, respectively, of subtraction artifacts. With our new method, subtraction artifacts due to normal structures such as blood vessels were substantially removed on temporal subtraction images. This computerized method can enhance lung nodules on chest MDCT images without disturbing misregistration artifacts.

  10. Variability in brain treatment during mummification of royal Egyptians dated to the 18th-20th dynasties: MDCT findings correlated with the archaeologic literature.

    PubMed

    Saleem, Sahar N; Hawass, Zahi

    2013-04-01

    The objective of our study was to use MDCT to study brain treatment and removal (excerebration) as part of mummification of royal Egyptian mummies dated to the 18th to early 20th Dynasties and to correlate the imaging findings with the archaeologic literature. As part of an MDCT study of the Royal Ancient Egyptian Mummies Project, we analyzed CT images of the heads of 12 mummies dated to circa 1493-1156 BC (18th to early 20th Dynasties). We reconstructed and analyzed CT images for the presence of cranial defects, brain remnants, intracranial embalming materials, and nasal packs. We compared the CT findings of mummies dated to the 18th Dynasty with those dated to the 19th to early 20th Dynasties. The Akhenaten mummy was excluded because of extensive postmortem skull fractures. CT showed that no brain treatment was offered to three mummies (Thutmose I, II, and III) who dated to the early 18th Dynasty and was offered to the eight mummies who dated later. The route of excerebration was transnasal in eight mummies; an additional suspected route was via a parietal defect. CT showed variable appearances of the intracranial contents. There were larger volumes of cranial packs and more variability in the appearances of the cranial packs in the royal mummies dated to the 19th to 20th Dynasties than in those dated to the 18th Dynasty. MDCT shows variations in brain treatment during mummification of royal Egyptian mummies (18th-20th Dynasties). This study sets a template for future CT studies of the heads of ancient Egyptian mummies and focuses on the key elements of cranial mummification in this ancient era.

  11. Longitudinal changes in structural abnormalities using MDCT in COPD: do the CT measurements of airway wall thickness and small pulmonary vessels change in parallel with emphysematous progression?

    PubMed Central

    Takayanagi, Shin; Kawata, Naoko; Tada, Yuji; Ikari, Jun; Matsuura, Yukiko; Matsuoka, Shin; Matsushita, Shoichiro; Yanagawa, Noriyuki; Kasahara, Yasunori; Tatsumi, Koichiro

    2017-01-01

    Background Recent advances in multidetector computed tomography (MDCT) facilitate acquiring important clinical information for managing patients with COPD. MDCT can detect the loss of lung tissue associated with emphysema as a low-attenuation area (LAA) and the thickness of airways as the wall area percentage (WA%). The percentage of small pulmonary vessels <5 mm2 (% cross-sectional area [CSA] <5) has been recently recognized as a parameter for expressing pulmonary perfusion. We aimed to analyze the longitudinal changes in structural abnormalities using these CT parameters and analyze the effect of exacerbation and smoking cessation on structural changes in COPD patients. Methods We performed pulmonary function tests (PFTs), an MDCT, and a COPD assessment test (CAT) in 58 patients with COPD at the time of their enrollment at the hospital and 2 years later. We analyzed the change in clinical parameters including CT indices and examined the effect of exacerbations and smoking cessation on the structural changes. Results The CAT score and forced expiratory volume in 1 second (FEV1) did not significantly change during the follow-up period. The parameters of emphysematous changes significantly increased. On the other hand, the WA% at the distal airways significantly decreased or tended to decrease, and the %CSA <5 slightly but significantly increased over the same period, especially in ex-smokers. The parameters of emphysematous change were greater in patients with exacerbations and continued to progress even after smoking cessation. In contrast, the WA% and %CSA <5 did not change in proportion to emphysema progression. Conclusion The WA% at the distal bronchi and the %CSA <5 did not change in parallel with parameters of LAA over the same period. We propose that airway disease and vascular remodeling may be reversible to some extent by smoking cessation and appropriate treatment. Optimal management may have a greater effect on pulmonary vascularity and airway disease

  12. Estimating Effective Dose of Radiation From Pediatric Cardiac CT Angiography Using a 64-MDCT Scanner: New Conversion Factors Relating Dose-Length Product to Effective Dose.

    PubMed

    Trattner, Sigal; Chelliah, Anjali; Prinsen, Peter; Ruzal-Shapiro, Carrie B; Xu, Yanping; Jambawalikar, Sachin; Amurao, Maxwell; Einstein, Andrew J

    2017-03-01

    The purpose of this study is to determine the conversion factors that enable accurate estimation of the effective dose (ED) used for cardiac 64-MDCT angiography performed for children. Anthropomorphic phantoms representative of 1- and 10-year-old children, with 50 metal oxide semiconductor field-effect transistor dosimeters placed in organs, underwent scanning performed using a 64-MDCT scanner with different routine clinical cardiac scan modes and x-ray tube potentials. Organ doses were used to calculate the ED on the basis of weighting factors published in 1991 in International Commission on Radiological Protection (ICRP) publication 60 and in 2007 in ICRP publication 103. The EDs and the scanner-reported dose-length products were used to determine conversion factors for each scan mode. The effect of infant heart rate on the ED and the conversion factors was also assessed. The mean conversion factors calculated using the current definition of ED that appeared in ICRP publication 103 were as follows: 0.099 mSv · mGy(-1) · cm(-1), for the 1-year-old phantom, and 0.049 mSv · mGy(-1) · cm(-1), for the 10-year-old phantom. These conversion factors were a mean of 37% higher than the corresponding conversion factors calculated using the older definition of ED that appeared in ICRP publication 60. Varying the heart rate did not influence the ED or the conversion factors. Conversion factors determined using the definition of ED in ICRP publication 103 and cardiac, rather than chest, scan coverage suggest that the radiation doses that children receive from cardiac CT performed using a contemporary 64-MDCT scanner are higher than the radiation doses previously reported when older chest conversion factors were used. Additional up-to-date pediatric cardiac CT conversion factors are required for use with other contemporary CT scanners and patients of different age ranges.

  13. Risk of contrast-medium-induced nephropathy in high-risk patients undergoing MDCT--a pooled analysis of two randomized trials.

    PubMed

    Thomsen, Henrik S; Morcos, Sameh K

    2009-04-01

    The incidence of contrast-medium-induced nephropathy (CIN) following intravenous (IV) CM administration of contrast media to renally impaired patients undergoing multidetector computed tomography (MDCT) is not well characterized. Our objective was to investigate the incidence of CIN in patients with glomerular filtration rate (GFR) <60 ml/min undergoing contrast-enhanced MDCT examinations and to compare the rates of CIN following the IV administration of low-osmolar contrast media (LOCM, iopamidol and iomeprol) and an iso-osmolar contrast medium (IOCM, iodixanol). A total of 301 adult patients with moderate-to-severe renal failure received a similar IV contrast dose (40 gI). Serum creatinine (SCr) was measured at screening, baseline and 48-72 +/- 6 h after the MDCT examination. Primary CIN outcome was an increase in SCr >or=0.5 mg/dl (>or=44.2 micromol/l) from baseline. The CIN rates were 2.3% in the total population, 0.6% when GFR >40 ml/min, 4.6% when GFR <40 ml/min and 7.8% in patients with GFR <30 ml/min. The incidence of CIN was significantly higher after iodixanol than after LOCM (seven patients, 4.7% following IOCM, no CIN cases following the LOCM; p = 0.007). Significant differences in favor of the LOCM were also observed in patients with GFR <40 ml/min and GFR <30 ml/min. Following the IV administration of nonionic contrast agents in patients with moderate-to-severe renal insufficiency, the risk of significant CIN seems to be low. The IOCM iodixanol caused a higher rate of CIN than the LOCM iopamidol and iomeprol, especially in high-risk patients. Differences in osmolality between these LOCM and iodixanol do not play a role in the genesis of CIN.

  14. Imaging assessment of desmoid tumours in familial adenomatous polyposis: is state-of-the-art 1.5 T MRI better than 64-MDCT?

    PubMed Central

    Sinha, A; Hansmann, A; Bhandari, S; Gupta, A; Burling, D; Rana, S; Phillips, R K; Clark, S K; Goh, V

    2012-01-01

    Objective Desmoid tumour is a common extraintestinal manifestation of patients with familial adenomatous polyposis (FAP) who have undergone prophylactic colectomy. We aimed to determine whether MRI provides equivalent or better assessment of desmoid tumours than CT, the current first-line investigation. Methods Following ethics approval and informed consent, FAP patients with known desmoid tumour underwent contrast-enhanced 64-slice multidetector CT (MDCT) and 1.5 T MRI (incorporating T1 weighted, T2 weighted, short tau inversion–recovery and T1 weighted with contrast, axial, sagittal and coronal sequences). The number, site, size, local extent, tumour signal intensity and desmoid-to-aorta enhancement ratio were analysed. Results MRI identified 23 desmoid tumours in 9 patients: 9 intra-abdominal desmoid (IAD) tumours, 10 abdominal wall desmoid (AWD) tumours and 4 extra-abdominal desmoid (EAD) tumours. CT identified only 21 desmoids; 1 EAD and 1 AWD were not identified. The two modalities were equivalent in terms of defining local extent of desmoid. Five IAD tumours involved the bowel, six caused ureteric compression and none compromised the proximal superior mesenteric artery. There was no difference in median desmoid size: 56.7 cm2 (range 2–215 cm2) on MDCT and 56.3 cm2 (3–215 cm2) on MRI (p=0.985). The mean MRI enhancement ratio, at 1.12 (standard deviation 0.43), was greater than the CT enhancement ratio, which was 0.48 (0.16) (p<0.0001). High signal intensity on T2 MRI was associated with increased MRI enhancement ratio (p=0.006). Conclusions MRI is at least equivalent (and may be superior) to MDCT for the detection of desmoid tumours in FAP. Coupled with the advantage of avoiding radiation, it should be considered as the primary imaging modality for young FAP patients. PMID:22215881

  15. Selection of peripheral intravenous catheters with 24-gauge side-holes versus those with 22-gauge end-hole for MDCT: A prospective randomized study.

    PubMed

    Tamura, Akio; Kato, Kenichi; Kamata, Masayoshi; Suzuki, Tomohiro; Suzuki, Michiko; Nakayama, Manabu; Tomabechi, Makiko; Nakasato, Tatsuhiko; Ehara, Shigeru

    2017-02-01

    To compare the 24-gauge side-holes catheter and conventional 22-gauge end-hole catheter in terms of safety, injection pressure, and contrast enhancement on multi-detector computed tomography (MDCT). In a randomized single-center study, 180 patients were randomized to either the 24-gauge side-holes catheter or the 22-gauge end-hole catheter groups. The primary endpoint was safety during intravenous administration of contrast material for MDCT, using a non-inferiority analysis (lower limit 95% CI greater than -10% non-inferiority margin for the group difference). The secondary endpoints were injection pressure and contrast enhancement. A total of 174 patients were analyzed for safety during intravenous contrast material administration for MDCT. The overall extravasation rate was 1.1% (2/174 patients); 1 (1.2%) minor episode occurred in the 24-gauge side-holes catheter group and 1 (1.1%) in the 22-gauge end-hole catheter group (difference: 0.1%, 95% CI: -3.17% to 3.28%, non-inferiority P=1). The mean maximum pressure was higher with the 24-gauge side-holes catheter than with the 22-gauge end-hole catheter (8.16±0.95kg/cm(2) vs. 4.79±0.63kg/cm(2), P<0.001). The mean contrast enhancement of the abdominal aorta, celiac artery, superior mesenteric artery, and pancreatic parenchyma in the two groups were not significantly different. In conclusion, our study showed that the 24-gauge side-holes catheter is safe and suitable for delivering iodine with a concentration of 300mg/mL at a flow-rate of 3mL/s, and it may contribute to the care of some patients, such as patients who have fragile and small veins. (Trial registration: UMIN000023727). Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Arterial double-contrast dual-energy MDCT: in-vivo rabbit atherosclerosis with iodinated nanoparticles and gadolinium agents

    NASA Astrophysics Data System (ADS)

    Carmi, Raz; Kafri, Galit; Altman, Ami; Goshen, Liran; Planer, David; Sosna, Jacob

    2010-03-01

    An in-vivo feasibility study of potentially improved atherosclerosis CT imaging is presented. By administration of two different contrast agents to rabbits with induced atherosclerotic plaques we aim at identifying both soft plaque and vessel lumen simultaneously. Initial injection of iodinated nanoparticle (INP) contrast agent (N1177 - Nanoscan Imaging), two to four hours before scan, leads to its later accumulation in macrophage-rich soft plaque, while a second gadolinium contrast agent (Magnevist) injected immediately prior to the scan blends with the aortic blood. The distinction between the two agents in a single scan is achieved with a double-layer dual-energy MDCT (Philips Healthcare) following material separation analysis using the reconstructed images of the different x-ray spectra. A single contrast agent injection scan, where only INP was injected two hours prior to the scan, was compared to a double-contrast scan taken four hours after INP injection and immediately after gadolinium injection. On the single contrast agent scan we observed along the aorta walls, localized iodine accumulation which can point on INP uptake by atherosclerotic plaque. In the double-contrast scan the gadolinium contributes a clearer depiction of the vessel lumen in addition to the lasting INP presence. The material separation shows a good correlation to the pathologies inferred from the conventional CT images of the two different scans while performing only a single scan prevents miss-registration problems and reduces radiation dose. These results suggest that a double-contrast dual-energy CT may be used for advanced clinical diagnostic applications.

  17. C-arm cone beam CT perfusion imaging in the angiographic suite: a comparison with MDCT perfusion imaging

    PubMed Central

    Niu, Kai; Yang, Pengfei; Wu, Yijing; Struffert, Tobias; Doerfler, Arnd; Schafer, Sebastian; Royalty, Kevin; Strother, Charles; Chen, Guang-Hong

    2015-01-01

    Purpose and background Perfusion imaging in the angiography suite may provide a way to reduce time from stroke onset to endovascular revascularization of patients with a large vessel occlusion. Our purpose was to compare CBCTP with MDCTP. Materials and Methods Data from seven subjects with both MDCTP and CBCTP were retrospectively processed and analyzed. Two algorithms were used to enhance temporal resolution, temporal sampling density and reduce noise of CBCT data before generating perfusion maps. Two readers performed qualitative image quality evaluation on maps using a 5-point scale. ROIs indicating CBF/CBV abnormalities were drawn. Quantitative analyses were performed using the Sørensen–Dice coefficients to quantify the similarity of abnormalities. A non-inferiority hypothesis was tested to compare CBCTP against CBCTP. Results Averaged image quality score for MDCTP and CBCTP images was 2.4 and 2.3 respectively. Averaged confidence scores in diagnosis were both 1.4 for MDCT and CBCT; averaged confidence scores on presence of a CBV/CBF mismatch was 1.7 (κ = 0.50) and 1.5 (κ = 0.64). For MDCTP and CBCTP maps the average score of confidence in making treatment decision was 1.4 (κ = 0.79) and 1.3 (κ = 0.90). Area under visual grading characteristic (AVGC) for the above four qualitative quality score showed an average AVGC of 0.50 with 95% confidence level cover centered at the mean for both readers. Sørensen–Dice coefficient for CBF maps is 0.81 and for CBV maps is 0.55. Conclusions After post-processing methods were applied to enhance image quality for CBCTP maps, the CBCTP maps were not inferior to those generated from MDCTP. PMID:26892987

  18. A novel scheme for detection of diffuse lung disease in MDCT by use of statistical texture features

    NASA Astrophysics Data System (ADS)

    Wang, Jiahui; Li, Feng; Doi, Kunio; Li, Qiang

    2009-02-01

    The successful development of high performance computer-aided-diagnostic systems has potential to assist radiologists in the detection and diagnosis of diffuse lung disease. We developed in this study an automated scheme for the detection of diffuse lung disease on multi-detector computed tomography (MDCT). Our database consisted of 68 CT scans, which included 31 normal and 37 abnormal cases with three kinds of abnormal patterns, i.e., ground glass opacity, reticular, and honeycombing. Two radiologists first selected the CT scans with abnormal patterns based on clinical reports. The areas that included specific abnormal patterns in the selected CT images were then delineated as reference standards by an expert chest radiologist. To detect abnormal cases with diffuse lung disease, the lungs were first segmented from the background in each slice by use of a texture analysis technique, and then divided into contiguous volumes of interest (VOIs) with a 64×64×64 matrix size. For each VOI, we calculated many statistical texture features, including the mean and standard deviation of CT values, features determined from the run length matrix, and features from the co-occurrence matrix. A quadratic classifier was employed for distinguishing between normal and abnormal VOIs by use of a leave-one-case-out validation scheme. A rule-based criterion was employed to further determine whether a case was normal or abnormal. For the detection of abnormal VOIs, our CAD system achieved a sensitivity of 86% and a specificity of 90%. For the detection of abnormal cases, it achieved a sensitivity of 89% and a specificity of 90%. This preliminary study indicates that our CAD system would be useful for the detection of diffuse lung disease.

  19. Radiation dose from MDCT using Monte Carlo simulations: estimating fetal dose due to pulmonary embolism scans accounting for overscan

    NASA Astrophysics Data System (ADS)

    Angel, E.; Wellnitz, C.; Goodsitt, M.; DeMarco, J.; Cagnon, C.; Ghatali, M.; Cody, D.; Stevens, D.; McCollough, C.; Primak, A.; McNitt-Gray, M.

    2007-03-01

    Pregnant women with shortness of breath are increasingly referred for CT Angiography to rule out Pulmonary Embolism (PE). While this exam is typically focused on the lungs, extending scan boundaries and overscan can add to the irradiated volume and have implications on fetal dose. The purpose of this work was to estimate radiation dose to the fetus when various levels of overscan were encountered. Two voxelized models of pregnant patients derived from actual patient anatomy were created based on image data. The models represent an early (< 7 weeks) and late term pregnancy (36 weeks). A previously validated Monte Carlo model of an MDCT scanner was used that takes into account physical details of the scanner. Simulated helical scans used 120 kVp, 4x5 mm beam collimation, pitch 1, and varying beam-off locations (edge of the irradiated volume) were used to represent different protocols plus overscan. Normalized dose (mGy/100mAs) was calculated for each fetus. For the early term and the late term pregnancy models, fetal dose estimates for a standard thoracic PE exam were estimated to be 0.05 and 0.3 mGy/100mAs, respectively, increasing to 9 mGy/100mAs when the beam-off location was extended to encompass the fetus. When performing PE exams to rule out PE in pregnant patients, the beam-off location may have a large effect on fetal dose, especially for late term pregnancies. Careful consideration of ending location of the x-ray beam - and not the end of image data - could result in significant reduction in radiation dose to the fetus.

  20. Underestimation of mortality due to chronic obstructive pulmonary disease (COPD) in Kentucky.

    PubMed

    Hughes, Therese S; Muldoon, Susan B; Tollerud, David J

    2006-08-01

    Chronic obstructive pulmonary disease (COPD) mortality may be underestimated because it is frequently listed as a contributory cause of death, rather then the underlying cause of death, on state death certificates. Contributory causes of death are not counted in mortality statistics. This may underestimate the true burden of disease. Determine the frequency in which COPD is listed as a contributory cause of death, rather than the underlying cause of death, per state mortality records for a one-year period, year 2000. 15,036 mortality records from Kentucky death certificates were examined for year 2000 for all deaths due to diseases most often associated with COPD; notably, heart disease, pneumonia/influenza, and asthma. Cases in which COPD was listed as a contributory cause of death for asthma, pneumonia and influenza was small (less than 1%). Cases in which COPD was listed as a contributory cause of death for heart disease was much higher at 6.8% (824 out of 12,084). Counting these cases increases the COPD age-adjusted mortality rate 39%, from 52.4 to 72.7/ 100,000 people. This study provided evidence to generate and support the hypothesis that COPD mortality is underestimated in Kentucky when the underlying cause of death is heart disease, thus underestimating the true burden of disease. COPD is a chronic, often severe disease commonly associated with comorbid conditions such as heart disease that ultimately lead to death, but which may not be accurately reflected in mortality statistics. Accurate reporting is essential for health planning, education, research, and treatment options.

  1. Underestimating the educability of Down's syndrome children: examination of methodological problems in recent literature.

    PubMed

    Rynders, J E; Spiker, D; Horrobin, J M

    1978-03-01

    For many years, the educational capabilities of Down's syndrome persons have been underestimated because a large number of studies purporting to give an accurate picture of Down's syndrome persons' developmental capabilities have had serious methodological flaws. A close examination of that literature, coupled with a look at findings from two current early education projects for Down's syndrome children, revealed that psychometrically defined educability is far more common in Down's syndrome persons than a cursory review of the literature would lead to believe.

  2. Underestimated Rate of Status Epilepticus according to the Traditional Definition of Status Epilepticus.

    PubMed

    Ong, Cheung-Ter; Wong, Yi-Sin; Sung, Sheng-Feng; Wu, Chi-Shun; Hsu, Yung-Chu; Su, Yu-Hsiang; Hung, Ling-Chien

    2015-01-01

    Status epilepticus (SE) is an important neurological emergency. Early diagnosis could improve outcomes. Traditionally, SE is defined as seizures lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness. Some specialists argued that the duration of seizures qualifying as SE should be shorter and the operational definition of SE was suggested. It is unclear whether physicians follow the operational definition. The objective of this study was to investigate whether the incidence of SE was underestimated and to investigate the underestimate rate. This retrospective study evaluates the difference in diagnosis of SE between operational definition and traditional definition of status epilepticus. Between July 1, 2012, and June 30, 2014, patients discharged with ICD-9 codes for epilepsy (345.X) in Chia-Yi Christian Hospital were included in the study. A seizure lasting at least 30 min or repeated seizures over 30 min without recovery of consciousness were considered SE according to the traditional definition of SE (TDSE). A seizure lasting between 5 and 30 min was considered SE according to the operational definition of SE (ODSE); it was defined as underestimated status epilepticus (UESE). During a 2-year period, there were 256 episodes of seizures requiring hospital admission. Among the 256 episodes, 99 episodes lasted longer than 5 min, out of which 61 (61.6%) episodes persisted over 30 min (TDSE) and 38 (38.4%) episodes continued between 5 and 30 min (UESE). In the 38 episodes of seizure lasting 5 to 30 minutes, only one episode was previously discharged as SE (ICD-9-CM 345.3). Conclusion. We underestimated 37.4% of SE. Continuing education regarding the diagnosis and treatment of epilepsy is important for physicians.

  3. the Underestimation of Isorene in Houston during the Texas 2013 DISCOVER-AQ Campaign

    NASA Astrophysics Data System (ADS)

    Choi, Y.; Diao, L.; Czader, B.; Li, X.; Estes, M. J.

    2014-12-01

    This study applies principal component analysis to aircraft data from the Texas 2013 DISCOVER-AQ (Deriving Information on Surface Conditions from Column and Vertically Resolved Observations Relevant to Air Quality) field campaign to characterize isoprene sources over Houston during September 2013. The biogenic isoprene signature appears in the third principal component and anthropogenic signals in the following two. Evaluations of the Community Multiscale Air Quality (CMAQ) model simulations of isoprene with airborne measurements are more accurate for suburban areas than for industrial areas. This study also compares model outputs to eight surface automated gas chromatograph (Auto-GC) measurements near the Houston ship channel industrial area during the nighttime and shows that modeled anthropogenic isoprene is underestimated by a factor of 10.60. This study employs a new simulation with a modified anthropogenic emissions inventory (constraining using the ratios of observed values versus simulated ones) that yields closer isoprene predictions at night with a reduction in the mean bias by 56.93%, implying that model-estimated isoprene emissions from the 2008 National Emission Inventory are underestimated in the city of Houston and that other climate models or chemistry and transport models using the same emissions inventory might also be underestimated in other Houston-like areas in the United States.

  4. Hearing in slow-motion: Humans underestimate the speed of moving sounds

    PubMed Central

    Senna, Irene; Parise, Cesare V.; Ernst, Marc O.

    2015-01-01

    Perception can often be described as a statistically optimal inference process whereby noisy and incomplete sensory evidence is combined with prior knowledge about natural scene statistics. Previous evidence has shown that humans tend to underestimate the speed of unreliable moving visual stimuli. This finding has been interpreted in terms of a Bayesian prior favoring low speed, given that in natural visual scenes objects are mostly stationary or slowly-moving. Here we investigated whether an analogous tendency to underestimate speed also occurs in audition: even if the statistics of the visual environment seem to favor low speed, the statistics of the stimuli reaching the individual senses may differ across modalities, hence potentially leading to different priors. Here we observed a systematic bias for underestimating the speed of unreliable moving sounds. This finding suggests the existence of a slow-motion prior in audition, analogous to the one previously found in vision. The nervous system might encode the overall statistics of the world, rather than the specific properties of the signals reaching the individual senses. PMID:26370720

  5. In-Vivo Assessment of Femoral Bone Strength Using Finite Element Analysis (FEA) Based on Routine MDCT Imaging: A Preliminary Study on Patients with Vertebral Fractures

    PubMed Central

    Liebl, Hans; Garcia, Eduardo Grande; Holzner, Fabian; Noel, Peter B.; Burgkart, Rainer; Rummeny, Ernst J.; Baum, Thomas; Bauer, Jan S.

    2015-01-01

    Purpose To experimentally validate a non-linear finite element analysis (FEA) modeling approach assessing in-vitro fracture risk at the proximal femur and to transfer the method to standard in-vivo multi-detector computed tomography (MDCT) data of the hip aiming to predict additional hip fracture risk in subjects with and without osteoporosis associated vertebral fractures using bone mineral density (BMD) measurements as gold standard. Methods One fresh-frozen human femur specimen was mechanically tested and fractured simulating stance and clinically relevant fall loading configurations to the hip. After experimental in-vitro validation, the FEA simulation protocol was transferred to standard contrast-enhanced in-vivo MDCT images to calculate individual hip fracture risk each for 4 subjects with and without a history of osteoporotic vertebral fractures matched by age and gender. In addition, FEA based risk factor calculations were compared to manual femoral BMD measurements of all subjects. Results In-vitro simulations showed good correlation with the experimentally measured strains both in stance (R2 = 0.963) and fall configuration (R2 = 0.976). The simulated maximum stress overestimated the experimental failure load (4743 N) by 14.7% (5440 N) while the simulated maximum strain overestimated by 4.7% (4968 N). The simulated failed elements coincided precisely with the experimentally determined fracture locations. BMD measurements in subjects with a history of osteoporotic vertebral fractures did not differ significantly from subjects without fragility fractures (femoral head: p = 0.989; femoral neck: p = 0.366), but showed higher FEA based risk factors for additional incident hip fractures (p = 0.028). Conclusion FEA simulations were successfully validated by elastic and destructive in-vitro experiments. In the subsequent in-vivo analyses, MDCT based FEA based risk factor differences for additional hip fractures were not mirrored by according BMD measurements. Our

  6. Sap flow is Underestimated by Thermal Dissipation Sensors due to Alterations of Wood Anatomy

    NASA Astrophysics Data System (ADS)

    Marañón-Jiménez, S.; Wiedemann, A.; van den Bulcke, J.; Cuntz, M.; Rebmann, C.; Steppe, K.

    2014-12-01

    The thermal dissipation technique (TD) is one of the most commonly adopted methods for sap flow measurements. However, underestimations of up to 60% of the tree transpiration have been reported with this technique, although the causes are not certainly known. The insertion of TD sensors within the stems causes damage of the wood tissue and subsequent healing reactions, changing wood anatomy and likely the sap flow path. However, the anatomical changes in response to the insertion of sap flow sensors and the effects on the measured flow have not been assessed yet. In this study, we investigate the alteration of vessel anatomy on wounds formed around TD sensors. Our main objectives were to elucidate the anatomical causes of sap flow underestimation for ring-porous and diffuse-porous species, and relate these changes to sap flow underestimations. Successive sets of TD probes were installed in early, mid and end of the growing season in Fagus sylvatica (diffuse-porous) and Quercus petraea (ring-porous) trees. They were logged after the growing season and additional sets of sensors were installed in the logged stems with presumably no healing reaction. The wood tissue surrounding each sensor was then excised and analysed by X-ray computed microtomography (X-ray micro CT). This technique allowed the quantification of vessel anatomical characteristics and the reconstruction of the 3-D internal microstructure of the xylem vessels so that extension and shape of the altered area could be determined. Gels and tyloses clogged the conductive vessels around the sensors in both beech and oak. The extension of the affected area was larger for beech although these anatomical changes led to similar sap flow underestimations in both species. The higher vessel size in oak may explain this result and, therefore, larger sap flow underestimation per area of affected conductive tissue. The wound healing reaction likely occurred within the first weeks after sensor installation, which

  7. Monte Carlo simulations in multi-detector CT (MDCT) for two PET/CT scanner models using MASH and FASH adult phantoms

    NASA Astrophysics Data System (ADS)

    Belinato, W.; Santos, W. S.; Paschoal, C. M. M.; Souza, D. N.

    2015-06-01

    The combination of positron emission tomography (PET) and computed tomography (CT) has been extensively used in oncology for diagnosis and staging of tumors, radiotherapy planning and follow-up of patients with cancer, as well as in cardiology and neurology. This study determines by the Monte Carlo method the internal organ dose deposition for computational phantoms created by multidetector CT (MDCT) beams of two PET/CT devices operating with different parameters. The different MDCT beam parameters were largely related to the total filtration that provides a beam energetic change inside the gantry. This parameter was determined experimentally with the Accu-Gold Radcal measurement system. The experimental values of the total filtration were included in the simulations of two MCNPX code scenarios. The absorbed organ doses obtained in MASH and FASH phantoms indicate that bowtie filter geometry and the energy of the X-ray beam have significant influence on the results, although this influence can be compensated by adjusting other variables such as the tube current-time product (mAs) and pitch during PET/CT procedures.

  8. Evaluation of Lung MDCT Nodule Annotation Across Radiologists and Methods1

    PubMed Central

    Meyer, Charles R.; Johnson, Timothy D.; McLennan, Geoffrey; Aberle, Denise R.; Kazerooni, Ella A.; MacMahon, Heber; Mullan, Brian F.; Yankelevitz, David F.; van Beek, Edwin J. R.; Armato, Samuel G.; McNitt-Gray, Michael F.; Reeves, Anthony P.; Gur, David; Henschke, Claudia I.; Hoffman, Eric A.; Bland, Peyton H.; Laderach, Gary; Pais, Richie; Qing, David; Piker, Chris; Guo, Junfeng; Starkey, Adam; Max, Daniel; Croft, Barbara Y.; Clarke, Laurence P.

    2007-01-01

    Rationale and Objectives Integral to the mission of the National Institutes of Health–sponsored Lung Imaging Database Consortium is the accurate definition of the spatial location of pulmonary nodules. Because the majority of small lung nodules are not resected, a reference standard from histopathology is generally unavailable. Thus assessing the source of variability in defining the spatial location of lung nodules by expert radiologists using different software tools as an alternative form of truth is necessary. Materials and Methods The relative differences in performance of six radiologists each applying three annotation methods to the task of defining the spatial extent of 23 different lung nodules were evaluated. The variability of radiologists’ spatial definitions for a nodule was measured using both volumes and probability maps (p-map). Results were analyzed using a linear mixed-effects model that included nested random effects. Results Across the combination of all nodules, volume and p-map model parameters were found to be significant at P < .05 for all methods, all radiologists, and all second-order interactions except one. The radiologist and methods variables accounted for 15% and 3.5% of the total p-map variance, respectively, and 40.4% and 31.1% of the total volume variance, respectively. Conclusion Radiologists represent the major source of variance as compared with drawing tools independent of drawing metric used. Although the random noise component is larger for the p-map analysis than for volume estimation, the p-map analysis appears to have more power to detect differences in radiologist-method combinations. The standard deviation of the volume measurement task appears to be proportional to nodule volume. PMID:16979075

  9. Underestimation of the Maximal Capacity of the Mitochondrial Electron Transport System in Oligomycin-Treated Cells

    PubMed Central

    Ruas, Juliana S.; Siqueira-Santos, Edilene S.; Amigo, Ignacio; Rodrigues-Silva, Erika; Kowaltowski, Alicia J.; Castilho, Roger F.

