Sample records for performance studies volume

  1. Volume associations in total hip arthroplasty: a nationwide Taiwan population-based study.

    PubMed

    Shi, Hon-Yi; Chang, Je-Ken; Chiu, Herng-Chia

    2013-12-01

    This cohort study retrospectively analyzed 78,364 THAs performed from 1998 to 2009. The mean hospital charge for all THAs performed during the study period was $4,131.9 dollars. The average hospital charges for high-volume hospitals and surgeons were 6% and 7% lower, respectively, than those for low-volume hospitals and surgeons. Analysis by propensity score matching showed that hospital charges significantly differed between THA procedures performed by high- and low-volume hospitals ($3,285.8 dollars versus $4,816.2 dollars, respectively) and between THA procedures performed by high- and low-volume surgeons, ($3,438.5 dollars versus $4,404.7 dollars, respectively) (P < 0.001). The data indicate that analysis and emulation of the treatment strategies used by high-volume hospitals and by high-volume surgeons may reduce overall hospital charges. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Mars power system concept definition study. Volume 2: Appendices

    NASA Technical Reports Server (NTRS)

    Littman, Franklin D.

    1994-01-01

    This report documents the work performed by Rockwell International's Rocketdyne Division on NASA Contract No. NAS3-25808 (Task Order No. 16) entitled 'Mars Power System Definition Study'. This work was performed for NASA's Lewis Research Center (LeRC). The report is divided into two volumes as follows: Volume 1 - Study Results; and Volume 2 - Appendices. The results of the power system characterization studies, operations studies, and technology evaluations are summarized in Volume 1. The appendices include complete, standalone technology development plans for each candidate power system that was investigated.

  3. Educational Objectives and Academic Performance in Higher Education. Volume 1. Prediction of Academic Performance. Volume 2. Aims and Objectives.

    ERIC Educational Resources Information Center

    Entwistle, Noel J.; And Others

    1977-01-01

    Volume 1 discusses a large-scale follow-up study of the correlates of academic success in 2,595 college students. Volume 2 presents a philosophical and historical approach to studying educational objectives. (Available in microfiche from: Carfax Publishing Company, Haddon House, Dorchester-on-Thames, Oxford 0X9 8JZ, England.) (CP)

  4. A systematic review of the impact of center volume in dialysis.

    PubMed

    Pieper, Dawid; Mathes, Tim; Marshall, Mark Roger

    2015-12-22

    A significant relationship exists between the volume of surgical procedures that a given center performs and subsequent outcomes. It seems plausible that such a volume-outcome relationship is also present in dialysis. MEDLINE and EMBASE were searched in November 2014 for non-experimental studies evaluating the association between center volume and patient outcomes [mortality, morbidity, peritonitis, switch to hemodialysis (HD) or any other treatment], without language restrictions or other limits. Selection of relevant studies, data extraction and critical appraisal were performed by two independent reviewers. We did not perform meta-analysis due to clinical and methodological heterogeneity (e.g. different volume categories). 16 studies met out inclusion criteria. Most studies were performed in the US. The study quality ranged from fair to good. Only few items were judged to have a high risk of bias, while many items were judged to have an unclear risk of bias due to insufficient reporting. All 10 studies that analyzed peritoneal dialysis (PD) technique survival by modeling switch to HD or any other treatment as an outcome showed a statistical significant effect. The relative effect measures ranged from 0.25 to 0.94 (median 0.73) in favor of high volume centers. All nine studies indicated a lower mortality for PD in high volume centers, but only study was statistical significant. This systematic review supports a volume-outcome relationship in peritoneal dialysis with respect to switch to HD or any other treatment. An effect on mortality is probably present in HD. Further research is needed to identify and understand the associations of center volume that are causally related to patient benefit.

  5. COMPARATIVE EFFECTIVENESS OF AN ADJUSTABLE TRANSFEMORAL PROSTHETIC INTERFACE ACCOMMODATING VOLUME FLUCTUATION: CASE STUDY

    PubMed Central

    Kahle, Jason T.; Klenow, Tyler D.; Highsmith, M. Jason

    2016-01-01

    The socket-limb interface is vital for functionality and provides stability and mobility for the amputee. Volume fluctuation can lead to compromised fit and function. Current socket technology does not accommodate for volume fluctuation. An adjustable interface may improve function and comfort by filling this technology gap. The purpose of this study was to compare the effectiveness of the standard of care (SOC) ischial ramus containment to an adjustable transfemoral prosthetic interface socket in the accommodation of volume fluctuation. A prospective experimental case study using repeated measures of subjective and performance outcome measures between socket conditions was employed. In the baseline volume condition, the adjustable socket improved subjective and performance measures 19% to 37% over SOC, whereas the two-minute walk test demonstrated equivalence. In the volume loss condition, the adjustable socket improved all subjective and performance measures 22% to 93%. All aggregated data improved 16% to 50% compared with the SOC. In simulated volume gain, the SOC socket failed, while the subject was able to complete the protocol using the adjustable socket. In this case study, the SOC socket was inferior to the comparative adjustable transfemoral amputation interface in subjective and performance outcomes. There is a lack of clinical trials and evidence comparing socket functional outcomes related to volume fluctuation. PMID:28066526

  6. Effects of plyometric training volume and training surface on explosive strength.

    PubMed

    Ramírez-Campillo, Rodrigo; Andrade, David C; Izquierdo, Mikel

    2013-10-01

    The purpose of this study is to examine the effects of different volume and training surfaces during a short-term plyometric training program on neuromuscular performance. Twenty-nine subjects were randomly assigned to 4 groups: control group (CG, n = 5), moderate volume group (MVG, n = 9, 780 jumps), moderate volume hard surface group (MVGHS, n = 8, 780 jumps), and high volume group (HVG, n = 7, 1,560 jumps). A series of tests were performed by the subjects before and after 7 weeks of plyometric training. These tests were measurement of maximum strength (5 maximum repetitions [5RMs]), drop jumps (DJs) of varying heights (20, 40, and 60 cm), squat and countermovement jumps (SJ and CMJ, respectively), timed 20-m sprint, agility, body weight, and height. The results of the present study suggest that high training volume leads to a significant increase in explosive performance that requires fast stretch-shortening cycle (SSC) actions (such as DJ and sprint) in comparison to what is observed after a moderate training volume regimen. Second, when plyometric training is performed on a hard training surface (high-impact reaction force), a moderate training volume induces optimal stimulus to increase explosive performance requiring fast SSC actions (e.g., DJ), maximal dynamic strength enhancement, and higher training efficiency. Thus, a finding of interest in the study was that after 7 weeks of plyometric training, performance enhancement in maximal strength and in actions requiring fast SSC (such as DJ and sprint) were dependent on the volume of training and the surface on which it was performed. This must be taken into account when using plyometric training on different surfaces.

  7. Calibration of automatic performance measures - speed and volume data: volume 2, evaluation of the accuracy of approach volume counts and speeds collected by microwave sensors.

    DOT National Transportation Integrated Search

    2016-05-01

    This study evaluated the accuracy of approach volumes and free flow approach speeds collected by the Wavetronix : SmartSensor Advance sensor for the Signal Performance Metrics system of the Utah Department of Transportation (UDOT), : using the field ...

  8. [Morbidity and mortality rates in relation to the "surgeon factor" after duodenopancreatectomy].

    PubMed

    Targarona, Javier; Pando, Elizabeth; Garatea, Rafael; Vavoulis, Alexandra; Montoya, Eduardo

    2007-10-01

    The present study was designed to determine whether the surgeon factor has an independent effect on morbidity and mortality rates after duodenopancreatectomy. Between October 2002 and December 2006, we performed a study of 119 patients who underwent duodenopancreatectomy. The surgeons were divided into 3 groups according to the number of interventions they performed each year: a low volume group (three Whipple procedures per year), a medium volume group (four to 10 Whipple procedures per year) and a high volume group (> 10 Whipple procedures per year). The morbidity rate was higher in the low volume group (82%) than in the high volume group (35%). Length of hospital stay was clearly longer in the low and medium volume groups (27 days, and 21 days) than in the high volume group (17 days). Comparison of the results of the 3 groups revealed that the group performing three or less interventions per year (low volume) had the highest mortality rate (47%), while the group performing more than 10 interventions per year (high volume) had a very low mortality rate (4%). We found that the volume-to-surgeon ratio was inversely proportional to morbidity, length of hospital stay, return to oral intake, and mortality rates. Therefore, increasing surgical volume could improve morbidity and mortality rates.

  9. Measurement of frontal lobe volume and thalamic volume in fetuses with congenital heart disease at different gestational weeks using three dimensional ultra sonography and its clinical value.

    PubMed

    Li-Fei, Zhu; Hong-Xiong, Liu; Ying, H E

    2016-11-01

    Our study aimed to investigate the measurement of frontal lobe volume and thalamic volume in fetuses with congenital heart disease (CHD) at different gestational weeks using three dimensional (3-D) ultrasonography and its clinical value. Then, 238 pregnant women who received obstetric ultrasonography in ultrasound department of Internal Medicine of our hospital were enrolled between March 2013 to April 2014. In this study, 85 fetuses were diagnosed to develop CHD by prenatal fetal echocardiography, and the other 153 fetuses were normal. Frontal lobe volume, thalamic volume and cerebral blood flow was determined by color Doppler ultrasonic diagnostic apparatus (type: GE Voluson E8). The level of MCA-PI and CPR in CHD fetus group performed significantly lower than that in normal fetus group (P<0.05), but the level of UA-PI performed significantly higher than that in normal fetus group (P<0.05). When gestational age <30 weeks, there was no significant difference in thalamic volume and frontal lobe volume between the two groups (P<0.05); when gestational age <30 weeks, the level of CHD fetus group performed significantly lower thalamic volume and frontal lobe volume than that in normal fetus group (P<0.05). When gestational age <30 weeks, there was no significant difference in BPD, HC, and GA between the two groups (P<0.05); when gestational age <30 weeks, the level of BPD, HC and GA in CHD fetus group performed significantly lower than that in normal fetus group (P<0.05). If gestational age <30 weeks, CHD performed a small impact on fetal frontal lobe volume and thalamic volume; if gestational age <30 weeks, the level of frontal lobe volume and thalamic volume in fetuses with CHD performed significantly lower than that in normal fetuses.

  10. Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 10. Subsystem Performance Requirements.

    DOT National Transportation Integrated Search

    1974-02-01

    The volume presents the results of the subsystem performance requirements study for an Advanced Air Traffic Management System (AATMS). The study determined surveillance and navigation subsystem requirements for terminal and enroute area operations. I...

  11. Semiautomatic regional segmentation to measure orbital fat volumes in thyroid-associated ophthalmopathy. A validation study.

    PubMed

    Comerci, M; Elefante, A; Strianese, D; Senese, R; Bonavolontà, P; Alfano, B; Bonavolontà, B; Brunetti, A

    2013-08-01

    This study was designed to validate a novel semi-automated segmentation method to measure regional intra-orbital fat tissue volume in Graves' ophthalmopathy. Twenty-four orbits from 12 patients with Graves' ophthalmopathy, 24 orbits from 12 controls, ten orbits from five MRI study simulations and two orbits from a digital model were used. Following manual region of interest definition of the orbital volumes performed by two operators with different levels of expertise, an automated procedure calculated intra-orbital fat tissue volumes (global and regional, with automated definition of four quadrants). In patients with Graves' disease, clinical activity score and degree of exophthalmos were measured and correlated with intra-orbital fat volumes. Operator performance was evaluated and statistical analysis of the measurements was performed. Accurate intra-orbital fat volume measurements were obtained with coefficients of variation below 5%. The mean operator difference in total fat volume measurements was 0.56%. Patients had significantly higher intra-orbital fat volumes than controls (p<0.001 using Student's t test). Fat volumes and clinical score were significantly correlated (p<0.001). The semi-automated method described here can provide accurate, reproducible intra-orbital fat measurements with low inter-operator variation and good correlation with clinical data.

  12. Blood volume analysis: a new technique and new clinical interest reinvigorate a classic study.

    PubMed

    Manzone, Timothy A; Dam, Hung Q; Soltis, Daniel; Sagar, Vidya V

    2007-06-01

    Blood volume studies using the indicator dilution technique and radioactive tracers have been performed in nuclear medicine departments for over 50 y. A nuclear medicine study is the gold standard for blood volume measurement, but the classic dual-isotope blood volume study is time-consuming and can be prone to technical errors. Moreover, a lack of normal values and a rubric for interpretation made volume status measurement of limited interest to most clinicians other than some hematologists. A new semiautomated system for blood volume analysis is now available and provides highly accurate results for blood volume analysis within only 90 min. The availability of rapid, accurate blood volume analysis has brought about a surge of clinical interest in using blood volume data for clinical management. Blood volume analysis, long a low-volume nuclear medicine study all but abandoned in some laboratories, is poised to enter the clinical mainstream. This article will first present the fundamental principles of fluid balance and the clinical means of volume status assessment. We will then review the indicator dilution technique and how it is used in nuclear medicine blood volume studies. We will present an overview of the new semiautomated blood volume analysis technique, showing how the study is done, how it works, what results are provided, and how those results are interpreted. Finally, we will look at some of the emerging areas in which data from blood volume analysis can improve patient care. The reader will gain an understanding of the principles underlying blood volume assessment, know how current nuclear medicine blood volume analysis studies are performed, and appreciate their potential clinical impact.

  13. Inpatient Volume and Quality of Mental Health Care Among Patients With Unipolar Depression.

    PubMed

    Rasmussen, Line Ryberg; Mainz, Jan; Jørgensen, Mette; Videbech, Poul; Johnsen, Søren Paaske

    2018-04-26

    The relationship between inpatient volume and the quality of mental health care remains unclear. This study examined the association between inpatient volume in psychiatric hospital wards and quality of mental health care among patients with depression admitted to wards in Denmark. In a nationwide, population-based cohort study, 17,971 patients (N=21,120 admissions) admitted to psychiatric hospital wards between 2011 and 2016 were identified from the Danish Depression Database. Inpatient volume was categorized into quartiles according to the individual ward's average caseload volume per year during the study period: low volume (quartile 1, <102 inpatients per year), medium volume (quartile 2, 102-172 inpatients per year), high volume (quartile 3, 173-227 inpatients per year) and very high volume (quartile 4, >227 inpatients per year). Quality of mental health care was assessed by receipt of process performance measures reflecting national clinical guidelines for care of depression. Compared with patients admitted to low-volume psychiatric hospital wards, patients admitted to very-high-volume wards were more likely to receive a high overall quality of mental health care (≥80% of the recommended process performance measures) (adjusted relative risk [ARR]=1.78, 95% confidence interval [CI]=1.02-3.09) as well as individual processes of care, including a somatic examination (ARR=1.35, CI=1.03-1.78). Admission to very-high-volume psychiatric hospital wards was associated with a greater chance of receiving guideline-recommended process performance measures for care of depression.

  14. The Impact of Surgeon Volume on Perioperative Outcomes in Hysterectomy

    PubMed Central

    Vree, Florentien E. M.; Cohen, Sarah L.; Chavan, Niraj

    2014-01-01

    Background and Objectives: To estimate the effect of surgeon volume on key perioperative outcomes after all modes of hysterectomy. Methods: We performed a review of 1914 hysterectomies performed at a large, academic tertiary-care hospital. Women who underwent abdominal, laparoscopic, vaginal, or robotic hysterectomy for benign non-obstetric indications in 2006, 2009, and 2010 were included. Results: Gynecologic surgeons were categorized according their average annual hysterectomy case volume: low volume (<11 cases per year), intermediate volume (11–50 cases per year), and high-volume (>51 cases per year). Taking all modes of hysterectomy together, surgeries performed by high-volume surgeons required a shorter operative time (155.11 minutes vs 199.19–203.35 minutes, P < .001) and resulted in less estimated blood loss compared with low- and intermediate-volume surgeons (161.09 mL vs 205.58–237.96 mL, P < .001). The 3 surgical volume groups did not differ from each other significantly in the conversion to laparotomy, readmission rate, or incidence of intraoperative or postoperative complications. These findings were maintained when subgroup analyses were performed by type of hysterectomy, with few exceptions. In the subgroup of vaginal hysterectomies by intermediate-volume surgeons, there were slightly more postoperative complications. There were fewer intraoperative complications in laparoscopic/robotic hysterectomies performed by high-volume surgeons, though not statistically significant. Conclusions: Hysterectomies performed by high-volume surgeons at our institution during the 3-year study period were associated with shorter operative times and less estimated blood loss. PMID:24960479

  15. Cerebellar contribution to motor and cognitive performance in multiple sclerosis: An MRI sub-regional volumetric analysis.

    PubMed

    D'Ambrosio, Alessandro; Pagani, Elisabetta; Riccitelli, Gianna C; Colombo, Bruno; Rodegher, Mariaemma; Falini, Andrea; Comi, Giancarlo; Filippi, Massimo; Rocca, Maria A

    2017-08-01

    To investigate the role of cerebellar sub-regions on motor and cognitive performance in multiple sclerosis (MS) patients. Whole and sub-regional cerebellar volumes, brain volumes, T2 hyperintense lesion volumes (LV), and motor performance scores were obtained from 95 relapse-onset MS patients and 32 healthy controls (HC). MS patients also underwent an evaluation of working memory and processing speed functions. Cerebellar anterior and posterior lobes were segmented using the Spatially Unbiased Infratentorial Toolbox (SUIT) from Statistical Parametric Mapping (SPM12). Multivariate linear regression models assessed the relationship between magnetic resonance imaging (MRI) measures and motor/cognitive scores. Compared to HC, only secondary progressive multiple sclerosis (SPMS) patients had lower cerebellar volumes (total and posterior cerebellum). In MS patients, lower anterior cerebellar volume and brain T2 LV predicted worse motor performance, whereas lower posterior cerebellar volume and brain T2 LV predicted poor cognitive performance. Global measures of brain volume and infratentorial T2 LV were not selected by the final multivariate models. Cerebellar volumetric abnormalities are likely to play an important contribution to explain motor and cognitive performance in MS patients. Consistently with functional mapping studies, cerebellar posterior-inferior volume accounted for variance in cognitive measures, whereas anterior cerebellar volume accounted for variance in motor performance, supporting the assessment of cerebellar damage at sub-regional level.

  16. Memory performance, global cerebral volumes and hippocampal subfield volumes in long-term survivors of Out-of-Hospital Cardiac Arrest.

    PubMed

    Ørbo, Marte C; Vangberg, Torgil R; Tande, Pål M; Anke, Audny; Aslaksen, Per M

    2018-05-01

    We explored the associations between global brain volumes, hippocampal subfield volumes and verbal memory performance in long-term survivors of out-of-hospital cardiac arrest (OHCA). Three months after OHCA, survivors and healthy, age-matched controls were assessed with cerebral MRI and the California Verbal Learning Test-II (CVLT-II). Volumetric brain segmentation was performed automatically by FreeSurfer. Twenty-six OHCA survivors who were living independently in regular homes at the time of assessment and 19 controls participated in the study. Thirteen of the survivors had been conscious upon arrival to the emergency department. The other 13 survivors had 0.5-7 days of inpatient coma before recovery. Memory was poorer in the OHCA group that had been comatose beyond initial hospital admission compared to both other groups. Total cortical volumes, total hippocampus volumes and several hippocampal subfield volumes were significantly smaller in the OHCA group comatose beyond initial hospital admission compared to controls. No significant differences between the OHCA group conscious upon emergency department arrival and the other two groups were found for brain volumes. No significant differences were observed between any groups for white matter or total subcortical volumes. In OHCA survivors with recovery from inpatient coma, the various CVLT-II trials were significantly, but differentially, correlated to total gray matter volume, cortical volume and the hippocampal subfield subiculum. In this small, single-site study, both hippocampal volume and cortical volume were smaller in good outcome OHCA survivors 3 months after resuscitation in comparison to healthy controls. Smaller cerebral volumes were correlated with poorer memory performance. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. The effect of surgeon and hospital volume on shoulder arthroplasty perioperative quality metrics.

    PubMed

    Singh, Anshu; Yian, Edward H; Dillon, Mark T; Takayanagi, Miwa; Burke, Mary F; Navarro, Ronald A

    2014-08-01

    There has been a significant increase in both the incidence of shoulder arthroplasty and the number of surgeons performing these procedures. Literature regarding the relationship between surgeon or hospital volume and the performance of modern shoulder arthroplasty is limited. This study examines the effect of surgeon or hospital shoulder arthroplasty volume on perioperative metrics related to shoulder hemiarthroplasty, total shoulder arthroplasty, and reverse shoulder arthroplasty. Blood loss, length of stay, and operative time were the main endpoints analyzed. Prospective data were analyzed from a multicenter shoulder arthroplasty registry; 1176 primary shoulder arthroplasty cases were analyzed. Correlation and analysis of covariance were used to examine the association between surgeon and hospital volume and perioperative metrics adjusting for age, sex, and body mass index. Surgeon volume is inversely correlated with length of stay for hemiarthroplasty and total shoulder arthroplasty and with blood loss and operative time for all 3 procedures. Hospital volume is inversely correlated with length of stay for hemiarthroplasty, with blood loss for total and reverse shoulder arthroplasty, and with operative time for all 3 procedures. High-volume surgeons performed shoulder arthroplasty 30 to 50 minutes faster than low-volume surgeons did. Higher surgeon and hospital case volumes led to improved perioperative metrics with all shoulder arthroplasty procedures, including reverse total shoulder arthroplasty, which has not been previously described in the literature. Surgeon volume had a larger effect on metrics than hospital volume did. This study supports the concept that complex shoulder procedures are, on average, performed more efficiently by higher volume surgeons in higher volume centers. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

  18. Age-related cognitive decline coincides with accelerated volume loss of the dorsal but not ventral hippocampus in mice.

    PubMed

    Reichel, J M; Bedenk, B T; Czisch, M; Wotjak, C T

    2017-01-01

    Even in the absence of neurodegenerative diseases, progressing age often coincides with cognitive decline and morphological changes. However, longitudinal studies that directly link these two processes are missing. In this proof-of-concept study we therefore performed repeated within-subject testing of healthy male R26R mice in a spatial learning task in combination with manganese-enhanced volumetric MRI analyses at the ages of 8, 16, and 24 months. We grouped the mice into good and poor performers (n = 6, each), based on their spatial learning abilities at the age of 24 months. Using this stratification, we failed to detect a priori volume differences, but observed a significant decrease in total hippocampal volume over time for both groups. Interestingly, this volume decrease was specific for the dorsal hippocampus and significantly accelerated in poor performers between 16 and 24 months of age. This is the first time that individual changes in hippocampal volume were traced alongside cognitive performance within the same subjects over 1½ years. Our study points to a causal link between volume loss of the dorsal hippocampus and cognitive impairments. In addition, it suggests accelerated degenerative processes rather than a priori volume differences as determining trajectories of age-related cognitive decline. Despite the relatively small sample sizes, the strong behavioral and moderate morphological alterations demonstrate the general feasibility of longitudinal studies of age-related decline in cognition and hippocampus integrity. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  19. Risk adjustment for case mix and the effect of surgeon volume on morbidity.

    PubMed

    Maas, Matthew B; Jaff, Michael R; Rordorf, Guy A

    2013-06-01

    Retrospective studies of large administrative databases have shown higher mortality for procedures performed by low-volume surgeons, but the adequacy of risk adjustment in those studies is in doubt. To determine whether the relationship between surgeon volume and outcomes is an artifact of case mix using a prospective sample of carotid endarterectomy cases. Observational cohort study from January 1, 2008, through December 31, 2010, with preoperative, immediate postoperative, and 30-day postoperative assessments acquired by independent monitors. Urban, tertiary academic medical center. All 841 patients who underwent carotid endarterectomy performed by a vascular surgeon or cerebrovascular neurosurgeon at the institution. Carotid endarterectomy without another concurrent surgery. Stroke, death, and other surgical complications occurring within 30 days of surgery along with other case data. A low-volume surgeon performed 40 or fewer cases per year. Variables used in a comparison administrative database study, as well as variables identified by our univariate analysis, were used for adjusted analyses to assess for an association between low-volume surgeons and the rate of stroke and death as well as other complications. RESULTS The rate of stroke and death was 6.9% for low-volume surgeons and 2.0% for high-volume surgeons (P = .001). Complications were similarly higher (13.4% vs 7.2%, P = .008). Low-volume surgeons performed more nonelective cases. Low-volume surgeons were significantly associated with stroke and death in the unadjusted analysis as well as after adjustment with variables used in the administrative database study (odds ratio, 3.61; 95% CI, 1.70-7.67, and odds ratio, 3.68; 95% CI, 1.72-7.89, respectively). However, adjusting for the significant disparity of American Society of Anesthesiologists Physical Status classification in case mix eliminated the effect of surgeon volume on the rate of stroke and death (odds ratio, 1.65; 95% CI, 0.59-4.64) and other complications. Variables selected for risk adjustment in studies using administrative databases appear to be inadequate to control for case mix bias between low-volume and high-volume surgeons. Risk adjustment should empirically analyze for case mix imbalances between surgeons to identify meaningful risk modifiers in clinical practice such as the American Society of Anesthesiologists Physical Status classification. A true relationship between surgeon volume and outcomes remains uncertain, and caution is advised in developing policies based on these findings.

  20. Relationship of Temporal Lobe Volumes to Neuropsychological Test Performance in Healthy Children

    PubMed Central

    Wells, Carolyn T.; Matson, Melissa A.; Kates, Wendy R.; Hay, Trisha; Horska, Alena

    2008-01-01

    Ecological validity of neuropsychological assessment includes the ability of tests to predict real-world functioning and/or covary with brain structures. Studies have examined the relationship between adaptive skills and test performance, with less focus on the association between regional brain volumes and neurobehavioral function in healthy children. The present study examined the relationship between temporal lobe gray matter volumes and performance on two neuropsychological tests hypothesized to measure temporal lobe functioning (Visual Perception-VP; Peabody Picture Vocabulary Test, Third Edition-PPVT-III) in 48 healthy children ages 5-18 years. After controlling for age and gender, left and right temporal and left occipital volumes were significant predictors of VP. Left and right frontal and temporal volumes were significant predictors of PPVT-III. Temporal volume emerged as the strongest lobar correlate with both tests. These results provide convergent and discriminant validity supporting VP as a measure of the “what” system; but suggest the PPVT-III as a complex measure of receptive vocabulary, potentially involving executive function demands. PMID:18513844

  1. Differences in navigation performance and postpartal striatal volume associated with pregnancy in humans.

    PubMed

    Lisofsky, Nina; Wiener, Jan; de Condappa, Olivier; Gallinat, Jürgen; Lindenberger, Ulman; Kühn, Simone

    2016-10-01

    Pregnancy is accompanied by prolonged exposure to high estrogen levels. Animal studies have shown that estrogen influences navigation strategies and, hence, affects navigation performance. High estrogen levels are related to increased use of hippocampal-based allocentric strategies and decreased use of striatal-based egocentric strategies. In humans, associations between hormonal shifts and navigation strategies are less well studied. This study compared 30 peripartal women (mean age 28years) to an age-matched control group on allocentric versus egocentric navigation performance (measured in the last month of pregnancy) and gray matter volume (measured within two months after delivery). None of the women had a previous pregnancy before study participation. Relative to controls, pregnant women performed less well in the egocentric condition of the navigation task, but not the allocentric condition. A whole-brain group comparison revealed smaller left striatal volume (putamen) in the peripartal women. Across the two groups, left striatal volume was associated with superior egocentric over allocentric performance. Limited by the cross-sectional study design, the findings are a first indication that human pregnancy might be accompanied by structural brain changes in navigation-related neural systems and concomitant changes in navigation strategy. Copyright © 2016 Elsevier Inc. All rights reserved.

  2. A prospective study of cerebral, frontal lobe, and temporal lobe volumes and neuropsychological performance in children with primary brain tumors treated with cranial radiation.

    PubMed

    Agbahiwe, Harold; Rashid, Arif; Horska, Alena; Mahone, E Mark; Lin, Doris; McNutt, Todd; Cohen, Kenneth; Redmond, Kristin; Wharam, Moody; Terezakis, Stephanie

    2017-01-01

    Cranial radiation therapy (RT) is an important component in the treatment of pediatric brain tumors. However, it can result in long-term effects on the developing brain. This prospective study assessed the effects of cranial RT on cerebral, frontal lobe, and temporal lobe volumes and their correlation with higher cognitive functioning. Ten pediatric patients with primary brain tumors treated with cranial RT and 14 age- and sex-matched healthy children serving as controls were evaluated. Quantitative magnetic resonance imaging and neuropsychological assessments (language, memory, auditory and visual processing, and vocabulary) were performed at the baseline and 6, 15, and 27 months after RT. The effects of age, the time since RT, and the cerebral RT dose on brain volumes and neuropsychological performance were analyzed with linear mixed effects model analyses. Cerebral volume increased significantly with age in both groups (P = .01); this increase in volume was more pronounced in younger children. Vocabulary performance was found to be significantly associated with a greater cerebral volume (P = .05) and a lower RT dose (P = .003). No relation was observed between the RT dose and the cerebral volume. There was no difference in the corresponding neuropsychological tests between the 2 groups. This prospective study found significant relations among the RT dose, cerebral volumes, and rate of vocabulary development among children receiving RT. The results of this study provide further support for clinical trials aimed at reducing cranial RT doses in the pediatric population. Cancer 2017;161-168. © 2016 American Cancer Society. © 2016 American Cancer Society.

  3. Impact of case volume on outcome and performance of targeted temperature management in out-of-hospital cardiac arrest survivors.

    PubMed

    Lee, Seung Joon; Jeung, Kyung Woon; Lee, Byung Kook; Min, Yong Il; Park, Kyu Nam; Suh, Gil Joon; Kim, Kyung Su; Kang, Gu Hyun

    2015-01-01

    This study aimed to determine the effect of case volume on targeted temperature management (TTM) performance, incidence of adverse events, and neurologic outcome in comatose out-of-hospital cardiac arrest (OHCA) survivors treated with TTM. We used a Web-based, multicenter registry (Korean Hypothermia Network registry), to which 24 hospitals throughout the Republic of Korea participated to study adult (≥18 years) comatose out-of-hospital cardiac arrest patients treated with TTM between 2007 and 2012. The primary outcome was neurologic outcome at hospital discharge. The secondary outcomes were inhospital mortality, TTM performance, and adverse events. We extracted propensity-matched cohorts to control for bias. Multivariate logistic regression analysis was performed to assess independent risk factors for neurologic outcome. A total of 901 patients were included in this study; 544 (60.4%) survived to hospital discharge, and 248 (27.5%) were discharged with good neurologic outcome. The high-volume hospitals initiated TTM significantly earlier and had lower rates of hyperglycemia, bleeding, hypotension, and rebound hyperthermia. However, neurologic outcome and inhospital mortality were comparable between high-volume (27.7% and 44.6%, respectively) and low-volume hospitals (21.1% and 40.5%) in the propensity-matched cohorts. The adjusted odds ratio for the high-volume hospitals compared with low-volume hospitals was 1.506 (95% confidence interval, 0.875-2.592) for poor neurologic outcome. Higher TTM case volume was significantly associated with early initiation of TTM and lower incidence of adverse events. However, case volume had no association with neurologic outcome and inhospital mortality. Copyright © 2014 Elsevier Inc. All rights reserved.

  4. Satellite voice broadcast. Volume 2: System study

    NASA Technical Reports Server (NTRS)

    Bachtell, E. E.; Bettadapur, S. S.; Coyner, J. V.; Farrell, C. E.

    1985-01-01

    The Technical Volume of the Satellite Broadcast System Study is presented. Designs are synthesized for direct sound broadcast satellite systems for HF-, VHF-, L-, and Ku-bands. Methods are developed and used to predict satellite weight, volume, and RF performance for the various concepts considered. Cost and schedule risk assessments are performed to predict time and cost required to implement selected concepts. Technology assessments and tradeoffs are made to identify critical enabling technologies that require development to bring technical risk to acceptable levels for full scale development.

  5. Surgical volume and conversion rate in laparoscopic hysterectomy: does volume matter? A multicenter retrospective cohort study.

    PubMed

    Keurentjes, José H M; Briët, Justine M; de Bock, Geertruida H; Mourits, Marian J E

    2018-02-01

    A multicenter, retrospective, cohort study was conducted in the Netherlands. The aim was to evaluate whether surgical volume of laparoscopic hysterectomies (LHs) performed by proven skilled gynecologists had an impact on the conversion rate from laparoscopy to laparotomy. In 14 hospitals, all LHs performed by 19 proven skilled gynecologists between 2007 and 2010 were included in the analysis. Surgical volume, conversion rate and type of conversion (reactive or strategic) were retrospectively assessed. To estimate the impact of surgical volume on the conversion rate, logistic regressions were performed. These regressions were adjusted for patient's age, Body Mass Index (BMI), ASA classification, previous abdominal surgery and the indication (malignant versus benign) for the LH. During the study period, 19 proven skilled gynecologists performed a total of 1051 LHs. Forty percent of the gynecologists performed over 20 LHs per year (median 17.3, range 5.4-49.5). Conversion to laparotomy occurred in 5.0% of all LHs (53 of 1051); 38 (3.6%) were strategic and 15 (1.4%) were reactive conversions. Performing over 20 LHs per year was significantly associated with a lower overall conversion rate (OR adjusted 0.43, 95% CI 0.24-0.77), a lower strategic conversion rate (OR adjusted 0.32, 95% CI 0.16-0.65), but not with a lower reactive conversion rate (OR adjusted 0.96, 95% CI 0.33-2.79). A higher annual surgical volume of LHs by proven skilled gynecologists is inversely related to the conversion rate to laparotomy, and results in a lower strategic conversion rate.

  6. Lower-volume muscle-damaging exercise protects against high-volume muscle-damaging exercise and the detrimental effects on endurance performance.

    PubMed

    Burt, Dean; Lamb, Kevin; Nicholas, Ceri; Twist, Craig

    2015-07-01

    This study examined whether lower-volume exercise-induced muscle damage (EIMD) performed 2 weeks before high-volume muscle-damaging exercise protects against its detrimental effect on running performance. Sixteen male participants were randomly assigned to a lower-volume (five sets of ten squats, n = 8) or high-volume (ten sets of ten squats, n = 8) EIMD group and completed baseline measurements for muscle soreness, knee extensor torque, creatine kinase (CK), a 5-min fixed-intensity running bout and a 3-km running time-trial. Measurements were repeated 24 and 48 h after EIMD, and the running time-trial after 48 h. Two weeks later, both groups repeated the baseline measurements, ten sets of ten squats and the same follow-up testing (Bout 2). Data analysis revealed increases in muscle soreness and CK and decreases in knee extensor torque 24-48 h after the initial bouts of EIMD. Increases in oxygen uptake [Formula: see text], minute ventilation [Formula: see text] and rating of perceived exertion were observed during fixed-intensity running 24-48 h after EIMD Bout 1. Likewise, time increased and speed and [Formula: see text] decreased during a 3-km running time-trial 48 h after EIMD. Symptoms of EIMD, responses during fixed-intensity and running time-trial were attenuated in the days after the repeated bout of high-volume EIMD performed 2 weeks after the initial bout. This study demonstrates that the protective effect of lower-volume EIMD on subsequent high-volume EIMD is transferable to endurance running. Furthermore, time-trial performance was found to be preserved after a repeated bout of EIMD.

  7. A Systematic Review and Meta-Analysis of the Relationship Between Hospital Volume and the Outcomes of Percutaneous Coronary Intervention

    PubMed Central

    Lin, Xiaojun; Tao, Hongbing; Cai, Miao; Liao, Aihua; Cheng, Zhaohui; Lin, Haifeng

    2016-01-01

    Abstract Previous reviews have suggested that hospital volume is inversely related to in-hospital mortality. However, percutaneous coronary intervention (PCI) practices have changed substantially in recent years, and whether this relationship persists remains controversial. A systematic search was performed using PubMed, Embase, and the Cochrane Library to identify studies that describe the effect of hospital volume on the outcomes of PCI. Critical appraisals of the methodological quality and the risk of bias were conducted independently by 2 authors. Fourteen of 96 potentiality relevant articles were included in the analysis. Twelve of the articles described the relationship between hospital volume and mortality and included data regarding odds ratios (ORs); 3 studies described the relationship between hospital volume and long-term survival, and only 1 study included data regarding hazard ratios (HRs). A meta-analysis of postoperative mortality was performed using a random effects model, and the pooled effect estimate was significantly in favor of high volume providers (OR: 0.79; 95% confidence interval [CI], 0.72–0.86; P < 0.001). A systematic review of long-term survival was performed, and a trend toward better long-term survival in high volume hospitals was observed. This meta-analysis only included studies published after 2006 and revealed that postoperative mortality following PCI correlates significantly and inversely with hospital volume. However, the magnitude of the effect of volume on long-term survival is difficult to assess. Additional research is necessary to confirm our findings and to elucidate the mechanism underlying the volume–outcome relationship. PMID:26844508

  8. Cognitive correlates of white matter lesion load and brain atrophy

    PubMed Central

    Dong, Chuanhui; Nabizadeh, Nooshin; Caunca, Michelle; Cheung, Ying Kuen; Rundek, Tatjana; Elkind, Mitchell S.V.; DeCarli, Charles; Sacco, Ralph L.; Stern, Yaakov

    2015-01-01

    Objective: We investigated white matter lesion load and global and regional brain volumes in relation to domain-specific cognitive performance in the stroke-free Northern Manhattan Study (NOMAS) population. Methods: We quantified white matter hyperintensity volume (WMHV), total cerebral volume (TCV), and total lateral ventricular (TLV) volume, as well as hippocampal and cortical gray matter (GM) lobar volumes in a subgroup. We used general linear models to examine MRI markers in relation to domain-specific cognitive performance, adjusting for key covariates. Results: MRI and cognitive data were available for 1,163 participants (mean age 70 ± 9 years; 60% women; 66% Hispanic, 17% black, 15% white). Across the entire sample, those with greater WMHV had worse processing speed. Those with larger TLV volume did worse on episodic memory, processing speed, and semantic memory tasks, and TCV did not explain domain-specific variability in cognitive performance independent of other measures. Age was an effect modifier, and stratified analysis showed that TCV and WMHV explained variability in some domains above age 70. Smaller hippocampal volume was associated with worse performance across domains, even after adjusting for APOE ε4 and vascular risk factors, whereas smaller frontal lobe volumes were only associated with worse executive function. Conclusions: In this racially/ethnically diverse, community-based sample, white matter lesion load was inversely associated with cognitive performance, independent of brain atrophy. Lateral ventricular, hippocampal, and lobar GM volumes explained domain-specific variability in cognitive performance. PMID:26156514

  9. Longitudinal Assessment of Synovial, Lymph Node, and Bone Volumes in Inflammatory Arthritis in Mice using in vivo MRI and micro-CT

    PubMed Central

    Proulx, Steven T.; Kwok, Edmund; You, Zhigang; Papuga, M. Owen; Beck, Christopher A.; Shealy, David J.; Ritchlin, Christopher T.; Awad, Hani A.; Boyce, Brendan F.; Xing, Lianping; Schwarz, Edward M.

    2009-01-01

    Objective Development of longitudinal 3D outcomes of inflammation and bone erosion in murine arthritis using contrast enhanced (CE) MRI and in vivo micro-CT; and in a pilot study, to determine the value of entrance criteria by age versus synovial volume in therapeutic intervention studies. Methods CE-MRI and in vivo micro-CT was performed on TNF-Tg and WT littermates to quantify the synovial and popliteal lymph node (LN) volumes and patella and talus bone volumes, respectively, which were validated with histology. These longitudinal outcome measures were used to assess the natural history of inflammatory-erosive arthritis. We also performed anti-TNF versus placebo efficacy studies in TNF-Tg mice in which treatment was initiated either by age (4–5 months) or synovial volume (3mm3 as detected by CE-MRI). Linear regression was performed to analyze the correlation between synovitis and focal erosion. Results CE-MRI demonstrated the highly variable nature of TNF-induced joint inflammation. Initiation of treatment by synovial volume produced significantly larger treatment effects on synovial volume (p=0.04) and lymph node volume (p<0.01) than initiation by age. By correlating the MRI and microCT data we were able to demonstrate a significant relationship between changes in synovial and patellar volumes (R2 =0.75; p<0.01). Conclusion In vivo CE-MRI and micro-CT 3D outcome measures are powerful tools that accurately demonstrate the progression of inflammatory-erosive arthritis in mice. These methods can be used to identify mice with arthritis of similar severity before intervention studies are initiated and thus minimize heterogeneity in outcome studies of chronic arthritis seen between genetically identical littermates. PMID:18050199

  10. Association of Very Low-Volume Practice With Vascular Surgery Outcomes in New York.

    PubMed

    Mao, Jialin; Goodney, Philip; Cronenwett, Jack; Sedrakyan, Art

    2017-08-01

    Little research has focused on very low-volume surgery, especially in the context of decreasing vascular surgery volume with the adoption of endovascular procedures. To investigate the existence and outcomes of open abdominal aortic aneurysm repair (OAR) and carotid endarterectomy (CEA) performed by very low-volume surgeons in New York. This cohort study examined inpatient data of patients undergoing elective OAR or CEA from 2000 to 2014 from all New York hospitals. Surgeons who performed 1 or less designated procedure per year on average were considered very low volume, as opposed to higher-volume surgeons. Temporal trends of the existence of very low-volume practice were evaluated. Hierarchical logistic regression was used to compare in-hospital outcomes and health care resource use between patients treated by very low-volume surgeons and higher-volume surgeons for both OAR and CEA, adjusting for patient, surgeon, and hospital characteristics. There were 8781 OAR procedures and 68 896 CEA procedures included in the study. The mean (SD) patient age was 71.7 (8.4) years for OAR and 71.5 (9.1) years for CEA. A total of 614 surgeons performed OAR and 1071 performed CEA in New York during the study period. Of these, 318 (51.8%) and 512 (47.8%), respectively, were very low-volume surgeons. Very low-volume surgeons were less likely to be vascular surgeons. The number and proportion of very low-volume surgeons decreased over years. Compared with patients treated by higher-volume surgeons, those treated by very low-volume surgeons were more likely to have higher in-hospital mortality (odds ratio [OR], 2.09; 95% CI, 1.41-3.08) following OAR and higher risks of postoperative myocardial infarction (OR, 1.83; 95% CI, 1.03-3.26) and stroke (OR, 1.78; 95% CI, 1.21-2.62) following CEA. Patients treated by very low-volume surgeons also had greater health care resource use following both surgeries, including prolonged length of stay (OR, 1.37; 95% CI, 1.11-1.70) following OAR as well as higher charges (OR, 1.28; 95% CI, 1.01-1.62) and increased 30-day readmission (OR, 1.30; 95% CI 1.04-1.62) following CEA. The OAR and CEA procedures performed by very low-volume surgeons resulted in worse postoperative outcomes and greater lengths of stay. Although the percentage of very low-volume surgeons declined from 2000 to 2014, it remains concerning, given ready access to higher-volume surgeons. Future research is needed to understand the existence of this practice pattern in other surgical fields. Efforts to eliminate this practice pattern are warranted to ensure high-quality care for all patients.

  11. A comparison of case volumes among urologic surgeons identified on an industry-sponsored website to an all provider peer group.

    PubMed

    See, William A; Jacobson, Kenneth; Derus, Sue; Langenstroer, Peter

    2014-11-01

    Industry-sponsored websites for robotic surgery direct to surgeons listed as performing specific robotic surgical procedures. The purpose of this study was to compare average annual, surgeon-specific, case volumes for those procedures for which they were listed as performing on the commercial website with the volumes of all providers performing these same procedures across a defined geographic region. A list of providers within the state of Wisconsin cited as performing specific urologic procedures was obtained through the Intuitive Surgical website 〈http://www.davincisurgery.com/da-vinci-urology/〉. Surgeon-specific annual case volumes from 2009 to 2013 for these same cases were obtained for all Wisconsin providers through DataBay Resources (Warrendale, PA) based on International classification of diseases-9 codes. Procedural activity was rank ordered, and surgeons were placed in "volume deciles" derived from the total annual number of cases performed by all surgeons. The distribution of commercially listed surgeon volumes, both 5-year average and most recent year, was compared with the average and 2013 volumes of all surgeons performing a specific procedure. A total of 35 individual urologic surgeons listed as performing robotic surgery in Wisconsin were identified through a "search" using the Intuitive Surgical website. Specific procedure analysis returned 5, 12, 9, and 15 surgeon names for cystectomy, partial nephrectomy, radical nephrectomy, and prostatectomy, respectively. This compared with the total number of surgeons who had performed the listed procedure in Wisconsin at least 1 time during the prior 5 years of 123, 153, 242, and 165, respectively. When distributed by surgeon-volume deciles, surgeons listed on industry-sponsored sites varied widely in their respective volume decile. More than half of site-listed, procedure-specific surgeons fell below the fifth decile for surgeon volume. Data analysis based solely on 2013 case volumes had no effect on the number of website-listed surgeons whose volumes fell below the fifth decile. Surgeons listed on an industry-sponsored website demonstrate wide variation in the actual volume of specific procedures performed. The inferred endorsement of competence by commercial sites has the potential to mislead patients seeking surgical expertise. Providers should consider the ethical and legal implications of these commercial advertising that do not have volume or outcome data. Published by Elsevier Inc.

  12. Association between surgeon volume and hospitalisation costs for patients with oral cancer: a nationwide population base study in Taiwan.

    PubMed

    Lee, C-C; Ho, H-C; Jack, Lee C-C; Su, Y-C; Lee, M-S; Hung, S-K; Chou, Pesus

    2010-02-01

    Oral cancer leads to a considerable use of and expenditure on health care. Wide resection of the tumour and reconstruction with a pedicle flap/free flap is widely used. This study was conducted to explore the relationship between hospitalisation costs and surgeon case volume when this operation was performed. A population-based study. This study uses data for the years 2005-2006 obtained from the National Health Insurance Research Database published in the Taiwanese National Health Research Institute. From this population-based data, the authors selected a total of 2663 oral cancer patients who underwent tumour resection and reconstruction. Case volume relationships were based on the following criteria; low-, medium-, high-, very high-volume surgeons were defined by or= 56 resections with reconstruction, respectively. Hierarchical linear regression analysis was subsequently performed to explore the relationship between surgeon case volume and the cost and length of hospitalisation. The mean hospitalisation cost among the 2663 patients was US$ 9528 (all costs are given in US dollars). After adjusting for physician, hospital, and patient characteristics in a hierarchical linear regression model, the cost per patient for low-volume surgeons was found to be US$ 741 (P = 0.012) higher than that for medium-volume surgeons, US$ 1546 (P < 0.001) higher than that for high-volume surgeons, and US$ 1820 (P < 0.001) higher than that for very-high-volume surgeons. After adjustment for physician, hospital, and patient characteristics, the hierarchical linear regression model revealed that the mean length of stay per patient for low-volume surgeons was the highest (P < 0.001). After adjustment for physician, hospital, and patient characteristics, low-volume surgeons performing wide excision with reconstructive surgery in oral cancer patients incurred significantly higher costs and longer hospital stays per patient than did other surgeons. Treatment strategies adopted by high- and very-high-volume surgeons should be analysed further and utilised more widely.

  13. Geosynchronous Microwave Atmospheric Sounding Radiometer (MASR) feasibility studies. Volume 1: Management summary

    NASA Technical Reports Server (NTRS)

    1978-01-01

    The mission of the microwave atmospheric sounding radiometer (MASR) is to collect data to aid in the observation and prediction of severe storms. The geosynchronous orbit allows the continuous atmospheric measurement needed to resolve mesoscale dynamics. The instrument may operate in conjunction with this document, Volume 1 - Management, which summarizes the highlights of final reports on both the radiometer instrument and antenna studies. The radiometer instrument summary includes a synopsis of Volume 2 - Radiometer Receiver Feasibility, including design, recommended configuration, performance estimates, and weight and power estimates. The summary of the antenna study includes a synopsis of Volume 3 - Antenna Feasibility, including preliminary design tradeoffs, performance of selected design, and details of the mechanical/thermal design.

  14. Can technical factors explain the volume-outcome relationship in gastric bypass surgery?

    PubMed

    Smith, Mark D; Patterson, Emma; Wahed, Abdus S; Belle, Steven H; Courcoulas, Anita P; Flum, David; Khandelwal, Saurabh; Mitchell, James E; Pomp, Alfons; Pories, Walter J; Wolfe, Bruce

    2013-01-01

    The existence of a relationship between surgeon volume and patient outcome has been reported for different complex surgical operations. This relationship has also been confirmed for patients undergoing Roux-en-Y gastric bypass (RYGB) in the Longitudinal Assessment of Bariatric Surgery (LABS) study. Despite multiple studies demonstrating volume-outcome relationships, fewer studies investigate the causes of this relationship. The purpose of the present study is to understand possible explanations for the volume-outcome relationship in LABS. LABS includes a 10-center, prospective study examining 30-day outcomes after bariatric surgery. The relationship between surgeon annual RYGB volume and incidence of a composite endpoint (CE) has been published previously. Technical aspects of RYGB surgery were compared between high and low volume surgeons. The previously published model was adjusted for select technical factors. High-volume surgeons (>100 RYGBs/yr) were more likely to perform a linear stapled gastrojejunostomy, use fibrin sealant, and place a drain at the gastrojejunostomy compared with low-volume surgeons (<25 RYGBs/yr), and less likely to perform an intraoperative leak test. After adjusting for the newly identified technical factors, the relative risk of CE was .93 per 10 RYGB/yr increase in volume, compared with .90 for clinical risk adjustment alone. High-volume surgeons exhibited certain differences in technique compared with low-volume surgeons. After adjusting for these differences, the strength of the volume-outcome relationship previously found was reduced only slightly, suggesting that other factors are also involved. Copyright © 2013 American Society for Bariatric Surgery. All rights reserved.

  15. High School Leaders and Their Schools. Volume II: Profiles of Effectiveness.

    ERIC Educational Resources Information Center

    Pellicer, Leonard O.; And Others

    This study was the third in a series of national studies of the high school principalship dating back to the early 1960s. Its major purpose was to analyze and describe high school leaders and their schools. This volume describes the characteristics and behaviors of high performing principals (type "A") and typically performing principals ("type…

  16. Bigger is better! Hippocampal volume and declarative memory performance in healthy young men.

    PubMed

    Pohlack, Sebastian T; Meyer, Patric; Cacciaglia, Raffaele; Liebscher, Claudia; Ridder, Stephanie; Flor, Herta

    2014-01-01

    The importance of the hippocampus for declarative memory processes is firmly established. Nevertheless, the issue of a correlation between declarative memory performance and hippocampal volume in healthy subjects still remains controversial. The aim of the present study was to investigate this relationship in more detail. For this purpose, 50 healthy young male participants performed the California Verbal Learning Test. Hippocampal volume was assessed by manual segmentation of high-resolution 3D magnetic resonance images. We found a significant positive correlation between putatively hippocampus-dependent memory measures like short-delay retention, long-delay retention and discriminability and percent hippocampal volume. No significant correlation with measures related to executive processes was found. In addition, percent amygdala volume was not related to any of these measures. Our data advance previous findings reported in studies of brain-damaged individuals in a large and homogeneous young healthy sample and are important for theories on the neural basis of episodic memory.

  17. Radiation Therapy After Breast-Conserving Surgery: Does Hospital Surgical Volume Matter? A Population-Based Study in Taiwan

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

    Chien, Chun-Ru; Department of Radiation Oncology, China Medical University Hospital, and School of Medicine, China Medical University, Taichung, Taiwan; Pan, I-Wen

    2012-01-01

    Purpose: To examine the association between hospital surgical volume and the use of radiation therapy (RT) after breast-conserving surgery (BCS) in Taiwan. Methods and Materials: We used claims data from the National Health Insurance program in Taiwan (1997-2005) in this retrospective population-based study. We identified patients with breast cancer, receipt of BCS, use of radiation, and the factors that could potentially associated with the use of RT from enrollment records, and the ICD-9 and billing codes in claims. We conducted logistic regression to examine factors associated with RT use after BCS, and performed subgroup analyses to examine whether the associationmore » differs by medical center status or hospital volumes. Results: Among 5,094 patients with newly diagnosed invasive breast cancer who underwent BCS, the rate of RT was significantly lower in low-volume hospitals (74% vs. 82%, p < 0.01). Patients treated in low-volume hospitals were less likely to receive RT after BCS (odds ratio = 0.72, 95% confidence interval = 0.62-0.83). In addition, patients treated after the implementation of the voluntary pay-for-performance policy in 2001 were more likely to receive RT (odds ratio = 1.23; 95% confidence interval = 1.05-1.45). Subgroup analyses indicated that the high-volume effect was limited to hospitals accredited as non-medical centers, and that the effect of the pay-for-performance policy was most pronounced among low-volume hospitals. Conclusions: Using population-based data from Taiwan, our study concluded that hospital surgical volume and pay-for-performance policy are positively associated with RT use after BCS.« less

  18. Entorhinal Cortex Volume Is Associated With Dual-Task Gait Cost Among Older Adults With MCI: Results From the Gait and Brain Study.

    PubMed

    Sakurai, Ryota; Bartha, Robert; Montero-Odasso, Manuel

    2018-05-15

    Low dual-task gait performance (the slowing of gait speed while performing a demanding cognitive task) is associated with low cognitive performance and an increased risk of progression to dementia in older adults with mild cognitive impairment. However, the reason for this remains unclear. This study aimed to examine the relationship between dual-task cost and regional brain volume, focusing on the hippocampus, parahippocampal gyrus, entorhinal cortex, and motor and lateral frontal cortices in older adults with mild cognitive impairment. Forty older adults with mild cognitive impairment from the "Gait and Brain Study" were included in this study. Gait velocity was measured during single-task (ie, walking alone) and dual-task (ie, counting backwards, subtracting serial sevens, and naming animals, in addition to walking) conditions, using an electronic walkway. Regional brain volumes were derived by automated segmentation, using 3T magnetic resonance imaging. Partial rank correlation analyses demonstrated that a smaller volume of the left entorhinal cortex was associated with higher dual-task costs in counting backwards and subtracting serial sevens conditions. Subsequent logistic regression analyses demonstrated that a smaller volume of the left entorhinal cortex was independently associated with higher dual-task cost (slowing down >20% when performing cognitive task) in these two conditions. There were no other significant associations. Our results show that lower dual-task gait performance is associated with volume reduction in the entorhinal cortex. Cognitive and motor dysfunction in older adults with mild cognitive impairment may reflect a shared pathogenic mechanism, and dual-task-related gait changes might be a surrogate motor marker for Alzheimer's disease pathology.

  19. Treatment Planning and Volumetric Response Assessment for Yttrium-90 Radioembolization: Semiautomated Determination of Liver Volume and Volume of Tumor Necrosis in Patients with Hepatic Malignancy

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

    Monsky, Wayne L., E-mail: wayne.monsky@ucdmc.ucdavis.edu; Garza, Armando S.; Kim, Isaac

    Purpose: The primary purpose of this study was to demonstrate intraobserver/interobserver reproducibility for novel semiautomated measurements of hepatic volume used for Yttrium-90 dose calculations as well as whole-liver and necrotic-liver (hypodense/nonenhancing) tumor volume after radioembolization. The secondary aim was to provide initial comparisons of tumor volumetric measurements with linear measurements, as defined by Response Evaluation Criteria in Solid Tumors criteria, and survival outcomes. Methods: Between 2006 and 2009, 23 consecutive radioembolization procedures were performed for 14 cases of hepatocellular carcinoma and 9 cases of hepatic metastases. Baseline and follow-up computed tomography obtained 1 month after treatment were retrospectively analyzed. Threemore » observers measured liver, whole-tumor, and tumor-necrosis volumes twice using semiautomated software. Results: Good intraobserver/interobserver reproducibility was demonstrated (intraclass correlation [ICC] > 0.9) for tumor and liver volumes. Semiautomated measurements of liver volumes were statistically similar to those obtained with manual tracing (ICC = 0.868), but they required significantly less time to perform (p < 0.0001, ICC = 0.088). There was a positive association between change in linear tumor measurements and whole-tumor volume (p < 0.0001). However, linear measurements did not correlate with volume of necrosis (p > 0.05). Dose, change in tumor diameters, tumor volume, and necrotic volume did not correlate with survival (p > 0.05 in all instances). However, Kaplan-Meier curves suggest that a >10% increase in necrotic volume correlated with survival (p = 0.0472). Conclusion: Semiautomated volumetric analysis of liver, whole-tumor, and tumor-necrosis volume can be performed with good intraobserver/interobserver reproducibility. In this small retrospective study, measurements of tumor necrosis were suggested to correlate with survival.« less

  20. Study of Alternate Space Shuttle Concepts. Volume 2, Part 2: Concept Analysis and Definition

    NASA Technical Reports Server (NTRS)

    1971-01-01

    This is the final report of a Phase A Study of Alternate Space Shuttle Concepts by the Lockheed Missiles & Space Company (LMSC) for the National Aeronautics and Space Administration George C. Marshall Space Flight Center (MSFC). The eleven-month study, which began on 30 June 1970, is to examine the stage-and-one-half and other Space Shuttle configurations and to establish feasibility, performance, cost, and schedules for the selected concepts. This final report consists of four volumes as follows: Volume I - Executive Summary, Volume II - Concept Analysis and Definition, Volume III - Program Planning, and Volume IV - Data Cost Data. This document is Volume II, Concept Analysis and Definition.

  1. Associations between regional brain volumes at term-equivalent age and development at 2 years of age in preterm children.

    PubMed

    Lind, Annika; Parkkola, Riitta; Lehtonen, Liisa; Munck, Petriina; Maunu, Jonna; Lapinleimu, Helena; Haataja, Leena

    2011-08-01

    Altered brain volumes and associations between volumes and developmental outcomes have been reported in prematurely born children. To assess which regional brain volumes are different in very low birth weight (VLBW) children without neurodevelopmental impairments ([NDI] cerebral palsy, hearing loss, blindness and significantly delayed cognitive performance) compared with VLBW children with NDI, and to evaluate the association between regional brain volumes at term-equivalent age and cognitive development and neurological performance at a corrected age of 2 years. The study group consisted of a regional cohort of 164 VLBW children, divided into one group of children without NDI (n = 148) and one group of children with NDI (n = 16). Brain (MRI) was performed at term-equivalent age, from which brain volumes were manually analysed. Cognitive development was assessed with the Bayley Scales of Infant Development II (BSID-II), and neurological performance with the Hammersmith Infant Neurological Examination at the corrected age of 2 years. The volumes of total brain tissue, cerebrum, frontal lobes, basal ganglia and thalami, and cerebellum were significantly smaller, and the volume of the ventricles significantly larger, in the children with NDI than in those without NDI. Even in children without NDI, a smaller cerebellar volume was significantly correlated with poor neurological performance at 2 years of corrected age. Volumetric analysis at brain MRI can provide an additional parameter for early prediction of outcome in VLBW children.

  2. Effect of Progressive Volume-Based Overload During Plyometric Training on Explosive and Endurance Performance in Young Soccer Players.