    2016-01-01

    The maximal capacity of the mitochondrial electron transport system (ETS) in intact cells is frequently estimated by promoting protonophore-induced maximal oxygen consumption preceded by inhibition of oxidative phosphorylation by oligomycin. In the present study, human glioma (T98G and U-87MG) and prostate cancer (PC-3) cells were titrated with different concentrations of the protonophore CCCP to induce maximal oxygen consumption rate (OCR) within respirometers in a conventional growth medium. The results demonstrate that the presence of oligomycin or its A-isomer leads to underestimation of maximal ETS capacity. In the presence of oligomycin, the spare respiratory capacity (SRC), i.e., the difference between the maximal and basal cellular OCR, was underestimated by 25 to 45%. The inhibitory effect of oligomycin on SRC was more pronounced in T98G cells and was observed in both suspended and attached cells. Underestimation of SRC also occurred when oxidative phosphorylation was fully inhibited by the ATP synthase inhibitor citreoviridin. Further experiments indicated that oligomycin cannot be replaced by the adenine nucleotide translocase inhibitors bongkrekic acid or carboxyatractyloside because, although these compounds have effects in permeabilized cells, they do not inhibit oxidative phosphorylation in intact cells. We replaced CCCP by FCCP, another potent protonophore and similar results were observed. Lower maximal OCR and SRC values were obtained with the weaker protonophore 2,4-dinitrophenol, and these parameters were not affected by the presence of oligomycin. In permeabilized cells or isolated brain mitochondria incubated with respiratory substrates, only a minor inhibitory effect of oligomycin on CCCP-induced maximal OCR was observed. We conclude that unless a previously validated protocol is employed, maximal ETS capacity in intact cells should be estimated without oligomycin. The inhibitory effect of an ATP synthase blocker on potent protonophore

  10. Underestimating the Alcohol Content of a Glass of Wine: The Implications for Estimates of Mortality Risk

    PubMed Central

    Britton, Annie; O’Neill, Darragh; Bell, Steven

    2016-01-01

    Aims Increases in glass sizes and wine strength over the last 25 years in the UK are likely to have led to an underestimation of alcohol intake in population studies. We explore whether this probable misclassification affects the association between average alcohol intake and risk of mortality from all causes, cardiovascular disease and cancer. Methods Self-reported alcohol consumption in 1997–1999 among 7010 men and women in the Whitehall II cohort of British civil servants was linked to the risk of mortality until mid-2015. A conversion factor of 8 g of alcohol per wine glass (1 unit) was compared with a conversion of 16 g per wine glass (2 units). Results When applying a higher alcohol content conversion for wine consumption, the proportion of heavy/very heavy drinkers increased from 28% to 41% for men and 15% to 28% for women. There was a significantly increased risk of very heavy drinking compared with moderate drinking for deaths from all causes and cancer before and after change in wine conversion; however, the hazard ratios were reduced when a higher wine conversion was used. Conclusions In this population-based study, assuming higher alcohol content in wine glasses changed the estimates of mortality risk. We propose that investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. Prospectively, researchers need to collect more detailed information on alcohol including serving sizes and strength. Short summary The alcohol content in a wine glass is likely to be underestimated in population surveys as wine strength and serving size have increased in recent years. We demonstrate that in a large cohort study, this underestimation affects estimates of mortality risk. Investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. PMID:27261472

  11. Family and professionals underestimate quality of life across diverse cultures and health conditions: systematic review.

    PubMed

    Crocker, Thomas F; Smith, Jaime K; Skevington, Suzanne M

    2015-05-01

    To examine how accurately proxies evaluate quality of life (QoL) in people they know, using cross-cultural data from the multidimensional, multilingual World Health Organization Quality of Life assessment short-form (the WHOQOL-BREF) and whether accuracy varies by health condition or proxy type (eg, family/professional). Systematic review with meta-analysis: We searched five databases for reports of proxy-completed WHOQOL-BREF scores and aggregated results using a random-effects model. Minimal clinically important difference values were calculated. Analyses included nine studies (1980 dyads) of physical (n = 762) or mental (n = 604) health conditions, or intellectual disability (n = 614), in 10 countries. Mean person-proxy correlations ranged from 0.28 (social QoL) to 0.44 (physical QoL). Proxy measures were underestimates (ie, significantly lower than persons reported for themselves) for social [mean difference (MD) = 4.7, 95% confidence interval (CI): 1.8, 7.6], psychological (MD = 3.7, 95% CI: 0.6, 6.8), and physical (MD = 3.1, 95% CI: 0.6, 5.6) QoL. Underestimates varied significantly between health conditions for social (P < 0.001), psychological (P = 0.009), and physical (P = 0.02) QoL. Family members assessed psychological and environmental QoL better than professionals. Proxies tend to be imprecise, underestimating QoL, and should be aware of this tendency. Where health care is decided for others, family members' views about QoL should be prioritized. Copyright © 2015 Elsevier Inc. All rights reserved.

  12. Underestimating the Alcohol Content of a Glass of Wine: The Implications for Estimates of Mortality Risk.

    PubMed

    Britton, Annie; O'Neill, Darragh; Bell, Steven

    2016-09-01

    Increases in glass sizes and wine strength over the last 25 years in the UK are likely to have led to an underestimation of alcohol intake in population studies. We explore whether this probable misclassification affects the association between average alcohol intake and risk of mortality from all causes, cardiovascular disease and cancer. Self-reported alcohol consumption in 1997-1999 among 7010 men and women in the Whitehall II cohort of British civil servants was linked to the risk of mortality until mid-2015. A conversion factor of 8 g of alcohol per wine glass (1 unit) was compared with a conversion of 16 g per wine glass (2 units). When applying a higher alcohol content conversion for wine consumption, the proportion of heavy/very heavy drinkers increased from 28% to 41% for men and 15% to 28% for women. There was a significantly increased risk of very heavy drinking compared with moderate drinking for deaths from all causes and cancer before and after change in wine conversion; however, the hazard ratios were reduced when a higher wine conversion was used. In this population-based study, assuming higher alcohol content in wine glasses changed the estimates of mortality risk. We propose that investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. Prospectively, researchers need to collect more detailed information on alcohol including serving sizes and strength. The alcohol content in a wine glass is likely to be underestimated in population surveys as wine strength and serving size have increased in recent years. We demonstrate that in a large cohort study, this underestimation affects estimates of mortality risk. Investigator-led cohorts need to revisit conversion factors based on more accurate estimates of alcohol content in wine glasses. © The Author 2016. Medical Council on Alcohol and Oxford University Press.

  13. Connectedness underlies the underestimation of the horizontal vertical illusion in L-shaped configurations.

    PubMed

    Cai, Yongchun; Wang, Ci; Song, Chao; Li, Zhi

    2017-05-01

    L-shaped configuration is a commonly used stimulus configuration in studying horizontal vertical illusion. Here, we report that the horizontal vertical illusion is substantially underestimated when the L-shaped configuration is used for evaluating the illusion. Experiment 1 found that, in a length perception task, the perceived length of a vertical bar was about 10% longer than that of a horizontal bar with the same physical size. Similar amount of HVI was found in a length comparison task, in which the length of a horizontal bar was compared to that of a vertical bar and the two bars were presented separately in space or in time. In contrast, when the length comparison task was conducted with the two bars being arranged in a connected L-shape, the illusion was halved in strength. Experiment 2 and 3 studied what might be the cause of this L-shape induced HVI-underestimation. Two factors were investigated: the connectedness of the two lines, and the 45° absolute orientation or the 45° inner angle information embedded in the upright isosceles L-shape. The results showed that the HVI strength was not much affected when the 45° absolute orientation and the 45° angle information was made useless for the length comparison task. In contrast, the illusion was significantly reduced in strength whenever the two lines were separated as compared to when they were connected. These results suggested that the connectedness of the two lines must underlie the underestimation of the horizontal vertical illusion in the L-shaped configurations.

  14. Underestimation of the Maximal Capacity of the Mitochondrial Electron Transport System in Oligomycin-Treated Cells.

    PubMed

    Ruas, Juliana S; Siqueira-Santos, Edilene S; Amigo, Ignacio; Rodrigues-Silva, Erika; Kowaltowski, Alicia J; Castilho, Roger F

    2016-01-01

    The maximal capacity of the mitochondrial electron transport system (ETS) in intact cells is frequently estimated by promoting protonophore-induced maximal oxygen consumption preceded by inhibition of oxidative phosphorylation by oligomycin. In the present study, human glioma (T98G and U-87MG) and prostate cancer (PC-3) cells were titrated with different concentrations of the protonophore CCCP to induce maximal oxygen consumption rate (OCR) within respirometers in a conventional growth medium. The results demonstrate that the presence of oligomycin or its A-isomer leads to underestimation of maximal ETS capacity. In the presence of oligomycin, the spare respiratory capacity (SRC), i.e., the difference between the maximal and basal cellular OCR, was underestimated by 25 to 45%. The inhibitory effect of oligomycin on SRC was more pronounced in T98G cells and was observed in both suspended and attached cells. Underestimation of SRC also occurred when oxidative phosphorylation was fully inhibited by the ATP synthase inhibitor citreoviridin. Further experiments indicated that oligomycin cannot be replaced by the adenine nucleotide translocase inhibitors bongkrekic acid or carboxyatractyloside because, although these compounds have effects in permeabilized cells, they do not inhibit oxidative phosphorylation in intact cells. We replaced CCCP by FCCP, another potent protonophore and similar results were observed. Lower maximal OCR and SRC values were obtained with the weaker protonophore 2,4-dinitrophenol, and these parameters were not affected by the presence of oligomycin. In permeabilized cells or isolated brain mitochondria incubated with respiratory substrates, only a minor inhibitory effect of oligomycin on CCCP-induced maximal OCR was observed. We conclude that unless a previously validated protocol is employed, maximal ETS capacity in intact cells should be estimated without oligomycin. The inhibitory effect of an ATP synthase blocker on potent protonophore

  15. Celiac Axis, Common Hepatic and Hepatic Artery Variants as Evidenced on MDCT Angiography in South Indian Population

    PubMed Central

    Parthasarathy, Ramesh

    2016-01-01

    Introduction With the increase in the hepatobiliary, pancreatic surgeries and liver transplantation, being aware of the anatomic variations of the celiac axis and the hepatic arteries is of paramount importance. Aim To illustrate the normal anatomy and variants of the celiac axis and the hepatic arteries with multidetector computed tomographic (MDCT) angiography in South Indian population and determine the potential variations in the celiac axis anatomy and the hepatic arteries, thus assisting the hepatobiliary surgeon and the interventional radiologist in avoiding iatrogenic injury to the arteries. Materials and Methods Two hundred patients undergoing abdominal CT angiography from July 2014 till July 2015 were retrospectively studied for hepatic arterial and celiac axis anatomical variation. The anatomic variations in our study were correlated with other studies. Results The celiac axis (CA) and the hepatic artery (HA) variations were analysed as per criteria laid by Song et al., and Michel. Out of 15 possible CA variations, 5 types of celiac artery variations were seen in 14 patients. A normal CA was seen in 179(89.5%) patients of the 200 patients. In the remaining 7 patients, the CA anatomy was classified as ambiguous since there was separate origin of the right and left hepatic arteries from the CA with absent common hepatic artery (CHA). The CHA originated normally from the celiac axis in 94% of the cases. Variation of CHA origin was seen in 5 patients. Normal HA anatomy was seen in 114 (57%) patients. Variation in HA anatomy was seen in 86 (43%) patients. Origin of the right hepatic artery (RHA) from the hepatic artery proper was seen in 182 (91%) patients and replaced origin of RHA from the superior mesenteric artery (SMA) was seen in 18 (9%) of the cases. Accessory RHA was seen in 7(3.5%) patients. The left hepatic artery (LHA) originated from the hepatic artery proper in 186 (93%) patients and replaced origin of LHA from the left gastric artery (LGA) was

  16. EPA underestimates, oversimplifies, miscommunicates, and mismanages cancer risks by ignoring human susceptibility.

    PubMed

    Finkel, Adam M

    2014-10-01

    If exposed to an identical concentration of a carcinogen, every human being would face a different level of risk, determined by his or her genetic, environmental, medical, and other uniquely individual characteristics. Various lines of evidence indicate that this susceptibility variable is distributed rather broadly in the human population, with perhaps a factor of 25- to 50-fold between the center of this distribution and either of its tails, but cancer risk assessment at the EPA and elsewhere has always treated every (adult) human as identically susceptible. The National Academy of Sciences "Silver Book" concluded that EPA and the other agencies should fundamentally correct their mis-computation of carcinogenic risk in two ways: (1) adjust individual risk estimates upward to provide information about the upper tail; and (2) adjust population risk estimates upward (by about sevenfold) to correct an underestimation due to a mathematical property of the interindividual distribution of human susceptibility, in which the susceptibility averaged over the entire (right-skewed) population exceeds the median value for the typical human. In this issue of Risk Analysis, Kenneth Bogen disputes the second adjustment and endorses the first, though he also relegates the problem of underestimated individual risks to the realm of "equity concerns" that he says should have little if any bearing on risk management policy. In this article, I show why the basis for the population risk adjustment that the NAS recommended is correct-that current population cancer risk estimates, whether they are derived from animal bioassays or from human epidemiologic studies, likely provide estimates of the median with respect to human variation, which in turn must be an underestimate of the mean. If cancer risk estimates have larger "conservative" biases embedded in them, a premise I have disputed in many previous writings, such a defect would not excuse ignoring this additional bias in the

  17. Underestimation of oxygen deficiency hazard through use of linearized temperature profiles

    SciTech Connect

    Kerby, J.

    1989-06-15

    The failure mode analysis for any cryogenic system includes the effects of a large liquid spill due to vessel rupture or overfilling. The Oxygen Deficiency Hazard (ODH) analysis for this event is a strong function of the estimated heat flux entering the spilled liquid. A common method for estimating the heat flux is to treat the surface on which the liquid spills as a semi-infinite solid. This note addresses the effect of linearizing the temperature profile in this form of analysis, and shows it to cause the calculated flux to be underestimated by more than a factor of two. 3 refs., 2 figs.

  18. Characteristic image quality of a third generation dual-source MDCT scanner: Noise, resolution, and detectability

    SciTech Connect

    Solomon, Justin; Wilson, Joshua; Samei, Ehsan

    2015-08-15

    increasing dose and decreasing phantom size. The CT system exhibited nonlinear noise and resolution properties, especially at very low-doses, large phantom sizes, and for low-contrast objects. Objective image quality metrics generally increased with increasing dose and ADMIRE strength, and with decreasing phantom size. The ADMIRE algorithm could offer comparable image quality at reduced doses or improved image quality at the same dose. The use of tube current modulation resulted in more consistent image quality with changing phantom size.

  19. Narita Target Heart Rate Equation Underestimates the Predicted Adequate Exercise Level in Sedentary Young Boys

    PubMed Central

    Siahkouhian, Marefat; Khodadadi, Davar

    2013-01-01

    Purpose Optimal training intensity and the adequate exercise level for physical fitness is one of the most important interests of coaches and sports physiologists. The aim of this study was to investigate the validity of the Narita et al target heart rate equation for the adequate exercise training level in sedentary young boys. Methods Forty two sedentary young boys (19.07±1.16 years) undertook a blood lactate transition threshold maximal treadmill test to volitional exhaustion with continuous respiratory gas measurements according to the Craig method. The anaerobic threshold (AT) of the participants then was calculated using the Narita target heart rate equation. Results Hopkin's spreadsheet to obtain confidence limit and the chance of the true difference between gas measurements and Narita target heart rate equation revealed that the Narita equation most likely underestimates the measured anaerobic threshold in sedentary young boys (168.76±15 vs. 130.08±14.36) (Difference ±90% confidence limit: 38.1±18). Intraclass correlation coefficient (ICC) showed a poor agreement between the criterion method and Narita equation (ICC= 0.03). Conclusion According to the results, the Narita equation underestimates the measured AT. It seems that the Narita equation is a good predictor of aerobic not AT which can be investigated in the future studies. PMID:24427475

  20. Underestimated risks of recurrent long-range ash dispersal from northern Pacific Arc volcanoes

    NASA Astrophysics Data System (ADS)

    Bourne, A. J.; Abbott, P. M.; Albert, P. G.; Cook, E.; Pearce, N. J. G.; Ponomareva, V.; Svensson, A.; Davies, S. M.

    2016-07-01

    Widespread ash dispersal poses a significant natural hazard to society, particularly in relation to disruption to aviation. Assessing the extent of the threat of far-travelled ash clouds on flight paths is substantially hindered by an incomplete volcanic history and an underestimation of the potential reach of distant eruptive centres. The risk of extensive ash clouds to aviation is thus poorly quantified. New evidence is presented of explosive Late Pleistocene eruptions in the Pacific Arc, currently undocumented in the proximal geological record, which dispersed ash up to 8000 km from source. Twelve microscopic ash deposits or cryptotephra, invisible to the naked eye, discovered within Greenland ice-cores, and ranging in age between 11.1 and 83.7 ka b2k, are compositionally matched to northern Pacific Arc sources including Japan, Kamchatka, Cascades and Alaska. Only two cryptotephra deposits are correlated to known high-magnitude eruptions (Towada-H, Japan, ca 15 ka BP and Mount St Helens Set M, ca 28 ka BP). For the remaining 10 deposits, there is no evidence of age- and compositionally-equivalent eruptive events in regional volcanic stratigraphies. This highlights the inherent problem of under-reporting eruptions and the dangers of underestimating the long-term risk of widespread ash dispersal for trans-Pacific and trans-Atlantic flight routes.

  1. Drastic underestimation of amphipod biodiversity in the endangered Irano-Anatolian and Caucasus biodiversity hotspots.

    PubMed

    Katouzian, Ahmad-Reza; Sari, Alireza; Macher, Jan N; Weiss, Martina; Saboori, Alireza; Leese, Florian; Weigand, Alexander M

    2016-03-01

    Biodiversity hotspots are centers of biological diversity and particularly threatened by anthropogenic activities. Their true magnitude of species diversity and endemism, however, is still largely unknown as species diversity is traditionally assessed using morphological descriptions only, thereby ignoring cryptic species. This directly limits evidence-based monitoring and management strategies. Here we used molecular species delimitation methods to quantify cryptic diversity of the montane amphipods in the Irano-Anatolian and Caucasus biodiversity hotspots. Amphipods are ecosystem engineers in rivers and lakes. Species diversity was assessed by analysing two genetic markers (mitochondrial COI and nuclear 28S rDNA), compared with morphological assignments. Our results unambiguously demonstrate that species diversity and endemism is dramatically underestimated, with 42 genetically identified freshwater species in only five reported morphospecies. Over 90% of the newly recovered species cluster inside Gammarus komareki and G. lacustris; 69% of the recovered species comprise narrow range endemics. Amphipod biodiversity is drastically underestimated for the studied regions. Thus, the risk of biodiversity loss is significantly greater than currently inferred as most endangered species remain unrecognized and/or are only found locally. Integrative application of genetic assessments in monitoring programs will help to understand the true magnitude of biodiversity and accurately evaluate its threat status.

  2. Underestimated risks of recurrent long-range ash dispersal from northern Pacific Arc volcanoes

    PubMed Central

    Bourne, A. J.; Abbott, P. M.; Albert, P. G.; Cook, E.; Pearce, N. J. G.; Ponomareva, V.; Svensson, A.; Davies, S. M.

    2016-01-01

    Widespread ash dispersal poses a significant natural hazard to society, particularly in relation to disruption to aviation. Assessing the extent of the threat of far-travelled ash clouds on flight paths is substantially hindered by an incomplete volcanic history and an underestimation of the potential reach of distant eruptive centres. The risk of extensive ash clouds to aviation is thus poorly quantified. New evidence is presented of explosive Late Pleistocene eruptions in the Pacific Arc, currently undocumented in the proximal geological record, which dispersed ash up to 8000 km from source. Twelve microscopic ash deposits or cryptotephra, invisible to the naked eye, discovered within Greenland ice-cores, and ranging in age between 11.1 and 83.7 ka b2k, are compositionally matched to northern Pacific Arc sources including Japan, Kamchatka, Cascades and Alaska. Only two cryptotephra deposits are correlated to known high-magnitude eruptions (Towada-H, Japan, ca 15 ka BP and Mount St Helens Set M, ca 28 ka BP). For the remaining 10 deposits, there is no evidence of age- and compositionally-equivalent eruptive events in regional volcanic stratigraphies. This highlights the inherent problem of under-reporting eruptions and the dangers of underestimating the long-term risk of widespread ash dispersal for trans-Pacific and trans-Atlantic flight routes. PMID:27445233

  3. Underestimation rate of lobular intraepithelial neoplasia in vacuum-assisted breast biopsy.

    PubMed

    Meroni, Stefano; Stefano, Meroni; Bozzini, Anna Carla; Carla, Bozzini Anna; Pruneri, Giancarlo; Giancarlo, Pruneri; Moscovici, Oana Codrina; Codrina, Moscovici Oana; Maisonneuve, Patrick; Patrick, Maisonneuve; Menna, Simona; Simona, Menna; Penco, Silvia; Silvia, Penco; Meneghetti, Lorenza; Lorenza, Meneghetti; Renne, Giuseppe; Giuseppe, Renne; Cassano, Enrico; Enrico, Cassano

    2014-07-01

    To evaluate the underestimation rate and clinical relevance of lobular neoplasia in vacuum-assisted breast biopsy (VABB). A total of 161 cases of LN were retrieved from 6,435 VABB. The histological diagnosis was ALH (atypical lobular hyperplasia) in 80 patients, LCIS (lobular carcinoma in situ) in 69 patients and PLCIS (pleomorphic lobular carcinoma in situ) in 12 patients. Seventy-six patients were operated on within 2 years after VABB and 85 were clinically and radiologically monitored. The mean follow-up was 5.2 years, and the prevalence of malignancy was evaluated in the group of 85 patients. The clinico-pathological characteristics significantly favouring surgery were larger lesions, occurrence of a residual lesion following VABB and histological LCIS and PLCIS subtypes. The VABB underestimation rate as compared to surgery was 7.1% for ALH, 12% for LCIS and 50% for PLCIS. Overall, 11 of the 148 patients included in this survival analysis developed an ipsilateral tumour. Although obtained retrospectively in a relatively small series of patients, our data suggest that only patients with a diagnosis of PLCIS in VABB should be treated with surgery, whereas patients with ALH and LCIS could be monitored by clinical and radiological examinations. • The treatment of ALH and LCIS in VABB is still debated • Some authors favour radical treatment and others a more conservative approach • Only patients with PLCIS in VABB should be treated by surgery.

  4. Cancer stem cells are underestimated by standard experimental methods in clear cell renal cell carcinoma

    PubMed Central

    Gedye, Craig; Sirskyj, Danylo; Lobo, Nazleen C.; Meens, Jalna; Hyatt, Elzbieta; Robinette, Michael; Fleshner, Neil; Hamilton, Robert J; Kulkarni, Girish; Zlotta, Alexandre; Evans, Andrew; Finelli, Antonio; Jewett, Michael A. S.; Ailles, Laurie E.

    2016-01-01

    Rare cancer stem cells (CSC) are proposed to be responsible for tumour propagation and re-initiation and are functionally defined by identifying tumour-initiating cells (TICs) using the xenotransplantation limiting dilution assay (LDA). While TICs in clear cell renal cell carcinoma (ccRCC) appeared rare in NOD/SCID/IL2Rγ−/− (NSG) mice, xenografts formed more efficiently from small tumour fragments, indicating the LDA underestimated ccRCC TIC frequency. Mechanistic interrogation of the LDA identified multiple steps that influence ccRCC TIC quantitation. For example, tissue disaggregation destroys most ccRCC cells, common assays significantly overestimate tumour cell viability, and microenvironmental supplementation with human extracellular factors or pharmacological inhibition of anoikis increase clonogenicity and tumourigenicity of ccRCC cell lines and primary tumour cells. Identification of these previously uncharacterized concerns that cumulatively lead to substantial underestimation of TICs in ccRCC provides a framework for development of more accurate TIC assays in the future, both for this disease and for other cancers. PMID:27121191

  5. Predictive equations underestimate resting energy expenditure in female adolescents with phenylketonuria

    PubMed Central

    Quirk, Meghan E.; Schmotzer, Brian J.; Schmotzer, Brian J.; Singh, Rani H.

    2010-01-01

    Resting energy expenditure (REE) is often used to estimate total energy needs. The Schofield equation based on weight and height has been reported to underestimate REE in female children with phenylketonuria (PKU). The objective of this observational, cross-sectional study was to evaluate the agreement of measured REE with predicted REE for female adolescents with PKU. A total of 36 females (aged 11.5-18.7 years) with PKU attending Emory University’s Metabolic Camp (June 2002 – June 2008) underwent indirect calorimetry. Measured REE was compared to six predictive equations using paired Student’s t-tests, regression-based analysis, and assessment of clinical accuracy. The differences between measured and predicted REE were modeled against clinical parameters to determine to if a relationship existed. All six selected equations significantly under predicted measured REE (P< 0.005). The Schofield equation based on weight had the greatest level of agreement, with the lowest mean prediction bias (144 kcal) and highest concordance correlation coefficient (0.626). However, the Schofield equation based on weight lacked clinical accuracy, predicting measured REE within ±10% in only 14 of 36 participants. Clinical parameters were not associated with bias for any of the equations. Predictive equations underestimated measured REE in this group of female adolescents with PKU. Currently, there is no accurate and precise alternative for indirect calorimetry in this population. PMID:20497783

  6. A large underestimate of the pyrogenic source of formic acid inferred from space-borne measurements.

    NASA Astrophysics Data System (ADS)

    Chaliyakunnel, S.; Millet, D. B.; Wells, K. C.; Cady-Pereira, K.; Shephard, M.

    2015-12-01

    Formic acid (HCOOH) is one of the most abundant carboxylic acids in the atmosphere, and a dominant source of acidity in the global troposphere. Recent work has revealed a major gap in our present understanding of the atmospheric formic acid budget, with observed concentrations much larger than can be reconciled with current estimates of its sources. In this work, we employ new space-based observations from the Tropospheric Emission Spectrometer (TES) satellite instrument with the GEOS-Chem chemical transport model to better quantify the source of atmospheric formic acid from biomass burning, and assess the degree to which this source can help close the large budget gap for this species. The space-based formic acid data reveal a severe model underestimate for HCOOH that is most prominent over tropical biomass burning regions, indicating a major missing source of organic acids from fires. Based on two independent methods for inferring the fractional contribution of fires to the measured HCOOH abundance, we find that the pyrogenic HCOOH:CO enhancement ratio measured by TES (including direct emissions plus secondary production) is 5-10 times higher than current estimates of the direct emission ratio, providing evidence of substantial secondary production of HCOOH in fire plumes. We further show that current models significantly underestimate (by a factor of 2-6) the total primary and secondary source of HCOOH from tropical fires.

  7. Social drinkers underestimate the additive impairing effects of alcohol and visual degradation on behavioral functioning.

    PubMed

    Harrison, Emily L R; Fillmore, Mark T

    2005-02-01

    Studies have shown that social drinkers are poor estimators of alcohol-induced impairment. Underestimates of blood alcohol concentration and other indices of intoxication are associated with decisions to perform risky behaviors, such as operating a motor vehicle. It is possible that self-evaluations of impaired functioning under alcohol might be particularly compromised in the presence of other sources of impairment. A common source of impairment that co-occurs with alcohol is visual degradation. The present study compared actual and self-evaluated impairment in response to four conditions (0.65 g/kg alcohol, degradation of task-relevant stimuli, alcohol plus visual degradation, and no-treatment control) to determine whether social drinkers would perceive an increase in impairment from the combined treatments. Actual psychomotor impairment was measured in 16 social drinkers (eight men) by a pursuit rotor task and their self-evaluations of this impairment were obtained on a rating scale. Alcohol and visual degradation impaired participants' actual performance to a similar degree and, in combination, the impairing effects were additive. Participants' self-evaluation ratings showed that they underestimated the additive impairment produced by the combination of alcohol and visual degradation. The findings suggest that social drinkers might be unable to appreciate an increase in behavioral impairment when alcohol is consumed in the context of another impairing influence.

  8. Drastic underestimation of amphipod biodiversity in the endangered Irano-Anatolian and Caucasus biodiversity hotspots

    PubMed Central

    Katouzian, Ahmad-Reza; Sari, Alireza; Macher, Jan N.; Weiss, Martina; Saboori, Alireza; Leese, Florian; Weigand, Alexander M.

    2016-01-01

    Biodiversity hotspots are centers of biological diversity and particularly threatened by anthropogenic activities. Their true magnitude of species diversity and endemism, however, is still largely unknown as species diversity is traditionally assessed using morphological descriptions only, thereby ignoring cryptic species. This directly limits evidence-based monitoring and management strategies. Here we used molecular species delimitation methods to quantify cryptic diversity of the montane amphipods in the Irano-Anatolian and Caucasus biodiversity hotspots. Amphipods are ecosystem engineers in rivers and lakes. Species diversity was assessed by analysing two genetic markers (mitochondrial COI and nuclear 28S rDNA), compared with morphological assignments. Our results unambiguously demonstrate that species diversity and endemism is dramatically underestimated, with 42 genetically identified freshwater species in only five reported morphospecies. Over 90% of the newly recovered species cluster inside Gammarus komareki and G. lacustris; 69% of the recovered species comprise narrow range endemics. Amphipod biodiversity is drastically underestimated for the studied regions. Thus, the risk of biodiversity loss is significantly greater than currently inferred as most endangered species remain unrecognized and/or are only found locally. Integrative application of genetic assessments in monitoring programs will help to understand the true magnitude of biodiversity and accurately evaluate its threat status. PMID:26928527

  9. Underestimated risks of recurrent long-range ash dispersal from northern Pacific Arc volcanoes.

    PubMed

    Bourne, A J; Abbott, P M; Albert, P G; Cook, E; Pearce, N J G; Ponomareva, V; Svensson, A; Davies, S M

    2016-07-21

    Widespread ash dispersal poses a significant natural hazard to society, particularly in relation to disruption to aviation. Assessing the extent of the threat of far-travelled ash clouds on flight paths is substantially hindered by an incomplete volcanic history and an underestimation of the potential reach of distant eruptive centres. The risk of extensive ash clouds to aviation is thus poorly quantified. New evidence is presented of explosive Late Pleistocene eruptions in the Pacific Arc, currently undocumented in the proximal geological record, which dispersed ash up to 8000 km from source. Twelve microscopic ash deposits or cryptotephra, invisible to the naked eye, discovered within Greenland ice-cores, and ranging in age between 11.1 and 83.7 ka b2k, are compositionally matched to northern Pacific Arc sources including Japan, Kamchatka, Cascades and Alaska. Only two cryptotephra deposits are correlated to known high-magnitude eruptions (Towada-H, Japan, ca 15 ka BP and Mount St Helens Set M, ca 28 ka BP). For the remaining 10 deposits, there is no evidence of age- and compositionally-equivalent eruptive events in regional volcanic stratigraphies. This highlights the inherent problem of under-reporting eruptions and the dangers of underestimating the long-term risk of widespread ash dispersal for trans-Pacific and trans-Atlantic flight routes.

  10. Typical pain experience but underestimation of others' pain: Emotion perception in self and others in autism spectrum disorder.

    PubMed

    Thaler, Hanna; Skewes, Joshua C; Gebauer, Line; Christensen, Peer; Prkachin, Kenneth M; Jegindø Elmholdt, Else-Marie

    2017-07-01

    Difficulties in emotion perception are commonly observed in autism spectrum disorder. However, it is unclear whether these difficulties can be attributed to a general problem of relating to emotional states, or whether they specifically concern the perception of others' expressions. This study addressed this question in the context of pain, a sensory and emotional state with strong social relevance. We investigated pain evaluation in self and others in 16 male individuals with autism spectrum disorder and 16 age- and gender-matched individuals without autism spectrum disorder. Both groups had at least average intelligence and comparable levels of alexithymia and pain catastrophizing. We assessed pain reactivity by administering suprathreshold electrical pain stimulation at four intensity levels. Pain evaluation in others was investigated using dynamic facial expressions of shoulder patients experiencing pain at the same four intensity levels. Participants with autism spectrum disorder evaluated their own pain as being more intense than the pain of others, showing an underestimation bias for others' pain at all intensity levels. Conversely, in the control group, self- and other evaluations of pain intensity were comparable and positively associated. Results indicate that emotion perception difficulties in autism spectrum disorder concern the evaluation of others' emotional expressions, with no evidence for atypical experience of own emotional states.

  11. The four different types of internal hernia occurring after laparascopic Roux-en-Y gastric bypass performed for morbid obesity: are there any multidetector computed tomography (MDCT) features permitting their distinction?

    PubMed

    Kawkabani Marchini, Aida; Denys, Alban; Paroz, Alexandre; Romy, Sébastien; Suter, Michel; Desmartines, Nicolas; Meuli, Reto; Schmidt, Sabine

    2011-04-01

    Four different types of internal hernias (IH) are known to occur after laparoscopic Roux-en-Y gastric bypass (LRYGBP) performed for morbid obesity. We evaluate multidetector row helical computed tomography (MDCT) features for their differentiation. From a prospectively collected database including 349 patients with LRYGBP, 34 acutely symptomatic patients (28 women, mean age 32.6), operated on for IH immediately after undergoing MDCT, were selected. Surgery confirmed 4 (11.6%) patients with transmesocolic, 10 (29.4%) with Petersen's, 15 (44.2%) with mesojejunal, and 5 (14.8%) with jejunojejunal IH. In consensus, 2 radiologists analyzed 13 MDCT features to distinguish the four types of IH. Statistical significance was calculated (p<0.05, Fisher's exact test, chi-square test). MDCT features of small bowel obstruction (SBO) (n=25, 73.5%), volvulus (n=22, 64.7%), or a cluster of small bowel loops (SBL) (n=27, 79.4%) were inconsistently present and overlapped between the four IH. The following features allowed for IH differentiation: left upper quadrant clustered small bowel loops (p<0.0001) and a mesocolic hernial orifice (p=0.0003) suggested transmesocolic IH. SBL abutting onto the left abdominal wall (p=0.0021) and left abdominal shift of the superior mesenteric vessels (SMV) (p=0.0045) suggested Petersen's hernia. The SMV predominantly shifted towards the right anterior abdominal wall in mesojejunal hernia (p=0.0033). Location of the hernial orifice near the distal anastomosis (p=0.0431) and jejunojejunal suture widening (p=0.0005) indicated jejunojejunal hernia. None of the four IH seems associated with a higher risk of SBO. Certain MDCT features, such as the position of clustered SBL and hernial orifice, help distinguish between the four IH and may permit straightforward surgery.

  12. Impact of aortic valve calcification, as measured by MDCT, on survival in patients with aortic stenosis: results of an international registry study.

    PubMed

    Clavel, Marie-Annick; Pibarot, Philippe; Messika-Zeitoun, David; Capoulade, Romain; Malouf, Joseph; Aggarval, Shivani; Araoz, Phillip A; Michelena, Hector I; Cueff, Caroline; Larose, Eric; Miller, Jordan D; Vahanian, Alec; Enriquez-Sarano, Maurice

    2014-09-23

    Aortic valve calcification (AVC) load measures lesion severity in aortic stenosis (AS) and is useful for diagnostic purposes. Whether AVC predicts survival after diagnosis, independent of clinical and Doppler echocardiographic AS characteristics, has not been studied. This study evaluated the impact of AVC load, absolute and relative to aortic annulus size (AVCdensity), on overall mortality in patients with AS under conservative treatment and without regard to treatment. In 3 academic centers, we enrolled 794 patients (mean age, 73 ± 12 years; 274 women) diagnosed with AS by Doppler echocardiography who underwent multidetector computed tomography (MDCT) within the same episode of care. Absolute AVC load and AVCdensity (ratio of absolute AVC to cross-sectional area of aortic annulus) were measured, and severe AVC was separately defined in men and women. During follow-up, there were 440 aortic valve implantations (AVIs) and 194 deaths (115 under medical treatment). Univariate analysis showed strong association of absolute AVC and AVCdensity with survival (both, p < 0.0001) with a spline curve analysis pattern of threshold and plateau of risk. After adjustment for age, sex, coronary artery disease, diabetes, symptoms, AS severity on hemodynamic assessment, and LV ejection fraction, severe absolute AVC (adjusted hazard ratio [HR]: 1.75; 95% confidence interval [CI]: 1.04 to 2.92; p = 0.03) or severe AVCdensity (adjusted HR: 2.44; 95% CI: 1.37 to 4.37; p = 0.002) independently predicted mortality under medical treatment, with additive model predictive value (all, p ≤ 0.04) and a net reclassification index of 12.5% (p = 0.04). Severe absolute AVC (adjusted HR: 1.71; 95% CI: 1.12 to 2.62; p = 0.01) and severe AVCdensity (adjusted HR: 2.22; 95% CI: 1.40 to 3.52; p = 0.001) also independently predicted overall mortality, even with adjustment for time-dependent AVI. This large-scale, multicenter outcomes study of quantitative Doppler echocardiographic and MDCT

  13. Patient Characteristics as Predictors of Image Quality and Diagnostic Accuracy of MDCT Compared With Conventional Coronary Angiography for Detecting Coronary Artery Stenoses: CORE-64 Multicenter International Trial

    PubMed Central

    Dewey, Marc; Vavere, Andrea L.; Arbab-Zadeh, Armin; Miller, Julie M.; Sara, Leonardo; Cox, Christopher; Gottlieb, Ilan; Yoshioka, Kunihiro; Paul, Narinder; Hoe, John; de Roos, Albert; Lardo, Albert C.; Lima, Joao A.; Clouse, Melvin E.

    2012-01-01

    OBJECTIVE The purpose of the study was to investigate patient characteristics associated with image quality and their impact on the diagnostic accuracy of MDCT for the detection of coronary artery stenosis. MATERIALS AND METHODS Two hundred ninety-one patients with a coronary artery calcification (CAC) score of ≤ 600 Agatston units (214 men and 77 women; mean age, 59.3 ± 10.0 years [SD]) were analyzed. An overall image quality score was derived using an ordinal scale. The accuracy of quantitative MDCT to detect significant (≥ 50%) stenoses was assessed using quantitative coronary angiography (QCA) per patient and per vessel using a modified 19-segment model. The effect of CAC, obesity, heart rate, and heart rate variability on image quality and accuracy were evaluated by multiple logistic regression. Image quality and accuracy were further analyzed in subgroups of significant predictor variables. Diagnostic analysis was determined for image quality strata using receiver operating characteristic (ROC) curves. RESULTS Increasing body mass index (BMI) (odds ratio [OR] = 0.89, p < 0.001), increasing heart rate (OR = 0.90, p < 0.001), and the presence of breathing artifact (OR = 4.97, p ≤ 0.001) were associated with poorer image quality whereas sex, CAC score, and heart rate variability were not. Compared with examinations of white patients, studies of black patients had significantly poorer image quality (OR = 0.58, p = 0.04). At a vessel level, CAC score (10 Agatston units) (OR = 1.03, p = 0.012) and patient age (OR = 1.02, p = 0.04) were significantly associated with the diagnostic accuracy of quantitative MDCT compared with QCA. A trend was observed in differences in the areas under the ROC curves across image quality strata at the vessel level (p = 0.08). CONCLUSION Image quality is significantly associated with patient ethnicity, BMI, mean scan heart rate, and the presence of breathing artifact but not with CAC score at a patient level. At a vessel level

  14. Do nurses risk underestimating the problems of patients with frontal lobe neoplasms?

    PubMed

    Palese, Alvisa; Romano, Alessia; Moreale, Renzo; Magee, Jesse

    2012-04-01

    Although the profile of the problems and risks associated with cancer patients has expanded over the past few years, and so has our available knowledge on the concordance between patients and nurses, there is a lack of evidence concerning neurosurgical patients. In comparison with patients who have neoplasm located in other lobes, those with frontal lobe cancer can suffer from personality changes, disinhibition, apathy, and higher-order attentional difficulties. Such behavior may give rise to a stigma, and consequently, pose a risk to have their problems misunderstood by caregivers, and be at greater risk than they are perceived to be. To explore the risk of nurses underestimating the problems of patients who were operated on for frontal neoplasm, compared to patients suffering from neoplasms located in other cerebral lobes. A prospective study was undertaken in 2008 in Italy. Patients admitted to the hospital with brain neoplasm were eligible for the study. For each patient with a frontal lobe neoplasm, a corresponding patient with a cerebral neoplasm located in either the temporal, parietal or occipital lobes was also included. Nurses working in the units involved and providing care to these patients were also included. On the afternoon of the 2nd postoperative day, the researcher interviewed both the patients, and the registered nurses (RNs) responsible for the patients' care, in regards to pain intensity, dependence in activities of daily living, anxiety and depression, and fear of falling, as each was perceived by patients and nurses. The level of concordance between the patients' and nurses' responses was calculated. Forty-six patients were considered (mean age 53.5 years); 23 had surgery for a frontal brain neoplasm and 23 for brain neoplasms located in either the temporal, parietal, or occipital areas. Overall, patients operated on for frontal lobe neoplasms had much of the same risks of underestimation of their problems, as patients with other cerebral

  15. Climate reconstructions of the NH mean temperature: Can underestimation of trends and variability be avoided?

    NASA Astrophysics Data System (ADS)

    Christiansen, Bo

    2010-05-01

    Knowledge about the climate in the period before instrumental records are available is based on climate proxies obtained from tree-rings, sediments, ice-cores etc. Reconstructing the climate from such proxies is therefore necessary for studies of climate variability and for placing recent climate change into a longer term perspective. More than a decade ago pioneering attempts at using a multi-proxy dataset to reconstruct the Northern Hemisphere (NH) mean temperature resulted in the much published "hockey-stick"; a NH mean temperature that did not vary much before the rapid increase in the last century. Subsequent reconstructions show some differences but the overall "hockey-stick" structure seems to be a persistent feature However, there has been an increasing awareness of the fact that the applied reconstruction methods underestimate the low-frequency variability and trends. The recognition of the inadequacies of the reconstruction methods has to a large degree originated from pseudo-proxy studies, i.e., from long climate model experiments where artificial proxies have been generated and reconstructions based on these have been compared to the known model climate. It has also been found that reconstructions contain a large element of stochasticity which is revealed as broad distributions of skills. This means that it is very difficult to draw conclusions from a single or a few realizations. Climate reconstruction methods are based on variants of linear regression models relating temperatures and proxies. In this contribution we review some of the theory of linear regression and error-in-variables models to identify the sources of the underestimation of variability. Based on the gained insight we formulate a reconstruction method supposed to minimize this underestimation. The method is tested by applying it to an ensemble of surrogate temperature fields based on two climate simulations covering the last 500 and 1000 years. Compared to the RegEM TTLS method and a

  16. Systematic Underestimation of Earthquake Magnitudes from Large Intracontinental Reverse Faults: Historical Ruptures Break Across Segment Boundaries

    NASA Technical Reports Server (NTRS)

    Rubin, C. M.

    1996-01-01

    Because most large-magnitude earthquakes along reverse faults have such irregular and complicated rupture patterns, reverse-fault segments defined on the basis of geometry alone may not be very useful for estimating sizes of future seismic sources. Most modern large ruptures of historical earthquakes generated by intracontinental reverse faults have involved geometrically complex rupture patterns. Ruptures across surficial discontinuities and complexities such as stepovers and cross-faults are common. Specifically, segment boundaries defined on the basis of discontinuities in surficial fault traces, pronounced changes in the geomorphology along strike, or the intersection of active faults commonly have not proven to be major impediments to rupture. Assuming that the seismic rupture will initiate and terminate at adjacent major geometric irregularities will commonly lead to underestimation of magnitudes of future large earthquakes.

  17. Underestimating nearby nature: affective forecasting errors obscure the happy path to sustainability.

    PubMed

    Nisbet, Elizabeth K; Zelenski, John M

    2011-09-01

    Modern lifestyles disconnect people from nature, and this may have adverse consequences for the well-being of both humans and the environment. In two experiments, we found that although outdoor walks in nearby nature made participants much happier than indoor walks did, participants made affective forecasting errors, such that they systematically underestimated nature's hedonic benefit. The pleasant moods experienced on outdoor nature walks facilitated a subjective sense of connection with nature, a construct strongly linked with concern for the environment and environmentally sustainable behavior. To the extent that affective forecasts determine choices, our findings suggest that people fail to maximize their time in nearby nature and thus miss opportunities to increase their happiness and relatedness to nature. Our findings suggest a happy path to sustainability, whereby contact with nature fosters individual happiness and environmentally responsible behavior.

  18. Does verbatim sentence recall underestimate the language competence of near-native speakers?

    PubMed Central

    Schweppe, Judith; Barth, Sandra; Ketzer-Nöltge, Almut; Rummer, Ralf

    2015-01-01

    Verbatim sentence recall is widely used to test the language competence of native and non-native speakers since it involves comprehension and production of connected speech. However, we assume that, to maintain surface information, sentence recall relies particularly on attentional resources, which differentially affects native and non-native speakers. Since even in near-natives language processing is less automatized than in native speakers, processing a sentence in a foreign language plus retaining its surface may result in a cognitive overload. We contrasted sentence recall performance of German native speakers with that of highly proficient non-natives. Non-natives recalled the sentences significantly poorer than the natives, but performed equally well on a cloze test. This implies that sentence recall underestimates the language competence of good non-native speakers in mixed groups with native speakers. The findings also suggest that theories of sentence recall need to consider both its linguistic and its attentional aspects. PMID:25698996

  19. Yellow jackets may be an underestimated component of an ant-seed mutualism

    USGS Publications Warehouse

    Bale, M.T.; Zettler, J.A.; Robinson, B.A.; Spira, T.P.; Allen, C.R.

    2003-01-01

    Yellow jackets (Hymenoptera: Vespidae) are attracted to the typically ant-dispersed seeds of trilliums and will take seeds from ants in the genus Aphaenogaster. To determine if yellow jacket, Vespula maculifrons (Buysson), presence interferes with seed foraging by ants, we presented seeds of Trillium discolor Wray to three species (A. texana carolinensis Wheeler, Formica schaufussi Mayr, and Solenopsis invicta Buren) of seed-carrying ants in areas where vespids were present or excluded. We found that interspecific aggression between yellow jackets and ants is species specific. Vespid presence decreased average foraging time and increased foraging efficiency of two of the three ant species studied, a situation that might reflect competition for a limited food source. We also found that yellow jackets removed more seeds than ants, suggestive that vespids are important, albeit underestimated, components of ant-seed mutualisms.

  20. Does the Congressional Budget Office underestimate savings from reform? A review of the historical record.

    PubMed

    Gabel, Jon R

    2010-01-01

    When the Congressional Budget Office (CBO) "scores" legislation, or assesses the likely cost impact, it requires substantial evidence that a cost-saving initiative has historically achieved savings. The agency has difficulty addressing the impact of multiple changes made simultaneously without historical precedent where there is an interaction effect among proposed changes. This study examines CBO scoring of major reform legislation enacted during each of the past three decades, including the prospective payment system for hospitals in the 1980s, the Balanced Budget Act of the 1990s, and the Medicare Modernization Act of 2003. In contrasting actual spending with predicted spending, CBO, in all three cases, substantially underestimated savings from these reform measures.

  1. Terrestrial pesticide exposure of amphibians: an underestimated cause of global decline?

    PubMed

    Brühl, Carsten A; Schmidt, Thomas; Pieper, Silvia; Alscher, Annika

    2013-01-01

    Amphibians, a class of animals in global decline, are present in agricultural landscapes characterized by agrochemical inputs. Effects of pesticides on terrestrial life stages of amphibians such as juvenile and adult frogs, toads and newts are little understood and a specific risk assessment for pesticide exposure, mandatory for other vertebrate groups, is currently not conducted. We studied the effects of seven pesticide products on juvenile European common frogs (Rana temporaria) in an agricultural overspray scenario. Mortality ranged from 100% after one hour to 40% after seven days at the recommended label rate of currently registered products. The demonstrated toxicity is alarming and a large-scale negative effect of terrestrial pesticide exposure on amphibian populations seems likely. Terrestrial pesticide exposure might be underestimated as a driver of their decline calling for more attention in conservation efforts and the risk assessment procedures in place do not protect this vanishing animal group.

  2. Exponential fitting of postextrasystolic potentiation may underestimate the cardiac Ca2+ recirculation fraction: a theoretical analysis.

    PubMed

    Doi, Yumiko; Araki, Junichi; Fujinaka, Waso; Kiyooka, Takahiko; Oshima, Yu; Iribe, Gentaro; Shimizu, Juichiro; Morita, Kiyoshi; Kajiya, Fumihiko; Suga, Hiroyuki

    2003-04-01

    The recirculation fraction of intramyocardial Ca(2+) (RF) has conventionally been obtained from the monotonic decay of postextrasystolic potentiation (PESP). The used assumption is that the decay is exponential. However, we have found that PESP usually decays in alternans even at spontaneous heart rates (>100 beats/min) in excised, cross-circulated canine heart preparations under normal coronary perfusion and normothermia. We have already devised a means of extracting the exponential decay component for RF calculation by subtracting the oscillatory component from the alternans PESP decay by a curve-fitting method. Using mathematics, we assessed the possible error in estimated RF when an exponential curve was naively fit to the alternans PESP decay. We obtained results showing that the exponential assumption may considerably underestimate RF even when the alternans is trivial with the oscillatory component of only 10% of the exponential component.

  3. Could the underestimation of bipolarity obstruct the search for novel antidepressant drugs?

    PubMed

    Fornaro, Michele; Aguglia, Eugenio; Dell'Osso, Liliana; Perugi, Giulio

    2011-12-01

    Despite the clinical and social relevance of depression, and the availability of numerous antidepressants and non-pharmacological interventions, response rates remain unsatisfactory and novel therapeutic targets are being explored. This review starts with a brief overview of the evolution of the current antidepressant drug scenario and ends with a focus on the potential influence of the underestimation of bipolarity on the exploration of novel antidepressant drugs. The field of antidepressant drug development has suffered from a relative decline recently and, with the exception of agomelatine, innovative non-monoaminergic antidepressants have yet to be developed. The need for more effective compounds is evident. Clinicians and researchers should pay greater attention to the impact of bipolarity in depression. The ultimate goal of this review is not to discourage the use of antidepressants but rather to encourage judicious prescriptions, and also to solicit a better collaboration between clinicians and preclinical researchers so that more reliable diagnostic criteria can be adopted.

  4. Individual differences in course choice result in underestimation of the validity of college admissions systems.

    PubMed

    Berry, Christopher M; Sackett, Paul R

    2009-07-01

    We demonstrate that the validity of SAT scores and high school grade point averages (GPAs) as predictors of academic performance has been underestimated because of previous studies' reliance on flawed performance indicators (i.e., college GPA) that are contaminated by the effects of individual differences in course choice. We controlled for this contamination by predicting individual course grades, instead of GPAs, in a data set containing more than 5 million college grades for 167,816 students. Percentage of variance accounted for by SAT scores and high school GPAs was 30 to 40% lower when the criteria were freshman and cumulative GPAs than when the criteria were individual course grades. SAT scores and high school GPAs together accounted for between 44 and 62% of the variance in college grades. This study provides new estimates of the criterion-related validity of SAT scores and high school GPAs, and highlights the care that must be taken in choosing appropriate criteria in validity studies.

  5. Idiopathic severe constriction of the fetal ductus arteriosus: a possible underestimated pathophysiology.

    PubMed

    Shima, Yoshio; Ishikawa, Hiroko; Matsumura, Yoshikatsu; Yashiro, Kentaro; Nakajima, Mizue; Migita, Makoto

    2011-02-01

    Idiopathic intrauterine constriction/closure of the ductus arteriosus, which is distinct from that secondary to maternal exposure to non-steroidal anti-inflammatory drugs, such as indomethacin, or structural cardiac defect, is an uncommon event that often results in severe fetal-neonatal morbidity and mortality. We reported a case of idiopathic fetal ductal constriction, in which the diagnosis was confirmed by documentation of an abnormal four-chamber view of the fetal heart at 38 weeks of gestation on obstetric ultrasound examination. A female infant weighing 2,816 g was born by Cesarean section, and her postnatal course was mild; transient tachypnea requiring only several days of supplemental oxygen with spontaneous regression of the abnormal echocardiographic findings by 3 months of age. The incidence of idiopathic constriction/closure of the fetal ductus arteriosus may be underestimated, particularly with a negative history of maternal drug exposure and mild postnatal clinical presentation.

  6. Women may underestimate their partners' desires to use condoms: possible implications for behaviour.

    PubMed

    Edwards, Gaynor L; Barber, Bonnie L

    2010-01-01

    Australian young adults reported how often they wanted to use condoms in both romantic (n = 667) and casual relationship (n = 152) contexts and how often they thought their partners wanted to use condoms. Young adults wanted to use condoms more often than they perceived their partners to in both casual and romantic relationship contexts. Gender interactions showed that this pattern was especially strong among young women. Women seemed to underestimate the frequency at which their male partners wanted to use condoms. Furthermore, both the participants' condom use desires and perceptions of their partners' condom use desires predicted condom use behavior. Results suggest that gendered expectations may play a part in how often individuals perceive their partners to want to use condoms, which, in effect, may determine condom use behavior.

  7. Maximum rates of climate change are systematically underestimated in the geological record

    NASA Astrophysics Data System (ADS)

    Kemp, David B.; Eichenseer, Kilian; Kiessling, Wolfgang

    2015-11-01

    Recently observed rates of environmental change are typically much higher than those inferred for the geological past. At the same time, the magnitudes of ancient changes were often substantially greater than those established in recent history. The most pertinent disparity, however, between recent and geological rates is the timespan over which the rates are measured, which typically differ by several orders of magnitude. Here we show that rates of marked temperature changes inferred from proxy data in Earth history scale with measurement timespan as an approximate power law across nearly six orders of magnitude (102 to >107 years). This scaling reveals how climate signals measured in the geological record alias transient variability, even during the most pronounced climatic perturbations of the Phanerozoic. Our findings indicate that the true attainable pace of climate change on timescales of greatest societal relevance is underestimated in geological archives.

  8. Virus mutation frequencies can be greatly underestimated by monoclonal antibody neutralization of virions.

    PubMed Central

    Holland, J J; de la Torre, J C; Steinhauer, D A; Clarke, D; Duarte, E; Domingo, E

    1989-01-01

    Monoclonal antibody-resistant mutants have been widely used to estimate virus mutation frequencies. We demonstrate that standard virion neutralization inevitably underestimates monoclonal antibody-resistant mutant genome frequencies of vesicular stomatitis virus, due to phenotypic masking-mixing when wild-type (wt) virions are present in thousandsfold greater numbers. We show that incorporation of antibody into the plaque overlay medium (after virus penetration at 37 degrees C) can provide accurate estimates of genome frequencies of neutral monoclonal antibody-resistant mutant viruses in wt clones. By using this method, we have observed two adjacent G----A base transition frequencies in the I3 epitope to be of the order of 10(-4) in a wt glycine codon. This appears to be slightly lower than the frequencies observed at other sites for total (viable and nonviable) virus genomes when using a direct sequence approach. Images PMID:2479770

  9. Latent ability: grades and test scores systematically underestimate the intellectual ability of negatively stereotyped students.

    PubMed

    Walton, Gregory M; Spencer, Steven J

    2009-09-01

    Past research has assumed that group differences in academic performance entirely reflect genuine differences in ability. In contrast, extending research on stereotype threat, we suggest that standard measures of academic performance are biased against non-Asian ethnic minorities and against women in quantitative fields. This bias results not from the content of performance measures, but from the context in which they are assessed-from psychological threats in common academic environments, which depress the performances of people targeted by negative intellectual stereotypes. Like the time of a track star running into a stiff headwind, such performances underestimate the true ability of stereotyped students. Two meta-analyses, combining data from 18,976 students in five countries, tested this latent-ability hypothesis. Both meta-analyses found that, under conditions that reduce psychological threat, stereotyped students performed better than nonstereotyped students at the same level of past performance. We discuss implications for the interpretation of and remedies for achievement gaps.

  10. Does verbatim sentence recall underestimate the language competence of near-native speakers?

    PubMed

    Schweppe, Judith; Barth, Sandra; Ketzer-Nöltge, Almut; Rummer, Ralf

    2015-01-01

    Verbatim sentence recall is widely used to test the language competence of native and non-native speakers since it involves comprehension and production of connected speech. However, we assume that, to maintain surface information, sentence recall relies particularly on attentional resources, which differentially affects native and non-native speakers. Since even in near-natives language processing is less automatized than in native speakers, processing a sentence in a foreign language plus retaining its surface may result in a cognitive overload. We contrasted sentence recall performance of German native speakers with that of highly proficient non-natives. Non-natives recalled the sentences significantly poorer than the natives, but performed equally well on a cloze test. This implies that sentence recall underestimates the language competence of good non-native speakers in mixed groups with native speakers. The findings also suggest that theories of sentence recall need to consider both its linguistic and its attentional aspects.

  11. Maximum rates of climate change are systematically underestimated in the geological record

    PubMed Central

    Kemp, David B.; Eichenseer, Kilian; Kiessling, Wolfgang

    2015-01-01

    Recently observed rates of environmental change are typically much higher than those inferred for the geological past. At the same time, the magnitudes of ancient changes were often substantially greater than those established in recent history. The most pertinent disparity, however, between recent and geological rates is the timespan over which the rates are measured, which typically differ by several orders of magnitude. Here we show that rates of marked temperature changes inferred from proxy data in Earth history scale with measurement timespan as an approximate power law across nearly six orders of magnitude (102 to >107 years). This scaling reveals how climate signals measured in the geological record alias transient variability, even during the most pronounced climatic perturbations of the Phanerozoic. Our findings indicate that the true attainable pace of climate change on timescales of greatest societal relevance is underestimated in geological archives. PMID:26555085

  12. Runners greatly underestimate sweat losses before and after a 1-hr summer run.

    PubMed

    O'Neal, Eric K; Davis, Brett A; Thigpen, Lauren K; Caufield, Christina R; Horton, Anthony D; McIntosh, Joyce R

    2012-10-01

    The purpose of this study was to determine how accurately runners estimate their sweat losses. Male (n = 19) and female (n = 20) runners (41 ± 10 yr, VO2max 57 ± 9 ml · kg(-1) · min(-1) from the southeastern U.S. completed an ~1-hr run during late summer on a challenging outdoor road course (wet bulb globe temperature 24.1 ± 1.5 °C). Runs began at ~6:45 a.m. or p.m. Before and after running, participants filled race-aid-station paper cups with a volume of fluid they felt would be equivalent to their sweat losses. Total sweat losses and losses by percent body weight differed (p < .01) between men (1,797 ± 449 ml, 2.3% ± 0.6%) and women (1,155 ± 258 ml, 1.9% ± 0.4%). Postrun estimates (738 ± 470 ml) were lower (p < .001) than sweat losses (1,468 ± 484 ml), equaling underestimations of 50% ± 23%, with no differences in estimation accuracy by percentage between genders. Runners who reported measuring changes in pre- and postrun weight to assess sweat losses within the previous month (n = 9, -54% ± 18%) were no more accurate (p = .55) than runners who had not (n = 30, -48% ± 24%). These results suggest that inadequate fluid intake during runs or between runs may stem from underestimations of sweat losses and that runners who do assess sweat-loss changes may be making sweat-loss calculation errors or do not accurately translate changes in body weight to physical volumes of water.

  13. Modeling microelectrode biosensors: free-flow calibration can substantially underestimate tissue concentrations.

    PubMed

    Newton, Adam J H; Wall, Mark J; Richardson, Magnus J E

    2017-03-01

    Microelectrode amperometric biosensors are widely used to measure concentrations of analytes in solution and tissue including acetylcholine, adenosine, glucose, and glutamate. A great deal of experimental and modeling effort has been directed at quantifying the response of the biosensors themselves; however, the influence that the macroscopic tissue environment has on biosensor response has not been subjected to the same level of scrutiny. Here we identify an important issue in the way microelectrode biosensors are calibrated that is likely to have led to underestimations of analyte tissue concentrations. Concentration in tissue is typically determined by comparing the biosensor signal to that measured in free-flow calibration conditions. In a free-flow environment the concentration of the analyte at the outer surface of the biosensor can be considered constant. However, in tissue the analyte reaches the biosensor surface by diffusion through the extracellular space. Because the enzymes in the biosensor break down the analyte, a density gradient is set up resulting in a significantly lower concentration of analyte near the biosensor surface. This effect is compounded by the diminished volume fraction (porosity) and reduction in the diffusion coefficient due to obstructions (tortuosity) in tissue. We demonstrate this effect through modeling and experimentally verify our predictions in diffusive environments.NEW & NOTEWORTHY Microelectrode biosensors are typically calibrated in a free-flow environment where the concentrations at the biosensor surface are constant. However, when in tissue, the analyte reaches the biosensor via diffusion and so analyte breakdown by the biosensor results in a concentration gradient and consequently a lower concentration around the biosensor. This effect means that naive free-flow calibration will underestimate tissue concentration. We develop mathematical models to better quantify the discrepancy between the calibration and tissue

  14. Hydrogen peroxide efflux from muscle mitochondria underestimates matrix superoxide production: a correction using glutathione depletion

    PubMed Central

    TREBERG, Jason R.; QUINLAN, Casey L.; BRAND, Martin D.

    2010-01-01

    Summary The production of H2O2 by isolated mitochondria is frequently used as a measure of mitochondrial superoxide formation. Matrix superoxide dismutase quantitatively converts matrix superoxide to H2O2. However, matrix enzymes such as the glutathione peroxidases can consume H2O2 and compete with efflux of H2O2, causing an underestimate of superoxide production. To assess this underestimate we depleted matrix glutathione in rat skeletal muscle mitochondria by more than 90% by pretreatment with 1-chloro-2,4-dintrobenzene (CDNB). The pretreatment protocol strongly diminished the mitochondrial capacity to consume exogenous H2O2, consistent with decreased peroxidase capacity, but avoided direct stimulation of superoxide production from complex I. It elevated the observed rates of H2O2 formation from matrix-directed superoxide up to two-fold from several sites of production, defined by substrates and electron transport inhibitors, over a wide range of control rates, from 0.2 to 2.5 nmol H2O2 • min−1 • mg protein−1. Similar results were obtained when glutathione was depleted using monochlorobimane or when soluble matrix peroxidase activity was removed by preparation of submitochondrial particles. The data indicate that the increased H2O2 efflux observed with CDNB pretreatment was a result of glutathione depletion and compromised peroxidase activity. A hyperbolic correction curve was constructed, making H2O2 efflux a more quantitative measure of matrix superoxide production. For rat muscle mitochondria, the correction equation was: [CDNB pretreated rate = control rate + (1.43*(control rate))/(0.55+control rate)]. These results have significant ramifications for the rates and topology of superoxide production by isolated mitochondria. PMID:20491900

  15. Modeling microelectrode biosensors: free-flow calibration can substantially underestimate tissue concentrations

    PubMed Central

    Wall, Mark J.