    PubMed

    Ramírez-Campillo, Rodrigo; Henríquez-Olguín, Carlos; Burgos, Carlos; Andrade, David C; Zapata, Daniel; Martínez, Cristian; Álvarez, Cristian; Baez, Eduardo I; Castro-Sepúlveda, Mauricio; Peñailillo, Luis; Izquierdo, Mikel

    2015-07-01

    The purpose of the study was to compare the effects of progressive volume-based overload with constant volume-based overload on muscle explosive and endurance performance adaptations during a biweekly short-term (i.e., 6 weeks) plyometric training intervention in young soccer players. Three groups of young soccer players (age 13.0 ± 2.3 years) were divided into: control (CG; n = 8) and plyometric training with (PPT; n = 8) and without (NPPT; n = 8) a progressive increase in volume (i.e., 16 jumps per leg per week, with an initial volume of 80 jumps per leg each session). Bilateral and unilateral horizontal and vertical countermovement jump with arms (CMJA), 20-cm drop jump reactive strength index (RSI20), maximal kicking velocity (MKV), 10-m sprint, change of direction speed (CODS), and Yo-Yo intermittent recovery level 1 test (Yo-Yo IR1) were measured. Although both experimental groups significantly increased CMJA, RSI20, CODS, and endurance performance, only PPT showed a significant improvement in MKV and 10-m sprint time. In addition, only PPT showed a significantly higher performance improvement in jumping, MKV, and Yo-Yo IR1 compared with CG. Also, PPT showed higher meaningful improvement compared with NPPT in all (except 1) jump performance measures. Furthermore, although PPT involved a higher total volume compared with NPPT, training efficiency (i.e., percentage change in performance/total jump volume) was similar between groups. Our results show that PPT and NPPT ensured significant improvement in muscle explosive and endurance performance measures. However, a progressive increase in plyometric training volume seems more advantageous to induce soccer-specific performance improvements.

  3. Auditory attention in autism spectrum disorder: An exploration of volumetric magnetic resonance imaging findings.

    PubMed

    Lalani, Sanam J; Duffield, Tyler C; Trontel, Haley G; Bigler, Erin D; Abildskov, Tracy J; Froehlich, Alyson; Prigge, Molly B D; Travers, Brittany G; Anderson, Jeffrey S; Zielinski, Brandon A; Alexander, Andrew; Lange, Nicholas; Lainhart, Janet E

    2018-06-01

    Studies have shown that individuals with autism spectrum disorder (ASD) tend to perform significantly below typically developing individuals on standardized measures of attention, even when controlling for IQ. The current study sought to examine within ASD whether anatomical correlates of attention performance differed between those with average to above-average IQ (AIQ group) and those with low-average to borderline ability (LIQ group) as well as in comparison to typically developing controls (TDC). Using automated volumetric analyses, we examined regional volume of classic attention areas including the superior frontal gyrus, anterior cingulate cortex, and precuneus in ASD AIQ (n = 38) and LIQ (n = 18) individuals along with 30 TDC. Auditory attention performance was assessed using subtests of the Test of Memory and Learning (TOMAL) compared among the groups and then correlated with regional brain volumes. Analyses revealed group differences in attention. The three groups did not differ significantly on any auditory attention-related brain volumes; however, trends toward significant size-attention function interactions were observed. Negative correlations were found between the volume of the precuneus and auditory attention performance for the AIQ ASD group, indicating larger volume related to poorer performance. Implications for general attention functioning and dysfunctional neural connectivity in ASD are discussed.

  4. A Review and Analysis of Performance Appraisal Processes, Volume III. Performance Appraisal for Professional Service Employees: Non-Technical Report. Professionalism in Schools Series.

    ERIC Educational Resources Information Center

    Ondrack, D. A.; Oliver, C.

    The third of three volumes, this report summarizes the findings of, first, a review and analysis of published literature on performance appraisal in general and particularly on the use of appraisals in public education systems, and, second, a series of field-site investigations of performance appraisal systems in action. The field site studies of…

  5. Multimodal airway evaluation in growing patients after rapid maxillary expansion.

    PubMed

    Fastuca, R; Meneghel, M; Zecca, P A; Mangano, F; Antonello, M; Nucera, R; Caprioglio, A

    2015-06-01

    The objective of this study was to evaluate the airway volume of growing patients combining a morphological approach using cone beam computed tomography associated with functional data obtained by polysomnography examination after rapid maxillary expansion treatment. 22 Caucasian patients (mean age 8.3±0.9 years) undergoing rapid maxillary expansion with Haas type expander banded on second deciduous upper molars were enrolled for this prospective study. Cone beam computed tomography scans and polysomnography exams were collected before placing the appliance (T0) and after 12 months (T1). Image processing with airway volume computing and analyses of oxygen saturation and apnoea/hypopnoea index were performed. Airway volume, oxygen saturation and apnea/hypopnea index underwent significant increase over time. However, no significant correlation was seen between their increases. The rapid maxillary expansion treatment induced significant increases in the total airway volume and respiratory performance. Functional respiratory parameters should be included in studies evaluating the RME treatment effects on the respiratory performance.

  6. Strategies for hydration and energy provision during soccer-specific exercise.

    PubMed

    Clarke, N D; Drust, B; MacLaren, D P M; Reilly, T

    2005-12-01

    The aim of the present study was to investigate the effect of manipulating the provision of sports drink during soccer-specific exercise on metabolism and performance. Soccer players (N = 12) performed a soccer-specific protocol on three occasions. On two, 7 mL/kg carbohydrate-electrolyte (CHOv) or placebo (PLA) solutions were ingested at 0 and 45 min. On a third, the same total volume of carbohydrate-electrolyte was consumed (CHOf) in smaller volumes at 0, 15, 30, 45, 60, and 75 min. Plasma glucose, glycerol, non-esterified free fatty acids (NEFA), cortisol, and CHO oxidation were not significantly different between CHOv and CHOf (P > 0.05). Sprint power was not significantly affected (P > 0.05) by the experimental trials. This study demonstrates when the total volume of carbohydrate consumed is equal, manipulating the timing and volume of ingestion elicits similar metabolic responses without affecting exercise performance.

  7. Use of an Assistant Surgeon Does not Mitigate the Effect of Lead Surgeon Volume on Outcomes Following Open Repair of Intact Abdominal Aortic Aneurysms.

    PubMed

    Deery, Sarah E; O'Donnell, Thomas F X; Zettervall, Sara L; Darling, Jeremy D; Shean, Katie E; O'Malley, A James; Landon, Bruce E; Schermerhorn, Marc L

    2018-05-01

    While higher lead surgeon volume has been associated with lower mortality following open abdominal aortic aneurysm (AAA) repair, little is known about the impact of using an attending surgeon as assistant surgeon. The aim of this study was to determine whether the presence of an assistant surgeon, particularly a high volume assistant, mitigates the relationship between lead surgeon volume and outcomes. All Medicare beneficiaries who underwent intact, open AAA repair between 2003 and 2008 were evaluated and nested regression models were constructed to evaluate the relationship between surgeon and assistant volume and peri-operative mortality, adjusting for comorbid conditions and hospital volume. In total 28,590 repairs were studied, of which 19,284 (67.5%) were performed by a single surgeon and 9306 (32.5%) included an assistant surgeon. Of cases with an assistant, 12.3% included a high volume assistant surgeon. Lower volume surgeons more frequently used an assistant (lead surgeon Q1 volume: 40%; Q2: 36%; Q3: 34%; Q4: 29%; Q5: 27% [p < .01]). In cases with no assistant, adjusted peri-operative mortality varied monotonically with surgeon volume (Q1: 4.7%; Q2: 4.4%; Q3: 4.1%; Q4: 3.3%; Q5: 3.2%). However, the use of a high or a low volume assistant surgeon, compared with no attending surgeon as assistant, was not associated with lower peri-operative mortality in any lead surgeon volume quintile, even among those operations performed by the lowest volume lead surgeons. Employing an assistant surgeon does not improve outcomes amongst any quintile of volume of the lead surgeon. As surgeons perform fewer open AAA repairs in the modern era, these data imply that even the help of a high volume assistant surgeon may not mitigate the detrimental effect of a lower volume surgeon. Copyright © 2018 European Society for Vascular Surgery. Published by Elsevier B.V. All rights reserved.

  8. Comparison of the outcomes for laparoscopic gastrectomy performed by the same surgeon between a low-volume hospital and a high-volume center.

    PubMed

    Kim, Min Gyu; Kwon, Sung Joon

    2014-05-01

    The volume-outcome relationship in laparoscopic surgery is controversial. This study was designed to identify differences in laparoscopic gastrectomy outcomes between a low-volume hospital and a high-volume center and to provide guidelines for overcoming the problems associated with a low-volume hospital. From April 2009 to November 2012, one surgeon performed 134 totally laparoscopic distal gastrectomies (TLDGs) at a high-volume center (HVC; ASAN Medical Center) and at a low-volume hospital (LVH; Hanyang University Guri Hospital). All laparoscopically assisted gastrectomies were excluded from this study. During the early period of laparoscopic gastrectomy at the low-volume hospital, TLDG with Roux-en-Y gastrojejunostomy (RYGJ) was performed according to the surgeon's choice. The reconstruction method was classified as gastroduodenostomy (GD) or RYGJ. Early surgical outcomes achieved at the LVH were investigated and compared with those obtained at the HVC. The early surgical outcomes differed significantly between the two hospitals. In particular, the postoperative complication rate for the patients who underwent TLDG RYGJ at the LVH was higher than at the HVC (LVH 15.4 % vs. HVC 0 %; p = 0.037). Furthermore, significant differences were observed in the mean operation time (TLDG GD: LVH 141.0 min vs. HVC 117.4 min, p = 0.001; TLDG RYGJ: LVH 186.3 min vs. HVC 134.6 min, p = 0.009) and length of hospital stay (TLDG GD: LVH 8.1 days vs. HVC 7.2 days, p = 0.044; TLDG RYGJ: LVH 11.5 day vs. HVC 6.8 day, p = 0.009). Although all the operations were performed by one experienced surgeon, the early surgical outcomes differed significantly between the low- and high-volume hospitals. Low-volume hospitals often lack well-trained surgical professionals such as first assistants and scrub nurses. Therefore, the authors recommend that a surgeon who works at an LVH should assess potential personnel shortages and find a solution before operating.

  9. Combined effects of marijuana and nicotine on memory performance and hippocampal volume.

    PubMed

    Filbey, Francesca M; McQueeny, Tim; Kadamangudi, Shrinath; Bice, Collette; Ketcherside, Ariel

    2015-10-15

    Combined use of marijuana (MJ) and tobacco is highly prevalent in today's population. Individual use of either substance is linked to structural brain changes and altered cognitive function, especially with consistent reports of hippocampal volume deficits and poorer memory performance. However, the combined effects of MJ and tobacco on hippocampal structure and on learning and memory processes remain unknown. In this study, we examined both the individual and combined effects of MJ and tobacco on hippocampal volumes and memory performance in four groups of adults taken from two larger studies: MJ-only users (n=36), nicotine-only (Nic-only, n=19), combined marijuana and nicotine users (MJ+Nic, n=19) and non-using healthy controls (n=16). Total bilateral hippocampal volumes and memory performance (WMS-III logical memory) were compared across groups controlling for total brain size and recent alcohol use. Results found MJ and MJ+Nic groups had smaller total hippocampal volumes compared to Nic-only and controls. No significant difference between groups was found between immediate and delayed story recall. However, the controls showed a trend for larger hippocampal volumes being associated with better memory scores, while MJ+Nic users showed a unique inversion, whereby smaller hippocampal volume was associated with better memory. Overall, results suggest abnormalities in the brain-behavior relationships underlying memory processes with combined use of marijuana and nicotine use. Further research will need to address these complex interactions between MJ and nicotine. Copyright © 2015 The Authors. Published by Elsevier B.V. All rights reserved.

  10. Cerebellum and cognition in multiple sclerosis: the fall status matters.

    PubMed

    Kalron, Alon; Allali, Gilles; Achiron, Anat

    2018-04-01

    Cerebellar volume has been linked with cognitive performances in MS; however, the association in terms of fall status has never been compared. Therefore, the objective of the current study was to compare cognitive performance with cerebellar volume between MS fallers and non-fallers. The cross-sectional study included 140 PwMS (96 women). MRI volumetric analysis was based on the FreeSurfer image analysis suite. Volumes of the cerebellar gray and white matter were identified as the region of interest. Cognitive function included scores obtained from a computerized cognitive battery of tests. The sample was divided into fallers and non-fallers. MS fallers demonstrated a lower global cognitive performance and reduced gray and white matter cerebellar volumes compared to non-fallers. A significant association was found between total gray and white matter cerebellar volume and visual spatial subdomain (P value = 0.044 and 0.032, respectively) in the non-fallers group. The association remained significant after controlling for the total cranial volume and neurological disability (P value = 0.026 and 0.047, respectively). A relationship was found between the visual spatial score and the left gray matter cerebellum volume; R 2  = 0.44, P value = 0.021. We believe that a unique relationship exists between the cerebellum structure and cognitive processing according to fall history in PwMS and should be considered when investigating the association between brain functioning and cognitive performances in MS.

  11. Statistical Issues in the Comparison of Quantitative Imaging Biomarker Algorithms using Pulmonary Nodule Volume as an Example

    PubMed Central

    2014-01-01

    Quantitative imaging biomarkers (QIBs) are being used increasingly in medicine to diagnose and monitor patients’ disease. The computer algorithms that measure QIBs have different technical performance characteristics. In this paper we illustrate the appropriate statistical methods for assessing and comparing the bias, precision, and agreement of computer algorithms. We use data from three studies of pulmonary nodules. The first study is a small phantom study used to illustrate metrics for assessing repeatability. The second study is a large phantom study allowing assessment of four algorithms’ bias and reproducibility for measuring tumor volume and the change in tumor volume. The third study is a small clinical study of patients whose tumors were measured on two occasions. This study allows a direct assessment of six algorithms’ performance for measuring tumor change. With these three examples we compare and contrast study designs and performance metrics, and we illustrate the advantages and limitations of various common statistical methods for QIB studies. PMID:24919828

  12. Relationship of Temporal Lobe Volumes to Neuropsychological Test Performance in Healthy Children

    ERIC Educational Resources Information Center

    Wells, Carolyn T.; Mahone, E. Mark; Matson, Melissa A.; Kates, Wendy R.; Hay, Trisha; Horska, Alena

    2008-01-01

    Ecological validity of neuropsychological assessment includes the ability of tests to predict real-world functioning and/or covary with brain structures. Studies have examined the relationship between adaptive skills and test performance, with less focus on the association between regional brain volumes and neurobehavioral function in healthy…

  13. Acute Effects of Static Stretching, Dynamic Exercises, and High Volume Upper Extremity Plyometric Activity on Tennis Serve Performance

    PubMed Central

    Gelen, Ertugrul; Dede, Muhittin; Bingul, Bergun Meric; Bulgan, Cigdem; Aydin, Mensure

    2012-01-01

    The purpose of this study was to compare the acute effects of static stretching; dynamic exercises and high volume upper extremity plyometric activity on tennis serve performance. Twenty-six elite young tennis players (15.1 ± 4.2 years, 167.9 ± 5.8 cm and 61.6 ± 8.1 kg) performed 4 different warm-up (WU) routines in a random order on non-consecutive days. The WU methods consisted of traditional WU (jogging, rally and serve practice) (TRAD); traditional WU and static stretching (TRSS); traditional WU and dynamic exercise (TRDE); and traditional WU and high volume upper extremity plyometric activity (TRPLYP). Following each WU session, subjects were tested on a tennis serve ball speed test. TRAD, TRSS, TRDE and TRPLYO were compared by repeated measurement analyses of variance and post-hoc comparisons. In this study a 1 to 3 percent increase in tennis serve ball speed was recorded in TRDE and TRPLYO when compared to TRAD (p< 0.05). However, no significant change in ball speed performance between TRSS and TRAD. (p> 0.05). ICCs for ball speed showed strong reliability (0.82 to 0.93) for the ball speed measurements.The results of this study indicate that dynamic and high volume upper extremity plyometric WU activities are likely beneficial to serve speed of elite junior tennis players. Key points After the traditional warm up in tennis, static stretching has no effect on serve speed. Tennis players should perform dynamic exercises and/or high volume upper extremity plyometric activities to improve their athletic performance. PMID:24150068

  14. Development and Use of Performance Appraisal of Certificated Education Staff in Ontario School Boards. Volume IV: Non-Technical Report. Professionalism in Schools Series.

    ERIC Educational Resources Information Center

    Lawton, S. B.; And Others

    This report, the fourth and final volume of a series, examines in a summary fashion the results from a massive study of performance appraisal policies and procedures currently used in Ontario school boards. The study, a two-year undertaking, focused on appraisal practices for certified educational personnel in Ontario: teachers, principals,…

  15. Miami-Dade Community College 1984 Institutional Self-Study. Volume IV: Student Information and Performance Standards (Advisement and Graduation Information System, Academic Alert, Standards of Academic Progress).

    ERIC Educational Resources Information Center

    Miami-Dade Community Coll., FL.

    Part of a systematic, in-depth assessment of Miami-Dade Community College's (MDCC's) educational programs, student support systems, and selected campus-level activities, this volume of the college's institutional self-study report examines the impact and effectiveness of student information systems and performance standards. This report presents…

  16. A driving simulator study of driver performance on deceleration lanes.

    PubMed

    Calvi, A; Benedetto, A; De Blasiis, M R

    2012-03-01

    Deceleration lanes are important because they help drivers transition from high-speed lanes to low-speed ramps. Although they are designed to allow vehicles to depart the freeway safely and efficiently, many studies report high accident rates on exit ramps with the highest percentage of crashes taking place in deceleration lanes. This paper describes the results of a driving simulator study that focused on driving performance while approaching a divergence area and decelerating during the exiting maneuver. Three different traffic scenarios were simulated to analyze the influence of traffic volume on driving performance. Thirty drivers drove in the simulator in these scenarios while data on their lateral position, speed and deceleration were collected. Our results indicate there are considerable differences between the main assumptions of models generally used to design deceleration lanes and actual driving performance. In particular, diverging drivers begin to decelerate before arriving at the deceleration lane, causing interference with the main flow. Moreover, speeds recorded at the end of the deceleration lane exceed those for which the ramp's curves are designed; this creates risky driving conditions that could explain the high crash rates found in studies of exit ramps. Finally, statistical analyses demonstrate significant influences of traffic volume on some aspects of exiting drivers' performance: lower traffic volume results in elevated exiting speed and deceleration, and diverging drivers begin to decelerate earlier along the main lane when traffic volume is low. However, speeds at the end of the deceleration lane and the site of lane changing are not significantly influenced by traffic volume. Copyright © 2011 Elsevier Ltd. All rights reserved.

  17. Low rates of complications for carotid artery stenting are associated with a high clinician volume of carotid artery stenting and aortic endografting but not with a high volume of percutaneous coronary interventions.

    PubMed

    Modrall, J Gregory; Chung, Jayer; Kirkwood, Melissa L; Baig, M Shadman; Tsai, Shirling X; Timaran, Carlos H; Valentine, R James; Rosero, Eric B

    2014-07-01

    Prior studies have demonstrated improved clinical outcomes for surgeons with a high-volume experience with certain open vascular operations. A high-volume experience with carotid artery stenting (CAS) improves clinical outcomes. Moreover, it is not known whether experience with other endovascular procedures, including percutaneous coronary interventions (PCIs), is an adequate substitute for experience with CAS. The goal of this study was to quantify the effect of increasing clinician volume of CAS, endovascular aneurysm repair (EVAR), and thoracic endovascular aortic aneurysm repair (TEVAR), and PCI on the outcomes for CAS. The Nationwide Inpatient Sample was analyzed to identify patients undergoing CAS for the years 2005 to 2009. Clinicians were stratified into tertiles of low-volume, medium-volume, and high-volume groups by annual volume of CAS, EVAR/TEVAR, and PCI. Multiple logistic regression analyses were used to examine the relationship between clinician volume and a composite outcome of the in-hospital stroke and death rate after CAS. Between 2005 and 2009, 56,374 elective CAS procedures were performed nationwide, with a crude in-hospital stroke and death rate of 3.22%. A median of nine CAS procedures (interquartile range, 3-20) were performed annually per clinician. As expected, stroke and death rates for CAS decreased with increasing volume of CAS performed by a clinician (low-volume vs medium-volume vs high-volume: 4.43% vs 2.89% vs 2.27%; P = .0001). Similar patterns were noted between clinicians' volume of EVAR/TEVAR (low-volume vs medium-volume vs high-volume: 4.58% vs 3.18% vs 2.16%; P = .0023). In contrast, increasing PCI volume was not associated with decreased stroke and death rates after CAS (low-volume vs medium-volume vs high-volume: 2.99% vs 3.18% vs 3.55%; P = .35). After adjusting for patient and hospital characteristics, clinician volume of CAS (odds ratio [OR], 0.84; 95% confidence interval [CI], 0.74-0.94; P = .003) and EVAR/TEVAR (OR, 0.85; 95% CI, 0.75-0.97; P = .020) remained significant predictors of stroke and death after CAS, whereas increasing clinician volume of PCI was associated with significantly increasing likelihood of stroke or death after CAS (OR, 1.025; 95% CI, 1.004-1.047; P = .019). The stroke and death rate for CAS to treat carotid stenosis is inversely affected by the number of CAS and EVAR/TEVAR procedures performed by a clinician. In contrast, a high-volume experience with PCI is not associated with improved outcomes after CAS. Copyright © 2014 Society for Vascular Surgery. All rights reserved.

  18. Relationships between maximal anaerobic power of the arms and legs and javelin performance.

    PubMed

    Bouhlel, E; Chelly, M S; Tabka, Z; Shephard, R

    2007-06-01

    The aim of this study was to examine relationships between maximal anaerobic power, as measured by leg and arm force-velocity tests, estimates of local muscle volume and javelin performance. Ten trained national level male javelin throwers (mean age 19.6+/- 2 years) participated in this study. Maximal anaerobic power, maximal force and maximal velocity were measured during leg (Wmax-L) and arm (Wmax-A) force-velocity tests, performed on appropriately modified forms of Monark cycle ergometer. Estimates of leg and arm muscle volume were made using a standard anthropometric kit. Maximal force of the leg (Fmax-L) was significantly correlated with estimated leg muscle volume (r=0.71, P<0.05). Wmax-L and Wmax-A were both significantly correlated with javelin performance (r=0.76, P<0.01; r=0.71, P <0.05, respectively). Maximal velocity of the leg (Vmax-L) was also significantly correlated with throwing performance (r=0.83; P<0.001). Wmax of both legs and arms were significantly correlated with javelin performance, the closest correlation being for Wmax-L; this emphasizes the importance of the leg muscles in this sport. Fmax-L and Vmax-L were related to muscle volume and to javelin performance, respectively. Force-velocity testing may have value in regulating conditioning and rehabilitation in sports involving throwing.

  19. A Study of Job Demands and Curriculum Development in Agricultural Training Related to the Muskegon County Wastewater Management System. Final Report. Volume III. Student Terminal Performance Objectives and Instructional Modules.

    ERIC Educational Resources Information Center

    Fisher, Harold S.; And Others

    This is the third volume of a four-volume report of a research project designed to (1) identify job needs for agricultural occupations which will result from the Muskegon County Wastewater Management System and perform a task analysis on each occupation, (2) develop instructional modules and determine their place in either high school or 2-year…

  20. MX Siting Investigation Geotechnical Evaluation. Volume IA. Nevada-Utah Verification Studies, FY 79.

    DTIC Science & Technology

    1979-08-24

    JUSTIFICATION E ECTE DISTRIUrION, D AVAILABILITY CODES DIST AVAIL AND/OR SPECIAL DATE ACCESSIONED 11 * Original contains color plates: All DTIC reproduct- IA...White River North, Garden- Coal , Reveille-Railroad and Big Smoky CDPs. Section 11.0 briefly explains previous work performed in Dry Lake and Ralston...Hamlin CDP Volume V - White River North CDP Volume VI - Garden- Coal CDP Volume VII - Reveille-Railroad CDP Volume VIII - Big Smoky CDP Volume IX - Dry

  1. Regional Differences in Brain Volume Predict the Acquisition of Skill in a Complex Real-Time Strategy Videogame

    ERIC Educational Resources Information Center

    Basak, Chandramallika; Voss, Michelle W.; Erickson, Kirk I.; Boot, Walter R.; Kramer, Arthur F.

    2011-01-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also…

  2. An analysis of malar fat volume in two age groups: implications for craniofacial surgery.

    PubMed

    Corey, Christina L; Popelka, Gerald R; Barrera, Jose E; Most, Sam P

    2012-12-01

    Objective To evaluate how malar fat pad (MFP) volumes vary with age, after controlling for gender and body mass index (BMI). Study Design A prospective case-control study evaluating volume of the MFP in women of two age groups. Methods Soft tissue dimensions were measured in eight subjects using magnetic resonance imaging. A multiplanar localizing sequence, followed in sagittal and coronal orientations using a turbo spin echo sequence, was performed to define the MFP. Volumetric calculations were then performed using a 3D image analysis application (Dextroscope, Volume Interactions, Republic of Singapore) to circumscribe areas, orient dimensions, and calculate volumes of the MFP. Results These data reveal no significant difference in the mean (standard deviation) right MFP (p = 0.50), left MFP (p = 0.41), or total MFP (p = 0.45) volumes when comparing the two age groups. In addition, these data indicate that there was no correlation between age and total MFP volume (Pearson correlation coefficient 0.27). Moreover, there was no correlation between age and the ratio of total volume/BMI (Pearson correlation coefficient -0.18). Conclusions Although the sample size of this study was small, these data indicate that ptosis of midfacial fat is more important than volume loss in midfacial aging. These data would suggest repositioning as the primary modality for craniofacial reconstruction.

  3. Breast surgery techniques: preoperative bracketing wire localization by surgeons.

    PubMed

    Burkholder, Hans C; Witherspoon, Laura E; Burns, R Phillip; Horn, Jeffrey S; Biderman, Michael D

    2007-06-01

    With the development of expertise in image guidance for breast surgery, many surgeons now perform preoperative wire localization themselves. Use of a single wire versus multiple wires to bracket a radiographic breast abnormality has previously been described, although benefits of this technique based on clinical outcomes such as margin status, tissue volume removed, and re-excision rates have not been established. This study is a retrospective analysis of wire-localized breast biopsies performed by 14 surgeons over 29 months; stereotactic and ultrasound guidance were used. During this time, 489 wire localizations were done, of which 159 used multiple wires. Two hundred eleven of these biopsies were done for malignant disease, 86 using multiple wires. After controlling for tumor node metastases stage, single and multiple wire placements were compared using endpoints of margin status, need for re-excision, and total volume of tissue removed. Neither margin status nor re-excision was related to the number of wires placed. However, the number of wires placed was significantly related to the total volume of tissue removed. Use of more than one localizing wire was associated with greater volume of tissue removal (measured in centimeters cubed) in benign disease (46 vs 25, P < 0.001), equivalent volumes in stage 0 disease (73 vs 67), less volume in stage 1 disease (113 vs 164), and less volume in stages 2 through 4 (158 vs 207, P = 0.03). Outcomes based on surgeon case volume during the study period demonstrated that low- (1-40), medium- (41-80), and high-volume (>80) surgeons did not differ in the type or stage of breast pathology treated. Surgeons with high case volumes were more likely to place multiple localizing wires (P < 0.001) and were more likely to do a breast-conserving procedure if re-excision was performed (P < 0.018). Surgeons with low case volumes were more likely to perform a re-excision (P < 0.025). Surgeon experience has a positive impact on quality outcome measures such as performance of a definitive procedure at the time of initial surgery and use of breast-conserving procedures at the time of re-excision. Multiple wire localization can be used to significantly reduce the volume of breast tissue removed in malignant disease without sacrificing margin status or increasing the need for future re-excision.

  4. Microvascular transplants in head and neck reconstruction: 3D evaluation of volume loss.

    PubMed

    Bittermann, Gido; Thönissen, Philipp; Poxleitner, Philipp; Zimmerer, Ruediger; Vach, Kirstin; Metzger, Marc C

    2015-10-01

    Despite oversized latissimus dorsi free flap reconstruction in the head and neck area, esthetic and functional problems continue to exist due to the well-known occurrence of transplant shrinkage. The purpose of this study was to acquire an estimation of the volume and time of the shrinkage process. The assessment of volume loss was performed using a 3D evaluation of two postoperative CT scans. A retrospective review was conducted on all latissimus dorsi free flap reconstructions performed between 2004 and 2013. Inclusion criteria for the assessment were: resection of an oral carcinoma and microsurgical defect coverage with latissimus dorsi free flap; a first postoperative CT (CT1) performed between 3 weeks and a maximum of 3 months after reconstruction surgery; and an additional CT scan (CT2) performed at least one year postoperatively. The exclusion criterion was surgical intervention in the local area between the acquisition of CT1 and CT2. The effect of adjuvant radiation therapy was considered. Volume determination of the transplant was carried out in CT1 and CT2 by manual segmentation of the graft. Fifteen patients were recruited. 3D evaluation showed an average volume loss of 34.4%. In the consideration of postoperative radiotherapy the volume reduction was 39.2% in patients with radiotherapy and 31.3% in patients without radiotherapy. The reconstruction flap volume required for overcorrection of the surgical defect was investigated. This study indicates that a volume loss of more than 30% could be expected one or more years after latissimus dorsi free flap reconstruction. Clinical trial number DRKS00007534. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  5. Impact of Formulas, Language and Instruction on Student Performance on Cost-Volume-Profit Problems

    ERIC Educational Resources Information Center

    Johnson, Benny G.; Sargent, Carol Springer

    2014-01-01

    This study investigated how three factors impacted performance on cost-volume-profit homework problems: language, formula use, and instruction. Students enrolled in Introduction to Financial Accounting (the first principles of accounting course) and Managerial Accounting (the second principles of accounting course) from eight different US colleges…

  6. Design and evaluation of high-volume fly ash (HVFA) concrete mixes, report B : bond behavior of mild reinforcing steel in HVFA concrete.