    2016-01-01

    Microelectrode amperometric biosensors are widely used to measure concentrations of analytes in solution and tissue including acetylcholine, adenosine, glucose, and glutamate. A great deal of experimental and modeling effort has been directed at quantifying the response of the biosensors themselves; however, the influence that the macroscopic tissue environment has on biosensor response has not been subjected to the same level of scrutiny. Here we identify an important issue in the way microelectrode biosensors are calibrated that is likely to have led to underestimations of analyte tissue concentrations. Concentration in tissue is typically determined by comparing the biosensor signal to that measured in free-flow calibration conditions. In a free-flow environment the concentration of the analyte at the outer surface of the biosensor can be considered constant. However, in tissue the analyte reaches the biosensor surface by diffusion through the extracellular space. Because the enzymes in the biosensor break down the analyte, a density gradient is set up resulting in a significantly lower concentration of analyte near the biosensor surface. This effect is compounded by the diminished volume fraction (porosity) and reduction in the diffusion coefficient due to obstructions (tortuosity) in tissue. We demonstrate this effect through modeling and experimentally verify our predictions in diffusive environments. NEW & NOTEWORTHY Microelectrode biosensors are typically calibrated in a free-flow environment where the concentrations at the biosensor surface are constant. However, when in tissue, the analyte reaches the biosensor via diffusion and so analyte breakdown by the biosensor results in a concentration gradient and consequently a lower concentration around the biosensor. This effect means that naive free-flow calibration will underestimate tissue concentration. We develop mathematical models to better quantify the discrepancy between the calibration and tissue

  16. Is oral cancer incidence among patients with oral lichen planus/oral lichenoid lesions underestimated?

    PubMed

    Gonzalez-Moles, M A; Gil-Montoya, J A; Ruiz-Avila, I; Bravo, M

    2017-02-01

    Oral lichen planus (OLP) and oral lichenoid lesions (OLL) are considered potentially malignant disorders with a cancer incidence of around 1% of cases, although this estimation is controversial. The aim of this study was to analyze the cancer incidence in a case series of patients with OLP and OLL and to explore clinicopathological aspects that may cause underestimation of the cancer incidence in these diseases. A retrospective study was conducted of 102 patients diagnosed with OLP (n = 21, 20.58%) or OLL (n = 81) between January 2006 and January 2016. Patients were informed of the risk of malignization and followed up annually. The number of sessions programmed for each patient was compared with the number actually attended. Follow-up was classified as complete (100% attendance), good (75-99%), moderate (25-74%), or poor (<25% attendance) compliance. Cancer was developed by four patients (3.9%), three males and one male. One of these developed three carcinomas, which were diagnosed at the follow-up visit (two in lower gingiva, one in floor of mouth); one had OLL and the other three had OLP. The carcinoma developed in mucosal areas with no OLP or OLL involvement in three of these patients, while OLP and cancer were diagnosed simultaneously in the fourth. Of the six carcinomas diagnosed, five (83.3%) were T1 and one (16.7%) T2. None were N+, and all patients remain alive and disease-free. The cancer incidence in OLP and OLL appears to be underestimated due to the strict exclusion criteria usually imposed. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  17. Confounding Environmental Colour and Distribution Shape Leads to Underestimation of Population Extinction Risk

    PubMed Central

    Fowler, Mike S.; Ruokolainen, Lasse

    2013-01-01

    The colour of environmental variability influences the size of population fluctuations when filtered through density dependent dynamics, driving extinction risk through dynamical resonance. Slow fluctuations (low frequencies) dominate in red environments, rapid fluctuations (high frequencies) in blue environments and white environments are purely random (no frequencies dominate). Two methods are commonly employed to generate the coloured spatial and/or temporal stochastic (environmental) series used in combination with population (dynamical feedback) models: autoregressive [AR(1)] and sinusoidal (1/f) models. We show that changing environmental colour from white to red with 1/f models, and from white to red or blue with AR(1) models, generates coloured environmental series that are not normally distributed at finite time-scales, potentially confounding comparison with normally distributed white noise models. Increasing variability of sample Skewness and Kurtosis and decreasing mean Kurtosis of these series alter the frequency distribution shape of the realised values of the coloured stochastic processes. These changes in distribution shape alter patterns in the probability of single and series of extreme conditions. We show that the reduced extinction risk for undercompensating (slow growing) populations in red environments previously predicted with traditional 1/f methods is an artefact of changes in the distribution shapes of the environmental series. This is demonstrated by comparison with coloured series controlled to be normally distributed using spectral mimicry. Changes in the distribution shape that arise using traditional methods lead to underestimation of extinction risk in normally distributed, red 1/f environments. AR(1) methods also underestimate extinction risks in traditionally generated red environments. This work synthesises previous results and provides further insight into the processes driving extinction risk in model populations. We must let

  18. Confounding environmental colour and distribution shape leads to underestimation of population extinction risk.

    PubMed

    Fowler, Mike S; Ruokolainen, Lasse

    2013-01-01

    The colour of environmental variability influences the size of population fluctuations when filtered through density dependent dynamics, driving extinction risk through dynamical resonance. Slow fluctuations (low frequencies) dominate in red environments, rapid fluctuations (high frequencies) in blue environments and white environments are purely random (no frequencies dominate). Two methods are commonly employed to generate the coloured spatial and/or temporal stochastic (environmental) series used in combination with population (dynamical feedback) models: autoregressive [AR(1)] and sinusoidal (1/f) models. We show that changing environmental colour from white to red with 1/f models, and from white to red or blue with AR(1) models, generates coloured environmental series that are not normally distributed at finite time-scales, potentially confounding comparison with normally distributed white noise models. Increasing variability of sample Skewness and Kurtosis and decreasing mean Kurtosis of these series alter the frequency distribution shape of the realised values of the coloured stochastic processes. These changes in distribution shape alter patterns in the probability of single and series of extreme conditions. We show that the reduced extinction risk for undercompensating (slow growing) populations in red environments previously predicted with traditional 1/f methods is an artefact of changes in the distribution shapes of the environmental series. This is demonstrated by comparison with coloured series controlled to be normally distributed using spectral mimicry. Changes in the distribution shape that arise using traditional methods lead to underestimation of extinction risk in normally distributed, red 1/f environments. AR(1) methods also underestimate extinction risks in traditionally generated red environments. This work synthesises previous results and provides further insight into the processes driving extinction risk in model populations. We must let

  19. Unusual vanishing interstitial lymphatic "pearls" in a patient presenting with extensive interstitial and mediastinal MDCT features of acute cardiogenic failure related to bradycardia and mitral regurgitation.

    PubMed

    Coulier, Bruno; El Khoury, Elie; Deprez, Fabrice C; Ghaye, Benoît; Van den Broeck, Stephane; Tourmous, Hussein

    2014-12-01

    Thoracic multidetector computed tomography-MDCT-was simultaneously performed during emergency abdominal CT in a patient presenting with abdominal pain and acute cardiogenic edema related to sick sinus syndrome and mitral prolapse with regurgitation. A constellation of severe but completely reversible interstitial and mediastinal features was found comprising pleural effusions, diffuse alveolar ground glass, thickening of the bronchial walls and septal lines, hazy infiltration of the mediastinal fat, and enlarged lymphatic nodes. Multiple atypical hypodense nodular "pearls" were also found. These oval shape or fusiform pearls were distributed along the thickened septal lines and disappeared completely after treatment. The hypothesis of transient lymphatic ectasia or lakes is proposed for these never previously described abnormalities.

  20. Differentiation of fat-poor angiomyolipoma from clear cell renal cell carcinoma in contrast-enhanced MDCT images using quantitative feature classification.

    PubMed

    Lee, Han Sang; Hong, Helen; Jung, Dae Chul; Park, Seunghyun; Kim, Junmo

    2017-07-01

    To develop a computer-aided classification system to differentiate benign fat-poor angiomyolipoma (fp-AML) from malignant clear cell renal cell carcinoma (ccRCC) using quantitative feature classification on histogram and texture patterns from contrast-enhanced multidetector computer tomography (CE MDCT) images. A dataset including 50 CE MDCT images of 25 fp-AML and 25 ccRCC patients was used. From these images, the tumors were manually segmented by an expert radiologist to define the regions of interest (ROI). A feature classification system was proposed for separating two types of renal masses, using histogram and texture features and machine learning classifiers. First, 64 quantitative image features, including histogram features based on basic histogram characteristics, percentages of pixels above the thresholds, percentile intensities, and texture features based on gray-level co-occurrence matrices (GLCM), gray-level run-length matrices (GLRLM), and local binary patterns (LBP), were extracted from each ROI. A number of feature selection methods including stepwise feature selection (SFS), ReliefF selection, and principal component analysis (PCA) transformation, were applied to select the group of useful features. Finally, the feature classifiers including logistic regression, k nearest neighbors (kNN), support vector machine (SVM), and random forest (RF), were trained on the selected features to differentiate benign fp-AML from malignant ccRCC. Each combination of feature selection and classification methods was tested using a fivefold cross-validation method and evaluated using accuracy, sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and area under receiver operating characteristic curve (AUC). In feature selection, the features commonly selected by different feature selection methods were assessed. From three selection methods, three histogram features including maximum intensity, percentages of pixels above the

  1. Whole-Chest 64-MDCT of Emergency Department Patients with Nonspecific Chest Pain: Radiation Dose and Coronary Artery Image Quality with Prospective ECG Triggering Versus Retrospective ECG Gating

    PubMed Central

    Shuman, William P.; Branch, Kelley R.; May, Janet M.; Mitsumori, Lee M.; Strote, Jared N.; Warren, Bill H.; Dubinsky, Theodore J.; Lockhart, David W.; Caldwell, James H.

    2012-01-01

    Objective The purpose of this study was to compare the patient radiation dose and coronary artery image quality of long-z-axis whole-chest 64-MDCT performed with retrospective ECG gating with those of CT performed with prospective ECG triggering in the evaluation of emergency department patients with nonspecific chest pain. Subjects and Methods Consecutively registered emergency department patients with nonspecific low-to-moderate-risk chest pain underwent whole-chest CT with retrospective gating (n = 41) or prospective triggering (n = 31). Effective patient radiation doses were estimated and compared by use of unpaired Student's t tests. Two reviewers independently scored the quality of images of the coronary arteries, and the scores were compared by use of ordinal logistic regression. Results Age, heart rate, body mass index, and z-axis coverage were not statistically different between the two groups. For retrospective gating, the mean effective radiation dose was 31.8 ± 5.1 mSv; for prospective triggering, the mean effective radiation dose was 9.2 ± 2.2 mSv (prospective triggering 71% lower, p < 0.001). Two of 512 segments imaged with retrospective gating were nonevaluable (0.4%), and two of 394 segments imaged with prospective triggering were nonevaluable (0.5%). Prospectively triggered images were 2.2 (95% CI, 1.1–4.5) times as likely as retrospectively gated images to receive a high image quality score for each segment after adjustment for segment differences (p < 0.05). Conclusion For long-z-axis whole-chest 64-MDCT of emergency department patients with nonspecific chest pain, use of prospective ECG triggering may result in substantially lower patient radiation doses and better coronary artery image quality than is achieved with retrospective ECG gating. PMID:19457832

  2. Hepatic Arterial Configuration in Relation to the Segmental Anatomy of the Liver; Observations on MDCT and DSA Relevant to Radioembolization Treatment

    SciTech Connect

    Hoven, Andor F. van den Leeuwen, Maarten S. van Lam, Marnix G. E. H. Bosch, Maurice A. A. J. van den

    2015-02-15

    PurposeCurrent anatomical classifications do not include all variants relevant for radioembolization (RE). The purpose of this study was to assess the individual hepatic arterial configuration and segmental vascularization pattern and to develop an individualized RE treatment strategy based on an extended classification.MethodsThe hepatic vascular anatomy was assessed on MDCT and DSA in patients who received a workup for RE between February 2009 and November 2012. Reconstructed MDCT studies were assessed to determine the hepatic arterial configuration (origin of every hepatic arterial branch, branching pattern and anatomical course) and the hepatic segmental vascularization territory of all branches. Aberrant hepatic arteries were defined as hepatic arterial branches that did not originate from the celiac axis/CHA/PHA. Early branching patterns were defined as hepatic arterial branches originating from the celiac axis/CHA.ResultsThe hepatic arterial configuration and segmental vascularization pattern could be assessed in 110 of 133 patients. In 59 patients (54 %), no aberrant hepatic arteries or early branching was observed. Fourteen patients without aberrant hepatic arteries (13 %) had an early branching pattern. In the 37 patients (34 %) with aberrant hepatic arteries, five also had an early branching pattern. Sixteen different hepatic arterial segmental vascularization patterns were identified and described, differing by the presence of aberrant hepatic arteries, their respective vascular territory, and origin of the artery vascularizing segment four.ConclusionsThe hepatic arterial configuration and segmental vascularization pattern show marked individual variability beyond well-known classifications of anatomical variants. We developed an individualized RE treatment strategy based on an extended anatomical classification.

  3. Whole-chest 64-MDCT of emergency department patients with nonspecific chest pain: Radiation dose and coronary artery image quality with prospective ECG triggering versus retrospective ECG gating.

    PubMed

    Shuman, William P; Branch, Kelley R; May, Janet M; Mitsumori, Lee M; Strote, Jared N; Warren, Bill H; Dubinsky, Theodore J; Lockhart, David W; Caldwell, James H

    2009-06-01

    The purpose of this study was to compare the patient radiation dose and coronary artery image quality of long-z-axis whole-chest 64-MDCT performed with retrospective ECG gating with those of CT performed with prospective ECG triggering in the evaluation of emergency department patients with nonspecific chest pain. Consecutively registered emergency department patients with nonspecific low-to-moderate-risk chest pain underwent whole-chest CT with retrospective gating (n = 41) or prospective triggering (n = 31). Effective patient radiation doses were estimated and compared by use of unpaired Student's t tests. Two reviewers independently scored the quality of images of the coronary arteries, and the scores were compared by use of ordinal logistic regression. Age, heart rate, body mass index, and z-axis coverage were not statistically different between the two groups. For retrospective gating, the mean effective radiation dose was 31.8 +/- 5.1 mSv; for prospective triggering, the mean effective radiation dose was 9.2 +/- 2.2 mSv (prospective triggering 71% lower, p < 0.001). Two of 512 segments imaged with retrospective gating were nonevaluable (0.4%), and two of 394 segments imaged with prospective triggering were nonevaluable (0.5%). Prospectively triggered images were 2.2 (95% CI, 1.1-4.5) times as likely as retrospectively gated images to receive a high image quality score for each segment after adjustment for segment differences (p < 0.05). For long-z-axis whole-chest 64-MDCT of emergency department patients with nonspecific chest pain, use of prospective ECG triggering may result in substantially lower patient radiation doses and better coronary artery image quality than is achieved with retrospective ECG gating.

  4. Optimal scan timing for artery-vein separation at whole-brain CT angiography using a 320-row MDCT volume scanner.

    PubMed

    Shirasaka, Takashi; Hiwatashi, Akio; Yamashita, Koji; Kondo, Masatoshi; Hamasaki, Hiroshi; Shimomiya, Yamato; Nakamura, Yasuhiko; Funama, Yoshinori; Honda, Hiroshi

    2017-02-01

    A 320-row multidetector CT (MDCT) is expected for a good artery-vein separation in terms of temporal resolution. However, a shortened scan duration may lead to insufficient vascular enhancement. We assessed the optimal scan timing for the artery-vein separation at whole-brain CT angiography (CTA) when bolus tracking was used at 320-row MDCT. We analyzed 60 patients, who underwent whole-brain four-dimensional CTA. Difference in CT attenuation between the internal carotid artery (ICA) and the superior sagittal sinus (Datt) was calculated in each phase. Using a visual evaluation score for the depiction of arteries and veins, we calculated the difference between the mean score for the intracranial arteries and the mean score for the veins (Dscore). We assessed the time at which the maximum Datt and Dscore were simultaneously observed. The maximum Datt was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s and 18.0 s in the venous-dominant phase after the contrast media arrival time at the ICA (Taa). The maximum Dscore was observed at 6.0 s and 8.0 s in the arterial-dominant phase and at 16.0 s in the venous-dominant phase after the Taa. There were no statistically significant differences in Datt (p = 0.375) or Dscore (p = 0.139) between these scan timings. The optimal scan timing for artery-vein separation at whole-brain CTA was 6.0 s or 8.0 s for the arteries and 16.0 s for the veins after the Taa. Advances in knowledge: Optimal scan timing allowed us to visualize intracranial arteries or veins with minimal superimposition.

  5. Morphometric evaluation of subaxial cervical spine using multi-detector computerized tomography (MD-CT) scan: the consideration for cervical pedicle screws fixation.

    PubMed

    Chanplakorn, Pongsthorn; Kraiwattanapong, Chaiwat; Aroonjarattham, Kitti; Leelapattana, Pittavat; Keorochana, Gun; Jaovisidha, Suphaneewan; Wajanavisit, Wiwat

    2014-04-11

    Cervical pedicle screw (CPS) insertion is a technically demanding procedure. The quantitative understanding of cervical pedicle morphology, especially the narrowest part of cervical pedicle or isthmus, would minimize the risk of catastrophic damage to surrounding neurovascular structures and improve surgical outcome. The aim of this study was to investigate morphology and quantify cortical thickness of the cervical isthmus by using Multi-detector Computerized Tomography (MD-CT) scan. The cervical CT scans were performed in 74 patients (37 males and 37 females) with 1-mm slice thickness and then retro-reconstructed into sagittal and coronal planes to measure various cervical parameters as follows: outer pedicle width (OPW), inner pedicle width (IPW), outer pedicle height (OPH), inner pedicle height (IPH), pedicle cortical thickness, pedicle sagittal angle (PSA), and pedicle transverse angle (PTA). Total numbers of 740 pedicles were measured in this present study. The mean OPW and IPW significantly increased from C3 to C7 while the mean OPH and IPH of those showed non-significant difference between any measured levels. The medial-lateral cortical thickness was significantly smaller than the superior-inferior one. PTA in the upper cervical spine was significantly wider than the lower ones. The PSA changed from upward inclination at upper cervical spine to the downward inclination at lower cervical spine. This study has demonstrated that cervical vertebra has relatively small and narrow inner pedicle canal with thick outer pedicle cortex and also shows a variable in pedicle width and inconsistent transverse angle. To enhance the safety of CPS insertion, the entry point and trajectories should be determined individually by using preoperative MD-CT scan and the inner pedicle width should be a key parameter to determine the screw dimensions.

  6. [Variations of pulmonary venous drainage and venous ostium index detection in atrial fibrillation patients prior to radiofrequency catheter ablation by MDCT pulmonary venography].

    PubMed

    Shan, Fei; Zhang, Zhi-Yong; Chen, Gang; Miao, Xi-Yin; Liu, Hao; Zhang, Li-Jun; Zeng, Liang-Bin

    2007-04-01

    To evaluate variations of pulmonary venous drainage and venous ostium index (VOI) in patients with atrial fibrillation (AF) prior to radio-frequency catheter ablation (RFCA) by MDCT pulmonary venography. 16-detector row CT pulmonary venography was performed in 64 AF patients referred to RFCA from June, 2005 to May, 2006. Variations in pulmonary venous drainage were observed in volume render imagines. Anterior-posterior and superior-inferior diameters of pulmonary venous ostium were measured on maximum intensity projection images. VOI derived from left superior, left inferior, right superior, right inferior pulmonary veins and variations in pulmonary venous drainage were calculated. Classic pulmonary veins anatomy was found in 11 patients (17.18%), early branching veins in 45 patients (70.31%), left common ostium in 5 patients (7.81%), right common ostia in 1 patient, right accessory (middle) pulmonary vein in 5 patients (7.81%) and left accessory (middle) pulmonary vein in 1 patient (1.56%). VOI of homolateral pulmonary veins and bilateral superior pulmonary veins were similar (P > 0.05) while there was a significant difference on VOIs derived from left superior and right inferior; two inferior, left inferior versus right superior veins (P < 0.05). Right inferior pulmonary venous ostium was most rounded and had the highest index (0.88) and left inferior pulmonary venous ostium was most oval and had the lowest index (0.72). Multidetector row CT pulmonary venography (MDCT-PV) could provide valuable informations on pulmonary venous anatomy in AF patients referred to RFCA and should be used as a routine examination prior to the operation.

  7. Increasing bone sclerosis during bortezomib therapy in multiple myeloma patients: results of a reduced-dose whole-body MDCT study.

    PubMed

    Schulze, Maximilian; Weisel, Katja; Grandjean, Caroline; Oehrlein, Katharina; Zago, Manola; Spira, Daniel; Horger, Marius

    2014-01-01

    The objective of our study was to assess the frequency, location, extent, and patterns of bone sclerosis occurring in patients with multiple myeloma (MM) during bortezomib-based therapy. From June 2003 through December 2011, 593 whole-body reduced-dose MDCT studies were performed of 79 consecutive patients receiving bortezomib. The median surveillance time was 21 months (range, 3-67 months). Baseline studies were compared with follow-up studies during therapy (follow-up 1), at the end of therapy (follow-up 2), and 12 months after cessation of bortezomib therapy (follow-up 3). We recorded any sclerotic change occurring inside or along the margins of the osteolytic lesions, in the cancellous bone, or inside preexistent medullary or extramedullary lesions. The time point of occurrence of bone sclerosis was correlated with the best hematologic response category. Fourteen (17.7%) patients developed focal (n = 11) or diffuse (n = 3) bone sclerosis. The time window from bortezomib initiation to radiographic detection of bone sclerosis was 8 months (SD, 7 months). Sclerosis occurred at multiple sites (n = 7) or at an isolated site (n = 7). On subsequent whole-body reduced-dose MDCT studies, sclerosis further increased in seven (50%) patients. Hematologic best response during bortezomib treatment was complete response (n = 1), very good partial response (n = 2), partial response (n = 8), and stable disease (n = 3). Radiologic response at the time of sclerosis detection was partial response (n = 8), stable disease (n = 2), and progressive disease (n = 4). Bone remineralization may occur during bortezomib-based therapy for MM in a substantial proportion of patients. The extent, location, and patterns of sclerosis differ among patients and are unpredictable. Sclerosis was documented even in patients showing suboptimal hematologic response.

  8. Hypnic jerks are an underestimated sleep motor phenomenon in patients with parkinsonism. A video-polysomnographic and neurophysiological study.

    PubMed

    Chiaro, Giacomo; Calandra-Buonaura, Giovanna; Sambati, Luisa; Cecere, Annagrazia; Ferri, Caterina; Caletti, Maria Turchese; Cortelli, Pietro; Provini, Federica

    2016-10-01

    Hypnic jerks (HJs) are sudden contractions of one or more body segments occurring mostly at sleep onset. They are highly sporadic and affect all ages and both sexes with prevalence between 60% and 70% in the general population. This study describes the frequency and the neurophysiological characteristics of HJs in a population of patients with parkinsonism by means of nocturnal video-polysomnographic recordings. This is a prospective cohort study and is reported following the STROBE guidelines. We analyzed the clinical and video-polysomnographic data of the first 66 consecutive patients recruited in the ongoing prospective study "Bologna motor and non-motor Prospective study on Parkinsonism at onset" (BoProPark). Each patient underwent a full neurological workup including a whole-night video- polysomnography. Neurophysiological characteristics including the propagation patterns of the HJs were studied with an extended muscle montage polysomnography. We recorded a total of 62 HJs in 16 patients out of 66 (24%). Sleep parameters were not statistically different between patients with and without HJs. All HJs were spontaneous and occurred randomly throughout the night. Electromyographic analysis showed that muscle activity arose from different muscles with no prevalence of one over the other and without any ordered propagation. No recurring motor pattern of the jerks was detected. Our findings demonstrated that HJs are a frequent, underestimated, sleep-related motor phenomenon in patients with parkinsonism. As they may represent a further cause of sleep disruption and insomnia, HJs should be actively examined. Neurophysiological analysis suggests a subcortical origin of HJs as shown previously for a healthy subject. Copyright © 2016 Elsevier B.V. All rights reserved.

  9. Co-occurrence of viruses and mosquitoes at the vectors' optimal climate range: An underestimated risk to temperate regions?

    PubMed

    Blagrove, Marcus S C; Caminade, Cyril; Waldmann, Elisabeth; Sutton, Elizabeth R; Wardeh, Maya; Baylis, Matthew

    2017-06-01

    Mosquito-borne viruses have been estimated to cause over 100 million cases of human disease annually. Many methodologies have been developed to help identify areas most at risk from transmission of these viruses. However, generally, these methodologies focus predominantly on the effects of climate on either the vectors or the pathogens they spread, and do not consider the dynamic interaction between the optimal conditions for both vector and virus. Here, we use a new approach that considers the complex interplay between the optimal temperature for virus transmission, and the optimal climate for the mosquito vectors. Using published geolocated data we identified temperature and rainfall ranges in which a number of mosquito vectors have been observed to co-occur with West Nile virus, dengue virus or chikungunya virus. We then investigated whether the optimal climate for co-occurrence of vector and virus varies between "warmer" and "cooler" adapted vectors for the same virus. We found that different mosquito vectors co-occur with the same virus at different temperatures, despite significant overlap in vector temperature ranges. Specifically, we found that co-occurrence correlates with the optimal climatic conditions for the respective vector; cooler-adapted mosquitoes tend to co-occur with the same virus in cooler conditions than their warmer-adapted counterparts. We conclude that mosquitoes appear to be most able to transmit virus in the mosquitoes' optimal climate range, and hypothesise that this may be due to proportionally over-extended vector longevity, and other increased fitness attributes, within this optimal range. These results suggest that the threat posed by vector-competent mosquito species indigenous to temperate regions may have been underestimated, whilst the threat arising from invasive tropical vectors moving to cooler temperate regions may be overestimated.

  10. Co-occurrence of viruses and mosquitoes at the vectors’ optimal climate range: An underestimated risk to temperate regions?

    PubMed Central

    Blagrove, Marcus S. C.; Caminade, Cyril; Waldmann, Elisabeth; Sutton, Elizabeth R.; Wardeh, Maya; Baylis, Matthew

    2017-01-01

    Mosquito-borne viruses have been estimated to cause over 100 million cases of human disease annually. Many methodologies have been developed to help identify areas most at risk from transmission of these viruses. However, generally, these methodologies focus predominantly on the effects of climate on either the vectors or the pathogens they spread, and do not consider the dynamic interaction between the optimal conditions for both vector and virus. Here, we use a new approach that considers the complex interplay between the optimal temperature for virus transmission, and the optimal climate for the mosquito vectors. Using published geolocated data we identified temperature and rainfall ranges in which a number of mosquito vectors have been observed to co-occur with West Nile virus, dengue virus or chikungunya virus. We then investigated whether the optimal climate for co-occurrence of vector and virus varies between “warmer” and “cooler” adapted vectors for the same virus. We found that different mosquito vectors co-occur with the same virus at different temperatures, despite significant overlap in vector temperature ranges. Specifically, we found that co-occurrence correlates with the optimal climatic conditions for the respective vector; cooler-adapted mosquitoes tend to co-occur with the same virus in cooler conditions than their warmer-adapted counterparts. We conclude that mosquitoes appear to be most able to transmit virus in the mosquitoes’ optimal climate range, and hypothesise that this may be due to proportionally over-extended vector longevity, and other increased fitness attributes, within this optimal range. These results suggest that the threat posed by vector-competent mosquito species indigenous to temperate regions may have been underestimated, whilst the threat arising from invasive tropical vectors moving to cooler temperate regions may be overestimated. PMID:28617853

  11. Underestimation of the early risk of recurrent stroke: evidence of the need for a standard definition.

    PubMed

    Coull, Andrew J; Rothwell, Peter M

    2004-08-01

    There is considerable variation in the definitions used for recurrent stroke. Most epidemiological studies exclude events within the first 28 days (eg, Monitoring Trends and Determinants in Cardiovascular Disease [MONICA]) or events within 21 days in the same territory as the presenting event (eg, most stroke incidence studies). However, recurrence is most common during this early period and these restrictive definitions could underestimate the benefits of early prevention. We determined the 90-day risk of recurrence after incident ischemic stroke in 2 population-based cohorts (Oxford Vascular Study [OXVASC] and Oxfordshire Community Stroke Project [OCSP]) with the 3 most common definitions: any stroke > or =24 hours after the incident event excluding early deterioration not caused by a stroke (definition A); as above, but excluding any stroke within 21 days in the same territory as the incident event (definition B); and any stroke > or =28 days after the incident event (definition C). 657 patients had 93 recurrent strokes between 24 hours and 90 days after the incident event. The 90-day recurrence risks (95% CI) using definition A were 14.5% (11.5 to 17.5) in the OCSP and 18.3% (10.8 to 25.8) in the OXVASC. The equivalent risks using definitions B and C were 8.3% (5.9 to 10.8) and 4.8% (2.8 to 6.7), respectively, in the OCSP and 7.0% (1.6 to 12.4) and 5.9% (1.0 to 10.9) in the OXVASC. The definition A risk of recurrence was particularly high after partial anterior (22.9%,17.5 to 28.2) and posterior (19.5%,13.0 to 25.9) circulation strokes. The 3 most widely used definitions of recurrent stroke yield markedly different 90-day risks. We suggest that, where possible, definition A be adopted as the standard to avoid underestimation of risk and to allow valid comparison of different studies.

  12. Characterization of potential EC flux underestimation of "sticky" trace gas species

    NASA Astrophysics Data System (ADS)

    Neftel, Albrecht; Hensen, Arjan; Ibrom, Andreas; Ammann, Christof; Voglmeier, Karl; Brümmer, Christian

    2017-04-01

    Eddy covariance (EC) flux measurements of "sticky" trace gas species are affected of damping of high frequency variations of the gas concentration. Several approaches have been developed to correct for this effect (see e.g. Ibrom et al., 2007, Ammann et al., 2006). These approaches have in common that the spectral properties of the scalar are compared with the sonic temperature deduced from the Sonic anemometer data that is only marginally damped. A main difference between the two method is that one uses power spectra, while the other is based on co-spectra of the gas concentration with the vertical wind speed. NH3 fluxes used in the analysis stem from two field experiments: a) Posieux intercomparison October 2015: NH3 emissions of a grazed pasture measured with Eddy Covariance using an Aerodyne quantum cascade laser and with a horizontal gradient measurement using MiniDOAS systems (Sintermann et al., 2016) in conjunction with a dispersion model. b) Dronten experiment June 2016 in the Netherlands: NH3 emissions from two manured circles within 40m diameters have been determined with four different approaches (Eddy Covariance, Integrated Horizontal Flux approach, horizontal gradients and plume measurements). Despite correction with standard methods, turbulent NH3 flux measurements with the eddy covariance method seem still be underestimated when, e.g., compared to flux estimated using gradient methods. We discuss possible correction algorithms and how such underestimations can be recognized in the usual case, where no alternative flux estimation methods are available. References: Ammann, C., Brunner, A., Spirig, C., and Neftel, A. 2006: Technical note: Water vapour concentration and flux measurements with PTR-MS, Atmos. Chem. Phys., 6, 4643-4651 Ibrom, A., Dellwik, E., Jensen, N.O., Flyvbjerg, H. and Pilegaard, K., 2007. Strong low-pass filtering effects on water vapour flux measurements with closed-path eddy correlation systems. Agricultural and Forest Meteorology

  13. Influenza Pneumonia Surveillance among Hospitalized Adults May Underestimate the Burden of Severe Influenza Disease

    PubMed Central

    Ortiz, Justin R.; Neuzil, Kathleen M.; Cooke, Colin R.; Neradilek, Moni B.; Goss, Christopher H.; Shay, David K.

    2014-01-01

    Background Studies seeking to estimate the burden of influenza among hospitalized adults often use case definitions that require presence of pneumonia. The goal of this study was to assess the extent to which restricting influenza testing to adults hospitalized with pneumonia could underestimate the total burden of hospitalized influenza disease. Methods We conducted a modelling study using the complete State Inpatient Databases from Arizona, California, and Washington and regional influenza surveillance data acquired from CDC from January 2003 through March 2009. The exposures of interest were positive laboratory tests for influenza A (H1N1), influenza A (H3N2), and influenza B from two contiguous US Federal Regions encompassing the study area. We identified the two outcomes of interest by ICD-9-CM code: respiratory and circulatory hospitalizations, as well as critical illness hospitalizations (acute respiratory failure, severe sepsis, and in-hospital death). We linked the hospitalization datasets with the virus surveillance datasets by geographic region and month of hospitalization. We used negative binomial regression models to estimate the number of influenza-associated events for the outcomes of interest. We sub-categorized these events to include all outcomes with or without pneumonia diagnosis codes. Results We estimated that there were 80,834 (95% CI 29,214–174,033) influenza-associated respiratory and circulatory hospitalizations and 26,760 (95% CI 14,541–47,464) influenza-associated critical illness hospitalizations. When a pneumonia diagnosis was excluded, the estimated number of influenza-associated respiratory and circulatory hospitalizations was 24,816 (95% CI 6,342–92,624). The estimated number of influenza-associated critical illness hospitalizations was 8,213 (95% CI 3,764–20,799). Around 30% of both influenza-associated respiratory and circulatory hospitalizations, as well as influenza-associated critical illness hospitalizations did not

  14. Satellites may underestimate rice residue and associated burning emissions in Vietnam

    NASA Astrophysics Data System (ADS)

    Lasko, Kristofer; Vadrevu, Krishna P.; Tran, Vinh T.; Ellicott, Evan; Nguyen, Thanh T. N.; Bui, Hung Q.; Justice, Christopher

    2017-08-01

    In this study, we estimate rice residue, associated burning emissions, and compare results with existing emissions inventories employing a bottom-up approach. We first estimated field-level post-harvest rice residues, including separate fuel-loading factors for rice straw and rice stubble. Results suggested fuel-loading factors of 0.27 kg m-2 (±0.033), 0.61 kg m-2 (±0.076), and 0.88 kg m-2 (±0.083) for rice straw, stubble, and total post-harvest biomass, respectively. Using these factors, we quantified potential emissions from rice residue burning and compared our estimates with other studies. Our results suggest total rice residue burning emissions as 2.24 Gg PM2.5, 36.54 Gg CO and 567.79 Gg CO2 for Hanoi Province, which are significantly higher than earlier studies. We attribute our higher emission estimates to improved fuel-loading factors; moreover, we infer that some earlier studies relying on residue-to-product ratios could be underestimating rice residue emissions by more than a factor of 2.3 for Hanoi, Vietnam. Using the rice planted area data from the Vietnamese government, and combining our fuel-loading factors, we also estimated rice residue PM2.5 emissions for the entirety of Vietnam and compared these estimates with an existing all-sources emissions inventory, and the Global Fire Emissions Database (GFED). Results suggest 75.98 Gg of PM2.5 released from rice residue burning accounting for 12.8% of total emissions for Vietnam. The GFED database suggests 42.56 Gg PM2.5 from biomass burning with 5.62 Gg attributed to agricultural waste burning indicating satellite-based methods may be significantly underestimating emissions. Our results not only provide improved residue and emission estimates, but also highlight the need for emissions mitigation from rice residue burning.

  15. Assessment of snowfall accumulation underestimation by tipping bucket gauges in the Spanish operational network

    NASA Astrophysics Data System (ADS)

    Buisán, Samuel T.; Earle, Michael E.; Luís Collado, José; Kochendorfer, John; Alastrué, Javier; Wolff, Mareile; Smith, Craig D.; López-Moreno, Juan I.

    2017-03-01

    Within the framework of the World Meteorological Organization Solid Precipitation Intercomparison Experiment (WMO-SPICE), the Thies tipping bucket precipitation gauge was assessed against the SPICE reference configuration at the Formigal-Sarrios test site located in the Pyrenees mountain range of Spain. The Thies gauge is the most widely used precipitation gauge by the Spanish Meteorological State Agency (AEMET) for the measurement of all precipitation types including snow. It is therefore critical that its performance is characterized. The first objective of this study is to derive transfer functions based on the relationships between catch ratio and wind speed and temperature. Multiple linear regression was applied to 1 and 3 h accumulation periods, confirming that wind is the most dominant environmental variable affecting the gauge catch efficiency, especially during snowfall events. At wind speeds of 1.5 m s-1 the tipping bucket recorded only 70 % of the reference precipitation. At 3 m s-1, the amount of measured precipitation decreased to 50 % of the reference, was even lower for temperatures colder than -2 °C and decreased to 20 % or less for higher wind speeds.The implications of precipitation underestimation for areas in northern Spain are discussed within the context of the present analysis, by applying the transfer function developed at the Formigal-Sarrios and using results from previous studies.

  16. Terrestrial biosphere models underestimate photosynthetic capacity and CO 2 assimilation in the Arctic

    DOE PAGES

    Rogers, Alistair; Serbin, Shawn P.; Ely, Kim S.; ...

    2017-09-06

    Terrestrial biosphere models (TBMs) are highly sensitive to model representation of photosynthesis, in particular the parameters maximum carboxylation rate and maximum electron transport rate at 25°C (Vc,max.25 and Jmax.25, respectively). Many TBMs do not include representation of Arctic plants, and those that do rely on understanding and parameterization from temperate species. We then measured photosynthetic CO2 response curves and leaf nitrogen (N) content in species representing the dominant vascular plant functional types found on the coastal tundra near Barrow, Alaska. The activation energies associated with the temperature response functions of Vc,max and Jmax were 17% lower than commonly used values.more » When scaled to 25°C, Vc,max.25 and Jmax.25 were two- to five-fold higher than the values used to parameterize current TBMs. This high photosynthetic capacity was attributable to a high leaf N content and the high fraction of N invested in Rubisco. Leaf-level modeling demonstrated that current parameterization of TBMs resulted in a two-fold underestimation of the capacity for leaf-level CO2 assimilation in Arctic vegetation. Our study highlights the poor representation of Arctic photosynthesis in TBMs, and provides the critical data necessary to improve our ability to project the response of the Arctic to global environmental change.« less

  17. Bioavailability of lysine for kittens in overheated casein is underestimated by the rat growth assay method.

    PubMed

    Larsen, J A; Fascetti, A J; Calvert, C C; Rogers, Q R

    2010-10-01

    Growth assays were performed to determine lysine bioavailability for kittens and rats in untreated and heated casein; these values were compared with estimates obtained with an in vitro method. Body weight, food intake, nitrogen and dry matter digestibility, and plasma lysine were determined during an 80-day growth trial using kittens (n = 16). Body weight and food intake were determined during a 21-day growth trial using weanling rats (n = 80). The growth data showed bioavailable lysine to be 102.4% and 100.2% (for untreated casein) and 66.1% and 51.7% (for heated casein) for kittens and rats, respectively. There was no relationship between plasma lysine and dietary lysine concentrations for kittens. There were no significant differences in nitrogen or dry matter digestibility among diets for kittens. The chemically reactive lysine content of untreated casein was 99.6%, and of heated casein was 67.1%. Heat treatment of casein resulted in significantly decreased lysine bioavailability as estimated by all methods. For untreated casein, both growth assays showed good agreement with the in vitro method for available lysine. For heated casein, the rat growth assay significantly underestimated bioavailable lysine as determined in kittens while the in vitro method closely approximated this value for the cat.

  18. Asbestos in Belgium: an underestimated health risk. The evolution of mesothelioma mortality rates (1969–2009)

    PubMed Central

    Van den Borre, Laura; Deboosere, Patrick

    2014-01-01

    Background: Although Belgium was once a major international manufacturer of asbestos products, asbestos-related diseases in the country have remained scarcely researched. Objectives: The aim of this study is to provide a descriptive analysis of Belgian mesothelioma mortality rates in order to improve the understanding of asbestos health hazards from an international perspective. Methods: Temporal and geographical analyses were performed on cause-specific mortality data (1969–2009) using quantitative demographic measures. Results were compared to recent findings on global mesothelioma deaths. Results: Belgium has one of the highest mesothelioma mortality rates in the world, following the UK, Australia, and Italy. With a progressive increase of male mesothelioma deaths in the mid-1980s, large differences in mortality rates between sexes are apparent. Mesothelioma deaths are primarily concentrated in geographic areas with proximity to former asbestos industries. Conclusions: Asbestos mortality in Belgium has been underestimated for decades. Our findings suggest that the location of asbestos industries is correlated with rates of mesothelioma, underlining the need to avert future asbestos exposure by thorough screening of potential contaminated sites and by pursuing a global ban on asbestos. PMID:24999848

  19. Impact of SNR and Gain-Function Over- and Under-estimation on Speech Intelligibility.

    PubMed

    Chen, Fei; Loizou, Philipos C

    2012-02-01

    Most noise reduction algorithms rely on obtaining reliable estimates of the SNR of each frequency bin. For that reason, much work has been done in analyzing the behavior and performance of SNR estimation algorithms in the context of improving speech quality and reducing speech distortions (e.g., musical noise). Comparatively little work has been reported, however, regarding the analysis and investigation of the effect of errors in SNR estimation on speech intelligibility. It is not known, for instance, whether it is the errors in SNR overestimation, errors in SNR underestimation, or both that are harmful to speech intelligibility. Errors in SNR estimation produce concomitant errors in the computation of the gain (suppression) function, and the impact of gain estimation errors on speech intelligibility is unclear. The present study assesses the effect of SNR estimation errors on gain function estimation via sensitivity analysis. Intelligibility listening studies were conducted to validate the sensitivity analysis. Results indicated that speech intelligibility is severely compromised when SNR and gain over-estimation errors are introduced in spectral components with negative SNR. A theoretical upper bound on the gain function is derived that can be used to constrain the values of the gain function so as to ensure that SNR overestimation errors are minimized. Speech enhancement algorithms that can limit the values of the gain function to fall within this upper bound can improve speech intelligibility.

  20. Vast underestimation of Madagascar's biodiversity evidenced by an integrative amphibian inventory.

    PubMed

    Vieites, David R; Wollenberg, Katharina C; Andreone, Franco; Köhler, Jörn; Glaw, Frank; Vences, Miguel

    2009-05-19

    Amphibians are in decline worldwide. However, their patterns of diversity, especially in the tropics, are not well understood, mainly because of incomplete information on taxonomy and distribution. We assess morphological, bioacoustic, and genetic variation of Madagascar's amphibians, one of the first near-complete taxon samplings from a biodiversity hotspot. Based on DNA sequences of 2,850 specimens sampled from over 170 localities, our analyses reveal an extreme proportion of amphibian diversity, projecting an almost 2-fold increase in species numbers from the currently described 244 species to a minimum of 373 and up to 465. This diversity is widespread geographically and across most major phylogenetic lineages except in a few previously well-studied genera, and is not restricted to morphologically cryptic clades. We classify the genealogical lineages in confirmed and unconfirmed candidate species or deeply divergent conspecific lineages based on concordance of genetic divergences with other characters. This integrative approach may be widely applicable to improve estimates of organismal diversity. Our results suggest that in Madagascar the spatial pattern of amphibian richness and endemism must be revisited, and current habitat destruction may be affecting more species than previously thought, in amphibians as well as in other animal groups. This case study suggests that worldwide tropical amphibian diversity is probably underestimated at an unprecedented level and stresses the need for integrated taxonomic surveys as a basis for prioritizing conservation efforts within biodiversity hotspots.

  1. Congenital isolated adrenocorticotropin deficiency: an underestimated cause of neonatal death, explained by TPIT gene mutations.

    PubMed

    Vallette-Kasic, Sophie; Brue, Thierry; Pulichino, Anne-Marie; Gueydan, Magali; Barlier, Anne; David, Michel; Nicolino, Marc; Malpuech, Georges; Déchelotte, Pierre; Deal, Cheri; Van Vliet, Guy; De Vroede, Monique; Riepe, Felix G; Partsch, Carl-Joachim; Sippell, Wolfgang G; Berberoglu, Merih; Atasay, Begüm; de Zegher, Francis; Beckers, Dominique; Kyllo, Jennifer; Donohoue, Patricia; Fassnacht, Martin; Hahner, Stefanie; Allolio, Bruno; Noordam, C; Dunkel, Leo; Hero, Matti; Pigeon, B; Weill, Jacques; Yigit, Sevket; Brauner, Raja; Heinrich, Juan Jorge; Cummings, Elizabeth; Riddell, Christie; Enjalbert, Alain; Drouin, Jacques

    2005-03-01

    Tpit is a T box transcription factor important for terminal differentiation of pituitary proopiomelanocortin-expressing cells. We demonstrated that human and mouse mutations of the TPIT gene cause a neonatal-onset form of congenital isolated ACTH deficiency (IAD). In the absence of glucocorticoid replacement, IAD can lead to neonatal death by acute adrenal insufficiency. This clinical entity was not previously well characterized because of the small number of published cases. Since identification of the first TPIT mutations, we have enlarged our series of neonatal IAD patients to 27 patients from 21 unrelated families. We found TPIT mutations in 17 of 27 patients. We identified 10 different TPIT mutations, with one mutation found in five unrelated families. All patients appeared to be homozygous or compound heterozygous for TPIT mutations, and their unaffected parents are heterozygous carriers, confirming a recessive mode of transmission. We compared the clinical and biological phenotype of the 17 IAD patients carrying a TPIT mutation with the 10 IAD patients with normal TPIT-coding sequences. This series of neonatal IAD patients revealed a highly homogeneous clinical presentation, suggesting that this disease may be an underestimated cause of neonatal death. Identification of TPIT gene mutations as the principal molecular cause of neonatal IAD permits prenatal diagnosis for families at risk for the purpose of early glucocorticoid replacement therapy.

  2. New Zealand Joint Registry data underestimates the rate of prosthetic joint infection.

    PubMed

    Zhu, Mark; Ravi, Saiprasad; Frampton, Chris; Luey, Chris; Young, Simon

    2016-08-01

    Background and purpose - Recent studies have revealed deficiencies in the accuracy of data from joint registries when reoperations for prosthetic joint infections (PJIs) are reported, particularly when no components are changed. We compared the accuracy of data from the New Zealand Joint Registry (NZJR) to a multicenter audit of hospital records to establish the rate of capture for PJI reoperations. Methods - 4,009 cases undergoing total knee or hip arthroplasty performed at 3 tertiary referral hospitals over a 3-year period were audited using multiple hospital datasets and the NZJR. The number of reoperations for PJI that were performed within 2 years of the primary arthroplasty was obtained using both methods and the data were compared. Results - The NZJR reported a 2-year reoperation rate for PJI of 0.67%, as compared to 1.1% from the audit of hospital records, giving the NZJR a sensitivity of 63%. Only 4 of 11 debridement-in-situ-only procedures and 7 of 12 modular exchange procedures were captured in the NZJR. Interpretation - The national joint registry underestimated the rate of reoperation for PJI by one third. Strategies for improving the accuracy of data might include revising and clarifying the registry forms to include all reoperations for PJI and frequent validation of the registry data against other databases.

  3. Misdiagnosis of Sacral Stress Fracture: An Underestimated Cause of Low Back Pain in Pregnancy?

    PubMed Central

    Perdomo, Ambar Deschamps; Tomé-Bermejo, Félix; Piñera, Angel R.; Alvarez, Luis

    2015-01-01

    Patient: Female, 28 Final Diagnosis: Sacral stress fracture Symptoms: Lumbosacral pain during pregnancy Medication: — Clinical Procedure: Activity modification • conservative treatment Specialty: Orthopedics and Traumatology Objective: Challenging differential diagnosis Background: Sacral stress fracture during pregnancy is an uncommon condition with unclear pathophysiology, presenting with non-specific symptoms and clinical findings. To date, few cases have been published in the literature describing the occurrence of sacral stress fracture during pregnancy. Case Report: We report a 28-year-old primigravid patient who developed lumbosacral pain at the end of the second trimester. Symptoms were overlooked throughout pregnancy and the postpartum period, resulting in the development of secondary chronic gait and balance problems. Conclusions: Stress fracture of the sacrum should be included in the differential diagnosis of low back and sacral pain during pregnancy. Its prevalence is probably underestimated because of the lack of specificity of the symptoms. Plain radiographs are not appropriate due to radiation exclusion; magnetic resonance is the only method that can be applied safely. There is limited information on natural history but many patients are expected to have a benign course. However, misdiagnosis may lead to prolonged morbidity and the development of secondary gait abnormalities. Stress fracture of the sacrum should be included in the differential diagnosis of low back and sacral pain during pregnancy. A high index of suspicion is necessary to establish an early diagnosis and appropriate treatment. PMID:25656418

  4. Exposure limits: the underestimation of absorbed cell phone radiation, especially in children.

    PubMed

    Gandhi, Om P; Morgan, L Lloyd; de Salles, Alvaro Augusto; Han, Yueh-Ying; Herberman, Ronald B; Davis, Devra Lee

    2012-03-01

    The existing cell phone certification process uses a plastic model of the head called the Specific Anthropomorphic Mannequin (SAM), representing the top 10% of U.S. military recruits in 1989 and greatly underestimating the Specific Absorption Rate (SAR) for typical mobile phone users, especially children. A superior computer simulation certification process has been approved by the Federal Communications Commission (FCC) but is not employed to certify cell phones. In the United States, the FCC determines maximum allowed exposures. Many countries, especially European Union members, use the "guidelines" of International Commission on Non-Ionizing Radiation Protection (ICNIRP), a non governmental agency. Radiofrequency (RF) exposure to a head smaller than SAM will absorb a relatively higher SAR. Also, SAM uses a fluid having the average electrical properties of the head that cannot indicate differential absorption of specific brain tissue, nor absorption in children or smaller adults. The SAR for a 10-year old is up to 153% higher than the SAR for the SAM model. When electrical properties are considered, a child's head's absorption can be over two times greater, and absorption of the skull's bone marrow can be ten times greater than adults. Therefore, a new certification process is needed that incorporates different modes of use, head sizes, and tissue properties. Anatomically based models should be employed in revising safety standards for these ubiquitous modern devices and standards should be set by accountable, independent groups.

  5. Robustness to divergence time underestimation when inferring species trees from estimated gene trees.

    PubMed

    DeGiorgio, Michael; Degnan, James H

    2014-01-01

    To infer species trees from gene trees estimated from phylogenomic data sets, tractable methods are needed that can handle dozens to hundreds of loci. We examine several computationally efficient approaches-MP-EST, STAR, STEAC, STELLS, and STEM-for inferring species trees from gene trees estimated using maximum likelihood (ML) and Bayesian approaches. Among the methods examined, we found that topology-based methods often performed better using ML gene trees and methods employing coalescent times typically performed better using Bayesian gene trees, with MP-EST, STAR, STEAC, and STELLS outperforming STEM under most conditions. We examine why the STEM tree (also called GLASS or Maximum Tree) is less accurate on estimated gene trees by comparing estimated and true coalescence times, performing species tree inference using simulations, and analyzing a great ape data set keeping track of false positive and false negative rates for inferred clades. We find that although true coalescence times are more ancient than speciation times under the multispecies coalescent model, estimated coalescence times are often more recent than speciation times. This underestimation can lead to increased bias and lack of resolution with increased sampling (either alleles or loci) when gene trees are estimated with ML. The problem appears to be less severe using Bayesian gene-tree estimates.

  6. Asymmetries of Poverty: Why Global Burden of Disease Valuations Underestimate the Burden of Neglected Tropical Diseases

    PubMed Central

    King, Charles H.; Bertino, Anne-Marie

    2008-01-01

    The disability-adjusted life year (DALY) initially appeared attractive as a health metric in the Global Burden of Disease (GBD) program, as it purports to be a comprehensive health assessment that encompassed premature mortality, morbidity, impairment, and disability. It was originally thought that the DALY would be useful in policy settings, reflecting normative valuations as a standardized unit of ill health. However, the design of the DALY and its use in policy estimates contain inherent flaws that result in systematic undervaluation of the importance of chronic diseases, such as many of the neglected tropical diseases (NTDs), in world health. The conceptual design of the DALY comes out of a perspective largely focused on the individual risk rather than the ecology of disease, thus failing to acknowledge the implications of context on the burden of disease for the poor. It is nonrepresentative of the impact of poverty on disability, which results in the significant underestimation of disability weights for chronic diseases such as the NTDs. Finally, the application of the DALY in policy estimates does not account for the nonlinear effects of poverty in the cost-utility analysis of disease control, effectively discounting the utility of comprehensively treating NTDs. The present DALY framework needs to be substantially revised if the GBD is to become a valid and useful system for determining health priorities. PMID:18365036

  7. Underestimated contribution of skeletal muscle in ornithine metabolism during mouse postnatal development.

    PubMed

    Ladeuix, Benjamin; Duchamp, Claude; Levillain, Olivier

    2014-01-01

    Ornithine aminotransferase (L-ornithine 2-oxoacid aminotransferase, OAT) is widely expressed in organs, but studies in mice have focused primarily on the intestine, kidney and liver because of the high OAT-specific activity in these tissues. This study aimed to investigate OAT activity in adult mouse tissues to assess the potential contribution to ornithine metabolism and to determine OAT control during postnatal development. OAT activity was widely distributed in mouse tissues. Sexual dimorphism was observed for most tissues in adults, with greater activity in females than in males. The contribution of skeletal muscles to total OAT activity (34% in males and 27% in females) was the greatest (50%) of the investigated tissues in pre-weaned mice and was similar to that of the liver in adults. OAT activity was found to be regulated in a tissue-specific manner during postnatal development in parallel with large changes in the plasma testosterone and corticosterone levels. After weaning, OAT activity markedly increased in the liver but dropped in the skeletal muscle and adipose tissue. Anticipating weaning for 3 days led to an earlier reduction of OAT activity in skeletal muscles. Orchidectomy in adults decreased OAT activity in the liver but increased it in skeletal muscle and adipose tissue. We concluded that the contribution of skeletal muscle to mouse ornithine metabolism may have been underestimated. The regulation of OAT in skeletal muscles differs from that in the liver. The present findings suggest important and tissue-specific metabolic roles for OAT during postnatal development in mice.

  8. Terrestrial biosphere models underestimate photosynthetic capacity and CO2 assimilation in the Arctic.

    PubMed

    Rogers, Alistair; Serbin, Shawn P; Ely, Kim S; Sloan, Victoria L; Wullschleger, Stan D

    2017-09-06

    Terrestrial biosphere models (TBMs) are highly sensitive to model representation of photosynthesis, in particular the parameters maximum carboxylation rate and maximum electron transport rate at 25°C (Vc,max.25 and Jmax.25 , respectively). Many TBMs do not include representation of Arctic plants, and those that do rely on understanding and parameterization from temperate species. We measured photosynthetic CO2 response curves and leaf nitrogen (N) content in species representing the dominant vascular plant functional types found on the coastal tundra near Barrow, Alaska. The activation energies associated with the temperature response functions of Vc,max and Jmax were 17% lower than commonly used values. When scaled to 25°C, Vc,max.25 and Jmax.25 were two- to five-fold higher than the values used to parameterize current TBMs. This high photosynthetic capacity was attributable to a high leaf N content and the high fraction of N invested in Rubisco. Leaf-level modeling demonstrated that current parameterization of TBMs resulted in a two-fold underestimation of the capacity for leaf-level CO2 assimilation in Arctic vegetation. This study highlights the poor representation of Arctic photosynthesis in TBMs, and provides the critical data necessary to improve our ability to project the response of the Arctic to global environmental change. No claim to original US Government works New Phytologist © 2017 New Phytologist Trust.

  9. Age, risk assessment, and sanctioning: Overestimating the old, underestimating the young.

    PubMed

    Monahan, John; Skeem, Jennifer; Lowenkamp, Christopher

    2017-04-01

    While many extoll the potential contribution of risk assessment to reducing the human and fiscal costs of mass incarceration without increasing crime, others adamantly oppose the incorporation of risk assessment in sanctioning. The principal concern is that any benefits in terms of reduced rates of incarceration achieved through the use of risk assessment will be offset by costs to social justice-which are claimed to be inherent in any risk assessment process that relies on variables for which offenders bear no responsibility, such as race, gender, and age. Previous research has addressed the variables of race and gender. Here, based on a sample of 7,350 federal offenders, we empirically test the predictive fairness of an instrument-the Post Conviction Risk Assessment (PCRA)-that includes the variable of age. We found that the strength of association between PCRA scores and future arrests was similar across younger (i.e., 25 years and younger), middle (i.e., 26-40 years), and older (i.e., 41 years and older) age groups (AUC values .70 or higher). Nevertheless, rates of arrest within each PCRA risk category were consistently lower for older than for younger offenders. Despite its inclusion of age as a risk factor, PCRA scores overestimated rates of recidivism for older offenders and underestimated rates of recidivism for younger offenders. (PsycINFO Database Record

  10. PCR diagnostics underestimate the prevalence of avian malaria (Plasmodium relictum) in experimentally-infected passerines.

    PubMed

    Jarvi, Susan I; Schultz, Jeffrey J; Atkinson, Carter T

    2002-02-01

    Several polymerase chain reaction (PCR)-based methods have recently been developed for diagnosing malarial infections in both birds and reptiles, but a critical evaluation of their sensitivity in experimentally-infected hosts has not been done. This study compares the sensitivity of several PCR-based methods for diagnosing avian malaria (Plasmodium relictum) in captive Hawaiian honeycreepers using microscopy and a recently developed immunoblotting technique. Sequential blood samples were collected over periods of up to 4.4 yr after experimental infection and rechallenge to determine both the duration and detectability of chronic infections. Two new nested PCR approaches for detecting circulating parasites based on P. relictum 18S rRNA genes and the thrombospondin-related anonymous protein (TRAP) gene are described. The blood smear and the PCR tests were less sensitive than serological methods for detecting chronic malarial infections. Individually, none of the diagnostic methods was 100% accurate in detecting subpatent infections, although serological methods were significantly more sensitive (97%) than either nested PCR (61-84%) or microscopy (27%). Circulating parasites in chronically infected birds either disappear completely from circulation or to drop to intensities below detectability by nested PCR. Thus, the use of PCR as a sole means of detection of circulating parasites may significantly underestimate true prevalence.

  11. EU-approved rapid tests might underestimate bovine spongiform encephalopathy infection in goats.

    PubMed

    Meloni, Daniela; Bozzetta, Elena; Langeveld, Jan P M; Groschup, Martin H; Goldmann, Wilfred; Andrèoletti, Olivier; Lantier, Isabelle; Van Keulen, Lucien; Bossers, Alex; Pitardi, Danilo; Nonno, Romolo; Sklaviadis, Theodoros; Ingravalle, Francesco; Peletto, Simone; Colussi, Silvia; Acutis, Pier Luigi

    2017-03-01

    We report the diagnostic sensitivity of 3 EU-approved rapid tests (ELISAs; 1 from IDEXX and 2 from Bio-Rad) for the detection of transmissible spongiform encephalopathy diseases in goats. Ninety-eight goat brainstem samples were tested. All the rapid tests had 100% specificity and ≥80% sensitivity, with the IDEXX test significantly more sensitive than the 2 Bio-Rad tests. All tests detected 100% of samples from goats with clinical scrapie, but missed 8% (IDEXX) to 33% (Bio-Rad SG) of samples from preclinical goats. Importantly, only IDEXX picked up all samples from clinical bovine spongiform encephalopathy (BSE)-infected goats, whereas the other 2 rapid tests missed 15% (Bio-Rad SG) to 25% (Bio-Rad SAP). These results show that a fraction of preclinical scrapie infections are likely missed by EU surveillance, with sensitivity of detection strongly dependent on the choice of the rapid test. Moreover, a significant proportion of clinical BSE infections are underestimated by using either Bio-Rad test. Assuming that the same sensitivity on preclinical goats would also occur in BSE-infected goats, our data suggest that IDEXX is likely the most sensitive test for detecting preclinical field cases of BSE infection in goats, although with an 8% failure rate. These results raise some concerns about the reliability of current EU surveillance figures on BSE infection in goats.

  12. Hazardous alcohol levels in adolescents are underestimated by barkeepers and security personnel.

    PubMed

    Wurdak, Mara; Dörfler, Tobias; Mentz, Julia; Schmidt, Anika; Wolstein, Jörg

    2012-12-01

    Drunkenness among adolescents represents a significant problem and is associated with adverse consequences. A Licensing Act, which prohibits the dispensing of alcoholic beverages to visibly intoxicated individuals, was introduced in Germany to curb excessive drinking. The objective of the study was to explore whether it is possible for barkeepers and security personnel to correctly estimate the alcohol level (AL) of adolescents merely based on their outer appearance and self-report. In a commercial dance club, 89 adolescents reported their past and current alcohol consumption and estimated their own AL. Their breath alcohol level was measured with a breathalyzer. The sample was divided into "moderate drinkers" and "binge drinkers." Barkeepers and security personnel spoke to and examined the adolescents in order to estimate the adolescents' AL. Professional staff underestimated the ALs of adolescents in 60.7 % of all cases. Estimates of the personnel showed greater deviations from the measured AL of the adolescents as compared to estimates of the adolescents themselves, especially in the group of binge drinkers (t = 2.764; p = 0.009). It seems that adolescents suffer less from observable effects of alcohol, such as sedation or impairment of motor function. Consequently, we do not recommend the application of the Licensing Act to adolescents, but suggest its replacement by other restrictions and prevention measures.

  13. Asbestos in Belgium: an underestimated health risk. The evolution of mesothelioma mortality rates (1969-2009).

    PubMed

    Van den Borre, Laura; Deboosere, Patrick

    2014-01-01

    Although Belgium was once a major international manufacturer of asbestos products, asbestos-related diseases in the country have remained scarcely researched. The aim of this study is to provide a descriptive analysis of Belgian mesothelioma mortality rates in order to improve the understanding of asbestos health hazards from an international perspective. Temporal and geographical analyses were performed on cause-specific mortality data (1969-2009) using quantitative demographic measures. Results were compared to recent findings on global mesothelioma deaths. Belgium has one of the highest mesothelioma mortality rates in the world, following the UK, Australia, and Italy. With a progressive increase of male mesothelioma deaths in the mid-1980s, large differences in mortality rates between sexes are apparent. Mesothelioma deaths are primarily concentrated in geographic areas with proximity to former asbestos industries. Asbestos mortality in Belgium has been underestimated for decades. Our findings suggest that the location of asbestos industries is correlated with rates of mesothelioma, underlining the need to avert future asbestos exposure by thorough screening of potential contaminated sites and by pursuing a global ban on asbestos.

  14. Gastroesophageal reflux disease vs. Panayiotopoulos syndrome: an underestimated misdiagnosis in pediatric age?

    PubMed

    Parisi, Pasquale; Pacchiarotti, Claudia; Ferretti, Alessandro; Bianchi, Simona; Paolino, Maria Chiara; Barreto, Mario; Principessa, Luigi; Villa, Maria Pia

    2014-12-01

    Autonomic signs and symptoms could be of epileptic or nonepileptic origin, and the differential diagnosis depends on a number of factors which include the nature of the autonomic manifestations themselves, the occurrence of other nonictal autonomic signs/symptoms, and the age of the patient. Here, we describe twelve children (aged from ten months to six years at the onset of the symptoms) with Panayiotopoulos syndrome misdiagnosed as gastroesophageal reflux disease. Gastroesophageal reflux disease and Panayiotopoulos syndrome may represent an underestimated diagnostic challenge. When the signs/symptoms occur mainly during sleep, a sleep EEG or, if available, a polysomnographic evaluation may be the most useful investigation to make a differential diagnosis between autonomic epileptic and nonepileptic disorders. An early detection can reduce both the high morbidity related to mismanagement and the high costs to the national health service related to the incorrect diagnostic and therapeutic approaches. To decide if antiseizure therapy is required, one should take into account both the frequency and severity of epileptic seizures and the tendency to have potentially lethal autonomic cardiorespiratory involvement. In conclusion, we would emphasize the need to make a differential diagnosis between gastroesophageal reflux disease and Panayiotopoulos syndrome in patients with "an unusual" late-onset picture of GERD and acid therapy-resistant gastroesophageal reflux, especially if associated with other autonomic symptoms and signs. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. The Dst index underestimates the solar cycle variation of geomagnetic activity.