    DOT National Transportation Integrated Search

    2012-10-01

    The main objective of this study was to determine the effect on bond performance : of high-volume fly ash (HVFA) concrete. The HVFA concrete test program consisted of : comparing the bond performance of two concrete mix designs with 70% cement : repl...

  7. Influence of nanofluids on the efficiency of Flat-Plate Solar Collectors (FPSC)

    NASA Astrophysics Data System (ADS)

    Nejad, Marjan B.; Mohammed, H. A.; Sadeghi, O.; Zubeer, Swar A.

    2017-11-01

    A numerical investigation is performed using finite volume method to study the laminar heat transfer in a three-dimensional flat-plate solar collector using different nanofluids as working fluids. Three nanofluids with different types of nanoparticles (Ag, MWCNT and Al2O3 dispersed in water) with 1-2 wt% volume fractions are analyzed. A constant heat flux, equivalent to solar radiation absorbed by the collector, is applied at the top surface of the absorber plate. In this study, several parameters including boundary conditions (different volume flow rates, different fluid inlet temperatures and different solar irradiance at Skudai, Malaysia), different types of nanoparticles, and different solar collector tilt angles are investigated to identify their effects on the heat transfer performance of FPSC. The numerical results reveal that the three types of nanofluid enhance the thermal performance of solar collector compared to pure water and FPSC with Ag nanofluid has the best thermal performance enhancement. For all the cases, the collector efficiency increased with the increase of volume flow rate while fluid outlet temperature decreased. It is found that FPSC with tilt angle of 10° and fluid inlet temperature of 301.15 K has the best thermal performance.

  8. Is Heart Rate Variability Better Than Routine Vital Signs for Prehospital Identification of Major Hemorrhage

    DTIC Science & Technology

    2015-01-01

    different PRBC transfusion volumes. We performed multivariate regression analysis using HRV metrics and routine vital signs to test the hypothesis that...study sponsors did not have any role in the study design, data collection, analysis and interpretation of data, report writing, or the decision to...primary outcome was hemorrhagic injury plus different PRBC transfusion volumes. We performed multivariate regression analysis using HRV metrics and

  9. Delivery of Essential Medicines to Primary Care Institutions and its Association with Procurement Volume and Price: A Case Study in Hubei Province, China.

    PubMed

    Tang, Yuqing; Liu, Chaojie; Zhang, Xinping

    2017-02-01

    The low availability of essential medicines is a worldwide issue of concern. In 2009, China introduced a National Essential Medicines List (NEML), with NEML medicines being purchased in bulk at contracted prices established by tenders conducted at the provincial level. The availability of essential medicines in the public sector largely relies on commercial supply chains. The objectives of this paper were to analyze the delivery performance of essential medicines under NEML provincial procurement arrangements, and to determine whether the procurement volume and price of medicines are associated with the delivery performance of suppliers. We reviewed 9390 recorded orders of 1099 essential medicines in Hubei province from August 2011 to April 2012. The reliability of medicine delivery in-full and on-time (DIFOT) was considered the performance indicator, and we used Spearman correlation analyses to explore whether there were any associations between DIFOT and procurement price and volume. Quantile regressions were performed to determine such associations. The DIFOT had positive correlations with procurement price and volume. The Spearman rank correlation coefficients between price and DIFOT were 0.114, 0.34 and 0.25 for medicines with low one-third, middle one-third and high one-third procurement volumes, respectively. The quantile regression analysis revealed a positive association between price and DIFOT across all quantiles of DIFOT, and although significant positive associations between volume and DIFOT were only found at the 25th percentile of DIFOT, volume showed significant interactions with price for both the 25th and 50th percentiles of DIFOT. Higher procurement price is associated with better delivery performance of essential medicines; however, it is important to link procurement price with procurement volume. Increasing procurement volume may alleviate the negative effect of low price on delivery performance. Variation in volumes of repeated orders imposes uncertainties and may jeopardize the delivery of essential medicines.

  10. Learning process for performing and analyzing 3D/4D transperineal ultrasound imaging and interobserver reliability study.

    PubMed

    Siafarikas, F; Staer-Jensen, J; Braekken, I H; Bø, K; Engh, M Ellström

    2013-03-01

    To evaluate the learning process for acquiring three- and four-dimensional (3D/4D) transperineal ultrasound volumes of the levator hiatus (LH) dimensions at rest, during pelvic floor muscle (PFM) contraction and on Valsalva maneuver, and for analyzing the ultrasound volumes, as well as to perform an interobserver reliability study between two independent ultrasound examiners. This was a prospective study including 22 women. We monitored the learning process of an inexperienced examiner (IE) performing 3D/4D transperineal ultrasonography and analyzing the volumes. The examination included acquiring volumes during three PFM contractions and three Valsalva maneuvers. LH dimensions were determined in the axial plane. The learning process was documented by estimating agreement between the IE and an experienced examiner (E) using the intraclass correlation coefficient. Agreement was calculated in blocks of 10 ultrasound examinations and analyzed volumes. After the learning process was complete the interobserver reliability for the technique was calculated between these two independent examiners. For offline analysis of the first 10 ultrasound volumes obtained by E, good to very good agreement between E and IE was achieved for all LH measurements except for the left and right levator-urethra gap and pubic arc. For the next 10 analyzed volumes, agreement improved for all LH measurements. Volumes that had been obtained by IE and E were then re-evaluated by IE, and good to very good agreement was found for all LH measurements indicating consistency in volume acquisition. The interobserver reliability study showed excellent ICC values (ICC, 0.81-0.97) for all LH measurements except the pubic arc (ICC = 0.67). 3D/4D transperineal ultrasound is a reliable technique that can be learned in a short period of time. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  11. Association Between Subcortical Volumes and Verbal Memory in Unmedicated Depressed Patients and Healthy Controls

    PubMed Central

    Turner, Arlener D.; Furey, Maura; Drevets, Wayne C.; Zarate, Carlos; Nugent, Allison

    2012-01-01

    Research has shown poor performance on verbal memory tasks in patients with major depressive disorder relative to healthy controls, as well as structural abnormalities in the subcortical structures that form the limbic-cortical-striatal-pallidal-thalamic circuitry. Few studies, however, have attempted to link the impairments in learning and memory in depression with these structural abnormalities, and of those which have done so, most have included patients medicated with psychotropic agents likely to influence cognitive performance. This study thus examines the relationship between subcortical structural abnormalities and verbal memory using the California Verbal Learning Test (CVLT) in unmedicated depressed patients. A T1 weighted Magnetic Resonance Imaging scan and the CVLT were obtained on 45 subjects with major depressive disorder and 44 healthy controls. Using the FMRIB’s Integrated Registration and Segmentation Tool (FIRST) volumes of selected subcortical structures were segmented and correlated with CVLT performance. Depressed participants showed significantly smaller right thalamus and right hippocampus volumes than healthy controls. Depressed participants also showed impaired performance on global verbal learning ability, and appeared to depend upon an inferior memory strategy (serial clustering). Measures of serial clustering were correlated significantly with right hippocampal volumes in depressed participants. Our findings indicate that depressed participants and healthy controls differ in the memory strategies they employ, and that while depressed participants had a smaller hippocampal volume, there was a positive correlation between volume and use of an inferior memory strategy. This suggests that larger hippocampal volume is related to better memory recall in depression, but specifically with regard to utilizing an inferior memory strategy. PMID:22714007

  12. Brain tissue volumes in relation to cognitive function and risk of dementia.

    PubMed

    Ikram, M Arfan; Vrooman, Henri A; Vernooij, Meike W; den Heijer, Tom; Hofman, Albert; Niessen, Wiro J; van der Lugt, Aad; Koudstaal, Peter J; Breteler, Monique M B

    2010-03-01

    We investigated in a population-based cohort study the association of global and lobar brain tissue volumes with specific cognitive domains and risk of dementia. Participants (n=490; 60-90 years) were non-demented at baseline (1995-1996). From baseline brain MRI-scans we obtained global and lobar volumes of CSF, GM, normal WM, white matter lesions and hippocampus. We performed neuropsychological testing at baseline to assess information processing speed, executive function, memory function and global cognitive function. Participants were followed for incident dementia until January 1, 2005. Larger volumes of CSF and WML were associated with worse performance on all neuropsychological tests, and an increased risk of dementia. Smaller WM volume was related to poorer information processing speed and executive function. In contrast, smaller GM volume was associated with worse memory function and increased risk of dementia. When investigating lobar GM volumes, we found that hippocampal volume and temporal GM volume were most strongly associated with risk of dementia, even in persons without objective and subjective cognitive deficits at baseline, followed by frontal and parietal GM volumes. Copyright 2008 Elsevier Inc. All rights reserved.

  13. Prognostic value of three-dimensional ultrasound for fetal hydronephrosis

    PubMed Central

    WANG, JUNMEI; YING, WEIWEN; TANG, DAXING; YANG, LIMING; LIU, DONGSHENG; LIU, YUANHUI; PAN, JIAOE; XIE, XING

    2015-01-01

    The present study evaluated the prognostic value of three-dimensional ultrasound for fetal hydronephrosis. Pregnant females with fetal hydronephrosis were enrolled and a novel three-dimensional ultrasound indicator, renal parenchymal volume/kidney volume, was introduced to predict the postnatal prognosis of fetal hydronephrosis in comparison with commonly used ultrasound indicators. All ultrasound indicators of fetal hydronephrosis could predict whether postnatal surgery was required for fetal hydronephrosis; however, the predictive performance of renal parenchymal volume/kidney volume measurements as an individual indicator was the highest. In conclusion, ultrasound is important in predicting whether postnatal surgery is required for fetal hydronephrosis, and the three-dimensional ultrasound indicator renal parenchymal volume/kidney volume has a high predictive performance. Furthermore, the majority of cases of fetal hydronephrosis spontaneously regress subsequent to birth, and the regression time is closely associated with ultrasound indicators. PMID:25667626

  14. Subregional volumes of the hippocampus in relation to cognitive function and risk of dementia.

    PubMed

    Evans, Tavia E; Adams, Hieab H H; Licher, Silvan; Wolters, Frank J; van der Lugt, Aad; Ikram, M Kamran; O'Sullivan, Michael J; Vernooij, Meike W; Ikram, M Arfan

    2018-05-18

    Total hippocampal volume has been consistently linked to cognitive function and dementia. Yet, given its complex and parcellated internal structure, the role of subregions of the hippocampus in cognition and risk of dementia remains relatively underexplored. We studied subregions of the hippocampus in a large population-based cohort to further understand their role in cognitive impairment and dementia risk. We studied 5035 dementia- and stroke-free persons from the Rotterdam Study, aged over 45 years. All participants underwent magnetic resonance imaging (1.5 T) between 2005 and 2015. Automatic segmentation of the hippocampus and 12 of its subregions was performed using the FreeSurfer software (version 6.0). A cognitive test battery was performed, and participants were followed up for the development of dementia until 2015. Associations of hippocampal subregion volumes with cognition and incident dementia were examined using linear and Cox regression models, respectively. All analyses were adjusted for age, sex, education, and total hippocampal volume. Mean age was 64.3 years (SD 10.6) with 56% women. Smaller volumes of the hippocampal fimbria, presubiculum and subiculum showed the strongest associations with poor performance on several cognitive domains, including executive function but not memory. During a mean follow-up of 5.5 years, 76 persons developed dementia. Smaller subiculum volume was associated with risk of dementia adjusted for total volume (hazard ratio per SD decrease in volume: 1.75, 95% confidence interval 1.35; 2.26). In a community-dwelling non-demented population, we describe patterns of association between hippocampal subregions with cognition and risk of dementia. Specifically, the subiculum was associated with both poorer cognition and higher risk of dementia. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  15. Hippocampal volume and memory performance in children with perinatal stroke.

    PubMed

    Gold, Jeffrey J; Trauner, Doris A

    2014-01-01

    Pediatric neurologists and neonatologists often are asked to predict cognitive outcome after perinatal brain injury (including likely memory and learning outcomes). However, relatively few data exist on how accurate predictions can be made. Furthermore, although the consequences of brain injury on hippocampal volume and memory performance have been studied extensively in adults, little work has been done in children. We measured the volume of the hippocampus in 27 children with perinatal stroke and 19 controls, and measured their performance on standardized verbal and non-verbal memory tests. We discovered the following: (1) As a group, children with perinatal stroke had smaller left and right hippocampi compared with control children. (2) Individually, children with perinatal stroke demonstrated 1 of 3 findings: no hippocampal loss, unilateral hippocampal loss, or bilateral hippocampal volume loss compared with control children. (3) Hippocampal volume inversely correlated with memory test performance in the perinatal stroke group, with smaller left and right hippocampal volumes related to poorer verbal and non-verbal memory test performance, respectively. (4) Seizures played a significant role in determining memory deficit and extent of hippocampal volume reduction in patients with perinatal stroke. These findings support the view that, in the developing brain, the left and right hippocampi preferentially support verbal and nonverbal memory respectively, a consistent finding in the adult literature but a subject of debate in the pediatric literature. This is the first work to report that children with focal brain injury incurred from perinatal stroke have volume reduction in the hippocampus and impairments in certain aspects of declarative memory. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Group differences in anterior hippocampal volume and in the retrieval of spatial and temporal context memory in healthy young versus older adults.

    PubMed

    Rajah, M Natasha; Kromas, Michelle; Han, Jung Eun; Pruessner, Jens C

    2010-12-01

    The ability to retrieve temporal and spatial context information from memory declines with healthy aging. The hippocampus (HC) has been shown to be associated with successful encoding and retrieval of spatio-temporal context, versus item recognition information (Davachi, Mitchell, & Wagner, 2003; Nadel, Samsonovich, Ryan, & Moscovitch, 2000; Ross & Slotnick, 2008). Aging has been linked to volume reduction in the HC (Bouchard, Malykhin, Martin, Hanstock, Emery, Fisher, & Camicioli, 2008; Malykhin, Bouchard, Camicioli, & Coupland, 2008; Raz et al., 2005). As such, age-associated reductions in anterior HC volume may contribute to the context memory deficits observed in older adults. In the current MRI study we investigated whether item recognition, spatial context and temporal context memory performance would be predicted by regional volumes in HC head (HH), body (HB) and tail (HT) volumes, using within group multiple regression analyses in a sample of 19 healthy young (mean age 24.3) and 20 older adults (mean age 67.7). We further examined between age-group differences in the volumes of the same HC sub-regions. Multiple regression analyses revealed that in younger adults both spatial and temporal context retrieval performance was predicted by anterior HC volume. Older age was associated with significant volume reductions in HH and HB, but not HT; and with reduced ability to retrieve spatial and temporal contextual details from episodic memory. However, HC volumes did not predict context retrieval performance in older adults. We conclude that individual differences in anterior, not posterior, HC volumes predict context memory performance in young adults. With age there may be a posterior-to-anterior shift from using HC-related processes, due to HC volume loss, to employing the prefrontal cortex to aid in the performance of cognitively demanding context memory tasks. However, due to concomitant changes in the prefrontal system with age, there are limits to compensation in the aging brain. Crown Copyright © 2010. Published by Elsevier Ltd. All rights reserved.

  17. Finite volume effects on the electric polarizability of neutral hadrons in lattice QCD

    NASA Astrophysics Data System (ADS)

    Lujan, M.; Alexandru, A.; Freeman, W.; Lee, F. X.

    2016-10-01

    We study the finite volume effects on the electric polarizability for the neutron, neutral pion, and neutral kaon using eight dynamically generated two-flavor nHYP-clover ensembles at two different pion masses: 306(1) and 227(2) MeV. An infinite volume extrapolation is performed for each hadron at both pion masses. For the neutral kaon, finite volume effects are relatively mild. The dependence on the quark mass is also mild, and a reliable chiral extrapolation can be performed along with the infinite volume extrapolation. Our result is αK0 phys=0.356 (74 )(46 )×10-4 fm3 . In contrast, for neutron, the electric polarizability depends strongly on the volume. After removing the finite volume corrections, our neutron polarizability results are in good agreement with chiral perturbation theory. For the connected part of the neutral pion polarizability, the negative trend persists, and it is not due to finite volume effects but likely sea quark charging effects.

  18. Performance enhancement of direct ethanol fuel cell using Nafion composites with high volume fraction of titania

    NASA Astrophysics Data System (ADS)

    Matos, B. R.; Isidoro, R. A.; Santiago, E. I.; Fonseca, F. C.

    2014-12-01

    The present study reports on the performance enhancement of direct ethanol fuel cell (DEFC) at 130 °C with Nafion-titania composite electrolytes prepared by sol-gel technique and containing high volume fractions of the ceramic phase. It is found that for high volume fractions of titania (>10 vol%) the ethanol uptake of composites is largely reduced while the proton conductivity at high-temperatures is weakly dependent on the titania content. Such tradeoff between alcohol uptake and conductivity resulted in a boost of DEFC performance at high temperatures using Nafion-titania composites with high fraction of the inorganic phase.

  19. Polymer gel dosimeters for pretreatment radiotherapy verification using the three-dimensional gamma evaluation and pass rate maps.

    PubMed

    Hsieh, Ling-Ling; Shieh, Jiunn-I; Wei, Li-Ju; Wang, Yi-Chun; Cheng, Kai-Yuan; Shih, Cheng-Ting

    2017-05-01

    Polymer gel dosimeters (PGDs) have been widely studied for use in the pretreatment verification of clinical radiation therapy. However, the readability of PGDs in three-dimensional (3D) dosimetry remain unclear. In this study, the pretreatment verifications of clinical radiation therapy were performed using an N-isopropyl-acrylamide (NIPAM) PGD, and the results were used to evaluate the performance of the NIPAM PGD on 3D dose measurement. A gel phantom was used to measure the dose distribution of a clinical case of intensity-modulated radiation therapy. Magnetic resonance imaging scans were performed for dose readouts. The measured dose volumes were compared with the planned dose volume. The relative volume histograms showed that relative volumes with a negative percent dose difference decreased as time elapsed. Furthermore, the histograms revealed few changes after 24h postirradiation. For the 3%/3mm and 2%/2mm criteria, the pass rates of the 12- and 24-h dose volumes were higher than 95%, respectively. This study thus concludes that the pass rate map can be used to evaluate the dose-temporal readability of PGDs and that the NIPAM PGD can be used for clinical pretreatment verifications. Copyright © 2017 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

  20. PRT Impact Study - Operational Phase : Volume 1. Travel Analysis.

    DOT National Transportation Integrated Search

    1979-03-01

    Part of a three-volume work, this report describes the analysis performed on travel data collected for the Pre-PRT Impact Study. The data analyzed consist of travel behavior, travel patterns, model utilization and travel costs of various modes of tra...

  1. PRT Impact Study Pre-PRT Phase : Volume 1. Travel Analysis.

    DOT National Transportation Integrated Search

    1976-03-01

    Part of a three-volume work, this report describes the analysis performed on travel data collected for the Pre-PRT Impact Study. The data analyzed consist of travel behavior, travel patterns, model utilization and travel costs of various modes of tra...

  2. Association of physical activity and physical performance with tibial cartilage volume and bone area in young adults.

    PubMed

    Antony, Benny; Venn, Alison; Cicuttini, Flavia; March, Lyn; Blizzard, Leigh; Dwyer, Terence; Cross, Marita; Jones, Graeme; Ding, Changhai

    2015-10-26

    Physical activity has been recommended to patients with knee osteoarthritis for improving their symptoms. However, it is still controversial if physical activity has effects on joint structures including cartilage volume. The aim of this study was to describe the associations between physical activity and performance measured 5 years prior and tibial cartilage volume and bone area in young adults. Subjects broadly representative of the Australian population (n = 328, aged 31-41 years, female 47.3 %) were selected from the Childhood Determinants of Adult Health study. They underwent T1-weighted fat-suppressed magnetic resonance imaging (MRI) scans of their knees. Tibial bone area and cartilage volume were measured from MRI. Physical activity (measured using long international physical activity questionnaire (IPAQ)) and performance measures (long jump, leg muscle strength, physical work capacity (PWC170)) were measured 5 years prior. In multivariable analyses, total physical activity (min/week) (β: 0.30 mm(3), 95 % CI: 0.13,0.47), vigorous (β: 0.54 mm(3), 95 % CI: 0.13,0.94), moderate (β: 0.34 mm(3), 95 % CI: 0.01,0.67), walking (β: 0.40 mm(3), 95 % CI: 0.07,0.72) and IPAQ category (β: 182.9 mm(3), 95 % CI: 51.8,314.0) were positively associated with total tibial cartilage volume but not tibial bone area. PWC170, long jump and leg muscle strength were positively and significantly associated with both total tibial cartilage volume and total tibial bone area; and the associations with tibial cartilage volume decreased in magnitude but remained significant for PWC170 and long jump after further adjustment for tibial bone area. While tibial bone area is affected only by physical performance, total tibial cartilage volume can be influenced by both physical activity and performance in younger adults. The clinical significance suggests a beneficial effect for cartilage but the bone area association was restricted to performance suggesting other factors rather than physical activity may be important.

  3. Statistical issues in the comparison of quantitative imaging biomarker algorithms using pulmonary nodule volume as an example.

    PubMed

    Obuchowski, Nancy A; Barnhart, Huiman X; Buckler, Andrew J; Pennello, Gene; Wang, Xiao-Feng; Kalpathy-Cramer, Jayashree; Kim, Hyun J Grace; Reeves, Anthony P

    2015-02-01

    Quantitative imaging biomarkers are being used increasingly in medicine to diagnose and monitor patients' disease. The computer algorithms that measure quantitative imaging biomarkers have different technical performance characteristics. In this paper we illustrate the appropriate statistical methods for assessing and comparing the bias, precision, and agreement of computer algorithms. We use data from three studies of pulmonary nodules. The first study is a small phantom study used to illustrate metrics for assessing repeatability. The second study is a large phantom study allowing assessment of four algorithms' bias and reproducibility for measuring tumor volume and the change in tumor volume. The third study is a small clinical study of patients whose tumors were measured on two occasions. This study allows a direct assessment of six algorithms' performance for measuring tumor change. With these three examples we compare and contrast study designs and performance metrics, and we illustrate the advantages and limitations of various common statistical methods for quantitative imaging biomarker studies. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  4. Bench performance of ventilators during simulated paediatric ventilation.

    PubMed

    Park, M A J; Freebairn, R C; Gomersall, C D

    2013-05-01

    This study compares the accuracy and capabilities of various ventilators using a paediatric acute respiratory distress syndrome lung model. Various compliance settings and respiratory rate settings were used. The study was done in three parts: tidal volume and FiO2 accuracy; pressure control accuracy and positive end-expiratory pressure (PEEP) accuracy. The parameters set on the ventilator were compared with either or both of the measured parameters by the test lung and the ventilator. The results revealed that none of the ventilators could consistently deliver tidal volumes within 1 ml/kg of the set tidal volume, and the discrepancy between the delivered volume and the volume measured by the ventilator varied greatly. The target tidal volume was 8 ml/kg, but delivered tidal volumes ranged from 3.6-11.4 ml/kg and the volumes measured by the ventilator ranged from 4.1-20.6 ml/kg. All the ventilators maintained pressure within 20% of the set pressure, except one ventilator which delivered pressures of up to 27% higher than the set pressure. Two ventilators maintained PEEP within 10% of the prescribed PEEP. The majority of the readings were also within 10%. However, three ventilators delivered, at times, PEEPs over 20% higher. In conclusion, as lung compliance decreases, especially in paediatric patients, some ventilators perform better than others. This study highlights situations where ventilators may not be able to deliver, nor adequately measure, set tidal volumes, pressure, PEEP or FiO2.

  5. BDNF polymorphism predicts the rate of decline in skilled task performance and hippocampal volume in healthy individuals

    PubMed Central

    Sanchez, M Millan; Das, D; Taylor, J L; Noda, A; Yesavage, J A; Salehi, A

    2011-01-01

    Numerous studies have indicated a link between the presence of polymorphism in brain-derived neurotrophic factor (BDNF) and cognitive and affective disorders. However, only a few have studied these effects longitudinally along with structural changes in the brain. This study was carried out to investigate whether valine-to-methionine substitution at position 66 (val66met) of pro-BDNF could be linked to alterations in the rate of decline in skilled task performance and structural changes in hippocampal volume. Participants consisted of 144 healthy Caucasian pilots (aged 40–69 years) who completed a minimum of 3 consecutive annual visits. Standardized flight simulator score (SFSS) was measured as a reliable and quantifiable indicator for skilled task performance. In addition, a subset of these individuals was assessed for hippocampal volume alterations using magnetic resonance imaging. We found that val66met substitution in BDNF correlated longitudinally with the rate of decline in SFSS. Structurally, age-dependent hippocampal volume changes were also significantly altered by this substitution. Our study suggests that val66met polymorphism in BDNF can be linked to the rate of decline in skilled task performance. Furthermore, this polymorphism could be used as a predictor of the effects of age on the structure of the hippocampus in healthy individuals. Such results have implications for understanding possible disabilities in older adults performing skilled tasks who are at a higher risk for cognitive and affective disorders. PMID:22833197

  6. A Quantitative Analysis of the Relationship between Medicare Payment and Service Volume for Glaucoma Procedures from 2005 through 2009.

    PubMed

    Gong, Dan; Jun, Lin; Tsai, James C

    2015-05-01

    To calculate the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures. Retrospective, longitudinal database study. A 100% dataset of all glaucoma procedures performed on Medicare Part B beneficiaries within the United States from 2005 to 2009. Fixed-effects regression model using Medicare Part B carrier data for all 50 states and the District of Columbia, controlling for time-invariant carrier-specific characteristics, national trends in glaucoma service volume, Medicare beneficiary population, number of ophthalmologists, and income per capita. Payment-volume elasticities, defined as the percent change in service volume per 1% change in Medicare payment, for laser trabeculoplasty (Current Procedural Terminology [CPT] code 65855), trabeculectomy without previous surgery (CPT code 66170), trabeculectomy with previous surgery (CPT code 66172), aqueous shunt to reservoir (CPT code 66180), laser iridotomy (CPT code 66761), and scleral reinforcement with graft (CPT code 67255). The payment-volume elasticity was nonsignificant for 4 of 6 procedures studied: laser trabeculoplasty (elasticity, -0.27; 95% confidence interval [CI], -1.31 to 0.77; P = 0.61), trabeculectomy without previous surgery (elasticity, -0.42; 95% CI, -0.85 to 0.01; P = 0.053), trabeculectomy with previous surgery (elasticity, -0.28; 95% CI, -0.83 to 0.28; P = 0.32), and aqueous shunt to reservoir (elasticity, -0.47; 95% CI, -3.32 to 2.37; P = 0.74). Two procedures yielded significant associations between Medicare payment and service volume. For laser iridotomy, the payment-volume elasticity was -1.06 (95% CI, -1.39 to -0.72; P < 0.001): for every 1% decrease in CPT code 66761 payment, laser iridotomy service volume increased by 1.06%. For scleral reinforcement with graft, the payment-volume elasticity was -2.92 (95% CI, -5.72 to -0.12; P = 0.041): for every 1% decrease in CPT code 67255 payment, scleral reinforcement with graft service volume increased by 2.92%. This study calculated the association between Medicare payment and service volume for 6 commonly performed glaucoma procedures and found varying magnitudes of payment-volume elasticities, suggesting that the volume response to changes in Medicare payments, if present, is not uniform across all Medicare procedures. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  7. Provider volume and other predictors of outcome after total knee arthroplasty: a population study in Ontario.

    PubMed

    Kreder, Hans J; Grosso, Paul; Williams, Jack I; Jaglal, Susan; Axcell, Tami; Wal, Eugene K; Stephen, David J G

    2003-02-01

    Because of rationing of the limited pool of health care resources, access to total knee arthroplasty (TKA) is limited, but investigation of variables that predict complications, length of hospital stay, cost and outcomes of TKA may allow us to optimize the available resources. The objective of this study was to examine the effect of various factors on complication rates after TKA in patients managed in Ontario. Patients who had undergone an elective TKA between 1993 and 1996, as captured in the Canadian Institute for Health Information (CIHI) database, formed the study cohort. The CIHI dataset was used to obtain information regarding in-hospital complications, hospital length of stay, revision rates, infection rates and mortality. Generalized estimating linear or logistic regression equations were used to model outcomes as a function of age, gender, comorbidity, diagnosis and provider volume. During the study period, 14,352 patients in Ontario underwent TKA. Mortality at 3 months was associated with patient age, gender and comorbidity. There was no association between provider volume and mortality or the infection rate. Higher revision rates at 1 and 3 years were significantly associated with lower patient age and low hospital volume (p < 0.05). Hospitals in which fewer than 48 TKA procedures were done per year (< 40th percentile) had 2.2-fold greater 1-year revision rates than hospitals performing more than 113 TKAs annually (> 80th percentile). Complications during admission were associated with increased patient age and comorbidity, and higher hospital volume. Longer hospital stay was associated with female gender, increasing patient comorbidity and age, and lower provider volume. Surgeons who performed fewer than 14 TKAs annually (< 40th percentile) kept patients in hospital an average of 1.4 days longer than surgeons performing more than 42 TKAs annually (> 80th percentile). Patient variables significantly affect the rate of complications. Age, sex and comorbidity were significant predictors of complications, length of hospital stay and mortality after TKA. Although low surgeon volume was related to longer hospital stay, there was no association between surgeon volume and complication rates. The increased early revision rate for low-volume hospitals demands further study.