    PubMed

    Temerin, Michael; Li, Xinlin

    2015-07-01

    It is known that the correction of the Kyoto Dst index for the secular variation of the Earth's internal field produces a discontinuity in the Kyoto Dst index at the end of each year. We show that this secular correction also introduces a significant baseline error to the Kyoto Dst index that leads to an underestimate of the solar cycle variation of geomagnetic activity and of the strength of the ring current as measured by the Kyoto Dst index. Thus, the average value of the Kyoto Dst index would be approximately 13 nT more negative for the active year 2003 compared to quiet years 2006 and 2009 if the Kyoto Dst index properly measured the effects of the ring current and other currents that influence the Dst observatories. Discontinuities in the Kyoto Dst index at the end of each year have an average value of about 5 nT, but the discontinuity at the end of year 2002 was approximately 12 nT, and the discontinuity at the end of year 1982 may have been as large as 20 nT.

  16. PCR diagnostics underestimate the prevalence of avian malaria (Plasmodium relictum) in experimentally-infected passerines

    USGS Publications Warehouse

    Jarvi, Susan I.; Schultz, Jeffrey J.; Atkinson, Carter T.

    2002-01-01

    Several polymerase chain reaction (PCR)-based methods have recently been developed for diagnosing malarial infections in both birds and reptiles, but a critical evaluation of their sensitivity in experimentally-infected hosts has not been done. This study compares the sensitivity of several PCR-based methods for diagnosing avian malaria (Plasmodium relictum) in captive Hawaiian honeycreepers using microscopy and a recently developed immunoblotting technique. Sequential blood samples were collected over periods of up to 4.4 yr after experimental infection and rechallenge to determine both the duration and detectability of chronic infections. Two new nested PCR approaches for detecting circulating parasites based on P. relictum 18S rRNA genes and the thrombospondin-related anonymous protein (TRAP) gene are described. The blood smear and the PCR tests were less sensitive than serological methods for detecting chronic malarial infections. Individually, none of the diagnostic methods was 100% accurate in detecting subpatent infections, although serological methods were significantly more sensitive (97%) than either nested PCR (61–84%) or microscopy (27%). Circulating parasites in chronically infected birds either disappear completely from circulation or to drop to intensities below detectability by nested PCR. Thus, the use of PCR as a sole means of detection of circulating parasites may significantly underestimate true prevalence.

  17. Consumer underestimation of sodium in fast food restaurant meals: Results from a cross-sectional observational study.

    PubMed

    Moran, Alyssa J; Ramirez, Maricelle; Block, Jason P

    2017-02-21

    Restaurants are key venues for reducing sodium intake in the U.S. but little is known about consumer perceptions of sodium in restaurant foods. This study quantifies the difference between estimated and actual sodium content of restaurant meals and examines predictors of underestimation in adult and adolescent diners at fast food restaurants. In 2013 and 2014, meal receipts and questionnaires were collected from adults and adolescents dining at six restaurant chains in four New England cities. The sample included 993 adults surveyed during 229 dinnertime visits to 44 restaurants and 794 adolescents surveyed during 298 visits to 49 restaurants after school or at lunchtime. Diners were asked to estimate the amount of sodium (mg) in the meal they had just purchased. Sodium estimates were compared with actual sodium in the meal, calculated by matching all items that the respondent purchased for personal consumption to sodium information on chain restaurant websites. Mean (SD) actual sodium (mg) content of meals was 1292 (970) for adults and 1128 (891) for adolescents. One-quarter of diners (176 (23%) adults, 155 (25%) adolescents) were unable or unwilling to provide estimates of the sodium content of their meals. Of those who provided estimates, 90% of adults and 88% of adolescents underestimated sodium in their meals, with adults underestimating sodium by a mean (SD) of 1013 mg (1,055) and adolescents underestimating by 876 mg (1,021). Respondents underestimated sodium content more for meals with greater sodium content. Education about sodium at point-of-purchase, such as provision of sodium information on restaurant menu boards, may help correct consumer underestimation, particularly for meals of high sodium content.

  18. Accuracy of multi-detector computed tomography (MDCT) in staging of renal cell carcinoma (RCC): analysis of risk factors for mis-staging and its impact on surgical intervention.

    PubMed

    El-Hefnawy, Ahmed S; Mosbah, Ahmed; El-Diasty, Tarek; Hassan, Mohammed; Shaaban, Atallah A

    2013-08-01

    To assess the accuracy of multi-detector computed tomography (MDCT) in preoperative staging of renal cell carcinoma (RCC) and to detect the possible risk factors for mis-staging. In addition, the impact of radiological mis-staging on surgical decision and operative procedures was evaluated. Data files of 693 patients, who underwent either radical or partial nephrectomy after preoperative staging by MDCT between January 2003 and December 2010, were retrospectively reviewed. Radiological data were compared to surgical and histopathological findings. Patients were classified according to 2009 TNM staging classification. Diagnostic accuracy per stage and its impact on surgical intervention were evaluated. The overall accuracy was 64.5%, and over-stage was detected in 29.5% and under-stage in 6%. Sensitivity and specificity were highest in stage T3b (85 and 99.5%, respectively), while T4 showed the lowest sensitivity and PPV (57 and 45%). Degree of agreement with pathological staging was substantial in T1 (κ = 0.7), fair in T2 (κ = 0. 4), perfect in T3b (κ = 0.81), and slight for the other stages (κ = <0.1). On multivariate analysis, conventional RCC and tumor size > 7 cm represent the significant risk factors (RR: 1.6, 95% CI: 1.1-2.3, P < 0.004 and RR: 2.4, 95% CI: 1.7-3.5, P < 0.001, respectively). Mis-staging was seen to have no negative impact on surgical decision. MDCT is an accepted tool for renal tumor staging. Tumor mis-staging after MDCT is of little clinical importance. Large tumor size >7 cm and conventional RCC are risk factors for tumor mis-staging.

  19. Trabecular bone structure analysis in the osteoporotic spine using a clinical in vivo setup for 64-slice MDCT imaging: comparison to microCT imaging and microFE modeling.

    PubMed

    Issever, Ahi S; Link, Thomas M; Kentenich, Marie; Rogalla, Patrik; Schwieger, Karsten; Huber, Markus B; Burghardt, Andrew J; Majumdar, Sharmila; Diederichs, Gerd

    2009-09-01

    Assessment of trabecular microarchitecture may improve estimation of biomechanical strength, but visualization of trabecular bone structure in vivo is challenging. We tested the feasibility of assessing trabecular microarchitecture in the spine using multidetector CT (MDCT) on intact human cadavers in an experimental in vivo-like setup. BMD, bone structure (e.g., bone volume/total volume = BV/TV; trabecular thickness = Tb.Th; structure model index = SMI) and bone texture parameters were evaluated in 45 lumbar vertebral bodies using MDCT (mean in-plane pixel size, 274 microm(2); slice thickness, 500 microm). These measures were correlated with structure measures assessed with microCT at an isotropic spatial resolution of 16 microm and to microfinite element models (microFE) of apparent modulus and stiffness. MDCT-derived BMD and structure measures showed significant correlations to the density and structure obtained by microCT (BMD, R(2) = 0.86, p < 0.0001; BV/TV, R(2) = 0.64, p < 0.0001; Tb.Th, R(2) = 0.36, p < 0.01). When comparing microCT-derived measures with microFE models, the following correlations (p < 0.001) were found for apparent modulus and stiffness, respectively: BMD (R(2) = 0.58 and 0.66), BV/TV (R(2) = 0.44 and 0.58), and SMI (R(2) = 0.44 and 0.49). However, the overall highest correlation (p < 0.001) with microFE app. modulus (R(2) = 0.75) and stiffness (R(2) = 0.76) was achieved by the combination of QCT-derived BMD with the bone texture measure Minkowski Dimension. In summary, although still limited by its spatial resolution, trabecular bone structure assessment using MDCT is overall feasible. However, when comparing with microFE-derived bone properties, BMD is superior compared with single parameters for microarchitecture, and correlations further improve when combining with texture measures.

  20. Have we underestimated the efficacy of pulmonary rehabilitation in improving mood?

    PubMed

    Harrison, S L; Greening, N J; Williams, J E A; Morgan, M D L; Steiner, M C; Singh, S J

    2012-06-01

    Patients with COPD have a high prevalence of anxiety and depression. The efficacy of pulmonary rehabilitation (PR) in treating more severe anxiety and depression is unknown. The study aimed to explore the effectiveness of PR in reducing symptoms of anxiety and depression across a spectrum of severities. The study used principles of comparative effectiveness research. Data was analysed from 518 patients with COPD [57.5% male, mean (SD) age 69.2 years (± 8.8 years)]. Patients were categorised into 3 groups based on their hospital anxiety and depression scale (HADS) scores pre PR ('none' 0-7, 'probable' 8-10 and 'presence' 11-21). A responder was defined as achieving a change of ≥ 48 m on the incremental shuttle walk test (ISWT). Patients were categorised as 'completers' if they attended their discharge assessment for PR. Anxiety and depression did not reduce following PR in patients with no symptoms (p > 0.05). Patients with a 'probable' or 'presence' of symptoms had significant reductions (both p < 0.001). There was a difference between sub-groups in change for anxiety and depression with patients scoring highest on the HADS having the greatest reductions (p < 0.001). There was no correlation between anxiety or depression and completion of PR (p > 0.05). Responders and non-responders did not differ in their anxiety or depression levels (p > 0.05). PR is effective in reducing symptoms of anxiety and depression. Previous studies may have underestimated the effectiveness of the PR programme in improving mood. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Disk Masses around Solar-mass Stars are Underestimated by CO Observations

    NASA Astrophysics Data System (ADS)

    Yu, Mo; Evans, Neal J., II; Dodson-Robinson, Sarah E.; Willacy, Karen; Turner, Neal J.

    2017-05-01

    Gas in protostellar disks provides the raw material for giant planet formation and controls the dynamics of the planetesimal-building dust grains. Accurate gas mass measurements help map the observed properties of planet-forming disks onto the formation environments of known exoplanets. Rare isotopologues of carbon monoxide (CO) have been used as gas mass tracers for disks in the Lupus star-forming region, with an assumed interstellar CO/H2 abundance ratio. Unfortunately, observations of T-Tauri disks show that CO abundance is not interstellar, a finding reproduced by models that show CO abundance decreasing both with distance from the star and as a function of time. Here, we present radiative transfer simulations that assess the accuracy of CO-based disk mass measurements. We find that the combination of CO chemical depletion in the outer disk and optically thick emission from the inner disk leads observers to underestimate gas mass by more than an order of magnitude if they use the standard assumptions of interstellar CO/H2 ratio and optically thin emission. Furthermore, CO abundance changes on million-year timescales, introducing an age/mass degeneracy into observations. To reach a factor of a few accuracy for CO-based disk mass measurements, we suggest that observers and modelers adopt the following strategies: (1) select low-J transitions; (2) observe multiple CO isotopologues and use either intensity ratios or normalized line profiles to diagnose CO chemical depletion; and (3) use spatially resolved observations to measure the CO-abundance distribution.

  2. Exploration of the Drosophila buzzatii transposable element content suggests underestimation of repeats in Drosophila genomes.

    PubMed

    Rius, Nuria; Guillén, Yolanda; Delprat, Alejandra; Kapusta, Aurélie; Feschotte, Cédric; Ruiz, Alfredo

    2016-05-10

    Many new Drosophila genomes have been sequenced in recent years using new-generation sequencing platforms and assembly methods. Transposable elements (TEs), being repetitive sequences, are often misassembled, especially in the genomes sequenced with short reads. Consequently, the mobile fraction of many of the new genomes has not been analyzed in detail or compared with that of other genomes sequenced with different methods, which could shed light into the understanding of genome and TE evolution. Here we compare the TE content of three genomes: D. buzzatii st-1, j-19, and D. mojavensis. We have sequenced a new D. buzzatii genome (j-19) that complements the D. buzzatii reference genome (st-1) already published, and compared their TE contents with that of D. mojavensis. We found an underestimation of TE sequences in Drosophila genus NGS-genomes when compared to Sanger-genomes. To be able to compare genomes sequenced with different technologies, we developed a coverage-based method and applied it to the D. buzzatii st-1 and j-19 genome. Between 10.85 and 11.16 % of the D. buzzatii st-1 genome is made up of TEs, between 7 and 7,5 % of D. buzzatii j-19 genome, while TEs represent 15.35 % of the D. mojavensis genome. Helitrons are the most abundant order in the three genomes. TEs in D. buzzatii are less abundant than in D. mojavensis, as expected according to the genome size and TE content positive correlation. However, TEs alone do not explain the genome size difference. TEs accumulate in the dot chromosomes and proximal regions of D. buzzatii and D. mojavensis chromosomes. We also report a significantly higher TE density in D. buzzatii and D. mojavensis X chromosomes, which is not expected under the current models. Our easy-to-use correction method allowed us to identify recently active families in D. buzzatii st-1 belonging to the LTR-retrotransposon superfamily Gypsy.

  3. An underestimated issue: unsuspected decrease of sound processor microphone sensitivity, technical, and clinical evaluation.

    PubMed

    Razza, Sergio; Burdo, Sandro

    2011-05-01

    To describe the rate of occurrence of unsuspected decrease in sensitivity of the sound processor microphone and to evaluate its effect on the patient's audiological performance in terms of reduction in speech recognition scores. Speech processor microphones were tested by connecting the speech processor acoustic monitor circuit to a hearing aid analyzer. The response curves were compared with those obtained from fully working microphones. During a 6-month investigation period, microphone response curves were measured from a group of cochlear implant recipients who had not reported any problems. Despite the absence of any subjective problem, some microphones were found to show a loss of sensitivity. Their users, aged between 4 and 67 years, were tested both with the defective and a working microphone in order to calculate the correlation between the degree of microphone failure and the decline in audiological performance. To quantify the effect of microphone failure, patients' speech recognition skills were measured by live voice connected discourse tracking series administered in different conditions and by recorded sentences lists. A total of 120 apparently fully functioning sound processors were tested in the investigation: 33 (27.5%) were affected by a subjectively unreported sensitivity decrease. Speech-tracking scores correlated significantly with the loss of microphone sensitivity in all test conditions (r = 0.69-0.77, P < 0.05). A high degree of correlation was also found for speech audiometry tests (r = 0.70-0.73, P < 0.05). Microphone sensitivity loss affected speech recognition skills, especially without lip reading and in the presence of background noise. The results indicate that any reduction in sound processor microphone sensitivity causes a degree of hearing decline that negatively affects the cochlear recipient's clinical performance. Microphone faults are often unreported events, and their occurrence rate is underestimated. To establish that the

  4. Noncommunicable disease in rural India: Are we seriously underestimating the risk? The Nallampatti noncommunicable disease study

    PubMed Central

    Swaminathan, Krishnan; Veerasekar, Ganesh; Kuppusamy, Sujatha; Sundaresan, Mohanraj; Velmurugan, Ganesan; Palaniswami, Nalla G.

    2017-01-01

    Aim: To assess the prevalence of noncommunicable diseases in a true rural farming population in South India and compare the data with the landmark contemporary Indian Council of Medical Research-India Diabetes (ICMR-INDIAB) study. Methods: Local Ethics Committee approval and informed consent was obtained from all participants. Inclusion criteria were participants, aged ≥20 and ≤85 years, from Nallampatti, a classical farming village from Tamil Nadu state, India. All participants were administered a detailed questionnaire, had anthropometric measurements including height, weight, and waist circumference. Bloods were drawn for random blood glucose, glycated hemoglobin (HbA1c), nonfasting lipid profile, Cystatin C, uric acid, and hemoglobin. All participants had carotid intima-media thickness (CIMT) done by high-resolution B-mode carotid ultrasound. Results: More than 50% of the population had either diabetes or prediabetes based on HbA1c. Nearly, 40% of the population had hypertension with suboptimal control in those with known hypertension. Nearly, a third of the population had dyslipidemia, elevated cystatin C levels, and abnormal CIMT. The burden was higher than the comparable ICMR-INDIAB study in rural Tamil Nadu. Conclusion: One-third to one-half of this rural farming population is at risk of cardiovascular disease, with poor control of preexisting cardiovascular risk factors. Current Indian data may underestimate the risk in different ethnic populations and regions of India. Long-term follow-up of this cohort for the incident cardiovascular disease will shed light on the true cardiovascular risk in a typical South Indian rural farming population. PMID:28217505

  5. Optical Disector Counting in Cryosections and Vibratome Sections Underestimates Particle Numbers: Effects of Tissue Quality

    PubMed Central

    Ward, Tyson S.; Rosen, Glenn D.; Von Bartheld, Christopher S.

    2013-01-01

    Optical disector counting is currently applied most often to cryosections, followed in frequency by resin-embedded tissues, paraffin, and vibratome sections. The preservation quality of these embedding options differs considerably; yet, the effect of tissue morphology on numerical estimates is unknown. We tested whether different embedding media significantly influence numerical estimates in optical disector counting, using the previously calibrated trochlear motor nucleus of hatchling chickens. Animals were perfusion-fixed with paraformaldehyde (PFA) only or in addition with glutaraldehyde (GA), or by Methacarn immersion fixation. Brains were prepared for paraffin, cryo-, vibratome- or celloidin sectioning. Complete penetration of the thionin stain was verified by z-axis analysis. Neuronal nuclei were counted using an unbiased counting rule, numbers were averaged for each group and compared by ANOVA. In paraffin sections, 906 ± 12 (SEM) neurons were counted, similar to previous calibrated data series, and results obtained from fixation with Methacarn or PFA were statistically indistinguishable. In celloidin sections, 912 ± 28 neurons were counted—not statistically different from paraffin. In cryosections, 812 ± 12 neurons were counted (underestimate of 10.4%) when fixed with PFA only, but 867 ± 17 neurons were counted when fixed with PFA and GA. Vibratome sections had the most serious aberration with 729 ± 31 neurons—a deficit of 20%. Thus, our analysis shows that PFA-fixed cryosections and vibratome sections result in a substantial numerical deficit. The addition of GA to the PFA fixative significantly improved counts in cryosections. These results may explain, in part, the significant numerical differences reported from different labs and should help investigators select optimal conditions for quantitative morphological studies. PMID:17868132

  6. Appropriate homoplasy metrics in linked SSRs to predict an underestimation of demographic expansion times.

    PubMed

    Ortega-Del Vecchyo, Diego; Piñero, Daniel; Jardón-Barbolla, Lev; van Heerwaarden, Joost

    2017-09-11

    Homoplasy affects demographic inference estimates. This effect has been recognized and corrective methods have been developed. However, no studies so far have defined what homoplasy metrics best describe the effects on demographic inference, or have attempted to estimate such metrics in real data. Here we study how homoplasy in chloroplast microsatellites (cpSSR) affects inference of population expansion time. cpSSRs are popular markers for inferring historical demography in plants due to their high mutation rate and limited recombination. In cpSSRs, homoplasy is usually quantified as the probability that two markers or haplotypes that are identical by state are not identical by descent (Homoplasy index, P). Here we propose a new measure of multi-locus homoplasy in linked SSR called Distance Homoplasy (DH), which measures the proportion of pairwise differences not observed due to homoplasy, and we compare it to P and its per cpSSR locus average, which we call Mean Size Homoplasy (MSH). We use simulations and analytical derivations to show that, out of the three homoplasy metrics analyzed, MSH and DH are more correlated to changes in the population expansion time and to the underestimation of that demographic parameter using cpSSR. We perform simulations to show that Approximate Bayesian Computation (ABC) can be used to obtain reasonable estimates of MSH and DH. Finally, we use ABC to estimate the expansion time, MSH and DH from a chloroplast SSR dataset in Pinus caribaea. To our knowledge, this is the first time that homoplasy has been estimated in population genetic data. We show that MSH and DH should be used to quantify how homoplasy affects estimates of population expansion time. We also demonstrate how ABC provides a methodology to estimate homoplasy in population genetic data.

  7. Are the impacts of land use on warming underestimated in climate policy?

    NASA Astrophysics Data System (ADS)

    Mahowald, Natalie M.; Ward, Daniel S.; Doney, Scott C.; Hess, Peter G.; Randerson, James T.

    2017-09-01

    While carbon dioxide emissions from energy use must be the primary target of climate change mitigation efforts, land use and land cover change (LULCC) also represent an important source of climate forcing. In this study we compute time series of global surface temperature change separately for LULCC and non-LULCC sources (primarily fossil fuel burning), and show that because of the extra warming associated with the co-emission of methane and nitrous oxide with LULCC carbon dioxide emissions, and a co-emission of cooling aerosols with non-LULCC emissions of carbon dioxide, the linear relationship between cumulative carbon dioxide emissions and temperature has a two-fold higher slope for LULCC than for non-LULCC activities. Moreover, projections used in the Intergovernmental Panel on Climate Change (IPCC) for the rate of tropical land conversion in the future are relatively low compared to contemporary observations, suggesting that the future projections of land conversion used in the IPCC may underestimate potential impacts of LULCC. By including a ‘business as usual’ future LULCC scenario for tropical deforestation, we find that even if all non-LULCC emissions are switched off in 2015, it is likely that 1.5 °C of warming relative to the preindustrial era will occur by 2100. Thus, policies to reduce LULCC emissions must remain a high priority if we are to achieve the low to medium temperature change targets proposed as a part of the Paris Agreement. Future studies using integrated assessment models and other climate simulations should include more realistic deforestation rates and the integration of policy that would reduce LULCC emissions.

  8. Underestimation of boreal soil carbon stocks by mathematical soil carbon models linked to soil nutrient status

    NASA Astrophysics Data System (ADS)

    Ťupek, Boris; Ortiz, Carina A.; Hashimoto, Shoji; Stendahl, Johan; Dahlgren, Jonas; Karltun, Erik; Lehtonen, Aleksi

    2016-08-01

    Inaccurate estimate of the largest terrestrial carbon pool, soil organic carbon (SOC) stock, is the major source of uncertainty in simulating feedback of climate warming on ecosystem-atmosphere carbon dioxide exchange by process-based ecosystem and soil carbon models. Although the models need to simplify complex environmental processes of soil carbon sequestration, in a large mosaic of environments a missing key driver could lead to a modeling bias in predictions of SOC stock change.We aimed to evaluate SOC stock estimates of process-based models (Yasso07, Q, and CENTURY soil sub-model v4) against a massive Swedish forest soil inventory data set (3230 samples) organized by a recursive partitioning method into distinct soil groups with underlying SOC stock development linked to physicochemical conditions.For two-thirds of measurements all models predicted accurate SOC stock levels regardless of the detail of input data, e.g., whether they ignored or included soil properties. However, in fertile sites with high N deposition, high cation exchange capacity, or moderately increased soil water content, Yasso07 and Q models underestimated SOC stocks. In comparison to Yasso07 and Q, accounting for the site-specific soil characteristics (e. g. clay content and topsoil mineral N) by CENTURY improved SOC stock estimates for sites with high clay content, but not for sites with high N deposition.Our analysis suggested that the soils with poorly predicted SOC stocks, as characterized by the high nutrient status and well-sorted parent material, indeed have had other predominant drivers of SOC stabilization lacking in the models, presumably the mycorrhizal organic uptake and organo-mineral stabilization processes. Our results imply that the role of soil nutrient status as regulator of organic matter mineralization has to be re-evaluated, since correct SOC stocks are decisive for predicting future SOC change and soil CO2 efflux.

  9. Neglecting Rice Milling Yield and Quality Underestimates Economic Losses from High-Temperature Stress

    PubMed Central

    Lyman, Nathaniel B.; Jagadish, Krishna S. V.; Nalley, L. Lanier; Dixon, Bruce L.; Siebenmorgen, Terry

    2013-01-01

    Future increases in global surface temperature threaten those worldwide who depend on rice production for their livelihoods and food security. Past analyses of high-temperature stress on rice production have focused on paddy yield and have failed to account for the detrimental impact of high temperatures on milling quality outcomes, which ultimately determine edible (marketable) rice yield and market value. Using genotype specific rice yield and milling quality data on six common rice varieties from Arkansas, USA, combined with on-site, half-hourly and daily temperature observations, we show a nonlinear effect of high-temperature stress exposure on yield and milling quality. A 1°C increase in average growing season temperature reduces paddy yield by 6.2%, total milled rice yield by 7.1% to 8.0%, head rice yield by 9.0% to 13.8%, and total milling revenue by 8.1% to 11.0%, across genotypes. Our results indicate that failure to account for changes in milling quality leads to understatement of the impacts of high temperatures on rice production outcomes. These dramatic losses result from reduced paddy yield and increased percentages of chalky and broken kernels, which together decrease the quantity and market value of milled rice. Recently published estimates show paddy yield reductions of up to 10% across the major rice-producing regions of South and Southeast Asia due to rising temperatures. The results of our study suggest that the often-cited 10% figure underestimates the economic implications of climate change for rice producers, thus potentially threatening future food security for global rice producers and consumers. PMID:23991056

  10. Comparing Two Epidemiologic Surveillance Methods to Assess Underestimation of Human Stampedes in India

    PubMed Central

    Ngai, Ka Ming; Lee, Wing Yan; Madan, Aditi; Sanyal, Saswata; Roy, Nobhojit; Burkle, Frederick M.; Hsu, Edbert B.

    2013-01-01

    Background: Two separate but complementary epidemiologic surveillance methods for human stampedes have emerged since the publication of the topic in 2009. The objective of this study is to estimate the degree of underreporting in India. Method: The Ngai Search Method was compared to the Roy Search Method for human stampede events occurring in India between 2001 and 2010. Results: A total of 40 stampedes were identified by both search methods. Using the Ngai method, 34 human stampedes were identified. Using a previously defined stampede scale: 2 events were class I, 21 events were class II, 8 events were class III, and 3 events were class IV. The median deaths were 5.5 per event and median injuries were 13.5 per event. Using the Roy method, 27 events were identified, including 9 events that were not identified by the Ngai method. After excluding events based on exclusion criteria, six additional events identified by the Roy’s method had a median of 4 deaths and 30 injuries. In multivariate analysis using the Ngai method, religious (6.52, 95%CI 1.73-24.66, p=0.006) and political (277.09, 95%CI 5.12-15,001.96, p=0.006) events had higher relative number of deaths. Conclusion: Many causes accounting for the global increase in human stampede events can only be elucidated through systematic epidemiological investigation. Focusing on a country with a high recurrence of human stampedes, we compare two independent methods of data abstraction in an effort to improve the existing database and to identify pertinent risk factors. We concluded that our previous publication underestimated stampede events in India by approximately 18% and an international standardized database to systematically record occurrence of human stampedes is needed to facilitate understanding of the epidemiology of human stampedes. PMID:24077300

  11. The Underestimated Role of Mechanical Stimuli in Brain Diseases and the Relate d In Vitro Models.

    PubMed

    Guo, Tingwang; Ren, Peng; Hao, Shilei; Wang, Bochu

    2017-01-01

    Besides the well-documented biochemical and electrophysiological effects, the mechanical stimuli also have prominent roles in the initiation and development of brain diseases but yet have been underestimated. To explore the role of mechanical stimuli and the followed mechanical-biochemical effects in the brain diseases. In this review, we discussed the initiation and effect of mechanical stimuli and the surrounding topography in brain diseases, especially for the intracerebral hemorrhage (ICH), Alzheimer's disease (AD), diffuse axonal injury (DAI) and primary brain tumors. The induced cascades of biological pathways by mechanical stimuli prior to and during the brain diseases were summarized. Strategies aiming to reduce the mechanical stimuli related damages or poor outcomes were also discussed, despite some could only prevent rather than cure. Literatures have indicated mechanical stimuli were the connection between the exogenous mechanotransduction and the inherent biochemical cascades. Therefore, we also reviewed in vitro models in the literatures that simulated the diverse range of mechanical stimuli, which connected the neural network with the tissue engineering, biomaterials and potential therapeutic strategies together. At the microscopic and macroscopic levels, the hydrostatic pressure, tensile/compressive force, shear force, and even the roughness of topography from the physical surrounding exert the influence on the neural network not only by themselves but also through the interaction with other factors, e.g. biochemical or electrophysiological effects. In the clinical management, taking the undervalued mechanical stimuli and the followed mechanical- biochemical effects into consideration are important and inevitable in preventing and treating brain diseases. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  12. Citation Analysis May Severely Underestimate the Impact of Clinical Research as Compared to Basic Research

    PubMed Central

    van Eck, Nees Jan; Waltman, Ludo; van Raan, Anthony F. J.; Klautz, Robert J. M.; Peul, Wilco C.

    2013-01-01

    Background Citation analysis has become an important tool for research performance assessment in the medical sciences. However, different areas of medical research may have considerably different citation practices, even within the same medical field. Because of this, it is unclear to what extent citation-based bibliometric indicators allow for valid comparisons between research units active in different areas of medical research. Methodology A visualization methodology is introduced that reveals differences in citation practices between medical research areas. The methodology extracts terms from the titles and abstracts of a large collection of publications and uses these terms to visualize the structure of a medical field and to indicate how research areas within this field differ from each other in their average citation impact. Results Visualizations are provided for 32 medical fields, defined based on journal subject categories in the Web of Science database. The analysis focuses on three fields: Cardiac & cardiovascular systems, Clinical neurology, and Surgery. In each of these fields, there turn out to be large differences in citation practices between research areas. Low-impact research areas tend to focus on clinical intervention research, while high-impact research areas are often more oriented on basic and diagnostic research. Conclusions Popular bibliometric indicators, such as the h-index and the impact factor, do not correct for differences in citation practices between medical fields. These indicators therefore cannot be used to make accurate between-field comparisons. More sophisticated bibliometric indicators do correct for field differences but still fail to take into account within-field heterogeneity in citation practices. As a consequence, the citation impact of clinical intervention research may be substantially underestimated in comparison with basic and diagnostic research. PMID:23638064

  13. Lactate minimum underestimates the maximal lactate steady-state in swimming mice.

    PubMed

    Rodrigues, Natalia Almeida; Torsoni, Adriana Souza; Fante, Thais; Dos Reis, Ivan Gustavo Masselli; Gobatto, Claudio Alexandre; Manchado-Gobatto, Fúlvia Barros

    2017-01-01

    The intensity of lactate minimum (LM) has presented a good estimate of the intensity of maximal lactate steady-state (MLSS); however, this relationship has not yet been verified in the mouse model. We proposed validating the LM protocol for swimming mice by investigating the relationship among intensities of LM and MLSS as well as differences between sexes, in terms of aerobic capacity. Nineteen mice (male: 10, female: 9) were submitted to the evaluation protocols for LM and MLSS. The LM protocol consisted of hyperlactatemia induction (30 s exercise (13% body mass (bm)), 30 s resting pause and exhaustive exercise (13% bm), 9 min resting pause and incremental test). The LM underestimated MLSS (mice: 17.6%; male: 13.5%; female: 21.6%). Pearson's analysis showed a strong correlation among intensities of MLSS and LM (male (r = 0.67, p = 0.033); female (r = 0.86, p = 0.003)), but without agreement between protocols. The Bland-Altman analysis showed that bias was higher for females (1.5 (0.98) % bm; mean (MLSS and LM): 4.4%-6.4% bm) as compared with males (0.84 (1.24) % bm; mean (MLSS and LM): 4.5%-7.5% bm). The error associated with the estimated of intensity for males was lower when compared with the range of means for MLSS and LM. Therefore, the LM test could be used to determine individual aerobic intensity for males (considering the bias) but not females. Furthermore, the females supported higher intensities than the males. The differences in body mass between sexes could not explain the higher intensities supported by the females.

  14. Concomitant spuriously elevated white blood cell count, a previously underestimated phenomenon in EDTA-dependent pseudothrombocytopenia.

    PubMed

    Xiao, Yufei; Xu, Yang

    2015-01-01

    The proportion and potential risk of concomitant spuriously elevated white blood cell count (SEWC) are underestimated in ethylenediaminetetraacetic acid (EDTA)-dependent pseudothrombocytopenia (PTCP). The proportion, kinetics and prevention of SEWC remain poorly understood. A total of 25 patients with EDTA-dependent PTCP were enrolled in this study. With the hematology analyzer Coulter LH 750, we determined the time courses of WBC count, WBC differential and platelet count in EDTA- and sodium citrate-anticoagulated blood, respectively. Blood smears were prepared to inspect the presence of platelet clumps using light microscopy. The effect of automatic instrumental correction on the extent of SEWC was evaluated. The proportion of SEWC was 92% in EDTA-dependent PTCP and 73.9% of SEWCs were within the normal range. The development of SEWC was time-dependent, and neutrophils and lymphocytes were the main subpopulations involved in SEWC. A strong and significant correlation (r = 0.9937, p < 0.001) was found between the increased WBC count and the decreased platelet count. Both corrected and uncorrected WBC counts at 15 minutes or later after blood collection in EDTA were significantly higher than their basal counts, respectively, p < 0.05. Interestingly, in citrated blood, WBC counts after blood collection were not significantly different from its basal counts, p > 0.05. A high proportion of concomitant SEWCs, which are mainly within normal range, are present in patients with EDTA-dependent PTCP. Proper interpretation of SEWC is crucial to avoid clinic errors. SEWC develops in a time-dependent pattern, although the Coulter LH 750 only partly mitigates the extent of SEWC, sodium citrate is able to effectively prevent SEWC.

  15. Infection due to travel-related carbapenemase-producing Enterobacteriaceae, a largely underestimated phenomenon in Belgium.

    PubMed

    Jans, B; D Huang, T-D; Bauraing, C; Berhin, C; Bogaerts, P; Deplano, A; Denis, O; Catry, B; Glupczynski, Y

    2015-06-01

    Carbapenemase-producing Enterobacteriaceae (CPE) are emerging worldwide, representing a major threat for public health. Early CPE detection is crucial in order to prevent infections and the development of reservoirs/outbreaks in hospitals. In 2008, most of the CPE strains reported in Belgium were imported from patients repatriated from abroad. Actually, this is no longer the case. A surveillance was set up in Belgian hospitals (2012) in order to explore the epidemiology and determinants of CPE, including the link with international travel/hospitalization. The present article describes travel-related CPE reported in Belgium. Different other potential sources for importation of CPE are discussed. Only 12% of all CPE cases reported in Belgium (2012-2013) were travel related (with/without hospitalization). This is undoubtedly an underestimation (missing travel data: 36%), considering the increasing tourism, the immigration from endemic countries, the growing number of foreign patients using scheduled medical care in Belgium, and the medical repatriations from foreign hospitals. The free movement of persons and services (European Union) contributes to an increase in foreign healthcare workers (HCW) in Belgian hospitals. Residents from nursing homes located at the country borders can be another potential source of dissemination of CPE between countries. Moreover, the high population density in Belgium can increase the risk for CPE-dissemination. Urban areas in Belgium may cumulate these potential risk factors for import/dissemination of CPE. Ideally, travel history data should be obtained from hospital hygiene teams, not from the microbiological laboratory. Patients who received medical care abroad (whatever the country) should be screened for CPE at admission.

  16. Neglecting rice milling yield and quality underestimates economic losses from high-temperature stress.

    PubMed

    Lyman, Nathaniel B; Jagadish, Krishna S V; Nalley, L Lanier; Dixon, Bruce L; Siebenmorgen, Terry

    2013-01-01

    Future increases in global surface temperature threaten those worldwide who depend on rice production for their livelihoods and food security. Past analyses of high-temperature stress on rice production have focused on paddy yield and have failed to account for the detrimental impact of high temperatures on milling quality outcomes, which ultimately determine edible (marketable) rice yield and market value. Using genotype specific rice yield and milling quality data on six common rice varieties from Arkansas, USA, combined with on-site, half-hourly and daily temperature observations, we show a nonlinear effect of high-temperature stress exposure on yield and milling quality. A 1 °C increase in average growing season temperature reduces paddy yield by 6.2%, total milled rice yield by 7.1% to 8.0%, head rice yield by 9.0% to 13.8%, and total milling revenue by 8.1% to 11.0%, across genotypes. Our results indicate that failure to account for changes in milling quality leads to understatement of the impacts of high temperatures on rice production outcomes. These dramatic losses result from reduced paddy yield and increased percentages of chalky and broken kernels, which together decrease the quantity and market value of milled rice. Recently published estimates show paddy yield reductions of up to 10% across the major rice-producing regions of South and Southeast Asia due to rising temperatures. The results of our study suggest that the often-cited 10% figure underestimates the economic implications of climate change for rice producers, thus potentially threatening future food security for global rice producers and consumers.

  17. Citation analysis may severely underestimate the impact of clinical research as compared to basic research.

    PubMed

    van Eck, Nees Jan; Waltman, Ludo; van Raan, Anthony F J; Klautz, Robert J M; Peul, Wilco C

    2013-01-01

    Citation analysis has become an important tool for research performance assessment in the medical sciences. However, different areas of medical research may have considerably different citation practices, even within the same medical field. Because of this, it is unclear to what extent citation-based bibliometric indicators allow for valid comparisons between research units active in different areas of medical research. A visualization methodology is introduced that reveals differences in citation practices between medical research areas. The methodology extracts terms from the titles and abstracts of a large collection of publications and uses these terms to visualize the structure of a medical field and to indicate how research areas within this field differ from each other in their average citation impact. Visualizations are provided for 32 medical fields, defined based on journal subject categories in the Web of Science database. The analysis focuses on three fields: Cardiac & cardiovascular systems, Clinical neurology, and Surgery. In each of these fields, there turn out to be large differences in citation practices between research areas. Low-impact research areas tend to focus on clinical intervention research, while high-impact research areas are often more oriented on basic and diagnostic research. Popular bibliometric indicators, such as the h-index and the impact factor, do not correct for differences in citation practices between medical fields. These indicators therefore cannot be used to make accurate between-field comparisons. More sophisticated bibliometric indicators do correct for field differences but still fail to take into account within-field heterogeneity in citation practices. As a consequence, the citation impact of clinical intervention research may be substantially underestimated in comparison with basic and diagnostic research.

  18. Underestimation of Species Richness in Neotropical Frogs Revealed by mtDNA Analyses

    PubMed Central

    Fouquet, Antoine; Gilles, André; Vences, Miguel; Marty, Christian; Blanc, Michel; Gemmell, Neil J.

    2007-01-01

    Background Amphibians are rapidly vanishing. At the same time, it is most likely that the number of amphibian species is highly underestimated. Recent DNA barcoding work has attempted to define a threshold between intra- and inter-specific genetic distances to help identify candidate species. In groups with high extinction rates and poorly known species boundaries, like amphibians, such tools may provide a way to rapidly evaluate species richness. Methodology Here we analyse published and new 16S rDNA sequences from 60 frog species of Amazonia-Guianas to obtain a minimum estimate of the number of undescribed species in this region. We combined isolation by distance, phylogenetic analyses, and comparison of molecular distances to evaluate threshold values for the identification of candidate species among these frogs. Principal Findings In most cases, geographically distant populations belong to genetically highly distinct lineages that could be considered as candidate new species. This was not universal among the taxa studied and thus widespread species of Neotropical frogs really do exist, contrary to previous assumptions. Moreover, the many instances of paraphyly and the wide overlap between distributions of inter- and intra-specific distances reinforce the hypothesis that many cryptic species remain to be described. In our data set, pairwise genetic distances below 0.02 are strongly correlated with geographical distances. This correlation remains statistically significant until genetic distance is 0.05, with no such relation thereafter. This suggests that for higher distances allopatric and sympatric cryptic species prevail. Based on our analyses, we propose a more inclusive pairwise genetic distance of 0.03 between taxa to target lineages that could correspond to candidate species. Conclusions Using this approach, we identify 129 candidate species, two-fold greater than the 60 species included in the current study. This leads to estimates of around 170 to 460

  19. Ceramic materials lead to underestimated DNA quantifications: a method for reliable measurements.

    PubMed

    Piccinini, E; Sadr, N; Martin, I

    2010-07-22

    In the context of investigating cell-material interactions or of material-guided generation of tissues, DNA quantification represents an elective method to precisely assess the number of cells attached or embedded within different substrates. Nonetheless, nucleic acids are known to electrostatically bind to ceramics, a class of materials commonly employed in orthopaedic implants and bone tissue engineering scaffolds. This phenomenon is expected to lead to a relevant underestimation of the DNA amount, resulting in erroneous experimental readouts. The present work aims at *lpar;i) investigating the effects of DNA-ceramic bond occurrence on DNA quantification, and (ii) developing a method to reliably extract and accurately quantify DNA in ceramic-containing specimens. A cell-free model was adopted to study DNA-ceramic binding, highlighting an evident DNA loss (up to 90%) over a wide range of DNA/ceramic ratios (w/w). A phosphate buffer-based (800 mM) enzymatic extraction protocol was developed and its efficacy in terms of reliable DNA extraction and measurement was confirmed with commonly used fluorometric assays, for various ceramic substrates. The proposed buffered DNA extraction technique was validated in a cell-based experiment showing 95% DNA retrieval in a cell seeding experiment, demonstrating a 3.5-fold increase in measured DNA amount as compared to a conventional enzymatic extraction protocol. In conclusion, the proposed phosphate buffer method consistently improves the DNA extraction process assuring unbiased analysis of samples and allowing accurate and sensitive cell number quantification on ceramic containing substrates.

  20. Disguised Distress in Children and Adolescents "Flying under the Radar": Why Psychological Problems Are Underestimated and How Schools Must Respond

    ERIC Educational Resources Information Center

    Flett, Gordon L.; Hewitt, Paul L.

    2013-01-01

    It is now recognized that there is a very high prevalence of psychological disorders among children and adolescents and relatively few receive psychological treatment. In the current article, we present the argument that levels of distress and dysfunction among young people are substantially underestimated and the prevalence of psychological…

  1. Disguised Distress in Children and Adolescents "Flying under the Radar": Why Psychological Problems Are Underestimated and How Schools Must Respond

    ERIC Educational Resources Information Center

    Flett, Gordon L.; Hewitt, Paul L.

    2013-01-01

    It is now recognized that there is a very high prevalence of psychological disorders among children and adolescents and relatively few receive psychological treatment. In the current article, we present the argument that levels of distress and dysfunction among young people are substantially underestimated and the prevalence of psychological…

  2. Underestimates of sensible heat flux due to vertical velocity measurement errors in non-orthogonal sonic anemometers

    Treesearch

    John M. Frank; William J. Massman; Brent E. Ewers

    2013-01-01

    Sonic thermometry and anemometry are fundamental to all eddy-covariance studies of surface energy balance. Recent studies have suggested that sonic anemometers with non-orthogonal transducers can underestimate vertical wind velocity (w) and sensible heat flux (H) when compared to orthogonal designs. In this study we tested whether a non-orthogonal sonic anemometer (...

  3. The role of underestimating body size for self-esteem and self-efficacy among grade five children in Canada.

    PubMed

    Maximova, Katerina; Khan, Mohammad K A; Austin, S Bryn; Kirk, Sara F L; Veugelers, Paul J

    2015-10-01

    Underestimating body size hinders healthy behavior modification needed to prevent obesity. However, initiatives to improve body size misperceptions may have detrimental consequences on self-esteem and self-efficacy. Using sex-specific multiple mixed-effect logistic regression models, we examined the association of underestimating versus accurate body size perceptions with self-esteem and self-efficacy in a provincially representative sample of 5075 grade five school children. Body size perceptions were defined as the standardized difference between the body mass index (BMI, from measured height and weight) and self-perceived body size (Stunkard body rating scale). Self-esteem and self-efficacy for physical activity and healthy eating were self-reported. Most of overweight boys and girls (91% and 83%); and most of obese boys and girls (93% and 90%) underestimated body size. Underestimating weight was associated with greater self-efficacy for physical activity and healthy eating among normal-weight children (odds ratio: 1.9 and 1.6 for boys, 1.5 and 1.4 for girls) and greater self-esteem among overweight and obese children (odds ratio: 2.0 and 6.2 for boys, 2.0 and 3.4 for girls). Results highlight the importance of developing optimal intervention strategies as part of targeted obesity prevention efforts that de-emphasize the focus on body weight, while improving body size perceptions. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations

    NASA Astrophysics Data System (ADS)

    Gu, J.; Bednarz, B.; Caracappa, P. F.; Xu, X. G.

    2009-05-01

    The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as

  5. The development, validation and application of a multi-detector CT (MDCT) scanner model for assessing organ doses to the pregnant patient and the fetus using Monte Carlo simulations.

    PubMed

    Gu, J; Bednarz, B; Caracappa, P F; Xu, X G

    2009-05-07

    The latest multiple-detector technologies have further increased the popularity of x-ray CT as a diagnostic imaging modality. There is a continuing need to assess the potential radiation risk associated with such rapidly evolving multi-detector CT (MDCT) modalities and scanning protocols. This need can be met by the use of CT source models that are integrated with patient computational phantoms for organ dose calculations. Based on this purpose, this work developed and validated an MDCT scanner using the Monte Carlo method, and meanwhile the pregnant patient phantoms were integrated into the MDCT scanner model for assessment of the dose to the fetus as well as doses to the organs or tissues of the pregnant patient phantom. A Monte Carlo code, MCNPX, was used to simulate the x-ray source including the energy spectrum, filter and scan trajectory. Detailed CT scanner components were specified using an iterative trial-and-error procedure for a GE LightSpeed CT scanner. The scanner model was validated by comparing simulated results against measured CTDI values and dose profiles reported in the literature. The source movement along the helical trajectory was simulated using the pitch of 0.9375 and 1.375, respectively. The validated scanner model was then integrated with phantoms of a pregnant patient in three different gestational periods to calculate organ doses. It was found that the dose to the fetus of the 3 month pregnant patient phantom was 0.13 mGy/100 mAs and 0.57 mGy/100 mAs from the chest and kidney scan, respectively. For the chest scan of the 6 month patient phantom and the 9 month patient phantom, the fetal doses were 0.21 mGy/100 mAs and 0.26 mGy/100 mAs, respectively. The paper also discusses how these fetal dose values can be used to evaluate imaging procedures and to assess risk using recommendations of the report from AAPM Task Group 36. This work demonstrates the ability of modeling and validating an MDCT scanner by the Monte Carlo method, as well as

  6. Underestimation of soil carbon stocks by Yasso07, Q, and CENTURY models in boreal forest linked to overlooking site fertility

    NASA Astrophysics Data System (ADS)

    Ťupek, Boris; Ortiz, Carina; Hashimoto, Shoji; Stendahl, Johan; Dahlgren, Jonas; Karltun, Erik; Lehtonen, Aleksi

    2016-04-01

    The soil organic carbon stock (SOC) changes estimated by the most process based soil carbon models (e.g. Yasso07, Q and CENTURY), needed for reporting of changes in soil carbon amounts for the United Nations Framework Convention on Climate Change (UNFCCC) and for mitigation of anthropogenic CO2 emissions by soil carbon management, can be biased if in a large mosaic of environments the models are missing a key factor driving SOC sequestration. To our knowledge soil nutrient status as a missing driver of these models was not tested in previous studies. Although, it's known that models fail to reconstruct the spatial variation and that soil nutrient status drives the ecosystem carbon use efficiency and soil carbon sequestration. We evaluated SOC stock estimates of Yasso07, Q and CENTURY process based models against the field data from Swedish Forest Soil National Inventories (3230 samples) organized by recursive partitioning method (RPART) into distinct soil groups with underlying SOC stock development linked to physicochemical conditions. These models worked for most soils with approximately average SOC stocks, but could not reproduce higher measured SOC stocks in our application. The Yasso07 and Q models that used only climate and litterfall input data and ignored soil properties generally agreed with two third of measurements. However, in comparison with measurements grouped according to the gradient of soil nutrient status we found that the models underestimated for the Swedish boreal forest soils with higher site fertility. Accounting for soil texture (clay, silt, and sand content) and structure (bulk density) in CENTURY model showed no improvement on carbon stock estimates, as CENTURY deviated in similar manner. We highlighted the mechanisms why models deviate from the measurements and the ways of considering soil nutrient status in further model development. Our analysis suggested that the models indeed lack other predominat drivers of SOC stabilization

  7. Pesticide mixtures, endocrine disruption, and amphibian declines: are we underestimating the impact?

    PubMed

    Hayes, Tyrone B; Case, Paola; Chui, Sarah; Chung, Duc; Haeffele, Cathryn; Haston, Kelly; Lee, Melissa; Mai, Vien Phoung; Marjuoa, Youssra; Parker, John; Tsui, Mable

    2006-04-01

    increase in plasma levels of the stress hormone corticosterone. Although it cannot be determined whether all the pesticides in the mixture contribute to these adverse effects or whether some pesticides are effectors, some are enhancers, and some are neutral, the present study revealed that estimating ecological risk and the impact of pesticides on amphibians using studies that examine only single pesticides at high concentrations may lead to gross underestimations of the role of pesticides in amphibian declines.

  8. Pesticide Mixtures, Endocrine Disruption, and Amphibian Declines: Are We Underestimating the Impact?

    PubMed Central

    Hayes, Tyrone B.; Case, Paola; Chui, Sarah; Chung, Duc; Haeffele, Cathryn; Haston, Kelly; Lee, Melissa; Mai, Vien Phoung; Marjuoa, Youssra; Parker, John; Tsui, Mable

    2006-01-01

    increase in plasma levels of the stress hormone corticosterone. Although it cannot be determined whether all the pesticides in the mixture contribute to these adverse effects or whether some pesticides are effectors, some are enhancers, and some are neutral, the present study revealed that estimating ecological risk and the impact of pesticides on amphibians using studies that examine only single pesticides at high concentrations may lead to gross underestimations of the role of pesticides in amphibian declines. PMID:16818245

  9. Randomised controlled trials may underestimate drug effects: balanced placebo trial design.

    PubMed

    Lund, Karen; Vase, Lene; Petersen, Gitte L; Jensen, Troels S; Finnerup, Nanna B

    2014-01-01

    It is an inherent assumption in randomised controlled trials that the drug effect can be estimated by subtracting the response during placebo from the response during active drug treatment. To test the assumption of additivity. The primary hypothesis was that the total treatment effect is smaller than the sum of the drug effect and the placebo effect. The secondary hypothesis was that non-additivity was most pronounced in participants with large placebo effects. We used a within-subject randomised blinded balanced placebo design and included 48 healthy volunteers (50% males), mean (SD) age 23.4 (6.2) years. Experimental pain was induced by injections of hypertonic saline into the masseter muscle. Participants received four injections with hypertonic saline along with lidocaine or matching placebo in randomised order: A: received hypertonic saline/told hypertonic saline; B: received hypertonic saline+lidocaine/told hypertonic saline; C: received hypertonic saline+placebo/told hypertonic saline+pain killer; D: received hypertonic saline+lidocaine/told hypertonic saline+pain killer. The primary outcome measure was the area under the curve (AUC, mm(2)) of pain intensity during injections. There was a significant difference between the sum of the drug effect and the placebo effect (mean AUC 6279 mm(2) (95% CI, 4936-7622)) and the total treatment effect (mean AUC 5455 mm(2) (95% CI, 4585-6324)) (P = 0.049). This difference was larger for participants with large versus small placebo effects (P = 0.015), and the difference correlated significantly with the size of the placebo effect (r = 0.65, P = 0.006). Although this study examined placebo effects and not the whole placebo response as in randomised controlled trials, it does suggest that the additivity assumption may be incorrect, and that the estimated drug effects in randomised controlled trials may be underestimated, particularly in studies reporting large placebo responses. The implications for

  10. Randomised Controlled Trials May Underestimate Drug Effects: Balanced Placebo Trial Design

    PubMed Central

    Lund, Karen; Vase, Lene; Petersen, Gitte L.; Jensen, Troels S.; Finnerup, Nanna B.

    2014-01-01

    Background It is an inherent assumption in randomised controlled trials that the drug effect can be estimated by subtracting the response during placebo from the response during active drug treatment. Objective To test the assumption of additivity. The primary hypothesis was that the total treatment effect is smaller than the sum of the drug effect and the placebo effect. The secondary hypothesis was that non-additivity was most pronounced in participants with large placebo effects. Methods We used a within-subject randomised blinded balanced placebo design and included 48 healthy volunteers (50% males), mean (SD) age 23.4 (6.2) years. Experimental pain was induced by injections of hypertonic saline into the masseter muscle. Participants received four injections with hypertonic saline along with lidocaine or matching placebo in randomised order: A: received hypertonic saline/told hypertonic saline; B: received hypertonic saline+lidocaine/told hypertonic saline; C: received hypertonic saline+placebo/told hypertonic saline+pain killer; D: received hypertonic saline+lidocaine/told hypertonic saline+pain killer. The primary outcome measure was the area under the curve (AUC, mm2) of pain intensity during injections. Results There was a significant difference between the sum of the drug effect and the placebo effect (mean AUC 6279 mm2 (95% CI, 4936–7622)) and the total treatment effect (mean AUC 5455 mm2 (95% CI, 4585–6324)) (P = 0.049). This difference was larger for participants with large versus small placebo effects (P = 0.015), and the difference correlated significantly with the size of the placebo effect (r = 0.65, P = 0.006). Conclusion Although this study examined placebo effects and not the whole placebo response as in randomised controlled trials, it does suggest that the additivity assumption may be incorrect, and that the estimated drug effects in randomised controlled trials may be underestimated, particularly in studies reporting large

  11. Discounting the duration of bolus exposure in impedance testing underestimates acid reflux.

    PubMed

    Vikneswaran, Namasivayam; Murray, Joseph A

    2016-06-08

    Combined impedance-pH testing (MII) allows for detection of reflux episodes regardless of pH. However impedance-based diagnosis of reflux may not routinely account for duration of the reflux episode. We hypothesize that impedance testing may be less sensitive than pH-testing in detecting acid reflux off therapy as a result of discounting duration of exposure. Baseline characteristics and reflux parameters of MII studies performed off-anti-secretory medications were analyzed. Studies on acid suppressive medication and those with recording times less than 20 h or low baseline impedance were excluded. A total of 73 consecutive MII studies were analyzed of which 31 MII studies had elevated acid exposure while 16 were abnormal by impedance criteria. MII testing off-therapy was more likely to be abnormal by pH criteria (percent time pH < 4) than impedance criteria (total reflux):[42 vs 22 % (p =0.02)]. Acid exposure (percent time pH < 4) identified more studies as abnormal than MII-detected acid reflux episodes [42 vs 34 % (p < 0.01)]. Mean acid clearance time (pH-detected) was significantly longer than median bolus clearance time (impedance-detected) in the total [98.7 s vs 12.6 s (p < 0.01)], upright [58.6 s vs 13.1 s (p < 0.01)], and recumbent positions [136.7 s vs 14.2 s (p < 0.01)] with the greatest difference seen in the recumbent position. The mean ratio of mean acid clearance time (pH-detected) and the median bolus clearance time (impedance-detected) was significantly higher in the recumbent position compared to the upright position [11. vs 5.3 (p = 0.01)]. Ambulatory impedance testing underestimates acid reflux compared to esophageal acid exposure by discounting the prolonged period of mucosal contact with each acid reflux episode, particularly in the recumbent position.

  12. Cachexia as a major underestimated and unmet medical need: facts and numbers.

    PubMed

    von Haehling, Stephan; Anker, Stefan D

    2010-09-01

    Cachexia is a serious, however underestimated and underrecognised medical consequence of malignant cancer, chronic heart failure (CHF), chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), cystic fibrosis, rheumatoid arthritis, Alzheimer's disease, infectious diseases, and many other chronic illnesses. The prevalence of cachexia is high, ranging from 5% to 15% in CHF or COPD to 60% to 80% in advanced cancer. By population prevalence, the most frequent cachexia subtypes are in order: COPD cachexia, cardiac cachexia (in CHF), cancer cachexia, and CKD cachexia. In industrialized countries (North America, Europe, Japan), the overall prevalence of cachexia (due to any disease) is growing and currently about 1%, i.e., about nine million patients. The relative prevalence of cachexia is somewhat less in Asia, but is a growing problem there as well. In absolute terms, cachexia is, in Asia (due to the larger population), as least as big a problem as in the Western world. Cachexia is also a big medical problem in South America and Africa, but data are scarce. A consensus statement recently proposed to diagnose cachexia in chronic diseases when there is weight loss exceeding 5% within the previous 3-12 months combined with symptoms characteristic for cachexia (e.g., fatigue), loss of skeletal muscle and biochemical abnormalities (e.g., anemia or inflammation). Treatment approaches using anabolics, anti-catabolic therapies, appetite stimulants, and nutritional interventions are under development. A more thorough understanding of the pathophysiology of cachexia development and progression is needed that likely will lead to combination therapies being developed. These efforts are greatly needed as presence of cachexia is always associated with high-mortality and poor-symptom status and dismal quality of life. It is thought that in cancer, more than 30% of patients die due to cachexia and more than 50% of patients with cancer die with cachexia being present

  13. Predicted Values for Spirometry may Underestimate Long-Standing Asthma Severity

    PubMed Central

    Sposato, Bruno

    2016-01-01

    Background: Asthma may show an accelerated lung function decline. Asthmatics, although having FEV1 and FEV1/VC (and z-scores) higher than the lower limit of normality, may show a significant FEV1 decline when compared to previous measurements. We assessed how many asymptomatic long-standing asthmatics (LSA) with normal lung function showed a significant FEV1 decline when an older FEV1 was taken as reference point. Methods: 46 well-controlled LSA (age: 48.8±12.1; 23 females) with normal FEV1 and FEV1/VC according to GLI2012 references (FEV1: 94.8±10.1%, z-score:-0.38±0.79; FEV1/VC: 79.3±5.2, z-score:-0.15±0.77) were selected. We considered FEV1 decline, calculated by comparing the latest value to one at least five years older or to the highest predicted value measured at 21 years for females and 23 for males. A FEV1 decline >15% or 30 ml/years was regarded as pathological. Results: When comparing the latest FEV1 to an at least 5-year-older one (mean 8.1±1.4 years between 2 measurements), 14 subjects (30.4%) showed a FEV1 decline <5% (mean: -2.2±2.6%), 19 (41.3%) had a FEV1 5-15% change (mean: -9.2±2.5%) and 13 (28.3%) a FEV1 decrease>15% (mean: -18.3±2.4). Subjects with a FEV1 decline>30 ml/year were 28 (60.8%). When using the highest predicted FEV1 as reference point and declines were corrected by subtracting the physiological decrease, 6 (13%) patients showed a FEV1 decline higher than 15%, whereas asthmatics with a FEV1 loss>30 ml/year were 17 (37%). Conclusion: FEV1 decline calculation may show how severe asthma actually is, avoiding a bronchial obstruction underestimation and a possible under-treatment in lots of apparent “well-controlled” LSA with GLI2012-normal-range lung function values. PMID:28144365

  14. System wide analyses have underestimated protein abundances and the importance of transcription in mammals.

    PubMed

    Li, Jingyi Jessica; Bickel, Peter J; Biggin, Mark D

    2014-01-01

    Large scale surveys in mammalian tissue culture cells suggest that the protein expressed at the median abundance is present at 8,000-16,000 molecules per cell and that differences in mRNA expression between genes explain only 10-40% of the differences in protein levels. We find, however, that these surveys have significantly underestimated protein abundances and the relative importance of transcription. Using individual measurements for 61 housekeeping proteins to rescale whole proteome data from Schwanhausser et al. (2011), we find that the median protein detected is expressed at 170,000 molecules per cell and that our corrected protein abundance estimates show a higher correlation with mRNA abundances than do the uncorrected protein data. In addition, we estimated the impact of further errors in mRNA and protein abundances using direct experimental measurements of these errors. The resulting analysis suggests that mRNA levels explain at least 56% of the differences in protein abundance for the 4,212 genes detected by Schwanhausser et al. (2011), though because one major source of error could not be estimated the true percent contribution should be higher. We also employed a second, independent strategy to determine the contribution of mRNA levels to protein expression. We show that the variance in translation rates directly measured by ribosome profiling is only 12% of that inferred by Schwanhausser et al. (2011), and that the measured and inferred translation rates correlate poorly (R(2) = 0.13). Based on this, our second strategy suggests that mRNA levels explain ∼81% of the variance in protein levels. We also determined the percent contributions of transcription, RNA degradation, translation and protein degradation to the variance in protein abundances using both of our strategies. While the magnitudes of the two estimates vary, they both suggest that transcription plays a more important role than the earlier studies implied and translation a much smaller

  15. Underestimated public health risks caused by overestimated VOC removal in wastewater treatment processes.

    PubMed

    Yang, Junchen; Wang, Kun; Zhao, Qingliang; Huang, Likun; Yuan, Chung-Shin; Chen, Wei-Hsiang; Yang, Wen-Bin

    2014-02-01

    The uncontrolled release of volatile organic compounds (VOCs) from wastewater treatment plants (WWTPs) and the adverse health effects on the public have been of increasing concern. In this study, a lab-scale bioreactor was prepared to analyze the mass distribution of three aromatic (benzene, toluene, and xylenes) and four chlorinated VOCs (chloroform, carbon tetrachloride, trichloroethylene, and tetrachloroethylene) among the air, water and sludge phases in wastewater treatment processes. The VOC distribution through a full-scale WWTP in northern China was further investigated with respect to the effects of seasonal temperature variations and treatment technologies, followed by the cancer risk assessment using a steady-state Gaussian plume model (Industrial Source Complex) to simulate the atmospheric behaviors of the VOCs emitted from the WWTP. It was found that three aromatic hydrocarbons, notably benzene, were more readily released from the wastewater into the atmosphere, whereas the chlorinated compounds except chloroform were mainly present in the water phase through the treatment processes. The primary clarifier was the technology releasing high levels of VOCs into the atmosphere from the wastewater. The extents of volatilization or biodegradation, two important mechanisms to remove VOCs from wastewater, appeared to be determined by the physicochemical characteristics of the compounds, as the influence of treatment technologies (e.g., aeration) and seasonal temperature variations was rather limited. More importantly, the people living in the areas even more than 4 km away from the WWTP were still potentially exposed to cancer risks exceeding the regulatory threshold limit. The findings described the complex nature of VOC emissions from WWTPs and quantitatively indicated that the associated health impacts on the public near the WWTPs could be severely underestimated, whereas their treatment efficiencies by wastewater treatment technologies were overestimated

  16. The underestimated challenges of burst-mode WDM transmission in TWDM-PON

    NASA Astrophysics Data System (ADS)

    Bonk, R.; Poehlmann, W.; van Veen, D.; Galaro, J.; Farah, R.; Schmuck, H.; Pfeiffer, Th.

    2015-12-01

    In this paper, the underestimated challenges of the burst-mode operation in the upstream path of time-and-wavelength-division-multiplexed passive optical networks are analyzed. Various challenges are disclosed, the influence of the associated physical effects on the signal quality is discussed and mitigation proposals are described: Intra-channel cross-talk can arise from optical network units induced background amplified-spontaneous emission noise and inter-channel cross-talk can be caused by non-ideal filter suppression between wavelength channels at the optical line termination receivers. Such cross-talk effects can be counteracted by reducing the laser burst-signal output power as well as its rival noise power simultaneously, i.e. by applying power leveling. A fast frequency drift in burst-mode operation is inherent to directly modulated lasers, but depends on the specific laser design, the laser output power and the burst length. Mitigation mechanisms are an optimized non-standard laser design or a specific mode of operation, e.g. an increase of the frequency drift during the preamble of the burst. The power dynamic range an optical pre-amplifier as part of the upstream signal receivers needs to handle can be in range of up to 40 dB, because of the multi-wavelength channel operation and of the optical distribution network differential path loss. This power dynamic faced at the receiver can not only cause challenges for the optical amplifier, but also for the burst-mode receivers. Additionally, the physical layer operation and maintenance of the upstream path is challenging too. Each optical network unit laser needs to be either wavelength pre-calibrated, which adds undesired costs or cross-channel synchronization of ranging windows has to be ensured. Otherwise rogue optical network unit behavior in wavelength and time domain will deteriorate system performance with every new optical network unit entering the network. Further, the operation of the optical

  17. Large-scale movements in European badgers: has the tail of the movement kernel been underestimated?

    PubMed

    Byrne, Andrew W; Quinn, John L; O'Keeffe, James J; Green, Stuart; Sleeman, D Paddy; Martin, S Wayne; Davenport, John

    2014-07-01

    movement distribution is currently underestimated. The implications of this for understanding the spatial ecology of badger populations and for the design of disease intervention strategies are potentially significant. © 2014 The Authors. Journal of Animal Ecology © 2014 British Ecological Society.