  8. A study of emissions from passenger cars in six cities. Volume B. Final report

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

    Not Available

    1979-01-01

    This is the second of two volumes presenting results from a series of exhaust emission and fuel economy tests performed on a representative sample of vehicles in six U.S. cities. Data presented in the following sections are generated in appendix form as part of a contract with the EPA to perform work for the FY 77 Passenger Car Emission Factor Program. Volume B includes the balance of individual vehicle data derived from the Two Speed Idle and Federal Three Mode tests. It also includes the results of Vehicle Driveability Evaluations, Maladjustment and Disablement Inspections, tire inspections and a listing ofmore » comparative mileage data. Information presented in Volume B should not be interpreted without the benefit of additional descriptive data presented in Volume A as both volumes comprise the results of a single work effort and are not intended to be considered separately.« less

  9. Patella resurfacing during total knee arthroplasty: have we got the issue covered?

    PubMed

    Sandiford, Nemandra A; Alao, Uthman; Salamut, Wazirl; Weitzel, Stefan; Skinner, J A

    2014-12-01

    Management of the patella during total knee arthroplasty (TKA) is controversial. Multiple studies have examined mechanical and clinical results of TKA with native and resurfaced patellae with no clear consensus. We surveyed a large cohort of consultant surgeons in a questionnaire based study in order to assess the indications for patella resurfacing and to correlate practice with degree of specialization, experience and volume of procedures performed. Six hundred and nineteen surgeons were included. The main indication for patella resurfacing was patellofemoral arthritis. The ratio of those who always:sometimes:never resurfaced was 1:2:1 irrespective of experience or volume performed. There was no difference between knee specialists and non-specialists (p = 0.977) or between high and lower volume surgeons (p = 0.826). Senior and high volume surgeons tended to always resurface. The majority of surgeons only sometimes resurfaced the patella. The number who always and never resurfaced were similar. There was a tendency for more experienced and high volume surgeons to always resurface.

  10. Patella Resurfacing during Total Knee Arthroplasty: Have We Got the Issue Covered?

    PubMed Central

    Alao, Uthman; Salamut, Wazirl; Weitzel, Stefan; Skinner, J.A.

    2014-01-01

    Background Management of the patella during total knee arthroplasty (TKA) is controversial. Multiple studies have examined mechanical and clinical results of TKA with native and resurfaced patellae with no clear consensus. Methods We surveyed a large cohort of consultant surgeons in a questionnaire based study in order to assess the indications for patella resurfacing and to correlate practice with degree of specialization, experience and volume of procedures performed. Results Six hundred and nineteen surgeons were included. The main indication for patella resurfacing was patellofemoral arthritis. The ratio of those who always:sometimes:never resurfaced was 1:2:1 irrespective of experience or volume performed. There was no difference between knee specialists and non-specialists (p = 0.977) or between high and lower volume surgeons (p = 0.826). Senior and high volume surgeons tended to always resurface. Conclusions The majority of surgeons only sometimes resurfaced the patella. The number who always and never resurfaced were similar. There was a tendency for more experienced and high volume surgeons to always resurface. PMID:25436059

  11. Mesial Temporal Lobe and Memory Function in Autism Spectrum Disorder: An Exploration of Volumetric Findings

    PubMed Central

    Trontel, Haley G.; Duffield, Tyler C.; Bigler, Erin D.; Abildskov, Tracy J.; Froehlich, Alyson; Prigge, Molly B.D.; Travers, Brittany G.; Anderson, Jeffrey S.; Zielinski, Brandon A.; Alexander, Andrew; Lange, Nicholas; Lainhart, Janet E.

    2015-01-01

    Studies have shown that individuals with autism spectrum disorder (ASD) tend to perform significantly below typical developing individuals on standardized measures of memory, even when not significantly different on measures of IQ. The current study sought to examine within ASD whether anatomical correlates of memory performance differed between those with average-to-above-average IQ (AIQ Group) compared to those with low average to borderline ability (LIQ group) as well as in relations to typically-developing comparisons (TDC). Using automated volumetric analyses, we examined regional volume of classic memory areas including the hippocampus, parahippocampal gyrus, entorhinal cortex, and amygdala in an all-male sample AIQ (n = 38) and LIQ (n = 18) individuals with ASD along with 30 typically-developing comparisons (TDC). Memory performance was assessed using the Test of Memory and Learning (TOMAL) compared among the groups and then correlated with regional brain volumes. Analyses revealed group differences on almost all facets of memory and learning as assessed by the various subtests of the TOMAL. The three groups did not differ on any ROI memory-related brain volumes. However, significant size-memory function interactions were observed. Negative correlations were found between the volume of the amygdala and composite, verbal, and delayed memory indices for the LIQ ASD group indicating larger volume related to poorer performance. Implications for general memory functioning and dysfunctional neural connectivity in ASD are discussed. PMID:25749302

  12. A cross-sectional study of hormone treatment and hippocampal volume in postmenopausal women: Evidence for a limited window of opportunity

    PubMed Central

    Erickson, Kirk I.; Voss, Michelle W.; Prakash, Ruchika S.; Chaddock, Laura; Kramer, Arthur F.

    2010-01-01

    The influence of hormone treatment on brain and cognition in postmenopausal women has been a controversial topic. Contradictory patterns of results have prompted speculation that a critical period, or a limited window of opportunity, exists for hormone treatment to protect against cognitive and neural decline in older women. Consistent with this hypothesis, studies in both humans and rodents indicate that the latency between the time of menopause and the initiation of hormone treatment is an important factor in determining whether hormone treatment will prevent or exacerbate cognitive impairment. In this cross-sectional study of 102 postmenopausal women, we examined whether hippocampal, amygdala, or caudate nucleus volumes and spatial memory performance were related to the interval between menopause and the initiation of hormone treatment. Consistent with a critical period hypothesis, we found that shorter intervals between menopause and the initiation of hormone treatment, as determined by self-report, were associated with larger hippocampal volumes compared with longer intervals between menopause and treatment initiation. Initiation of hormone treatment at the time of menopause was also associated with larger hippocampal volumes when compared to peers who had never used hormone treatment. Furthermore, these effects were independent from potentially confounding factors such as age, years of education, the duration of hormone treatment, current or past use of hormone therapy, the type of therapy, and the age at menopause. Larger hippocampal volumes in women who initiated hormone treatment at the time of menopause failed to translate to improved spatial memory performance. There was no relationship between the timing of hormone initiation, spatial memory performance, and amygdala or caudate nucleus volume. Our results provide support for the idea that there is a limited window of opportunity at the time of menopause for hormone treatment to influence hippocampal volume, yet the degree to which these effects translate to improved memory performance is uncertain. PMID:20063947

  13. The combination of ovarian volume and outline has better diagnostic accuracy than prostate-specific antigen (PSA) concentrations in women with polycystic ovarian syndrome (PCOs).

    PubMed

    Bili, Eleni; Bili, Authors Eleni; Dampala, Kaliopi; Iakovou, Ioannis; Tsolakidis, Dimitrios; Giannakou, Anastasia; Tarlatzis, Basil C

    2014-08-01

    The aim of this study was to determine the performance of prostate specific antigen (PSA) and ultrasound parameters, such as ovarian volume and outline, in the diagnosis of polycystic ovary syndrome (PCOS). This prospective, observational, case-controlled study included 43 women with PCOS, and 40 controls. Between day 3 and 5 of the menstrual cycle, fasting serum samples were collected and transvaginal ultrasound was performed. The diagnostic performance of each parameter [total PSA (tPSA), total-to-free PSA ratio (tPSA:fPSA), ovarian volume, ovarian outline] was estimated by means of receiver operating characteristic (ROC) analysis, along with area under the curve (AUC), threshold, sensitivity, specificity as well as positive (+) and negative (-) likelihood ratios (LRs). Multivariate logistical regression models, using ovarian volume and ovarian outline, were constructed. The tPSA and tPSA:fPSA ratio resulted in AUC of 0.74 and 0.70, respectively, with moderate specificity/sensitivity and insufficient LR+/- values. In the multivariate logistic regression model, the combination of ovarian volume and outline had a sensitivity of 97.7% and a specificity of 97.5% in the diagnosis of PCOS, with +LR and -LR values of 39.1 and 0.02, respectively. In women with PCOS, tPSA and tPSA:fPSA ratio have similar diagnostic performance. The use of a multivariate logistic regression model, incorporating ovarian volume and outline, offers very good diagnostic accuracy in distinguishing women with PCOS patients from controls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  14. Patterns of Lung Volume Use during an Extemporaneous Speech Task in Persons with Parkinson Disease

    ERIC Educational Resources Information Center

    Bunton, K.

    2005-01-01

    This study examined patterns of lung volume use in speakers with Parkinson disease (PD) during an extemporaneous speaking task. The performance of a control group was also examined. Behaviors described are based on acoustic, kinematic and linguistic measures. Group differences were found in breath group duration, lung volume initiation, and lung…

  15. Older age relates to worsening of fine motor skills: a population-based study of middle-aged and elderly persons.

    PubMed

    Hoogendam, Yoo Young; van der Lijn, Fedde; Vernooij, Meike W; Hofman, Albert; Niessen, Wiro J; van der Lugt, Aad; Ikram, M Arfan; van der Geest, Jos N

    2014-01-01

    In a population-based study of 1,912 community-dwelling persons of 45 years and older, we investigated the relation between age and fine motor skills using the Archimedes spiral-drawing test. Also, we studied the effect of brain volume on fine motor skills. Participants were required to trace a template of a spiral on an electronic drawing board. Clinical scores from this test were obtained by visual assessment of the drawings. Quantitative measures were objectively determined from the recorded data of the drawings. As tremor is known to occur increasingly with advancing age, we also rated drawings to assess presence of tremor. We found presence of a tremor in 1.3% of the drawings. In the group without tremor, we found that older age was related to worse fine motor skills. Additionally, participants over the age of 75 showed increasing deviations from the template when drawing the spiral. Larger cerebral volume and smaller white matter lesion volume were related to better spiral-drawing performance, whereas cerebellar volume was not related to spiral-drawing performance. Older age is related to worse fine motor skills, which can be captured by clinical scoring or quantitative measures of the Archimedes spiral-drawing test. Persons with a tremor performed worse on almost all measures of the spiral-drawing test. Furthermore, larger cerebral volume is related to better fine motor skills.

  16. Conjunction Assessment Screening Volume Sizing and Event Filtering in Light of Natural Conjunction Event Development Behaviors

    NASA Technical Reports Server (NTRS)

    Hejduk, M. D.; Pachura, D. A.

    2017-01-01

    Conjunction Assessment screening volumes used in the protection of NASA satellites are constructed as geometric volumes about these satellites, of a size expected to capture a certain percentage of the serious conjunction events by a certain time before closest approach. However, the analyses that established these sizes were grounded on covariance-based projections rather than empirical screening results, did not tailor the volume sizes to ensure operational actionability of those results, and did not consider the adjunct ability to produce data that could provide prevenient assistance for maneuver planning. The present study effort seeks to reconsider these questions based on a six-month dataset of empirical screening results using an extremely large screening volume. The results, pursued here for a highly-populated orbit regime near 700 km altitude, identify theoretical limits of screening volume performance, explore volume configuration to facilitate both maneuver remediation planning as well as basic asset protection, and recommend sizing principles that maximize volume performance while minimizing the capture of "chaff" conjunctions that are unlikely ever to become serious events.

  17. Feasibility of Reducing the Fiber Content in Ultra-High-Performance Fiber-Reinforced Concrete under Flexure.

    PubMed

    Park, Jung-Jun; Yoo, Doo-Yeol; Park, Gi-Joon; Kim, Sung-Wook

    2017-01-28

    In this study, the flexural behavior of ultra-high-performance fiber-reinforced concrete (UHPFRC) is examined as a function of fiber length and volume fraction. Straight steel fiber with three different lengths ( l f ) of 13, 19.5, and 30 mm and four different volume fractions ( v f ) of 0.5%, 1.0%, 1.5%, and 2.0% are considered. Test results show that post-cracking flexural properties of UHPFRC, such as flexural strength, deflection capacity, toughness, and cracking behavior, improve with increasing fiber length and volume fraction, while first-cracking properties are not significantly influenced by fiber length and volume fraction. A 0.5 vol % reduction of steel fiber content relative to commercial UHPFRC can be achieved without deterioration of flexural performance by replacing short fibers ( l f of 13 mm) with longer fibers ( l f of 19.5 mm and 30 mm).

  18. Feasibility of Reducing the Fiber Content in Ultra-High-Performance Fiber-Reinforced Concrete under Flexure

    PubMed Central

    Park, Jung-Jun; Yoo, Doo-Yeol; Park, Gi-Joon; Kim, Sung-Wook

    2017-01-01

    In this study, the flexural behavior of ultra-high-performance fiber-reinforced concrete (UHPFRC) is examined as a function of fiber length and volume fraction. Straight steel fiber with three different lengths (lf) of 13, 19.5, and 30 mm and four different volume fractions (vf) of 0.5%, 1.0%, 1.5%, and 2.0% are considered. Test results show that post-cracking flexural properties of UHPFRC, such as flexural strength, deflection capacity, toughness, and cracking behavior, improve with increasing fiber length and volume fraction, while first-cracking properties are not significantly influenced by fiber length and volume fraction. A 0.5 vol % reduction of steel fiber content relative to commercial UHPFRC can be achieved without deterioration of flexural performance by replacing short fibers (lf of 13 mm) with longer fibers (lf of 19.5 mm and 30 mm). PMID:28772477

  19. Breath-stacking and incentive spirometry in Parkinson's disease: Randomized crossover clinical trial.

    PubMed

    Ribeiro, Rhayssa; Brandão, Daniella; Noronha, Jéssica; Lima, Cibelle; Fregonezi, Guilherme; Resqueti, Vanessa; Dornelas de Andrade, Arméle

    2018-05-01

    Patients with Parkinson's disease often exhibit respiratory disorders and there are no Respiratory Therapy protocols which are suggested as interventions in Parkinson's patients. The aim of this study is to evaluate the effects of Breathing-Stacking (BS) and incentive spirometer (IS) techniques in volume variations of the chest wall in patients with Parkinson's Disease (PD). 14 patients with mild-moderate PD were included in this randomized cross-over study. Volume variations of the chest wall were assessed before, immediately after, then 15 and 30 min after BS and IS performance by optoelectronic plethysmography. Tidal volume (VT) and minute ventilation (MV) significantly increased after BS and IS techniques (p < 0.05). There was greater involvement of pulmonary and abdominal compartments after IS. The results suggest that these re-expansion techniques can be performed to immediately improve volume. Copyright © 2018 Elsevier B.V. All rights reserved.

  20. Investigation of Rotating Stall Phenomena in Axial Flow Compressors. Volume I. Basic Studies of Rotating Stall

    DTIC Science & Technology

    1976-06-01

    rotating stall control system which was tested both on a low speed rig and a J-85-S engine. The second objective was to perform fundamental studies of the...Stator Stage 89 6 Annular Cascade Configuration Used for Rotating Stall Studies on Rotoi-Stator Stage ..... .............. ... 90 7 Static Pressure Rise...ground tests on a J-8S-S turbojet engine. The work i3 reported in three separate volumes. Volume I entitled, "Basic Studies of Rotating Stall", covers

  1. Study of Abrasive Wear Volume Map for PTFE and PTFE Composites

    NASA Astrophysics Data System (ADS)

    Unal, H.; Sen, U.; Mimaroglu, A.

    2007-11-01

    The potential of this work is based on consideration of wear volume map for the evaluation of abrasive wear performance of polytetrafluoroethylene (PTFE) and PTFE composites. The fillers used in the composite are 25% bronze, 35% graphite and 17% glass fibre glass (GFR). The influence of filler materials, abrasion surface roughness and applied load values on abrasive wear performance of PTFE and PTFE composites were studied and evaluated. Experimental abrasive wear tests were carried out at atmospheric condition on pin-on-disc wear tribometer. Tests were performed under 4, 6, 8 and 10 N load values, travelling speed of 1 m/sec and abrasion surface roughness values of 5, 20 and 45 µm. Wear volume maps were obtained and the results showed that the lowest wear volume rate for PTFE is reached using GFR filler. Furthermore, the results also showed that the higher is the applied load and the roughness of the abrasion surface, the higher is the wear rate. Finally it is also concluded that abrasive wear process mechanism include ploughing and cutting mechanisms.

  2. Amateur endurance triathletes' performance is improved independently of volume or intensity based training.

    PubMed

    Clemente-Suárez, Vicente Javier; Delgado-Moreno, Rosa; González, Beatriz; Ortega, Javier; Ramos-Campo, Domingo Jesús

    2018-04-12

    The aim of the present research was to compare the effects in swimming and running performance, horizontal jump test, autonomic modulation, and body composition of four training weeks with emphasis on volume versus intensity in moderate trained triathletes. Thirty-two amateur triathletes (20 males and 12 females) were randomly divided in three different groups that performed 6 training session per week: Intensity (INT): training focused on performs intensity training Volume (VOL): training focused on performs volume training; and Control (CON): physical active group with no periodized training. Body composition, heart rate variability, horizontal jump test, swimming and 2000 m running test were tested before and after the training period. There were no significant differences between INT and VOL in running test. Furthermore, both INT and VOL training groups improved 50 m (p: 0.046 and 0.042 respectively) and 400 m (p: 0.044 and 0.041 respectively) swimming performance. Moreover, there were no significant differences among groups in any moment in HRV variables. No significant difference was observed for horizontal jump test and body composition between the INT and VOL group at any time. According to the results of the present study, four weeks of training with either high intensity or volume results to similar adaptations in endurance, horizontal jump test and body composition parameters in amateur triathletes. Copyright © 2018. Published by Elsevier Inc.

  3. Colorectal Surgery Fellowship Improves In-hospital Mortality After Colectomy and Proctectomy Irrespective of Hospital and Surgeon Volume.

    PubMed

    Saraidaridis, Julia T; Hashimoto, Daniel A; Chang, David C; Bordeianou, Liliana G; Kunitake, Hiroko

    2018-03-01

    General surgery residents are increasingly pursuing sub-specialty training in colorectal (CR) surgery. However, the majority of operations performed by CR surgeons are also performed by general surgeons. This study aimed to assess in-hospital mortality stratified by CR training status after adjusting for surgeon and hospital volume. The Statewide Planning and Research Cooperative system database was used to identify all patients who underwent colectomy/proctectomy from January 1, 2000, to December 31, 2014, in the state of New York. Operations performed by board-certified CR surgeons were identified. The relationships between CR board certification and in-hospital mortality, in-hospital complications, length of stay, and ostomy were assessed using multivariate regression models. Two hundred seventy thousand six hundred eighty-four patients underwent colectomy/proctectomy over the study period. Seventy-two thousand two hundred seventy-nine (26.7%) of operations were performed by CR surgeons. Without adjusting for hospital and surgeon volume, in-hospital mortality was lower for those undergoing colectomy/proctectomy by a CR surgeon (OR 0.49, CI 0.44-0.54, p = 0.001). After controlling for hospital and surgeon volume, the odds of inpatient mortality after colectomy/proctectomy for those operated on by CR surgeons weakened to 0.76 (CI 0.68-0.86, p = 0.001). Hospital and surgeon volume accounted for 53% of the reduction in in-hospital mortality when CR surgeons performed colectomy/proctectomy. Patients who underwent surgery by a CR surgeon had a shorter inpatient stay (0.8 days, p = 0.001) and a decreased chance of colostomy (OR 0.86, CI 0.78-0.95, p < 0.001). For patients undergoing colectomy/proctectomy, in-hospital mortality decreased when the operation was performed by a CR surgeon even after accounting for hospital and surgeon volume.

  4. Neuroimaging correlates of parent ratings of working memory in typically developing children

    PubMed Central

    Mahone, E. Mark; Martin, Rebecca; Kates, Wendy R.; Hay, Trisha; Horská, Alena

    2009-01-01

    The purpose of the present study was to investigate construct validity of parent ratings of working memory in children, using a multi-trait/multi-method design including neuroimaging, rating scales, and performance-based measures. Thirty-five typically developing children completed performance-based tests of working memory and nonexecutive function (EF) skills, received volumetric MRI, and were rated by parents on both EF-specific and broad behavior rating scales. After controlling for total cerebral volume and age, parent ratings of working memory were significantly correlated with frontal gray, but not temporal, parietal, or occipital gray, or any lobar white matter volumes. Performance-based measures of working memory were also moderately correlated with frontal lobe gray matter volume; however, non-EF parent ratings and non-EF performance-based measures were not correlated with frontal lobe volumes. Results provide preliminary support for the convergent and discriminant validity of parent ratings of working memory, and emphasize their utility in exploring brain–behavior relationships in children. Rating scales that directly examine EF skills may potentially have ecological validity, not only for “everyday” function, but also as correlates of brain volume. PMID:19128526

  5. A semi-automatic method for left ventricle volume estimate: an in vivo validation study

    NASA Technical Reports Server (NTRS)

    Corsi, C.; Lamberti, C.; Sarti, A.; Saracino, G.; Shiota, T.; Thomas, J. D.

    2001-01-01

    This study aims to the validation of the left ventricular (LV) volume estimates obtained by processing volumetric data utilizing a segmentation model based on level set technique. The validation has been performed by comparing real-time volumetric echo data (RT3DE) and magnetic resonance (MRI) data. A validation protocol has been defined. The validation protocol was applied to twenty-four estimates (range 61-467 ml) obtained from normal and pathologic subjects, which underwent both RT3DE and MRI. A statistical analysis was performed on each estimate and on clinical parameters as stroke volume (SV) and ejection fraction (EF). Assuming MRI estimates (x) as a reference, an excellent correlation was found with volume measured by utilizing the segmentation procedure (y) (y=0.89x + 13.78, r=0.98). The mean error on SV was 8 ml and the mean error on EF was 2%. This study demonstrated that the segmentation technique is reliably applicable on human hearts in clinical practice.

  6. An Investigation into the Performance, Solution Strategies and Difficulties in Middle School Students' Calculation of the Volume of a Rectangular Prism

    ERIC Educational Resources Information Center

    Tekin-Sitrava, Reyhan; Isiksal-Bostan, Mine

    2014-01-01

    This qualitative study examined middle school students' performance, solution strategies, difficulties and the underlying reasons for their difficulties in calculating the volume of a rectangular prism. The data was collected from 35 middle school students (6th, 7th and 8th grade students) enrolled in a private school in Istanbul, Turkey. The data…

  7. Specialization and utilization after hepatectomy in academic medical centers.

    PubMed

    Shaw, Joshua J; Santry, Heena P; Shah, Shimul A

    2013-11-01

    Specialized procedures such as hepatectomy are performed by a variety of specialties in surgery. We aimed to determine whether variation exists among utilization of resources, cost, and patient outcomes by specialty, surgeon case volume, and center case volume for hepatectomy. We queried centers (n = 50) in the University Health Consortium database from 2007-2010 for patients who underwent elective hepatectomy in which specialty was designated general surgeon (n = 2685; 30%) or specialist surgeon (n = 6277; 70%), surgeon volume was designated high volume (>38 cases annually) and center volume was designated high volume (>100 cases annually). We then stratified our cohort by primary diagnosis, defined as primary tumor (n = 2241; 25%), secondary tumor (n = 5466; 61%), and benign (n = 1255; 14%). Specialist surgeons performed more cases for primary malignancy (primary 26% versus 15%) while general surgeons operated more for secondary malignancies (67% versus 61%) and benign disease (18% versus 13%). Specialists were associated with a shorter total length of stay (LOS) (5 d versus 6 d; P < 0.01) and lower in-hospital morbidity (7% versus 11%; P < 0.01). Patients treated by high volume surgeons or at high volume centers were less likely to die than those treated by low volume surgeons or at low volume centers, (OR 0.55; 95% CI 0.33-0.89) and (OR 0.44; 95% CI 0.13-0.56). Surgical specialization, surgeon volume and center volume may be important metrics for quality and utilization in complex procedures like hepatectomy. Further studies are necessary to link direct factors related to hospital performance in the changing healthcare environment. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Influence of face mask design on bag-valve-mask ventilation performance: a randomized simulation study.

    PubMed

    Na, J U; Han, S K; Choi, P C; Cho, J H; Shin, D H

    2013-10-01

    Different face mask designs can influence bag-valve-mask (BVM) ventilation performance during resuscitation. We compared a single-use, air-cushioned face mask (AM) with a reusable silicone face mask (SM) for quality of BVM ventilation on a manikin simulating cardiac arrest. Thirty-two physicians were recruited, and a prospective, randomized, crossover observational study was conducted after an American Heart Association-accredited basic life support provider course and standardized practice time were completed. Participants performed 12 cycles of BVM ventilation with both the AM and SM on a SmartMan lung simulator. Mean tidal volume was significantly higher in ventilations performed using the AM vs. the SM (548 ± 159 ml vs. 439 ± 163 ml, P < 0.01). In addition, the proportion of low-volume ventilation was significantly lower with the AM than the SM [6/12 (2-11) vs. 9/12 (5-12), P = 0.03]. Bag-valve-AM ventilation volume was not affected by the physical characteristics of the rescuers, except for sex. In contrast, bag-valve-SM ventilation volume was affected by most of the characteristics tested, including sex, height, weight, hand width, hand length, and grip power. The AM seems to be a more efficient face mask than the SM at delivering sufficient ventilation volumes. The performance of the AM did not seem to be associated with the physical characteristics of the rescuers, whereas that of the SM was affected by these factors. The SM may not be an appropriate face mask for performing one-person BVM ventilation during resuscitation for rescuers who are smaller in stature, have a smaller hand size, or have weaker grip power. © 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. Grey-matter volume as a potential feature for the classification of Alzheimer's disease and mild cognitive impairment: an exploratory study.

    PubMed

    Guo, Yane; Zhang, Zengqiang; Zhou, Bo; Wang, Pan; Yao, Hongxiang; Yuan, Minshao; An, Ningyu; Dai, Haitao; Wang, Luning; Zhang, Xi; Liu, Yong

    2014-06-01

    Specific patterns of brain atrophy may be helpful in the diagnosis of Alzheimer's disease (AD). In the present study, we set out to evaluate the utility of grey-matter volume in the classification of AD and amnestic mild cognitive impairment (aMCI) compared to normal control (NC) individuals. Voxel-based morphometric analyses were performed on structural MRIs from 35 AD patients, 27 aMCI patients, and 27 NC participants. A two-sample two-tailed t-test was computed between the NC and AD groups to create a map of abnormal grey matter in AD. The brain areas with significant differences were extracted as regions of interest (ROIs), and the grey-matter volumes in the ROIs of the aMCI patients were included to evaluate the patterns of change across different disease severities. Next, correlation analyses between the grey-matter volumes in the ROIs and all clinical variables were performed in aMCI and AD patients to determine whether they varied with disease progression. The results revealed significantly decreased grey matter in the bilateral hippocampus/parahippocampus, the bilateral superior/middle temporal gyri, and the right precuneus in AD patients. The grey-matter volumes were positively correlated with clinical variables. Finally, we performed exploratory linear discriminative analyses to assess the classifying capacity of grey-matter volumes in the bilateral hippocampus and parahippocampus among AD, aMCI, and NC. Leave-one-out cross-validation analyses demonstrated that grey-matter volumes in hippocampus and parahippocampus accurately distinguished AD from NC. These findings indicate that grey-matter volumes are useful in the classification of AD.

  10. Accurate assessment of breast volume: a study comparing the volumetric gold standard (direct water displacement measurement of mastectomy specimen) with a 3D laser scanning technique.

    PubMed

    Yip, Jia Miin; Mouratova, Naila; Jeffery, Rebecca M; Veitch, Daisy E; Woodman, Richard J; Dean, Nicola R

    2012-02-01

    Preoperative assessment of breast volume could contribute significantly to the planning of breast-related procedures. The availability of 3D scanning technology provides us with an innovative method for doing this. We performed this study to compare measurements by this technology with breast volume measurement by water displacement. A total of 30 patients undergoing 39 mastectomies were recruited from our center. The volume of each patient's breast(s) was determined with a preoperative 3D laser scan. The volume of the mastectomy specimen was then measured in the operating theater by water displacement. There was a strong linear association between breast volumes measured using the 2 different methods when using a Pearson correlation (r = 0.95, P < 0.001). The mastectomy mean volume was defined by the equation: mastectomy mean volume = (scan mean volume × 1.03) -70.6. This close correlation validates the Cyberware WBX Scanner as a tool for assessment of breast volume.

  11. A decade of changes in brain volume and cognition.

    PubMed

    Aljondi, Rowa; Szoeke, Cassandra; Steward, Chris; Yates, Paul; Desmond, Patricia

    2018-05-09

    Brain atrophy can occur several decades prior to onset of cognitive impairments. However, few longitudinal studies have examined the relationship between brain volume changes and cognition over a long follow-up period in healthy elderly women. In the present study we investigate the relationship between whole brain and hippocampal atrophy rates and longitudinal changes in cognition, including verbal episodic memory and executive function, in older women. We also examine whether baseline brain volume predicts subsequent changes in cognitive performance over a 10-year period. A total of 60 individuals from the population-based Women's Healthy Ageing Project with a mean age at baseline of 59 years underwent 3T MRI. Of these, 40 women completed follow-up cognitive assessments, 23 of whom had follow-up MRI scans. Linear regression analysis was used to examine the relationship between brain atrophy and changes in verbal episodic memory and executive function over a 10-year period. The results show that baseline measurements of frontal and temporal grey matter volumes predict changes in verbal episodic memory performance, whereas hippocampal volume at baseline is associated with changes in executive function performance over a 10-year period of follow-ups. In addition, higher whole brain and hippocampal atrophy rates are correlated with a decline in verbal episodic memory. These findings indicate that in addition to atrophy rate, smaller regional grey matter volumes even 10 years prior is associated with increased rates of cognitive decline. This study suggests useful neuroimaging biomarkers for the prediction of cognitive decline in healthy elderly women.