  18. Fully automated lobe-based airway taper index calculation in a low dose MDCT CF study over 4 time-points

    NASA Astrophysics Data System (ADS)

    Weinheimer, Oliver; Wielpütz, Mark O.; Konietzke, Philip; Heussel, Claus P.; Kauczor, Hans-Ulrich; Brochhausen, Christoph; Hollemann, David; Savage, Dasha; Galbán, Craig J.; Robinson, Terry E.

    2017-02-01

    Cystic Fibrosis (CF) results in severe bronchiectasis in nearly all cases. Bronchiectasis is a disease where parts of the airways are permanently dilated. The development and the progression of bronchiectasis is not evenly distributed over the entire lungs - rather, individual functional units are affected differently. We developed a fully automated method for the precise calculation of lobe-based airway taper indices. To calculate taper indices, some preparatory algorithms are needed. The airway tree is segmented, skeletonized and transformed to a rooted acyclic graph. This graph is used to label the airways. Then a modified version of the previously validated integral based method (IBM) for airway geometry determination is utilized. The rooted graph, the airway lumen and wall information are then used to calculate the airway taper indices. Using a computer-generated phantom simulating 10 cross sections of airways we present results showing a high accuracy of the modified IBM. The new taper index calculation method was applied to 144 volumetric inspiratory low-dose MDCT scans. The scans were acquired from 36 children with mild CF at 4 time-points (baseline, 3 month, 1 year, 2 years). We found a moderate correlation with the visual lobar Brody bronchiectasis scores by three raters (r2 = 0.36, p < .0001). The taper index has the potential to be a precise imaging biomarker but further improvements are needed. In combination with other imaging biomarkers, taper index calculation can be an important tool for monitoring the progression and the individual treatment of patients with bronchiectasis.

  19. Association of C-reactive protein and homocysteine with subclinical coronary plaque subtype and stenosis using low-dose MDCT coronary angiography.

    PubMed

    Lin, Tsann; Liu, Juhn-Cherng; Chang, Li-Ya; Shen, Chien-Wei

    2010-10-01

    Given the uncertainty regarding the relationship of C-reactive protein (CRP) and homocysteine (Hcy) to atherosclerotic burden, our aim was to determine whether CRP and Hcy are related to the presence of subclinical coronary plaque and stenosis. We did a cross-sectional analysis of data gathered on 1248 consecutive, newly self-referred, middle-aged subjects who underwent health check ups at China Medical University Hospital. Participants had at least one cardiac risk factor, but no known coronary heart disease. Low-dose multidetector computed tomography coronary angiography (MDCT-CA) was used to measure coronary artery stenosis and identify plaque subtypes. Subjects were divided into quartiles based on levels of high-sensitivity (hs)-CRP and Hcy. hs-CRP level and Hcy level were associated with the relative proportion of plaque subtypes; Hcy level (P<0.05) but not hs-CRP level (P>0.05) was associated with prevalence of artery segment stenosis. After multivariate adjustment for traditional cardiovascular risk factors through logistic regression analysis, neither hs-CRP level nor Hcy level was independently associated with coronary plaque subtypes and stenosis (P>0.05). Subclinical atherosclerosis is mildly increased in subjects with higher CRP and Hcy levels, but this association is not independent of traditional cardiovascular risk factors. CRP and Hcy are poor predictors of atherosclerotic burden and coronary stenosis. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Impact of underestimating the effects of cold temperature on motor vehicle start emissions of air toxics in the United States.

    PubMed

    Cook, Richard; Touma, Jawad S; Fernandez, Antonio; Brzezinski, David; Bailey, Chad; Scarbro, Carl; Thurman, James; Strum, Madeleine; Ensley, Darrell; Baldauf, Richard

    2007-12-01

    Analyses of U.S. Environmental Protection Agency (EPA) certification data, California Air Resources Board surveillance testing data, and EPA research testing data indicated that EPA's MOBILE6.2 emission factor model substantially underestimates emissions of gaseous air toxics occurring during vehicle starts at cold temperatures for light-duty vehicles and trucks meeting EPA Tier 1 and later standards. An unofficial version of the MOBILE6.2 model was created to account for these underestimates. When this unofficial version of the model was used to project emissions into the future, emissions increased by almost 100% by calendar year 2030, and estimated modeled ambient air toxics concentrations increased by 6-84%, depending on the pollutant. To address these elevated emissions, EPA recently finalized standards requiring reductions of emissions when engines start at cold temperatures.

  1. Overweight parents are twice as likely to underestimate the weight of their teenage children, regardless of their sociodemographic characteristics.

    PubMed

    Christofaro, Dgd; Andrade, S M; Fernandes, R A; Cabrera, Mas; Rodríguez-Artalejo, F; Mesas, A E

    2016-10-01

    It is unclear whether parents' weight affects their ability to recognise whether their teenage children are overweight. This study analysed whether overweight parents assessed their child's weight as well as normal weight parents. This cross-sectional study was carried out in Londrina, Brazil, in 2011 and included teenagers between 14 and 17 years of age and their parents or guardians. We recorded the weight and height of the teenagers and asked the parents or guardians to fill in a questionnaire that included how they perceived their child's weight and demographic information. We studied 1231 teenagers - 58.2% girls - and 19.4% were overweight or obese. In 842 (68.4%) of cases both parents replied to the questionnaire. We found that 8.7% of the 1202 mothers and 10.0% of the 871 fathers underestimated how overweight their child was. The adjusted analyses confirmed they were twice as likely to underestimate their child's weight if they were overweight themselves, with an odds ratio of 1.96 for the mothers and 2.04 for the fathers. Sociodemographic characteristics did not affect the results. Overweight parents were twice as likely to underestimate the weight of their teenage children, regardless of the sociodemographic characteristics. ©2016 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  2. Smokers still underestimate the risks posed by secondhand smoke: a repeated cross-sectional study.

    PubMed

    Lonergan, Bernie J; Meaney, Sarah; Perry, Ivan J; Comber, Harry; Power, Bernadette; Bradley, Colin; Greiner, Birgit A

    2014-08-01

    Little is known about risk perception of secondhand smoke (SHS) and its changes over time. The aim of the study was to examine the role of smoking status and demographics on perceiving a range of health risks of SHS exposure and their trends over time among a representative sample of the Irish general population. This study included 2 repeated cross-sectional samples of Irish adults in 1999 (n = 1,240) and 2006 (n = 1,000), in addition to a representative sample of General Practitioners (2006: n = 248), sampled as a health care professional's view on SHS risk. Participants were asked to consider whether a nonsmoker, exposed to SHS, is at an increased risk of asthma, lung cancer, heart disease, bronchitis, diabetes, and ear infections in children. There was a significant increase in the general population's risk perception of SHS for asthma, lung cancer, heart disease, and bronchitis from 1999 to 2006. Not even half of the general population in 1999 and in 2006 perceived a risk for the development of ear infections in children with SHS exposure (45% in 1999, 46% in 2006). With the exception of ear infections in children in 2006, the risk perception of all diseases differed significantly by smoking status; smokers' risk perception of SHS was significantly lower. Encouraging results suggest that the differences in risk perception between smokers and nonsmokers have decreased. Risk perception of SHS exposure has improved as has the gap in perception between smokers and nonsmokers. This research points to a lack of awareness among the general population of the risk perception of SHS exposure to children. © The Author 2014. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  3. Accuracy of contrast-enhanced ultrasound (CEUS) in the identification and characterization of traumatic solid organ lesions in children: a retrospective comparison with baseline US and CE-MDCT.

    PubMed

    Menichini, Guendalina; Sessa, Barbara; Trinci, Margherita; Galluzzo, Michele; Miele, Vittorio

    2015-11-01

    Localized low-energy abdominal trauma is very frequent in the pediatric population. The findings of several studies have shown that ultrasonography (US) can represent a useful and cost-effective tool in the evaluation of blunt abdominal trauma both in adults and children. However, many parenchymal injuries are not correctly visualized at baseline US examination. The introduction of specific US contrast agents contrast-enhanced ultrasound (CEUS) has enabled a better identification of traumatic organ injuries. The correct use of CEUS could therefore identify and select the children who need further diagnostic investigation computed tomography (CT), avoiding unnecessary radiation and iodinated contrast medium exposure. The purpose of our study was to assess the sensibility and feasibility of CEUS in the assessment of low-energy abdominal trauma compared to baseline US in pediatric patients, using contrast-enhanced MDCT as the reference standard. We retrospectively reviewed 73 children (51 M and 22 F; mean age 8.7 ± 2.8 years) who presented in our Emergency Department between October 2012 and October 2013, with history of minor abdominal trauma according to the Abbreviated Injury Scale and who underwent US, CEUS, and CE-MDCT. Inclusion criteria were: male or female, aged 0-16, hemodynamically stable patients with a history of minor blunt abdominal trauma. Exclusion criteria were adulthood, hemodynamical instability, history of major trauma. Sensitivity, specificity, PPV, NPV, and accuracy were determined for US and CEUS compared to MDCT. 6/73 patients were negative at US, CEUS, and MDCT for the presence of organ injuries. In the remaining 67 patients, US depicted 26/67 parenchymal lesions. CEUS identified 67/67 patients (67/67) with parenchymal lesions: 21 lesions of the liver (28.8 %), 26 lesions of the spleen (35.6 %), 7 lesions of right kidney (9.6 %), 13 lesions of left kidney. MDCT confirmed all parenchymal lesions (67/67). Thus, the diagnostic performance of

  4. A new approach to the assessment of lumen visibility of coronary artery stent at various heart rates using 64-slice MDCT

    PubMed Central

    Groen, J. M.; van Ooijen, P. M. A.; Oudkerk, M.

    2007-01-01

    Coronary artery stent lumen visibility was assessed as a function of cardiac movement and temporal resolution with an automated objective method using an anthropomorphic moving heart phantom. Nine different coronary stents filled with contrast fluid and surrounded by fat were scanned using 64-slice multi-detector computed tomography (MDCT) at 50–100 beats/min with the moving heart phantom. Image quality was assessed by measuring in-stent CT attenuation and by a dedicated tool in the longitudinal and axial plane. Images were scored by CT attenuation and lumen visibility and compared with theoretical scoring to analyse the effect of multi-segment reconstruction (MSR). An average increase in CT attenuation of 144 ± 59 HU and average diminished lumen visibility of 29 ± 12% was observed at higher heart rates in both planes. A negative correlation between image quality and heart rate was non-significant for the majority of measurements (P > 0.06). No improvement of image quality was observed in using MSR. In conclusion, in-stent CT attenuation increases and lumen visibility decreases at increasing heart rate. Results obtained with the automated tool show similar behaviour compared with attenuation measurements. Cardiac movement during data acquisition causes approximately twice as much blurring compared with the influence of temporal resolution on image quality. Electronic supplementary material The online version of this article (doi:10.1007/s00330-007-0568-8) contains supplementary material, which is available to authorized users. PMID:17429648

  5. 64-MDCT imaging of the coronary arteries and systemic arterial vascular tree in a single examination: optimisation of the scan protocol and contrast-agent administration.

    PubMed

    Napoli, A; Anzidei, M; Francone, M; Cavallo Marincola, B; Carbone, I; Geiger, D; Zaccagna, F; Di Paolo, P L; Zini, C; Catalano, C; Passariello, R

    2008-09-01

    The aim of this study was to validate a 64-row multidetector computed tomography (64-MDCT) acquisition protocol with biphasic administration of contrast medium for comprehensive assessment of the coronary and systemic arterial tree in a single examination. The scanning protocol comprised two acquisitions: an electrocardiograph (ECG)-gated scan at the level of the heart, followed by a total-body, low-dose scan of the systemic arterial circulation. Twenty patients were evaluated using two different strategies for contrast administration. In ten patients, the delay between the two acquisitions was set at 40 s, whereas in the remaining patients, it varied between 45 s and 65 s. For both strategies, the degree of systemic arterial opacification and the attenuation gradient between arterial and venous structures were quantitatively assessed at six extracoronary locations. Two observers evaluated in consensus the presence or absence of atherosclerosis and the degree of stenosis of arterial segments. Three hundred coronary segments were analysed. Arterial-wall changes were depicted in 155 (51%) segments, and in 35 (23%), the degree of stenosis was > 50%. Of the 640 extracoronary arterial segments, 250 (39%) presented atherosclerotic wall alterations, in 50 (20%), the degree of stenosis was > 50% and five were affected by aneurysmal dilatation. The magnitude of arterial opacification values and attenuation gradients between arterial and venous structures were significantly higher in patients scanned with the 40-s fixed-delay strategy. Whole-body CT angiography with biphasic administration of contrast agent and fixed scan delay has been shown to be a feasible and reproducible technique. Comprehensive data on the global atherosclerotic burden potentially offer important therapeutic options for subclinical, high-risk segments.

  6. Nonlinear image blending for dual-energy MDCT of the abdomen: can image quality be preserved if the contrast medium dose is reduced?

    PubMed

    Mileto, Achille; Ramirez-Giraldo, Juan Carlos; Marin, Daniele; Alfaro-Cordoba, Marcela; Eusemann, Christian D; Scribano, Emanuele; Blandino, Alfredo; Mazziotti, Silvio; Ascenti, Giorgio

    2014-10-01

    The objective of this study was to compare the image quality of a dual-energy nonlinear image blending technique at reduced load of contrast medium with a simulated 120-kVp linear blending technique at a full dose during portal venous phase MDCT of the abdomen. Forty-five patients (25 men, 20 women; mean age, 65.6 ± 9.7 [SD] years; mean body weight, 74.9 ± 12.4 kg) underwent contrast-enhanced single-phase dual-energy CT of the abdomen by a random assignment to one of three different contrast medium (iomeprol 400) dose injection protocols: 1.3, 1.0, or 0.65 mL/kg of body weight. The contrast-to-noise ratio (CNR) and noise at the portal vein, liver, aorta, and kidney were compared among the different datasets using the ANOVA. Three readers qualitatively assessed all datasets in a blinded and independent fashion. Nonlinear blended images at a 25% reduced dose allowed a significant improvement in CNR (p < 0.05 for all comparisons), compared with simulated 120-kVp linear blended images at a full dose. No statistically significant difference existed in CNR and noise between the nonlinear blended images at a 50% reduced dose and the simulated 120-kVp linear blended images at a full dose. Nonlinear blended images at a 50% reduced dose were considered in all cases to have acceptable image quality. The dual-energy nonlinear image blending technique allows reducing the dose of contrast medium up to 50% during portal venous phase imaging of the abdomen while preserving image quality.

  7. Two-way hydro-mechanical coupling is required not to underestimate fault fluid flow in numerical simulations

    NASA Astrophysics Data System (ADS)

    Tillner, Elena; Nakaten, Benjamin; Kempka, Thomas

    2015-04-01

    Pressure elevation in saturated porous media induced by any kind of fluid injection into a reservoir generally triggers pore volume changes in the host rocks and/or adjacent fault zones due to volumetric strain increments. Consequently, the hydraulic conductivity of faults can increase by several orders of magnitude, and thus allows for unwanted upward migration of fluids accompanied by environmental impacts in shallower aquifers. Interaction between hydraulic and mechanical processes is significant in this context. Hence, coupled hydro-mechanical simulations were applied in the present study to assess the impact of saline aquifer utilization on the recent stress state and fluid flow at a prospective German onshore carbon dioxide storage site, in particular with regard to present fault zones. The location of interest is a Mesozoic anticline structure, approximately 80 km southeast of the German capital Berlin [1, 2]. A Lower Triassic saline sandstone aquifer, the Detfurth Formation located at a depth of about 1,080 m, was chosen as storage horizon for 34 Mt CO2, injected within 20 years. Four major regional fault zones consisting of individual faults with different dip angles and directions are located at a distance of minimum 5 km and maximum 45 km from the injection location at the anticline top. The storage formation is overlain by several cap rocks from the Triassic to Tertiary with thicknesses varying between 50 m and 520 m. The Upper Tertiary Rupelian clay forms the main regional barrier separating salt water bearing aquifers from Tertiary and Quaternary freshwater reservoirs. However, glacial erosion resulted in thinning or a complete absence of the Rupelian clay in some areas that meet parts of the fault zones. The structural geological model applied for coupled hydro-mechanical simulations has an extent of 70 km x 100 km and extends from 5,000 m depth up to the ground surface. Multi-phase flow simulations were carried out using the scientific code TOUGH2

  8. Journal Club: Comparison of assessment of preoperative pulmonary vasculature in patients with non-small cell lung cancer by non-contrast- and 4D contrast-enhanced 3-T MR angiography and contrast-enhanced 64-MDCT.

    PubMed

    Ohno, Yoshiharu; Nishio, Mizuho; Koyama, Hisanobu; Yoshikawa, Takeshi; Matsumoto, Sumiaki; Seki, Shinichiro; Sugimura, Kazuro

    2014-03-01

    The purpose of this article is to prospectively and directly compare the capabilities of non-contrast-enhanced MR angiography (MRA), 4D contrast-enhanced MRA, and contrast-enhanced MDCT for assessing pulmonary vasculature in patients with non-small cell lung cancer (NSCLC) before surgical treatment. A total of 77 consecutive patients (41 men and 36 women; mean age, 71 years) with pathologically proven and clinically assessed stage I NSCLC underwent thin-section contrast-enhanced MDCT, non-contrast-enhanced and contrast-enhanced MRA, and surgical treatment. The capability for anomaly assessment of the three methods was independently evaluated by two reviewers using a 5-point visual scoring system, and final assessment for each patient was made by consensus of the two readers. Interobserver agreement for pulmonary arterial and venous assessment was evaluated with the kappa statistic. Then, sensitivity, specificity, and accuracy for the detection of anomalies were directly compared among the three methods by use of the McNemar test. Interobserver agreement for pulmonary artery and vein assessment was substantial or almost perfect (κ=0.72-0.86). For pulmonary arterial and venous variation assessment, there were no significant differences in sensitivity, specificity, and accuracy among non-contrast-enhanced MRA (pulmonary arteries: sensitivity, 77.1%; specificity, 97.4%; accuracy, 87.7%; pulmonary veins: sensitivity, 50%; specificity, 98.5%; accuracy, 93.2%), 4D contrast-enhanced MRA (pulmonary arteries: sensitivity, 77.1%; specificity, 97.4%; accuracy, 87.7%; pulmonary veins: sensitivity, 62.5%; specificity, 100.0%; accuracy, 95.9%), and thin-section contrast-enhanced MDCT (pulmonary arteries: sensitivity, 91.4%; specificity, 89.5%; accuracy, 90.4%; pulmonary veins: sensitivity, 50%; specificity, 100.0%; accuracy, 95.9%) (p>0.05). Pulmonary vascular assessment of patients with NSCLC before surgical resection by non-contrast-enhanced MRA can be considered equivalent to

  9. Dual-energy X-ray absorptiometry underestimates in vivo lumbar spine bone mineral density in overweight rats.

    PubMed

    Cherif, Rim; Vico, Laurence; Laroche, Norbert; Sakly, Mohsen; Attia, Nebil; Lavet, Cedric

    2017-02-01

    Dual-energy X-ray absorptiometry (DXA) is currently the most widely used technique for measuring areal bone mineral density (BMD). However, several studies have shown inaccuracy, with either overestimation or underestimation of DXA BMD measurements in the case of overweight or obese individuals. We have designed an overweight rat model based on junk food to compare the effect of obesity on in vivo and ex vivo BMD and bone mineral content measurements. Thirty-eight 6-month old male rats were given a chow diet (n = 13) or a high fat and sucrose diet (n = 25), with the calorie amount being kept the same in the two groups, for 19 weeks. L1 BMD, L1 bone mineral content, amount of abdominal fat, and amount of abdominal lean were obtained from in vivo DXA scan. Ex vivo L1 BMD was also measured. A difference between in vivo and ex vivo DXA BMD measurements (P < 0.0001) is evidenced with an underestimation of in vivo BMD by (8.47 ± 10.54)%. This difference was found for the chow and high fat, high sucrose diets (P = 0.008), and a significant interaction between in vivo measurements, ex vivo measurements, and diet was observed (P = 0.030). Also, the data show a positive significant correlation of ex vivo BMD with body weight, perirenal fat, abdominal fat, and abdominal lean. Multiple linear regression analysis shows that body weight, abdominal fat, and abdominal lean were independently related to ex vivo BMD. DXA underestimated lumbar in vivo BMD in overweight rats, and this measurement error is related to body weight and abdominal fat. Therefore, caution must be used when one is interpreting BMD among overweight and obese individuals.

  10. Effects of underestimating the kinematics of trunk rotation on simultaneous reaching movements: predictions of a biomechanical model

    PubMed Central

    2013-01-01

    Background Rotation of the torso while reaching produces torques (e.g., Coriolis torque) that deviate the arm from its planned trajectory. To ensure an accurate reaching movement, the brain may take these perturbing torques into account during movement planning or, alternatively, it may correct hand trajectory during movement execution. Irrespective of the process selected, it is expected that an underestimation of trunk rotation would likely induce inaccurate shoulder and elbow torques, resulting in hand deviation. Nonetheless, it is still undetermined to what extent a small error in the perception of trunk rotations, translating into an inappropriate selection of motor commands, would affect reaching accuracy. Methods To investigate, we adapted a biomechanical model (J Neurophysiol 89: 276-289, 2003) to predict the consequences of underestimating trunk rotations on right hand reaching movements performed during either clockwise or counter clockwise torso rotations. Results The results revealed that regardless of the degree to which the torso rotation was underestimated, the amplitude of hand deviation was much larger for counter clockwise rotations than for clockwise rotations. This was attributed to the fact that the Coriolis and centripetal joint torques were acting in the same direction during counter clockwise rotation yet in opposite directions during clockwise rotations, effectively cancelling each other out. Conclusions These findings suggest that in order to anticipate and compensate for the interaction torques generated during torso rotation while reaching, the brain must have an accurate prediction of torso rotation kinematics. The present study proposes that when designing upper limb prostheses controllers, adding a sensor to monitor trunk kinematics may improve prostheses control and performance. PMID:23758968

  11. Effects of underestimating the kinematics of trunk rotation on simultaneous reaching movements: predictions of a biomechanical model.

    PubMed

    Simoneau, Martin; Guillaud, Étienne; Blouin, Jean

    2013-06-12

    Rotation of the torso while reaching produces torques (e.g., Coriolis torque) that deviate the arm from its planned trajectory. To ensure an accurate reaching movement, the brain may take these perturbing torques into account during movement planning or, alternatively, it may correct hand trajectory during movement execution. Irrespective of the process selected, it is expected that an underestimation of trunk rotation would likely induce inaccurate shoulder and elbow torques, resulting in hand deviation. Nonetheless, it is still undetermined to what extent a small error in the perception of trunk rotations, translating into an inappropriate selection of motor commands, would affect reaching accuracy. To investigate, we adapted a biomechanical model (J Neurophysiol 89: 276-289, 2003) to predict the consequences of underestimating trunk rotations on right hand reaching movements performed during either clockwise or counter clockwise torso rotations. The results revealed that regardless of the degree to which the torso rotation was underestimated, the amplitude of hand deviation was much larger for counter clockwise rotations than for clockwise rotations. This was attributed to the fact that the Coriolis and centripetal joint torques were acting in the same direction during counter clockwise rotation yet in opposite directions during clockwise rotations, effectively cancelling each other out. These findings suggest that in order to anticipate and compensate for the interaction torques generated during torso rotation while reaching, the brain must have an accurate prediction of torso rotation kinematics. The present study proposes that when designing upper limb prostheses controllers, adding a sensor to monitor trunk kinematics may improve prostheses control and performance.

  12. Do you know how I feel? Parents underestimate worry and overestimate optimism compared to child self-report.

    PubMed

    Lagattuta, Kristin Hansen; Sayfan, Liat; Bamford, Christi

    2012-10-01

    Three studies assessed parent-child agreement in perceptions of children's everyday emotions in typically developing 4- to 11-year-old children. Study 1 (N=228) and Study 2 (N=195) focused on children's worry and anxiety. Study 3 (N=90) examined children's optimism. Despite child and parent reporters providing internally consistent responses, their perceptions about children's emotional wellbeing consistently failed to correlate. Parents significantly underestimated child worry and anxiety and overestimated optimism compared to child self-report (suggesting a parental positivity bias). Moreover, parents' self-reported emotions correlated with how they reported their children's emotions (suggesting an egocentric bias). These findings have implications for developmental researchers, clinicians, and parents.

  13. X-ray computed microtomography characterizes the wound effect that causes sap flow underestimation by thermal dissipation sensors.

    PubMed

    Marañón-Jiménez, S; Van den Bulcke, J; Piayda, A; Van Acker, J; Cuntz, M; Rebmann, C; Steppe, K

    2017-09-06

    Insertion of thermal dissipation (TD) sap flow sensors in living tree stems causes damage of the wood tissue, as is the case with other invasive methods. The subsequent wound formation is one of the main causes of underestimation of tree water-use measured by TD sensors. However, the specific alterations in wood anatomy in response to inserted sensors have not yet been characterized, and the linked dysfunctions in xylem conductance and sensor accuracy are still unknown. In this study, we investigate the anatomical mechanisms prompting sap flow underestimation and the dynamic process of wound formation. Successive sets of TD sensors were installed in the early, mid and end stage of the growing season in diffuse- and ring-porous trees, Fagus sylvatica (Linnaeus) and Quercus petraea ((Mattuschka) Lieblein), respectively. The trees were cut in autumn and additional sensors were installed in the cut stem segments as controls without wound formation. The wounded area and volume surrounding each sensor was then visually determined by X-ray computed microtomography (X-ray microCT). This technique allowed the characterization of vessel anatomical transformations such as tyloses formation, their spatial distribution and quantification of reduction in conductive area. MicroCT scans showed considerable formation of tyloses that reduced the conductive area of vessels surrounding the inserted TD probes, thus causing an underestimation in sap flux density (SFD) in both beech and oak. Discolored wood tissue was ellipsoidal, larger in the radial plane, more extensive in beech than in oak, and also for sensors installed for longer times. However, the severity of anatomical transformations did not always follow this pattern. Increased wound size with time, for example, did not result in larger SFD underestimation. This information helps us to better understand the mechanisms involved in wound effects with TD sensors and allows the provision of practical recommendations to reduce

  14. Accuracy and underestimation of malignancy of breast core needle biopsy: the Florence experience of over 4000 consecutive biopsies.

    PubMed

    Ciatto, Stefano; Houssami, Nehmat; Ambrogetti, Daniela; Bianchi, Simonetta; Bonardi, Rita; Brancato, Beniamino; Catarzi, Sandra; Risso, Gabriella G

    2007-03-01

    Breast core needle biopsy (CNB) is used for sampling breast lesions in both the screening and diagnostic context. We present the accuracy of breast CNB from a consecutive series of 4035 core biopsies, using methods that minimise selection and verification bias. We calculate accuracy and underestimation of malignancy for both automated (14G) and directional vacuum-assisted (11G) CNB performed under stereotactic or sonographic guidance. Overall sensitivity of CNB is 94.2% (92.9-95.5%) and specificity is 88.1% (86.6-89.6%), positive and negative predictive values are 84.8% (82.9-86.7%) and 95.6% (94.6-96.6%), respectively. In sampling microcalcification, the overall underestimation of malignancy is 26.6% (22.9-30.3%): underestimation is significantly higher for automated CB relative to VAB (chi2 ((df = 1)) = 8.90 , P = 0.002), the absolute difference in underestimation being 14% (5-23%); sensitivity is higher for VAB than automated CB (chi2 ((df = 1)) = 3.28, P = 0.06) but specificity is significantly higher for automated CB (14G) relative to VAB (11G) (chi2 ((df = 1)) = 6.37, P = 0.01), and the overall accuracy of the two methods is similar. Sensitivity of CNB improved with experience (over time and in relation to caseload). Accuracy was not substantially affected by lesion palpability or image-guidance method, and was similar for both masses and calcification but lower for lesions depicted as distortions on mammography. Inadequacy was very low and decreased with greater operator caseload, and was not associated with core gauge or image-guidance method. False negatives occurred in 4.4% (3.4-5.4%) of cases, and where core histology was benign but discordant with (suspicious) imaging and/or clinical findings the likelihood of malignancy was 33.1% (18.5-47.7%), emphasising the importance of correlating all test information in breast diagnosis.

  15. [Underestimation of dermatology based on ignorance and its impact on patient's health].

    PubMed

    Fuentes-Suárez, Adán; Domínguez-Soto, Luciano

    2015-01-01

    With the emergence of medical specialties in different areas of medicine, assessment of patients became narrow and specialized. There is also the perception that some specialties are more difficult than others. Dermatology has long been seen by most physicians non dermatologists as a relaxed area, without real emergencies or requirement of great intellectual effort. Some specialists, erroneously think that everything can be cured with topical steroids and/or antifungal creams. Although several skin diseases are common complains seen by the general practitioner, very few time and credits are granted to cover these diseases during the years of undergraduate training. Thus, the primary care physicians and others medical specialists believe that skin diseases are not life threatening and hence irrelevant. Nonetheless, they feel competent enough to prescribe a variety of treatments for skin diseases that may lead to iatrogenesis.

  16. Umbilical Pilonidal Sinus, an Underestimated and Little-Known Clinical Entity: Report of Two Cases

    PubMed Central

    Kaplan, Mehmet; Kaplan, Elif Tugce; Kaplan, Tugba; Kaplan, Fatma Cigdem

    2017-01-01

    Case series Patient: Male, 26 • Female, 21 Final Diagnosis: Umbilical pilonidal sinus Symptoms: Hair tuft in the umbilicus • pain • periumbilical dermatitis • purulent discharge from the umbilicus • skin lesions • pruritis Medication: — Clinical Procedure: Umbilicus preserving surgery Specialty: General Surgery • Dermatology • Plastic Surgery Objective: Rare disease Background: Umbilical pilonidal sinus (UPS) is a rare disease of young, hirsute, dark men with deep navels and poor personal hygiene. UPS could easily be misdiagnosed and mistreated due to its rarity and lack of awareness of the condition by physicians. However, the diagnosis is easy to establish with physical examination and a detailed history. Although it is being diagnosed and reported more frequently, there is still no consensus regarding best treatment options. Case Report: In this report, we present two cases of UPS, one in a man and one in a woman, who had typical symptoms of pain, swelling, and intermittent malodorous discharge from the umbilicus. They had small sinus openings with hair protruding deep in the navel. Because these two patients had previous histories of failed conservative treatments, an umbilicus preserving surgery was performed for both cases. Wounds were healed in 2–3 weeks with acceptable cosmetic results. During a more than 2 year follow-up period, there were no signs of recurrence. Conclusions: In a patient presenting with a history of intermittent discharge, itching, pain, or bleeding from the umbilicus and the presence of granulation tissue with or without protruding hair and periumbilical dermatitis, the diagnosis should consider UPS, even in female patients. Treatment generally depends on the severity of the disease, ranging from good personal hygiene to surgical excision of umbilical complex. The treatment of choice for chronic intermittent cases is surgical removal of the affected portion; paying special attention to cosmetic appearance. PMID

  17. The cube pessary: an underestimated treatment option for pelvic organ prolapse? Subjective 1-year outcomes.

    PubMed

    Nemeth, Zoltan; Nagy, Sándor; Ott, Johannes

    2013-10-01

    Pelvic organ prolapse (POP) is a common condition. The use of pessaries for conservative management of PO