  12. Volume vs. intensity in the training of competitive swimmers.

    PubMed

    Faude, O; Meyer, T; Scharhag, J; Weins, F; Urhausen, A; Kindermann, W

    2008-11-01

    The present study aimed at comparing a high-volume, low-intensity vs. low-volume, high-intensity swim training. In a randomized cross-over design, 10 competitive swimmers performed two different 4-week training periods, each followed by an identical taper week. One training period was characterized by a high-training volume (HVT) whereas high-intensity training was prevalent during the other program (HIT). Before, after two and four weeks and after the taper week subjects performed psychometric and performance testing: profile of mood states (POMS), incremental swimming test (determination of individual anaerobic threshold, IAT), 100 m and 400 m. A small significant increase in IAT was observed after taper periods compared to pre-training (+ 0.01 m/s; p = 0.01). Maximal 100-m and 400-m times were not significantly affected by training. The POMS subscore of "vigor" decreased slightly after both training periods (p = 0.06). None of the investigated parameters showed a significant interaction between test-time and training type (p > 0.13). Nearly all (83 %) subjects swam personal best times during the 3 months after each training cycle. It is concluded that, for a period of 4 weeks, high-training volumes have no advantage compared to high-intensity training of lower volume.

  13. Three-Dimensional Topographic Surface Changes in Response to Compartmental Volumization of the Medial Cheek: Defining a Malar Augmentation Zone.

    PubMed

    Stern, Carrie S; Schreiber, Jillian E; Surek, Chris C; Garfein, Evan S; Jelks, Elizabeth B; Jelks, Glenn W; Tepper, Oren M

    2016-05-01

    Given the widespread use of facial fillers and recent identification of distinct facial fat compartments, a better understanding of three-dimensional surface changes in response to volume augmentation is needed. Advances in three-dimensional imaging technology now afford an opportunity to elucidate these morphologic changes for the first time. A cadaver study was undertaken in which volumization of the deep medial cheek compartment was performed at intervals up to 4 cc (n = 4). Three-dimensional photographs were taken after each injection to analyze the topographic surface changes, which the authors define as the "augmentation zone." Perimeter, diameter, and projection were studied. The arcus marginalis of the inferior orbit consistently represented a fixed boundary of the augmentation zone, and additional cadavers underwent similar volumization following surgical release of this portion of the arcus marginalis (n = 4). Repeated three-dimensional computer analysis was performed comparing the augmentation zone with and without arcus marginalis release. Volumization of the deep medial cheek led to unique topographic changes of the malar region defined by distinct boundaries. Interestingly, the cephalic border of the augmentation zone was consistently noted to be at the level of the arcus marginalis in all specimens. When surgical release of the arcus marginalis was performed, the cephalic border of the augmentation zone was no longer restricted. Using advances in three-dimensional photography and computer analysis, the authors demonstrate characteristic surface anatomy changes in response to volume augmentation of facial compartments. This novel concept of the augmentation zone can be applied to volumization of other distinct facial regions. Therapeutic, V.

  14. Thalamic and hippocampal volume associated with memory functions in multiple sclerosis.

    PubMed

    Tremblay, Alexandra; Jobin, Céline; Demers, Mélanie; Dagenais, Emmanuelle; Narayanan, Sridar; Araújo, David; Douglas, Arnold L; Roger, Elaine; Chamelian, Laury; Duquette, Pierre; Rouleau, Isabelle

    2018-06-08

    Although multiple sclerosis (MS) has long been considered to primarily affect white matter, it is now recognized that cognitive deficits in MS are also related to neocortical, thalamic and hippocampal damage. However, the association between damage to these structures and memory deficits in MS is unclear. This study examines whether MS patients with cognitive impairment have a reduction of hippocampal and/or thalamic volumes compared to cognitively intact patients, and whether these volume reductions correlate with various aspects of memory function. Volumetric MRI measures of thalamus and hippocampus of forty-one patients with MS were performed. The patients were divided in two groups depending on the presence or absence of cognitive impairment, based on their neuropsychological tests scores. Right hippocampal volume was found to be associated with learning, and the left thalamic volume was found to predict performance in verbal memory. Cognitively impaired patients had a tendency to have a reduced left thalamic volume compared to cognitively intact patients. This study does not support a direct relationship between hippocampal atrophy and verbal memory. These results add to the growing evidence of the involvement of thalamus in cognitive impairment in MS and its association with verbal memory deficits. Copyright © 2018. Published by Elsevier Inc.

  15. Quantitative analysis of aortic regurgitation: real-time 3-dimensional and 2-dimensional color Doppler echocardiographic method--a clinical and a chronic animal study

    NASA Technical Reports Server (NTRS)

    Shiota, Takahiro; Jones, Michael; Tsujino, Hiroyuki; Qin, Jian Xin; Zetts, Arthur D.; Greenberg, Neil L.; Cardon, Lisa A.; Panza, Julio A.; Thomas, James D.

    2002-01-01

    BACKGROUND: For evaluating patients with aortic regurgitation (AR), regurgitant volumes, left ventricular (LV) stroke volumes (SV), and absolute LV volumes are valuable indices. AIM: The aim of this study was to validate the combination of real-time 3-dimensional echocardiography (3DE) and semiautomated digital color Doppler cardiac flow measurement (ACM) for quantifying absolute LV volumes, LVSV, and AR volumes using an animal model of chronic AR and to investigate its clinical applicability. METHODS: In 8 sheep, a total of 26 hemodynamic states were obtained pharmacologically 20 weeks after the aortic valve noncoronary (n = 4) or right coronary (n = 4) leaflet was incised to produce AR. Reference standard LVSV and AR volume were determined using the electromagnetic flow method (EM). Simultaneous epicardial real-time 3DE studies were performed to obtain LV end-diastolic volumes (LVEDV), end-systolic volumes (LVESV), and LVSV by subtracting LVESV from LVEDV. Simultaneous ACM was performed to obtain LVSV and transmitral flows; AR volume was calculated by subtracting transmitral flow volume from LVSV. In a total of 19 patients with AR, real-time 3DE and ACM were used to obtain LVSVs and these were compared with each other. RESULTS: A strong relationship was found between LVSV derived from EM and those from the real-time 3DE (r = 0.93, P <.001, mean difference (3D - EM) = -1.0 +/- 9.8 mL). A good relationship between LVSV and AR volumes derived from EM and those by ACM was found (r = 0.88, P <.001). A good relationship between LVSV derived from real-time 3DE and that from ACM was observed (r = 0.73, P <.01, mean difference = 2.5 +/- 7.9 mL). In patients, a good relationship between LVSV obtained by real-time 3DE and ACM was found (r = 0.90, P <.001, mean difference = 0.6 +/- 9.8 mL). CONCLUSION: The combination of ACM and real-time 3DE for quantifying LV volumes, LVSV, and AR volumes was validated by the chronic animal study and was shown to be clinically applicable.

  16. Humidity sensitive polymers In solution processed adjustable pore-volume Cu(In,Ga)S2 photocathodes for solar hydrogen production

    NASA Astrophysics Data System (ADS)

    Zhang, Chuan; Luo, Wenjun; Wen, Xin; Guan, Zhongjie; Zou, Zhigang

    2017-11-01

    P-type Cu(In,Ga)S2 semiconductors are promising candidates to be used as photocathodes for solar water splitting. Porous structures have been widely used to improve the performances of photoelectrodes due to good minority carrier transport. However, a porous photoelectrode has longer transport distance of majority carriers, which limits its performance. Controlling pore volume of a photoelectrode can balance minority and majority carrier transport and improve the performance. Here, a porous Cu(In,Ga)S2 film is prepared by facile spin-coating method. The pore volume of Cu(In,Ga)S2 film is controlled by adjusting relative humidity (RH) of air during spin-coating process. Further studies suggest that polyvinyl acetate (PVAc) in precursor solution is a humidity sensitive polymer and plays a key role to form different pore volume. The 40% RH sample has the best performance due to its optimum pore volume. After further coated with CdS surface passivation layer and Pt electrocatalyst on the surface, a 40% RH Cu(In,Ga)S2 photocathode indicates a photocurrent density of 8.6 mA cm-2 at 0 V RHE, which is one of the highest photocurrents of Cu(In,Ga)S2 photocathodes. This new strategy for adjusting pore volume is also suitable to prepare other solution-processed inorganic materials.

  17. Deorientation of PolSAR coherency matrix for volume scattering retrieval

    NASA Astrophysics Data System (ADS)

    Kumar, Shashi; Garg, R. D.; Kushwaha, S. P. S.

    2016-05-01

    Polarimetric SAR data has proven its potential to extract scattering information for different features appearing in single resolution cell. Several decomposition modelling approaches have been developed to retrieve scattering information from PolSAR data. During scattering power decomposition based on physical scattering models it becomes very difficult to distinguish volume scattering as a result from randomly oriented vegetation from scattering nature of oblique structures which are responsible for double-bounce and volume scattering , because both are decomposed in same scattering mechanism. The polarization orientation angle (POA) of an electromagnetic wave is one of the most important character which gets changed due to scattering from geometrical structure of topographic slopes, oriented urban area and randomly oriented features like vegetation cover. The shift in POA affects the polarimetric radar signatures. So, for accurate estimation of scattering nature of feature compensation in polarization orientation shift becomes an essential procedure. The prime objective of this work was to investigate the effect of shift in POA in scattering information retrieval and to explore the effect of deorientation on regression between field-estimated aboveground biomass (AGB) and volume scattering. For this study Dudhwa National Park, U.P., India was selected as study area and fully polarimetric ALOS PALSAR data was used to retrieve scattering information from the forest area of Dudhwa National Park. Field data for DBH and tree height was collect for AGB estimation using stratified random sampling. AGB was estimated for 170 plots for different locations of the forest area. Yamaguchi four component decomposition modelling approach was utilized to retrieve surface, double-bounce, helix and volume scattering information. Shift in polarization orientation angle was estimated and deorientation of coherency matrix for compensation of POA shift was performed. Effect of deorientation on RGB color composite for the forest area can be easily seen. Overestimation of volume scattering and under estimation of double bounce scattering was recorded for PolSAR decomposition without deorientation and increase in double bounce scattering and decrease in volume scattering was noticed after deorientation. This study was mainly focused on volume scattering retrieval and its relation with field estimated AGB. Change in volume scattering after POA compensation of PolSAR data was recorded and a comparison was performed on volume scattering values for all the 170 forest plots for which field data were collected. Decrease in volume scattering after deorientation was noted for all the plots. Regression between PolSAR decomposition based volume scattering and AGB was performed. Before deorientation, coefficient determination (R2) between volume scattering and AGB was 0.225. After deorientation an improvement in coefficient of determination was found and the obtained value was 0.613. This study recommends deorientation of PolSAR data for decomposition modelling to retrieve reliable volume scattering information from forest area.

  18. Outcomes of PCI in Relation to Procedural Characteristics and Operator Volumes in the United States.

    PubMed

    Fanaroff, Alexander C; Zakroysky, Pearl; Dai, David; Wojdyla, Daniel; Sherwood, Matthew W; Roe, Matthew T; Wang, Tracy Y; Peterson, Eric D; Gurm, Hitinder S; Cohen, Mauricio G; Messenger, John C; Rao, Sunil V

    2017-06-20

    Professional guidelines have reduced the recommended minimum number to an average of 50 percutaneous coronary intervention (PCI) procedures performed annually by each operator. Operator volume patterns and associated outcomes since this change are unknown. The authors describe herein PCI operator procedure volumes; characteristics of low-, intermediate-, and high-volume operators; and the relationship between operator volume and clinical outcomes in a large, contemporary, nationwide sample. Using data from the National Cardiovascular Data Registry collected between July 1, 2009, and March 31, 2015, we examined operator annual PCI volume. We divided operators into low- (<50 PCIs per year), intermediate- (50 to 100 PCIs per year), and high- (>100 PCIs per year) volume groups, and determined the adjusted association between annual PCI volume and in-hospital outcomes, including mortality. The median annual number of procedures performed per operator was 59; 44% of operators performed <50 PCI procedures per year. Low-volume operators more frequently performed emergency and primary PCI procedures and practiced at hospitals with lower annual PCI volumes. Unadjusted in-hospital mortality was 1.86% for low-volume operators, 1.73% for intermediate-volume operators, and 1.48% for high-volume operators. The adjusted risk of in-hospital mortality was higher for PCI procedures performed by low- and intermediate-volume operators compared with those performed by high-volume operators (adjusted odds ratio: 1.16 for low versus high; adjusted odds ratio: 1.05 for intermediate vs. high volume) as was the risk for new dialysis post PCI. No volume relationship was observed for post-PCI bleeding. Many PCI operators in the United States are performing fewer than the recommended number of PCI procedures annually. Although absolute risk differences are small and may be partially explained by unmeasured differences in case mix between operators, there remains an inverse relationship between PCI operator volume and in-hospital mortality that persisted in risk-adjusted analyses. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  19. Estimation of past seepage volumes from calcite distribution in the Topopah Spring Tuff, Yucca Mountain, Nevada

    USGS Publications Warehouse

    Marshall, B.D.; Neymark, L.A.; Peterman, Z.E.

    2003-01-01

    Low-temperature calcite and opal record the past seepage of water into open fractures and lithophysal cavities in the unsaturated zone at Yucca Mountain, Nevada, site of a proposed high-level radioactive waste repository. Systematic measurements of calcite and opal coatings in the Exploratory Studies Facility (ESF) tunnel at the proposed repository horizon are used to estimate the volume of calcite at each site of calcite and/or opal deposition. By estimating the volume of water required to precipitate the measured volumes of calcite in the unsaturated zone, seepage rates of 0.005 to 5 liters/year (l/year) are calculated at the median and 95th percentile of the measured volumes, respectively. These seepage rates are at the low end of the range of seepage rates from recent performance assessment (PA) calculations, confirming the conservative nature of the performance assessment. However, the distribution of the calcite and opal coatings indicate that a much larger fraction of the potential waste packages would be contacted by this seepage than is calculated in the performance assessment.

  20. The Surgeon Volume-outcome Relationship: Not Yet Ready for Policy.

    PubMed

    Modrall, J Gregory; Minter, Rebecca M; Minhajuddin, Abu; Eslava-Schmalbach, Javier; Joshi, Girish P; Patel, Shivani; Rosero, Eric B

    2018-05-01

    Increasing surgeon volume may improve outcomes for index operations. We hypothesized that there may be surrogate operative experiences that yield similar outcomes for surgeons with a low-volume experience with a specific index operation, such as esophagectomy. The relationship between surgeon volume and outcomes has potential implications for credentialing of surgeons. Restrictions of privileges based on surgeon volume are only reasonable if there is no substitute for direct experience with the index operation. This study was aimed at determining whether there are valid surrogates for direct experience with a sample index operation-open esophagectomy. The Nationwide Inpatient Sample (2003-2009) was utilized. Surgeons were stratified into low and high-volume groups based on annual volume of esophagectomy. Surrogate volume was defined as the aggregate annual volume per surgeon of upper gastrointestinal operations including excision of esophageal diverticulum, gastrectomy, gastroduodenectomy, and repair of diaphragmatic hernia. In all, 26,795 esophagectomies were performed nationwide (2003-2009), with a crude inhospital mortality rate of 5.2%. Inhospital mortality decreased with increasing volume of esophagectomies performed annually: 7.7% and 3.8% for low and high-volume surgeons, respectively (P < 0.0001). Among surgeons with a low-volume esophagectomy experience, increasing volume of surrogate operations improved the outcomes observed for esophagectomy: 9.7%, 7.1%, and 4.3% for low, medium, and high-surrogate-volume surgeons, respectively (P = 0.016). Both operation-specific volume and surrogate volume are significant predictors of inhospital mortality for esophagectomy. Based on these observations, it would be premature to limit hospital privileges based solely on operation-specific surgeon volume criteria.

  1. Electrolyte volume effects on electrochemical performance and solid electrolyte interphase in Si-graphite/NMC lithium-ion pouch cells

    DOE PAGES

    An, Seong Jin; Li, Jianlin; Daniel, Claus; ...

    2017-05-15

    This study aims to explore the correlations between electrolyte volume, electrochemical performance, and properties of the solid electrolyte interphase in pouch cells with Si-graphite composite anodes. The electrolyte is 1.2 M LiPF 6 in ethylene carbonate:ethylmethyl carbonate with 10 wt.% fluoroethylene carbonate. Single layer pouch cells (100 mAh) were constructed with 15 wt.% Si-graphite/LiNi 0.5Mn 0.3CO 0.2O 2 electrodes. It is found that a minimum electrolyte volume factor of 3.1 times the total pore volume of cell components (cathode, anode, and separator) is needed for better cycling stability. Less electrolyte causes increases in ohmic and charge transfer resistances. Lithium dendritesmore » are observed when the electrolyte volume factor is low. The resistances from the anodes become significant as the cells are discharged. As a result, solid electrolyte interphase thickness grows as the electrolyte volume factor increases and is non-uniform after cycling.« less

  2. Evaluation of Diesel Engine Performance with Intake and Exhaust System Throttling : Volume 2. Appendix 1.

    DOT National Transportation Integrated Search

    1975-11-01

    The appendix to the preceding volume presents the data for the subject diesel engine noise study, including an engine sound power level analysis and sound spectrums showing the effect of intake and exhaust restrictions.

  3. Guidelines for operating traffic signals during low-volume conditions

    DOT National Transportation Integrated Search

    2006-08-01

    The main objective of this research is to investigate the performance of flashing traffic signals as a device to control traffic periods with low traffic volumes, particularly during late night/early morning hours. First, the study identifies the mai...

  4. Simulated pressure denaturation thermodynamics of ubiquitin.

    PubMed

    Ploetz, Elizabeth A; Smith, Paul E

    2017-12-01

    Simulations of protein thermodynamics are generally difficult to perform and provide limited information. It is desirable to increase the degree of detail provided by simulation and thereby the potential insight into the thermodynamic properties of proteins. In this study, we outline how to analyze simulation trajectories to decompose conformation-specific, parameter free, thermodynamically defined protein volumes into residue-based contributions. The total volumes are obtained using established methods from Fluctuation Solution Theory, while the volume decomposition is new and is performed using a simple proximity method. Native and fully extended ubiquitin are used as the test conformations. Changes in the protein volumes are then followed as a function of pressure, allowing for conformation-specific protein compressibility values to also be obtained. Residue volume and compressibility values indicate significant contributions to protein denaturation thermodynamics from nonpolar and coil residues, together with a general negative compressibility exhibited by acidic residues. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Regional Differences in Brain Volume Predict the Acquisition of Skill in a Complex Real-Time Strategy Videogame

    PubMed Central

    Basak, Chandramallika; Voss, Michelle W.; Erickson, Kirk I.; Boot, Walter R.; Kramer, Arthur F.

    2015-01-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also be useful in predicting the acquisition of skill in complex tasks, such as strategy-based video games. Twenty older adults were trained for over 20 hours to play Rise of Nations, a complex real-time strategy game. These adults showed substantial improvements over the training period in game performance. MRI scans obtained prior to training revealed that the volume of a number of brain regions, which have been previously associated with subsets of the trained skills, predicted a substantial amount of variance in learning on the complex game. Thus, regional differences in brain volume can predict learning in complex tasks that entail the use of a variety of perceptual, cognitive and motor processes. PMID:21546146

  6. Regional differences in brain volume predict the acquisition of skill in a complex real-time strategy videogame.

    PubMed

    Basak, Chandramallika; Voss, Michelle W; Erickson, Kirk I; Boot, Walter R; Kramer, Arthur F

    2011-08-01

    Previous studies have found that differences in brain volume among older adults predict performance in laboratory tasks of executive control, memory, and motor learning. In the present study we asked whether regional differences in brain volume as assessed by the application of a voxel-based morphometry technique on high resolution MRI would also be useful in predicting the acquisition of skill in complex tasks, such as strategy-based video games. Twenty older adults were trained for over 20 h to play Rise of Nations, a complex real-time strategy game. These adults showed substantial improvements over the training period in game performance. MRI scans obtained prior to training revealed that the volume of a number of brain regions, which have been previously associated with subsets of the trained skills, predicted a substantial amount of variance in learning on the complex game. Thus, regional differences in brain volume can predict learning in complex tasks that entail the use of a variety of perceptual, cognitive and motor processes. Copyright © 2011 Elsevier Inc. All rights reserved.

  7. Brain structure correlates of component reading processes: implications for reading disability.

    PubMed

    Phinney, Erin; Pennington, Bruce F; Olson, Richard; Filley, Christopher M; Filipek, Pauline A

    2007-08-01

    Brain structures implicated in developmental dyslexia (reading disability - RD) vary greatly across structural magnetic resonance imaging (MRI) studies due to methodological differences regarding the definition of RD and the exact measurements of a specific brain structure. The current study attempts to resolve some of those methodological concerns by examining brain volume as it relates to components of proposed RD subtypes. We performed individual regression analyses on total cerebral volume, neocortical volume, subcortical volume, 9 neo-cortical structures and 2 sub-cortical structures. These analyses used three dimensions of reading, phonemic ability (PA), orthographic ability, and rapid naming (RN) ability, while accounting for total cerebral volume, age, and performance IQ (PIQ). Primary analyses included membership to a group (poor reader vs. good reader) in the analysis. The result was a significant interaction between PA and reading ability as it predicts total cerebral volume. Analyses revealed that poor readers lacked a relationship between PA and brain size, but that good readers had a significant positive relationship. This pattern of interaction was not present for the other two reading component factors. These findings bring into question the general belief that individuals with RD are at the low end of a reading ability distribution and do not have a unique disorder. Additional analyses revealed only a few significant relationships between brain size and task performance, most notably a positive correlation between orthographic ability and the angular gyrus (AG), as well as a negative correlation between RN ability and the parietal operculum (PO).

  8. Effects of peripubertal gonadotropin-releasing hormone agonist on brain development in sheep--a magnetic resonance imaging study.

    PubMed

    Nuruddin, Syed; Bruchhage, Muriel; Ropstad, Erik; Krogenæs, Anette; Evans, Neil P; Robinson, Jane E; Endestad, Tor; Westlye, Lars T; Madison, Cindee; Haraldsen, Ira Ronit Hebold

    2013-10-01

    In many species sexual dimorphisms in brain structures and functions have been documented. In ovine model, we have previously demonstrated that peri-pubertal pharmacological blockade of gonadotropin releasing hormone (GnRH) action increased sex-differences of executive emotional behavior. The structural substrate of this behavioral alteration however is unknown. In this magnetic resonance image (MRI) study on the same animals, we investigated the effects of GnRH agonist (GnRHa) treatment on the volume of total brain, hippocampus and amygdala. In total 41 brains (17 treated; 10 females and 7 males, and 24 controls; 11 females and 13 males) were included in the MRI study. Image acquisition was performed with 3-T MRI scanner. Segmentation of the amygdala and the hippocampus was done by manual tracing and total gray and white matter volumes were estimated by means of automated brain volume segmentation of the individual T2-weighted MRI volumes. Statistical comparisons were performed with general linear models. Highly significant GnRHa treatment effects were found on the volume of left and right amygdala, indicating larger amygdalae in treated animals. Significant sex differences were found for total gray matter and right amygdala, indicating larger volumes in male compared to female animals. Additionally, we observed a significant interaction between sex and treatment on left amygdala volume, indicating stronger effects of treatment in female compared to male animals. The effects of GnRHa treatment on amygdala volumes indicate that increasing GnRH concentration during puberty may have an important impact on normal brain development in mammals. These novel findings substantiate the need for further studies investigating potential neurobiological side effects of GnRHa treatment on the brains of young animals and humans. Copyright © 2013 Elsevier Ltd. All rights reserved.

  9. Prone positioning reduces mortality from acute respiratory distress syndrome in the low tidal volume era: a meta-analysis

    PubMed Central

    Shaefi, Shahzad; Montesi, Sydney B.; Devlin, Amy; Loring, Stephen H.; Talmor, Daniel; Malhotra, Atul

    2014-01-01

    Purpose Prone positioning for ARDS has been performed for decades without definitive evidence of clinical benefit. A recent multicenter trial demonstrated for the first time significantly reduced mortality with prone positioning. This meta-analysis was performed to integrate these findings with existing literature and test whether differences in tidal volume explain conflicting results among randomized trials. Methods Studies were identified using MEDLINE, EMBASE, Cochrane Register of Controlled Trials, LILACS, and citation review. Included were randomized trials evaluating the effect on mortality of prone versus supine positioning during conventional ventilation for ARDS. The primary outcome was risk ratio of death at 60 days meta-analyzed using random effects models. Analysis stratified by high (>8 ml/kg predicted body weight) or low (≤8 ml/kg PBW) mean baseline tidal volume was planned a priori. Results Seven trials were identified including 2,119 patients, of whom 1,088 received prone positioning. Overall, prone positioning was not significantly associated with the risk ratio of death (RR 0.83; 95 % CI 0.68–1.02; p = 0.073; I2 = 64 %). When stratified by high or low tidal volume, prone positioning was associated with a significant decrease in RR of death only among studies with low baseline tidal volume (RR 0.66; 95 % CI 0.50–0.86; p = 0.002; I2 = 25 %). Stratification by tidal volume explained over half the between-study heterogeneity observed in the unstratified analysis. Conclusions Prone positioning is associated with significantly reduced mortality from ARDS in the low tidal volume era. Substantial heterogeneity across studies can be explained by differences in tidal volume. PMID:24435203

  10. Forensic postmortem computed tomography: volumetric measurement of the heart and liver.

    PubMed

    Jakobsen, Lykke Schrøder; Lundemose, Sissel; Banner, Jytte; Lynnerup, Niels; Jacobsen, Christina

    2016-12-01

    The purpose of this study was to investigate the utility of postmortem computed tomography (PMCT) images in estimating organ sizes and to examine the use of the cardiothoracic ratio (CTR). We included 45 individuals (19 females), who underwent a medico-legal autopsy. Using the computer software program Mimics ® , we determined in situ heart and liver volumes derived from linear measurements (width, height and depth) on a whole body PMCT-scan, and compared the volumes with ex vivo volumes derived by CT-scan of the eviscerated heart and liver. The ex vivo volumes were also compared with the organ weights. Further, we compared the CTR with the ex vivo heart volume and a heart weight-ratio (HWR). Intra- and inter-observer analyses were performed. We found no correlation between the in situ and ex vivo volumes of the heart and liver. However, a highly significant correlation was found between the ex vivo volumes and weights of the heart and liver. No correlations between CTR and the ex vivo heart volume nor with HWR was found. Concerning cardiomegaly, we found no agreement between the CTR and HWR. The intra- and inter-observer analyses showed no significant differences. Noninvasive in situ PMCT methods for organ measuring, as performed in this study, are not useful tools in forensic pathology. The best method to estimate organ volume is a CT-scan of the eviscerated organ. PMCT-determined CTR seems to be useless for ascertaining cardiomegaly, as it neither correlated with the ex vivo heart volume nor with the HWR.

  11. Volume reduction of the corpus callosum and its relationship with deficits in interhemispheric transfer of information in recent-onset psychosis.

    PubMed

    Chaim, Tiffany M; Schaufelberger, Maristela S; Ferreira, Luiz K; Duran, Fábio L S; Ayres, Adriana M; Scazufca, Marcia; Menezes, Paulo R; Amaro, Edson; Leite, Claudia C; Murray, Robin M; McGuire, Philip K; Rushe, Teresa M; Busatto, Geraldo F

    2010-10-30

    The present study aimed to investigate the presence of corpus callosum (CC) volume deficits in a population-based recent-onset psychosis (ROP) sample, and whether CC volume relates to interhemispheric communication deficits. For this purpose, we used voxel-based morphometry comparisons of magnetic resonance imaging data between ROP (n =122) and healthy control (n = 94) subjects. Subgroups (38 ROP and 39 controls) were investigated for correlations between CC volumes and performance on the Crossed Finger Localization Test (CFLT). Significant CC volume reductions in ROP subjects versus controls emerged after excluding substance misuse and non-right-handedness. CC reductions retained significance in the schizophrenia subgroup but not in affective psychoses subjects. There were significant positive correlations between CC volumes and CFLT scores in ROP subjects, specifically in subtasks involving interhemispheric communication. From these results, we can conclude that CC volume reductions are present in association with ROP. The relationship between such deficits and CFLT performance suggests that interhemispheric communication impairments are directly linked to CC abnormalities in ROP. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Architectural and Behavioral Systems Design Methodology and Analysis for Optimal Habitation in a Volume-Limited Spacecraft for Long Duration Flights

    NASA Technical Reports Server (NTRS)

    Kennedy, Kriss J.; Lewis, Ruthan; Toups, Larry; Howard, Robert; Whitmire, Alexandra; Smitherman, David; Howe, Scott

    2016-01-01

    As our human spaceflight missions change as we reach towards Mars, the risk of an adverse behavioral outcome increases, and requirements for crew health, safety, and performance, and the internal architecture, will need to change to accommodate unprecedented mission demands. Evidence shows that architectural arrangement and habitability elements impact behavior. Net habitable volume is the volume available to the crew after accounting for elements that decrease the functional volume of the spacecraft. Determination of minimum acceptable net habitable volume and associated architectural design elements, as mission duration and environment varies, is key to enabling, maintaining, andor enhancing human performance and psychological and behavioral health. Current NASA efforts to derive minimum acceptable net habitable volumes and study the interaction of covariates and stressors, such as sensory stimulation, communication, autonomy, and privacy, and application to internal architecture design layouts, attributes, and use of advanced accommodations will be presented. Furthermore, implications of crew adaptation to available volume as they transfer from Earth accommodations, to deep space travel, to planetary surface habitats, and return, will be discussed.

  13. Kidney volume measurement methods for clinical studies on autosomal dominant polycystic kidney disease

    PubMed Central

    Sharma, Kanishka; Caroli, Anna; Quach, Le Van; Petzold, Katja; Bozzetto, Michela; Serra, Andreas L.; Remuzzi, Giuseppe; Remuzzi, Andrea

    2017-01-01

    Background In autosomal dominant polycystic kidney disease (ADPKD), total kidney volume (TKV) is regarded as an important biomarker of disease progression and different methods are available to assess kidney volume. The purpose of this study was to identify the most efficient kidney volume computation method to be used in clinical studies evaluating the effectiveness of treatments on ADPKD progression. Methods and findings We measured single kidney volume (SKV) on two series of MR and CT images from clinical studies on ADPKD (experimental dataset) by two independent operators (expert and beginner), twice, using all of the available methods: polyline manual tracing (reference method), free-hand manual tracing, semi-automatic tracing, Stereology, Mid-slice and Ellipsoid method. Additionally, the expert operator also measured the kidney length. We compared different methods for reproducibility, accuracy, precision, and time required. In addition, we performed a validation study to evaluate the sensitivity of these methods to detect the between-treatment group difference in TKV change over one year, using MR images from a previous clinical study. Reproducibility was higher on CT than MR for all methods, being highest for manual and semiautomatic contouring methods (planimetry). On MR, planimetry showed highest accuracy and precision, while on CT accuracy and precision of both planimetry and Stereology methods were comparable. Mid-slice and Ellipsoid method, as well as kidney length were fast but provided only a rough estimate of kidney volume. The results of the validation study indicated that planimetry and Stereology allow using an importantly lower number of patients to detect changes in kidney volume induced by drug treatment as compared to other methods. Conclusions Planimetry should be preferred over fast and simplified methods for accurately monitoring ADPKD progression and assessing drug treatment effects. Expert operators, especially on MR images, are required for performing reliable estimation of kidney volume. The use of efficient TKV quantification methods considerably reduces the number of patients to enrol in clinical investigations, making them more feasible and significant. PMID:28558028

  14. Comparison of volume estimation methods for pancreatic islet cells

    NASA Astrophysics Data System (ADS)

    Dvořák, JiřÃ.­; Å vihlík, Jan; Habart, David; Kybic, Jan

    2016-03-01

    In this contribution we study different methods of automatic volume estimation for pancreatic islets which can be used in the quality control step prior to the islet transplantation. The total islet volume is an important criterion in the quality control. Also, the individual islet volume distribution is interesting -- it has been indicated that smaller islets can be more effective. A 2D image of a microscopy slice containing the islets is acquired. The input of the volume estimation methods are segmented images of individual islets. The segmentation step is not discussed here. We consider simple methods of volume estimation assuming that the islets have spherical or ellipsoidal shape. We also consider a local stereological method, namely the nucleator. The nucleator does not rely on any shape assumptions and provides unbiased estimates if isotropic sections through the islets are observed. We present a simulation study comparing the performance of the volume estimation methods in different scenarios and an experimental study comparing the methods on a real dataset.

  15. Inter-method Performance Study of Tumor Volumetry Assessment on Computed Tomography Test-retest Data

    PubMed Central

    Buckler, Andrew J.; Danagoulian, Jovanna; Johnson, Kjell; Peskin, Adele; Gavrielides, Marios A.; Petrick, Nicholas; Obuchowski, Nancy A.; Beaumont, Hubert; Hadjiiski, Lubomir; Jarecha, Rudresh; Kuhnigk, Jan-Martin; Mantri, Ninad; McNitt-Gray, Michael; Moltz, Jan Hendrik; Nyiri, Gergely; Peterson, Sam; Tervé, Pierre; Tietjen, Christian; von Lavante, Etienne; Ma, Xiaonan; Pierre, Samantha St.; Athelogou, Maria

    2015-01-01

    Rationale and objectives Tumor volume change has potential as a biomarker for diagnosis, therapy planning, and treatment response. Precision was evaluated and compared among semi-automated lung tumor volume measurement algorithms from clinical thoracic CT datasets. The results inform approaches and testing requirements for establishing conformance with the Quantitative Imaging Biomarker Alliance (QIBA) CT Volumetry Profile. Materials and Methods Industry and academic groups participated in a challenge study. Intra-algorithm repeatability and inter-algorithm reproducibility were estimated. Relative magnitudes of various sources of variability were estimated using a linear mixed effects model. Segmentation boundaries were compared to provide a basis on which to optimize algorithm performance for developers. Results Intra-algorithm repeatability ranged from 13% (best performing) to 100% (least performing), with most algorithms demonstrating improved repeatability as the tumor size increased. Inter-algorithm reproducibility determined in three partitions and found to be 58% for the four best performing groups, 70% for the set of groups meeting repeatability requirements, and 84% when all groups but the least performer were included. The best performing partition performed markedly better on tumors with equivalent diameters above 40 mm. Larger tumors benefitted by human editing but smaller tumors did not. One-fifth to one-half of the total variability came from sources independent of the algorithms. Segmentation boundaries differed substantially, not just in overall volume but in detail. Conclusions Nine of the twelve participating algorithms pass precision requirements similar to what is indicated in the QIBA Profile, with the caveat that the current study was not designed to explicitly evaluate algorithm Profile conformance. Change in tumor volume can be measured with confidence to within ±14% using any of these nine algorithms on tumor sizes above 10 mm. No partition of the algorithms were able to meet the QIBA requirements for interchangeability down to 10 mm, though the partition comprised of the best performing algorithms did meet this requirement above a tumor size of approximately 40 mm. PMID:26376841

  16. Older Age Relates to Worsening of Fine Motor Skills: A Population-Based Study of Middle-Aged and Elderly Persons

    PubMed Central

    Hoogendam, Yoo Young; van der Lijn, Fedde; Vernooij, Meike W.; Hofman, Albert; Niessen, Wiro J.; van der Lugt, Aad; Ikram, M. Arfan; van der Geest, Jos N.

    2014-01-01

    Introduction: In a population-based study of 1,912 community-dwelling persons of 45 years and older, we investigated the relation between age and fine motor skills using the Archimedes spiral-drawing test. Also, we studied the effect of brain volume on fine motor skills. Methods: Participants were required to trace a template of a spiral on an electronic drawing board. Clinical scores from this test were obtained by visual assessment of the drawings. Quantitative measures were objectively determined from the recorded data of the drawings. As tremor is known to occur increasingly with advancing age, we also rated drawings to assess presence of tremor. Results: We found presence of a tremor in 1.3% of the drawings. In the group without tremor, we found that older age was related to worse fine motor skills. Additionally, participants over the age of 75 showed increasing deviations from the template when drawing the spiral. Larger cerebral volume and smaller white matter lesion volume were related to better spiral-drawing performance, whereas cerebellar volume was not related to spiral-drawing performance. Conclusion: Older age is related to worse fine motor skills, which can be captured by clinical scoring or quantitative measures of the Archimedes spiral-drawing test. Persons with a tremor performed worse on almost all measures of the spiral-drawing test. Furthermore, larger cerebral volume is related to better fine motor skills. PMID:25309436

  17. Computer program to perform cost and weight analysis of transport aircraft. Volume 2: Technical volume

    NASA Technical Reports Server (NTRS)

    1973-01-01

    An improved method for estimating aircraft weight and cost using a unique and fundamental approach was developed. The results of this study were integrated into a comprehensive digital computer program, which is intended for use at the preliminary design stage of aircraft development. The program provides a means of computing absolute values for weight and cost, and enables the user to perform trade studies with a sensitivity to detail design and overall structural arrangement. Both batch and interactive graphics modes of program operation are available.

  18. A survey of electric and hybrid vehicles simulation programs. Volume 2: Questionnaire responses

    NASA Technical Reports Server (NTRS)

    Bevan, J.; Heimburger, D. A.; Metcalfe, M. A.

    1978-01-01

    The data received in a survey conducted within the United States to determine the extent of development and capabilities of automotive performance simulation programs suitable for electric and hybrid vehicle studies are presented. The survey was conducted for the Department of Energy by NASA's Jet Propulsion Laboratory. Volume 1 of this report summarizes and discusses the results contained in Volume 2.

  19. Faculty Assessment Project for Colleges of Osteopathic Medicine. Final Report, Covers Period of Performance During September 26, 1977-October 25, 1978. Volumes 1, 2, and 3.

    ERIC Educational Resources Information Center

    American Association of Colleges of Osteopathic Medicine, Washington, DC.

    The three volume report includes (1) an executive summary; (2) a comprehensive report reviewing the literature on current faculty development needs in schools of osteopathic medicine; and (3) a volume of resource materials. The study gauges the formal organizational and programmatic factors that influence the success of faculty development…

  20. Optimization-based mesh correction with volume and convexity constraints

    DOE PAGES

    D'Elia, Marta; Ridzal, Denis; Peterson, Kara J.; ...

    2016-02-24

    In this study, we consider the problem of finding a mesh such that 1) it is the closest, with respect to a suitable metric, to a given source mesh having the same connectivity, and 2) the volumes of its cells match a set of prescribed positive values that are not necessarily equal to the cell volumes in the source mesh. This volume correction problem arises in important simulation contexts, such as satisfying a discrete geometric conservation law and solving transport equations by incremental remapping or similar semi-Lagrangian transport schemes. In this paper we formulate volume correction as a constrained optimizationmore » problem in which the distance to the source mesh defines an optimization objective, while the prescribed cell volumes, mesh validity and/or cell convexity specify the constraints. We solve this problem numerically using a sequential quadratic programming (SQP) method whose performance scales with the mesh size. To achieve scalable performance we develop a specialized multigrid-based preconditioner for optimality systems that arise in the application of the SQP method to the volume correction problem. Numerical examples illustrate the importance of volume correction, and showcase the accuracy, robustness and scalability of our approach.« less

  1. The current status of emergency operations at a high-volume cancer center.

    PubMed

    Komori, Koji; Kimura, Kenya; Kinoshita, Takashi; Ito, Seiji; Abe, Tetsuya; Senda, Yoshiki; Misawa, Kazunari; Ito, Yuichi; Uemura, Norihisa; Natsume, Seiji; Kawai, Ryosuke; Kawakami, Jiro; Asano, Tomonari; Iwata, Yoshinori; Kurahashi, Shintaro; Tsutsuyama, Masayuki; Shigeyoshi, Itaru; Shimizu, Yasuhiro

    2014-01-01

    This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.

  2. Hand surgery volume and the US economy: is there a statistical correlation?

    PubMed

    Gordon, Chad R; Pryor, Landon; Afifi, Ahmed M; Gatherwright, James R; Evans, Peter J; Hendrickson, Mark; Bernard, Steven; Zins, James E

    2010-11-01

    To the best of our knowledge, there have been no previous studies evaluating the correlation of the US economy and hand surgery volume. Therefore, in light of the current recession, our objective was to study our institution's hand surgery volume over the last 17 years in relation to the nation's economy. A retrospective analysis of our institution's hand surgery volume, as represented by our most common procedure (ie, carpal tunnel release), was performed between January 1992 and October 2008. Liposuction and breast augmentation volumes were chosen to serve as cosmetic plastic surgery comparison groups. Pearson correlation statistics were used to estimate the relationship between the surgical volume and the US economy, as represented by the 3 market indices (Dow Jones, NASDAQ, and S&P500). A combined total of 7884 hand surgery carpal tunnel release (open or endoscopic) patients were identified. There were 1927 (24%) and 5957 (76%) patients within the departments of plastic and orthopedic surgery, respectively. In the plastic surgery department, there was a strong negative (ie, inverse relationship) correlation between hand surgery volume and the economy (P < 0.001). In converse, the orthopedic department's hand surgery volume demonstrated a positive (ie, parallel) correlation (P < 0.001). The volumes of liposuction and breast augmentation also showed a positive correlation (P < 0.001). To our knowledge, we have demonstrated for the first time an inverse (ie, negative) correlation between hand surgery volumes performed by plastic surgeons in relation to the US economy, as represented by the 3 major market indices. In contrast, orthopedic hand surgery volume and cosmetic surgery show a parallel (ie, positive) correlation. This data suggests that plastic surgeons are increasing their cosmetic surgery-to-reconstructive/hand surgery ratio during strong economic times and vice versa during times of economic slowdown.

  3. THE EPIDEMIOLOGY OF EMERGENCY DEPARTMENT THORACOTOMY IN A STATEWIDE TRAUMA SYSTEM: DOES CENTER VOLUME MATTER?

    PubMed

    Dumas, Ryan P; Seamon, Mark J; Smith, Brian P; Yang, Wei; Cannon, Jeremy W; Schwab, C William; Reilly, Patrick M; Holena, Daniel N

    2018-04-17

    The relationship between high volume and improved outcomes has been described for a host of elective high-impact, low-frequency procedures, but there are little data to support such a relationship in high-impact low-frequency procedures in trauma. Using emergency department thoracotomy (EDT) as a model, we hypothesized that patients presenting to centers with higher institutional volumes of EDT would have improved survival referent to those presenting to lower volume institutions. We queried the Pennsylvania Trauma Outcomes Study (PTOS) registry from 2007-2015 for all EDTs performed at level I and II centers identified by ICD-9 procedure codes and a location stamp indicating the emergency department. We examined patient-level risk factors for survival in univariate regression and multivariable regression models. Centers were divided into tertiles of mean annual EDT volume and the association between mean annual EDT volume and patient survival was examined using logistic regression after controlling for patient factors. 1,399 emergency department thoracotomies were performed at 28 centers. Overall survival was 6.8%. After controlling for patient age, mechanism of injury, signs of life, and injury severity, patients presenting to centers in the highest tertile of volume had significantly higher odds of survival compared to patients presenting to centers in the lowest tertile of volume (OR 4.56, 95% CI 1.43-14.50). Patients presenting to centers with higher mean annual volume of EDTs have improved survival compared to those presenting to institutions with lower mean annual EDT volume. Efforts to understand the etiology of this finding may lead to interventions to improve outcomes at lower volume centers. Level 3: Retrospective cohort study.

  4. The in vivo performance of a novel thermal accelerant agent used for augmentation of microwave energy delivery within biologic tissues during image-guided thermal ablation: a porcine study.

    PubMed

    Park, William Keun Chan; Maxwell, Aaron Wilhelm Palmer; Frank, Victoria Elizabeth; Primmer, Michael Patrick; Paul, Jarod Brian; Collins, Scott Andrew; Lombardo, Kara Anne; Lu, Shaolei; Borjeson, Tiffany Marie; Baird, Grayson Luderman; Dupuy, Damian Edward

    2018-02-01

    To investigate the effects of a novel caesium-based thermal accelerant (TA) agent on ablation zone volumes following in vivo microwave ablation of porcine liver and skeletal muscle, and to correlate the effects of TA with target organ perfusion. This prospective study was performed following institutional animal care and use committee approval. Microwave ablation was performed in liver and resting skeletal muscle in eight Sus scrofa domesticus swine following administration of TA at concentrations of 0 mg/mL (control), 100 mg/mL and 250 mg/mL. Treated tissues were explanted and stained with triphenyltetrazolium chloride (TTC) for quantification of ablation zone volumes, which were compared between TA and control conditions. Hematoxylin and eosin (H&E) staining was also performed for histologic analysis. General mixed modelling with a log-normal distribution was used for all quantitative comparisons (p = 0.05). A total of 28 ablations were performed in the liver and 18 in the skeletal muscle. The use of TA significantly increased ablation zone volumes in a dose-dependent manner in both the porcine muscle and liver (p < 0.01). Both the absolute mean ablation zone volume and percentage increase in ablation zone volume were greater in the resting skeletal muscle than in the liver. In one swine, a qualitative mitigation of heat sink effects was observed by TTC and H&E staining. Non-lethal polymorphic ventricular tachycardia was identified in one swine, treated with intravenous amiodarone. The use of a novel TA agent significantly increased mean ablation zone volumes following microwave ablation using a porcine model. The relationship between TA administration and ablation size was dose-dependent and inversely proportional to the degree of target organ perfusion, and a qualitative reduction in heat-sink effects was observed.

  5. Fuzzy hidden Markov chains segmentation for volume determination and quantitation in PET.

    PubMed

    Hatt, M; Lamare, F; Boussion, N; Turzo, A; Collet, C; Salzenstein, F; Roux, C; Jarritt, P; Carson, K; Cheze-Le Rest, C; Visvikis, D

    2007-06-21

    Accurate volume of interest (VOI) estimation in PET is crucial in different oncology applications such as response to therapy evaluation and radiotherapy treatment planning. The objective of our study was to evaluate the performance of the proposed algorithm for automatic lesion volume delineation; namely the fuzzy hidden Markov chains (FHMC), with that of current state of the art in clinical practice threshold based techniques. As the classical hidden Markov chain (HMC) algorithm, FHMC takes into account noise, voxel intensity and spatial correlation, in order to classify a voxel as background or functional VOI. However the novelty of the fuzzy model consists of the inclusion of an estimation of imprecision, which should subsequently lead to a better modelling of the 'fuzzy' nature of the object of interest boundaries in emission tomography data. The performance of the algorithms has been assessed on both simulated and acquired datasets of the IEC phantom, covering a large range of spherical lesion sizes (from 10 to 37 mm), contrast ratios (4:1 and 8:1) and image noise levels. Both lesion activity recovery and VOI determination tasks were assessed in reconstructed images using two different voxel sizes (8 mm3 and 64 mm3). In order to account for both the functional volume location and its size, the concept of % classification errors was introduced in the evaluation of volume segmentation using the simulated datasets. Results reveal that FHMC performs substantially better than the threshold based methodology for functional volume determination or activity concentration recovery considering a contrast ratio of 4:1 and lesion sizes of <28 mm. Furthermore differences between classification and volume estimation errors evaluated were smaller for the segmented volumes provided by the FHMC algorithm. Finally, the performance of the automatic algorithms was less susceptible to image noise levels in comparison to the threshold based techniques. The analysis of both simulated and acquired datasets led to similar results and conclusions as far as the performance of segmentation algorithms under evaluation is concerned.

  6. Reading skill and structural brain development

    PubMed Central

    Houston, S.M.; Lebel, C.; Katzir, T.; Manis, F.R.; Kan, E.; Rodriguez, G.R.; Sowell, E.R.

    2014-01-01

    Reading is a learned skill that is likely influenced by both brain maturation and experience. Functional imaging studies have identified brain regions important for skilled reading, but the structural brain changes that co-occur with reading acquisition remain largely unknown. We investigated maturational volume changes in brain reading regions and their association with performance on reading measures. Sixteen typically developing children (5-15 years old, 8 male, mean age of sample=10.06 ±3.29) received two magnetic resonance imaging (MRI) scans, (mean inter-scan interval =2.19 years), and were administered a battery of cognitive measures. Volume changes between time points in five bilateral cortical regions of interest were measured, and assessed for relationships to three measures of reading. Better baseline performances on measures of word reading, fluency and rapid naming, independent of age and total cortical gray matter volume change, were associated with volume decrease in the left inferior parietal cortex. Better baseline performance on a rapid naming measure was associated with volume decrease in the left inferior frontal region. These results suggest that children who are better readers, and who perhaps read more than less skilled readers, exhibit different development trajectories in brain reading regions. Understanding relationships between reading performance, reading experience and brain maturation trajectories may help with the development and evaluation of targeted interventions. PMID:24407200

  7. Association between provider volume and healthcare expenditures of patients with oral cancer in Taiwan: a population-based study.

    PubMed

    Chen, Li-Fu; Ho, Hsu-Chueh; Su, Yu-Chieh; Lee, Moon-Sing; Hung, Shih-Kai; Chou, Pesus; Lee, Ching-Chieh J; Lin, Li-Chu; Lee, Ching-Chih

    2013-01-01

    Oral cancer requires considerable utilization of healthcare services. Wide resection of the tumor and reconstruction with free flap are widely used. Due to high recurrence rate, close follow-up is mandatory. This study was conducted to explore the relationship between the healthcare expenditure of oncological surgery and one-year follow up and provider volume. From the National Health Insurance Research Database published by the Taiwanese National Health Research Institute, the authors selected a total of 1300 oral cancer patients who underwent tumor resection and free flap reconstruction in 2008. Hierarchical linear regression analysis was subsequently performed to explore the relationship between provider volume and expenditures of oncological surgery and one-year follow-up period. Emergency department (ED) visits and 30-day readmission rates were also analyzed. The mean expenditure for oncological surgery was $11080±4645 (all costs are given in U.S. dollars) and $10129±9248 for one-year follow up. For oncological surgery expenditure, oral cancer patients treated by low-volume surgeons had an additional $845 than those in high-volume surgeons in mixed model. For one-year follow-up expenditure, patients in low-volume hospitals had an additional $3439 than those in high-volume hospitals; patient in low-volume surgeons and medium-volume surgeons incurred an additional expenditure of $2065 and $1811 than those in high-volume surgeons. Oral cancer patients treated in low-volume hospitals incurred higher risk of 30-day readmission rate (odds ratio, 6.6; 95% confidence interval, 1.6-27). After adjusting for physician, hospital, and patient characteristics, low-volume provider performing wide excision with reconstructive surgery in oral cancer patients incurred significantly higher expenditure for oncological surgery and one-year healthcare per patient than did others with higher volumes. Treatment strategies adapted by high-volume providers should be further analyzed.

  8. Impact of robotic technique and surgical volume on the cost of radical prostatectomy.

    PubMed

    Hyams, Elias S; Mullins, Jeffrey K; Pierorazio, Phillip M; Partin, Alan W; Allaf, Mohamad E; Matlaga, Brian R

    2013-03-01

    Our present understanding of the effect of robotic surgery and surgical volume on the cost of radical prostatectomy (RP) is limited. Given the increasing pressures placed on healthcare resource utilization, such determinations of healthcare value are becoming increasingly important. Therefore, we performed a study to define the effect of robotic technology and surgical volume on the cost of RP. The state of Maryland mandates that all acute-care hospitals report encounter-level and hospital discharge data to the Health Service Cost Review Commission (HSCRC). The HSCRC was queried for men undergoing RP between 2008 and 2011 (the period during which robot-assisted laparoscopic radical prostatectomy [RALRP] was coded separately). High-volume hospitals were defined as >60 cases per year, and high-volume surgeons were defined as >40 cases per year. Multivariate regression analysis was performed to evaluate whether robotic technique and high surgical volume impacted the cost of RP. There were 1499 patients who underwent RALRP and 2565 who underwent radical retropubic prostatectomy (RRP) during the study period. The total cost for RALRP was higher than for RRP ($14,000 vs 10,100; P<0.001) based primarily on operating room charges and supply charges. Multivariate regression demonstrated that RALRP was associated with a significantly higher cost (β coeff 4.1; P<0.001), even within high-volume hospitals (β coeff 3.3; P<0.001). High-volume surgeons and high-volume hospitals, however, were associated with a significantly lower cost for RP overall. High surgeon volume was associated with lower cost for RALRP and RRP, while high institutional volume was associated with lower cost for RALRP only. High surgical volume was associated with lower cost of RP. Even at high surgical volume, however, the cost of RALRP still exceeded that of RRP. As robotic surgery has come to dominate the healthcare marketplace, strategies to increase the role of high-volume providers may be needed to improve the cost-effectiveness of prostate cancer surgical therapy.

  9. Shuttle payload interface verification equipment study. Volume 3: Specification data

    NASA Technical Reports Server (NTRS)

    1976-01-01

    A complete description is given of the IVE physical and performance design requirements as evolved in this study. The data are presented in a format to facilitate the development of an item specification. Data were used to support the development of the project plan data (schedules, cost, etc.) contained in Volume 4 of this report.

  10. Evaluation of performance, safety, subject acceptance, and compliance of a disposable autoinjector for subcutaneous injections in healthy volunteers.

    PubMed

    Berteau, Cecile; Schwarzenbach, Florence; Donazzolo, Yves; Latreille, Mathilde; Berube, Julie; Abry, Herve; Cotten, Joël; Feger, Celine; Laurent, Philippe E

    2010-10-05

    A disposable autoinjector was developed for subcutaneous (SC) self-injection by patients with chronic diseases. To verify its performance and evaluate its acceptance, a clinical study was conducted in healthy volunteers, comparing SC injections performed by subjects using the autoinjector with SC injections performed by nurses using a syringe. This was a randomized, single-center, crossover study comparing SC self-injection using an autoinjector with SC nurse-administered injection using a syringe. Two volumes (0.2 mL and 1 mL) were injected into healthy volunteers. Study objectives included assessment of the accuracy and consistency of the volume injected by the injection systems, and skin reaction and pain associated with the injection. The fluid depot in the SC tissue layer was evaluated by ultrasound. Subject acceptance was evaluated using questionnaires on attitudes and emotions towards the injection technique, and challenged by seeking the subjects' preferred system for a final study injection or future treatment. A total of 960 injections (480 with autoinjector, 480 with syringe) were performed in 40 subjects. There were no significant differences in mean fluid leakage and injected volumes between the systems. Pain associated with the injection was significantly lower with the auto-injector than with the syringe. Local skin reaction at the injection site was overall satisfactory. Injections were appropriately performed by all subjects. At study end, all 40 subjects preferred the autoinjector for a final study injection and for future treatment. This study indicated that the autoinjector used by the subject was similar to a syringe used by a nurse in terms of performance and safety in administering the injections, and better in terms of pain, overall acceptance, and preference.

  11. Gross morphology and morphometric sequelae in the hippocampus, fornix, and corpus callosum of patients with severe non-missile traumatic brain injury without macroscopically detectable lesions: a T1 weighted MRI study

    PubMed Central

    Tomaiuolo, F; Carlesimo, G; Di, P; Petrides, M; Fera, F; Bonanni, R; Formisano, R; Pasqualetti, P; Caltagirone, C

    2004-01-01

    Objective: The gross morphology and morphometry of the hippocampus, fornix, and corpus callosum in patients with severe non-missile traumatic brain injury (nmTBI) without obvious neuroradiological lesions was examined and the volumes of these structures were correlated with performance on memory tests. In addition, the predictability of the length of coma from the selected anatomical volumes was examined. Method: High spatial resolution T1 weighted MRI scans of the brain (1 mm3) and neuropsychological evaluations with standardised tests were performed at least 3 months after trauma in 19 patients. Results: In comparison with control subjects matched in terms of gender and age, volume reduction in the hippocampus, fornix, and corpus callosum of the nmTBI patients was quantitatively significant. The length of coma correlated with the volume reduction in the corpus callosum. Immediate free recall of word lists correlated with the volume of the fornix and the corpus callosum. Delayed recall of word lists and immediate recall of the Rey figure both correlated with the volume of the fornix. Delayed recall of the Rey figure correlated with the volume of the fornix and the right hippocampus. Conclusion: These findings demonstrate that in severe nmTBI without obvious neuroradiological lesions there is a clear hippocampal, fornix, and callosal volume reduction. The length of coma predicts the callosal volume reduction, which could be considered a marker of the severity of axonal loss. A few memory test scores correlated with the volumes of the selected anatomical structures. This relationship with memory performance may reflect the diffuse nature of the damage, leading to the disruption of neural circuits at multiple levels and the progressive neural degeneration occurring in TBI. PMID:15314123

  12. Relative Impact of Surgeon and Hospital Volume on Operative Mortality and Complications Following Pancreatic Resection in Medicare Patients

    PubMed Central

    Mehta, Hemalkumar B.; Parmar, Abhishek D.; Adhikari, Deepak; Tamirisa, Nina P.; Dimou, Francesca; Jupiter, Daniel; Riall, Taylor S.

    2016-01-01

    Background Surgeon and hospital volume are both known to affect outcomes for patients undergoing pancreatic resection. The objective was to evaluate the relative effects of surgeon and hospital volume on 30-day mortality and 30-day complications after pancreatic resection among older patients. Materials and Methods The study used Texas Medicare data (2000–2012), identifying high-volume surgeons as those performing ≥4 pancreatic resections/year, and high-volume hospitals as those performing ≥11 pancreatic resections/year, on Medicare patients. Three-level hierarchical logistic regression models were used to evaluate the relative effects of surgeon and hospital volumes on mortality and complications, after adjusting for case mix differences. Results There were 2,453 pancreatic resections performed by 490 surgeons operating in 138 hospitals. 4.5% of surgeons and 6.5% of hospitals were high-volume. The overall 30-day mortality was 9.0%, and the 30-day complication rate was 40.6%. Overall, 8.9% of the variance in 30-day mortality was attributed to surgeon factors and 9.8% to hospital factors. For 30-day complications, 4.7% of the variance was attributed to surgeon factors and 1.2% to hospital factors. After adjusting for patient, surgeon and hospital characteristics, high surgeon volume (OR 0.54, 95% CI 0.33–0.87) and high hospital volume (OR, 0.52; 95% CI, 0.30–0.92) were associated with lower risk of mortality; high surgeon volume (OR 0.71, 95% CI 0.55–0.93) was also associated lower risk of 30-day complications. Conclusions Both hospital and surgeon factors contributed significantly to the observed variance in mortality, but only surgeon factors impacted complications. PMID:27565068

  13. Critical Propulsion Components. Volume 2; Combustor

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Several studies have concluded that a supersonic aircraft, if environmentally acceptable and economically viable, could successfully compete in the 21st century marketplace. However, before industry can commit to what is estimated as a 15 to 20 billion dollar investment, several barrier issues must be resolved. In an effort to address these barrier issues, NASA and Industry teamed to form the High-Speed Research (HSR) program. As part of this program, the Critical Propulsion Components (CPC) element was created and assigned the task of developing those propulsion component technologies necessary to: (1) reduce cruise emissions by a factor of 10 and (2) meet the ever-increasing airport noise restrictions with an economically viable propulsion system. The CPC-identified critical components were ultra-low emission combustors, low-noise/high-performance exhaust nozzles, low-noise fans, and stable/high-performance inlets. Propulsion cycle studies (coordinated with NASA Langley Research Center sponsored airplane studies) were conducted throughout this CPC program to help evaluate candidate components and select the best concepts for the more complex and larger scale research efforts. The propulsion cycle and components ultimately selected were a mixed-flow turbofan (MFTF) engine employing a lean, premixed, prevaporized (LPP) combustor coupled to a two-dimensional mixed compression inlet and a two-dimensional mixer/ejector nozzle. Due to the large amount of material presented in this report, it was prepared in four volumes; Volume 1: Summary, Introduction, and Team. Propulsion System Studies, Volume 2: Combustor, Volume 3: Exhaust Nozzle, and Volume 4: Inlet and Fan/Inlet Acoustic Team.

  14. Critical Propulsion Components. Volume 3; Exhaust Nozzle

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Several studies have concluded that a supersonic aircraft, if environmentally acceptable and economically viable, could successfully compete in the 21st century marketplace. However, before industry can commit to what is estimated as a 15 to 20 billion dollar investment, several barrier issues must be resolved. In an effort to address these barrier issues, NASA and Industry teamed to form the High-Speed Research (HSR) program. As part of this program, the Critical Propulsion Components (CPC) element was created and assigned the task of developing those propulsion component technologies necessary to: (1) reduce cruise emissions by a factor of 10 and (2) meet the ever-increasing airport noise restrictions with an economically viable propulsion system. The CPC-identified critical components were ultra-low emission combustors, low-noise/high-performance exhaust nozzles, low-noise fans, and stable/high-performance inlets. Propulsion cycle studies (coordinated with NASA Langley Research Center sponsored airplane studies) were conducted throughout this CPC program to help evaluate candidate components and select the best concepts for the more complex and larger scale research efforts. The propulsion cycle and components ultimately selected were a mixed-flow turbofan (MFTF) engine employing a lean, premixed, prevaporized (LPP) combustor coupled to a two-dimensional mixed compression inlet and a two-dimensional mixer/ejector nozzle. Due to the large amount of material presented in this report, it was prepared in four volumes; Volume 1: Summary, Introduction, and Propulsion System Studies, Volume 2: Combustor, Volume 3: Exhaust Nozzle, and Volume 4: Inlet and Fan/Inlet Acoustic Team.

  15. Correlation between liver volume, portal vascular anatomy, and hepatic perfusion in dogs with congenital portosystemic shunt before and after placement of ameroid constrictors.

    PubMed

    Zwingenberger, Allison L; Daniel, Leticia; Steffey, Michele A; Mayhew, Philipp D; Mayhew, Kelli N; Culp, William T N; Hunt, Geraldine B

    2014-11-01

    To correlate changes in hepatic volume, hepatic perfusion, and vascular anatomy of dogs with congenital extrahepatic portosystemic shunts, before and after attenuation with an ameroid constrictor. Prospective study. Dogs (n = 22) with congenital extrahepatic portosystemic shunts. CT angiography and perfusion scans were performed before and after attenuation of a portosystemic shunt with an ameroid constrictor. Changes in hepatic volume, hepatic perfusion, and vascular anatomy were measured. Portal scintigraphy was performed in 8 dogs preoperatively and 22 dogs postoperatively. Dogs with smaller preoperative liver volumes had greater increases in liver volume postoperatively compared with those with larger preoperative liver volumes. Hepatic arterial fraction was increased in dogs preoperatively and returned to normal range after shunt attenuation, and was correlated with increase in liver size and decreased shunt fraction. Three dogs with no visible portal vasculature preoperatively developed portal branches postoperatively. Dogs with smaller preoperative liver volumes had the largest postoperative increase in liver volume. Hepatic arterial perfusion and portal scintigraphy correlate with liver volume and are indicators of successful shunt attenuation. Dogs without visible vasculature on CT angiography had visible portal vasculature postoperatively. © Copyright 2014 by The American College of Veterinary Surgeons.

  16. Long-Term Prediction of Emergency Department Revenue and Visitor Volume Using Autoregressive Integrated Moving Average Model

    PubMed Central

    Chen, Chieh-Fan; Ho, Wen-Hsien; Chou, Huei-Yin; Yang, Shu-Mei; Chen, I-Te; Shi, Hon-Yi

    2011-01-01

    This study analyzed meteorological, clinical and economic factors in terms of their effects on monthly ED revenue and visitor volume. Monthly data from January 1, 2005 to September 30, 2009 were analyzed. Spearman correlation and cross-correlation analyses were performed to identify the correlation between each independent variable, ED revenue, and visitor volume. Autoregressive integrated moving average (ARIMA) model was used to quantify the relationship between each independent variable, ED revenue, and visitor volume. The accuracies were evaluated by comparing model forecasts to actual values with mean absolute percentage of error. Sensitivity of prediction errors to model training time was also evaluated. The ARIMA models indicated that mean maximum temperature, relative humidity, rainfall, non-trauma, and trauma visits may correlate positively with ED revenue, but mean minimum temperature may correlate negatively with ED revenue. Moreover, mean minimum temperature and stock market index fluctuation may correlate positively with trauma visitor volume. Mean maximum temperature, relative humidity and stock market index fluctuation may correlate positively with non-trauma visitor volume. Mean maximum temperature and relative humidity may correlate positively with pediatric visitor volume, but mean minimum temperature may correlate negatively with pediatric visitor volume. The model also performed well in forecasting revenue and visitor volume. PMID:22203886

  17. Long-term prediction of emergency department revenue and visitor volume using autoregressive integrated moving average model.

    PubMed

    Chen, Chieh-Fan; Ho, Wen-Hsien; Chou, Huei-Yin; Yang, Shu-Mei; Chen, I-Te; Shi, Hon-Yi

    2011-01-01

    This study analyzed meteorological, clinical and economic factors in terms of their effects on monthly ED revenue and visitor volume. Monthly data from January 1, 2005 to September 30, 2009 were analyzed. Spearman correlation and cross-correlation analyses were performed to identify the correlation between each independent variable, ED revenue, and visitor volume. Autoregressive integrated moving average (ARIMA) model was used to quantify the relationship between each independent variable, ED revenue, and visitor volume. The accuracies were evaluated by comparing model forecasts to actual values with mean absolute percentage of error. Sensitivity of prediction errors to model training time was also evaluated. The ARIMA models indicated that mean maximum temperature, relative humidity, rainfall, non-trauma, and trauma visits may correlate positively with ED revenue, but mean minimum temperature may correlate negatively with ED revenue. Moreover, mean minimum temperature and stock market index fluctuation may correlate positively with trauma visitor volume. Mean maximum temperature, relative humidity and stock market index fluctuation may correlate positively with non-trauma visitor volume. Mean maximum temperature and relative humidity may correlate positively with pediatric visitor volume, but mean minimum temperature may correlate negatively with pediatric visitor volume. The model also performed well in forecasting revenue and visitor volume.

  18. Pressure-volume behavior of the upper airway.

    PubMed

    Fouke, J M; Teeter, J P; Strohl, K P

    1986-09-01

    The study was performed to investigate the relationship between force generation and upper airway expansion during respiratory efforts by upper airway muscles. In 11 anesthetized dogs we isolated the upper airway (nasal, oral, pharyngeal, and laryngeal regions) by transecting the cervical trachea and sealing the nasal and oral openings. During spontaneous respiratory efforts the pressure within the sealed upper airway, used as an index of dilating force, decreased during inspiration. On alternate breaths the upper airway was opened to a pneumotachograph, and an increase in volume occurred, also during inspiration. Progressive hyperoxic hypercapnia produced by rebreathing increased the magnitude of change in pressure and volume. At any level of drive, peak pressure or volume occurred at the same point during inspiration. At any level of drive, volume and pressure changes increased with end-expiratory occlusion of the trachea. The force-volume relationship determined from measurements during rebreathing was compared with pressure-volume curves performed by passive inflation of the airway while the animal was apneic. The relationship during apnea was 1.06 +/- 0.55 (SD) ml/cmH2O, while the force-volume relationship from rebreathing trials was -1.09 +/- 0.45 ml/cmH2O. We conclude that there is a correspondence between force production and volume expansion in the upper airway during active respiratory efforts.

  19. The performances of standard and ResMed masks during bag-valve-mask ventilation.

    PubMed

    Lee, Hyoung Youn; Jeung, Kyung Woon; Lee, Byung Kook; Lee, Seung Joon; Jung, Yong Hun; Lee, Geo Sung; Min, Yong Il; Heo, Tag

    2013-01-01

    A tight mask seal is frequently difficult to obtain and maintain during single-rescuer bag-valve-mask (BVM) ventilation. The ResMed mask (Bella Vista, NSW, Australia) is a continuous-positive-airway-pressure mask (CM) designed for noninvasive ventilation. In this study, we compared the ventilation performances of a standard mask (SM) and a ResMed CM using a simulation manikin in an out-of-hospital single-rescuer BVM ventilation scenario. Thirty emergency medical technicians (EMTs) performed two 2-minute attempts to ventilate a simulation manikin using BVM ventilation, alternatively, with the SM or the ResMed CM in a randomized order. Ventilation parameters including tidal volume and peak airway pressure were measured using computer analysis software connected to the simulation manikin. Successful volume delivery was defined as delivery of 440-540 mL of tidal volume in accord with present cardiopulmonary resuscitation guidelines. BVM ventilation using the ResMed CM produced higher mean (± standard deviation) tidal volumes (452 ± 50 mL vs. 394 ± 113 mL, p = 0.014) and had a higher proportion of successful volume deliveries (65.3% vs. 26.7%, p < 0.001) than that using the SM. Peak airway pressure was higher in BVM ventilation using the ResMed CM (p = 0.035). Stomach insufflation did not occur during either method. Twenty-nine of the participants (96.7%) preferred BVM ventilation using the ResMed CM. BVM ventilations using ResMed CM resulted in a significantly higher proportion of successful volume deliveries meeting the currently recommended range of tidal volume. Clinical studies are needed to determine the value of the ResMed CM for BVM ventilation.

  20. Amygdala volume and verbal memory performance in schizophrenia and bipolar disorder.

    PubMed

    Killgore, William D S; Rosso, Isabelle M; Gruber, Staci A; Yurgelun-Todd, Deborah A

    2009-03-01

    To clarify the relationship between amygdala-hippocampal volume and cognitive performance in schizophrenia and bipolar disorder. Abnormalities of the amygdala-hippocampal complex and memory deficits have been reported in both schizophrenia and bipolar illness. We examined memory performance and its relationship to the volumes of the whole brain, lateral ventricles, hippocampus, and amygdala using morphometric magnetic resonance imaging in 19 patients with schizophrenia, 11 bipolar patients, and 20 healthy controls. Schizophrenia patients performed more poorly than bipolar patients and controls on indices of memory functioning, whereas patients with bipolar disorder showed milder impairments relative to controls. The schizophrenia group showed reduced total cerebral volume and enlarged ventricles relative to controls, but no group differences were found for amygdala or hippocampal volume. Left amygdala volume was predictive of memory performance in both groups, correlating positively with better immediate and delayed verbal memory for bipolar patients and negatively with immediate and delayed verbal recall for schizophrenia patients. Amygdala volume was unrelated to memory performance in healthy subjects. Schizophrenia and bipolar disorder both seem to be associated with anomalous and differential limbic volume-function relationships, such that the amygdala may facilitate hippocampal-dependent memory processes in bipolar disorder but impair these same processes in schizophrenia.

  1. Partial volume correction and image analysis methods for intersubject comparison of FDG-PET studies

    NASA Astrophysics Data System (ADS)

    Yang, Jun

    2000-12-01

    Partial volume effect is an artifact mainly due to the limited imaging sensor resolution. It creates bias in the measured activity in small structures and around tissue boundaries. In brain FDG-PET studies, especially for Alzheimer's disease study where there is serious gray matter atrophy, accurate estimate of cerebral metabolic rate of glucose is even more problematic due to large amount of partial volume effect. In this dissertation, we developed a framework enabling inter-subject comparison of partial volume corrected brain FDG-PET studies. The framework is composed of the following image processing steps: (1)MRI segmentation, (2)MR-PET registration, (3)MR based PVE correction, (4)MR 3D inter-subject elastic mapping. Through simulation studies, we showed that the newly developed partial volume correction methods, either pixel based or ROI based, performed better than previous methods. By applying this framework to a real Alzheimer's disease study, we demonstrated that the partial volume corrected glucose rates vary significantly among the control, at risk and disease patient groups and this framework is a promising tool useful for assisting early identification of Alzheimer's patients.

  2. Eliminating the blood-flow confounding effect in intravoxel incoherent motion (IVIM) using the non-negative least square analysis in liver.

    PubMed

    Gambarota, Giulio; Hitti, Eric; Leporq, Benjamin; Saint-Jalmes, Hervé; Beuf, Olivier

    2017-01-01

    Tissue perfusion measurements using intravoxel incoherent motion (IVIM) diffusion-MRI are of interest for investigations of liver pathologies. A confounding factor in the perfusion quantification is the partial volume between liver tissue and large blood vessels. The aim of this study was to assess and correct for this partial volume effect in the estimation of the perfusion fraction. MRI experiments were performed at 3 Tesla with a diffusion-MRI sequence at 12 b-values. Diffusion signal decays in liver were analyzed using the non-negative least square (NNLS) method and the biexponential fitting approach. In some voxels, the NNLS analysis yielded a very fast-decaying component that was assigned to partial volume with the blood flowing in large vessels. Partial volume correction was performed by biexponential curve fitting, where the first data point (b = 0 s/mm 2 ) was eliminated in voxels with a very fast-decaying component. Biexponential fitting with partial volume correction yielded parametric maps with perfusion fraction values smaller than biexponential fitting without partial volume correction. The results of the current study indicate that the NNLS analysis in combination with biexponential curve fitting allows to correct for partial volume effects originating from blood flow in IVIM perfusion fraction measurements. Magn Reson Med 77:310-317, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  3. Revista de Investigacion Educativa, 1999 (Journal of Educational Research, 1999).

    ERIC Educational Resources Information Center

    Revista de Investigacion Educativa, 1999

    1999-01-01

    Articles in this volume, written in Spanish, focus on the following: intellectual style and academic performance; an explanatory integrated model of academic goals, learning strategies, and academic performance; a comparative situational study of drug addiction; early childhood depression and academic performance: a comparative study of patients…

  4. Pilot expertise and hippocampal size: associations with longitudinal flight simulator performance.

    PubMed

    Adamson, Maheen M; Bayley, Peter J; Scanlon, Blake K; Farrell, Michelle E; Hernandez, Beatriz; Weiner, Michael W; Yesavage, Jerome A; Taylor, Joy L

    2012-09-01

    Previous research suggests that the size of the hippocampus can vary in response to intensive training (e.g., during the acquisition of expert knowledge). However, the role of the hippocampus in maintenance of skilled performance is not well understood. The Stanford/Veterans Affairs Aviation MRI Study offers a unique opportunity to observe the interaction of brain structure and multiple levels of expertise on longitudinal flight simulator performance. The current study examined the relationship between hippocampal volume and three levels of aviation expertise, defined by pilot proficiency ratings issued by the U.S. Federal Aviation Administration (11). At 3 annual time points, 60 pilots who varied in their level of aviation expertise (ages ranging from 45 to 69 yr) were tested. At baseline, higher expertise was associated with better flight simulator performance, but not with hippocampal volume. Longitudinally, there was an Expertise x Hippocampal volume interaction, in the direction that a larger hippocampus was associated with better performance at higher levels of expertise. These results are consistent with the notion that expertise in a cognitively demanding domain involves the interplay of acquired knowledge ('mental schemas') and basic hippocampal-dependent processes.

  5. Brain activity changes in cognitive networks in relapsing-remitting multiple sclerosis - insights from a longitudinal FMRI study.

    PubMed

    Loitfelder, Marisa; Fazekas, Franz; Koschutnig, Karl; Fuchs, Siegrid; Petrovic, Katja; Ropele, Stefan; Pichler, Alexander; Jehna, Margit; Langkammer, Christian; Schmidt, Reinhold; Neuper, Christa; Enzinger, Christian

    2014-01-01

    Extrapolations from previous cross-sectional fMRI studies suggest cerebral functional changes with progression of Multiple Sclerosis (MS), but longitudinal studies are scarce. We assessed brain activation changes over time in MS patients using a cognitive fMRI paradigm and examined correlations with clinical and cognitive status and brain morphology. 13 MS patients and 15 healthy controls (HC) underwent MRI including fMRI (go/no-go task), neurological and neuropsychological exams at baseline (BL) and follow-up (FU; minimum 12, median 20 months). We assessed estimates of and changes in fMRI activation, total brain and subcortical grey matter volumes, cortical thickness, and T2-lesion load. Bland-Altman (BA) plots served to assess fMRI signal variability. Cognitive and disability levels remained largely stable in the patients. With the fMRI task, both at BL and FU, patients compared to HC showed increased activation in the insular cortex, precuneus, cerebellum, posterior cingulate cortex, and occipital cortex. At BL, patients vs. HC also had lower caudate nucleus, thalamus and putamen volumes. Over time, patients (but not HC) demonstrated fMRI activity increments in the left inferior parietal lobule. These correlated with worse single-digit-modality test (SDMT) performance. BA-plots attested to reproducibility of the fMRI task. In the patients, the right caudate nucleus decreased in volume which again correlated with worsening SDMT performance. Given preserved cognitive performance, the increased activation at BL in the patients may be viewed as largely adaptive. In contrast, the negative correlation with SDMT performance suggests increasing parietal activation over time to be maladaptive. Several areas with purported relevance for cognition showed decreased volumes at BL and right caudate nucleus volume decline correlated with decreasing SDMT performance. This highlights the dynamics of functional changes and the strategic importance of specific brain areas for cognitive processes in MS.

  6. The relationship between patient volume and mortality in American trauma centres: a systematic review of the evidence.

    PubMed

    Caputo, Lisa M; Salottolo, Kristin M; Slone, Denetta Sue; Mains, Charles W; Bar-Or, David

    2014-03-01

    To synthesise published and unpublished findings examining the relationship between institutional trauma centre volume or trauma patient volume per surgeon and mortality. Evidence on the relationship between patient volume and survival in trauma patients is inconclusive in the literature and remains controversial. A literature search was performed to identify studies published between 1976 and 2013 via MEDLINE (Pubmed) and the Cumulative Index to Nursing and Allied Health Literature (EbscoHost) as well as footnote chasing. Abstracts from appropriate conferences and ProQuest Dissertations and Theses were also searched. Inclusion criteria required studies to be original research published in English that examined the relationship between mortality and either institutional or per surgeon volume in American trauma centres. We employed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement checklist and flowchart. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach was employed to rate the quality of the evidence. Of 1392 studies reviewed, 19 studies met defined inclusion criteria; all studies were retrospective. The definition of volume was heterogeneous across the studies. Patient population and analysis methods also varied across the studies. Sixteen studies (84%) examined the relationship between institutional trauma centre volume and mortality. Of the 16 studies, 12 examined the volume of severely injured patients and eight examined overall trauma patient volume. High institutional volume was associated with at least somewhat improved mortality in ten of 16 studies (63%); however, nearly half of these studies found only some subpopulations experienced benefits. In the remaining six studies, volume was not associated with any benefits. Four studies (25%) analysed the impact of surgeon volume on mortality. High volume per surgeon was associated with improved mortality in only one of four studies (25%). The studies were extremely heterogeneous, thus definitive conclusions cannot be drawn regarding optimal volume before a clear advantage in survival is observed. A prospective study defining volume as a continuous variable is warranted to support current admission criteria for American trauma patients. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Lung volume changes during cleaning of closed endotracheal suction catheters: a randomized crossover study using electrical impedance tomography.

    PubMed

    Corley, Amanda; Sharpe, Nicola; Caruana, Lawrence R; Spooner, Amy J; Fraser, John F

    2014-04-01

    Airway suctioning in mechanically ventilated patients is required to maintain airway patency. Closed suction catheters (CSCs) minimize lung volume loss during suctioning but require cleaning post-suction. Despite their widespread use, there is no published evidence examining lung volumes during CSC cleaning. The study objectives were to quantify lung volume changes during CSC cleaning and to determine whether these changes were preventable using a CSC with a valve in situ between the airway and catheter cleaning chamber. This prospective randomized crossover study was conducted in a metropolitan tertiary ICU. Ten patients mechanically ventilated via volume-controlled synchronized intermittent mandatory ventilation (SIMV-VC) and requiring manual hyperinflation (MHI) were included in this study. CSC cleaning was performed using 2 different brands of CSC (one with a valve [Ballard Trach Care 72, Kimberly-Clark, Roswell, Georgia] and one without [Portex Steri-Cath DL, Smiths Medical, Dublin, Ohio]). The maneuvers were performed during both SIMV-VC and MHI. Lung volume change was measured via impedance change using electrical impedance tomography. A mixed model was used to compare the estimated means. During cleaning of the valveless CSC, significant decreases in lung impedance occurred during MHI (-2563 impedance units, 95% CI 2213-2913, P < .001), and significant increases in lung impedance occurred during SIMV (762 impedance units, 95% CI 452-1072, P < .001). In contrast, cleaning of the CSC with a valve in situ resulted in non-significant lung volume changes and maintenance of normal ventilation during MHI and SIMV-VC, respectively (188 impedance units, 95% CI -136 to 511, P = .22; and 22 impedance units, 95% CI -342 to 299, P = .89). When there is no valve between the airway and suction catheter, cleaning of the CSC results in significant derangements in lung volume. Therefore, the presence of such a valve should be considered essential in preserving lung volumes and uninterrupted ventilation in mechanically ventilated patients.

  8. Influence of compressive gear on powerlifting performance: role of blood flow restriction training.

    PubMed

    Godawa, Travis M; Credeur, Daniel P; Welsch, Michael A

    2012-05-01

    This study investigated the effects of powerlifting gear on training volume and performance, defined by the squat, bench press, and deadlift. Eighteen powerlifters (18-26 years) were randomized into either a group that trained and competed using compressive gear (CG) or without the gear (NON). Training volume, volume progression, and powerlifting performance were assessed before and after 10 weeks of training. Training volume increased in the first 4 weeks for both groups. Volume lifted for squat and the totals were greater in the CG. There was an increase in squat (19.05 ± 30.97 lb, p = 0.02), deadlift (19.05 ± 21.17 lb, p = 0.001), and the total score (44.00 ± 60.44 lb, p = 0.005) for both the groups. The improvements in squat (CG = 33.85 vs. NON = 5.74, p = 0.07) and totals (CG = 66.59 vs. NON = 23.67, p = 0.15) were greater in the CG. Both groups showed a significant and similar increase in the Wilks scores (+13.54 points, p = 0.03). There was a trend toward greater volume progression in those wearing CG during the initial stages of training. Both the groups significantly improved performance for the squat, and deadlift, and had higher totals, and Wilks scores, indicating significant strength gains. The greater magnitude of improvements in the squat and totals for the CG lifters suggests an ergogenic potential of training with powerlifting gear.

  9. Cardiologist service volume, percutaneous coronary intervention and hospital level in relation to medical costs and mortality in patients with acute myocardial infarction: a nationwide study.

    PubMed

    Liu, C-Y; Lin, Y-N; Lin, C-L; Chang, Y-J; Hsu, Y-H; Tsai, W-C; Kao, C-H

    2014-07-01

    We explore whether cardiologist service volume, hospital level and percutaneous coronary intervention (PCI) are associated with medical costs and acute myocardial infarction (AMI) mortality. From the 1997-2010 Taiwan National Health Insurance Research Database of the National Health Research Institute, we identified AMI patients and performed multiple regression analyses to explore the relationships among the different hospital levels and treatment factors. We identified 2942 patients with AMI in medical centers and 4325 patients with AMI in regional hospitals. Cardiologist service volume, performing PCI and medical costs per patient were higher in medical centers than in regional hospitals (P < 0.0001). However, the two hospital levels did not differ significantly in in-hospital mortality (P = 0.1557). Post hoc analysis showed significant differences in in-hospital mortality rate and in medical costs among the eight groups subdivided on the basis of hospital level, cardiologist service volume, and whether PCI was performed (P < 0.001 and P = 0.001, respectively). These results highlight the importance of encouraging hospitals to develop PCI capability and increase their cardiologist service volume after taking medical costs into account. Transferring AMI patients to hospitals with higher cardiologist service volume and PCI performed can also be very important. © The Author 2014. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  10. Detection of EEG electrodes in brain volumes.

    PubMed

    Graffigna, Juan P; Gómez, M Eugenia; Bustos, José J

    2010-01-01

    This paper presents a method to detect 128 EEG electrodes in image study and to merge with the Nuclear Magnetic Resonance volume for better diagnosis. First we propose three hypotheses to define a specific acquisition protocol in order to recognize the electrodes and to avoid distortions in the image. In the second instance we describe a method for segmenting the electrodes. Finally, registration is performed between volume of the electrodes and NMR.

  11. Cerebellar Volume in Children With Attention-Deficit Hyperactivity Disorder (ADHD).

    PubMed

    Wyciszkiewicz, Aleksandra; Pawlak, Mikolaj A; Krawiec, Krzysztof

    2017-02-01

    Attention Deficit Hyperactivity Disorder (ADHD) is associated with altered cerebellar volume and cerebellum is associated with cognitive performance. However there are mixed results regarding the cerebellar volume in young patients with ADHD. To clarify the size and direction of this effect, we conducted the analysis on the large public database of brain images. The aim of this study was to confirm that cerebellar volume in ADHD is smaller than in control subjects in currently the largest publicly available cohort of ADHD subjects.We applied cross-sectional case control study design by comparing 286 ADHD patients (61 female) with age and gender matched control subjects. Volumetric measurements of cerebellum were obtained using automated segmentation with FreeSurfer 5.1. Statistical analysis was performed in R-CRAN statistical environment. Patients with ADHD had significantly smaller total cerebellar volumes (134.5±17.11cm 3 vs.138.90±15.32 cm 3 ). The effect was present in both females and males (males 136.9±14.37 cm 3 vs. 141.20±14.75 cm 3 ; females 125.7±12.34 cm 3 vs. 131.20±15.03 cm 3 ). Age was positively and significantly associated with the cerebellar volumes. These results indicate either delayed or disrupted cerebellar development possibly contributing to ADHD pathophysiology.

  12. Predictors of laparoscopic simulation performance among practicing obstetrician gynecologists.

    PubMed

    Mathews, Shyama; Brodman, Michael; D'Angelo, Debra; Chudnoff, Scott; McGovern, Peter; Kolev, Tamara; Bensinger, Giti; Mudiraj, Santosh; Nemes, Andreea; Feldman, David; Kischak, Patricia; Ascher-Walsh, Charles

    2017-11-01

    While simulation training has been established as an effective method for improving laparoscopic surgical performance in surgical residents, few studies have focused on its use for attending surgeons, particularly in obstetrics and gynecology. Surgical simulation may have a role in improving and maintaining proficiency in the operating room for practicing obstetrician gynecologists. We sought to determine if parameters of performance for validated laparoscopic virtual simulation tasks correlate with surgical volume and characteristics of practicing obstetricians and gynecologists. All gynecologists with laparoscopic privileges (n = 347) from 5 academic medical centers in New York City were required to complete a laparoscopic surgery simulation assessment. The physicians took a presimulation survey gathering physician self-reported characteristics and then performed 3 basic skills tasks (enforced peg transfer, lifting/grasping, and cutting) on the LapSim virtual reality laparoscopic simulator (Surgical Science Ltd, Gothenburg, Sweden). The association between simulation outcome scores (time, efficiency, and errors) and self-rated clinical skills measures (self-rated laparoscopic skill score or surgical volume category) were examined with regression models. The average number of laparoscopic procedures per month was a significant predictor of total time on all 3 tasks (P = .001 for peg transfer; P = .041 for lifting and grasping; P < .001 for cutting). Average monthly laparoscopic surgical volume was a significant predictor of 2 efficiency scores in peg transfer, and all 4 efficiency scores in cutting (P = .001 to P = .015). Surgical volume was a significant predictor of errors in lifting/grasping and cutting (P < .001 for both). Self-rated laparoscopic skill level was a significant predictor of total time in all 3 tasks (P < .0001 for peg transfer; P = .009 for lifting and grasping; P < .001 for cutting) and a significant predictor of nearly all efficiency scores and errors scores in all 3 tasks. In addition to total time, there was at least 1 other objective performance measure that significantly correlated with surgical volume for each of the 3 tasks. Higher-volume physicians and those with fellowship training were more confident in their laparoscopic skills. By determining simulation performance as it correlates to active physician practice, further studies may help assess skill and individualize training to maintain skill levels as case volumes fluctuate. Copyright © 2017 Elsevier Inc. All rights reserved.

  13. Critical Propulsion Components. Volume 1; Summary, Introduction, and Propulsion Systems Studies

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Several studies have concluded that a supersonic aircraft, if environmentally acceptable and economically viable, could successfully compete in the 21st century marketplace. However, before industry can commit to what is estimated as a 15 to 20 billion dollar investment, several barrier issues must be resolved. In an effort to address these barrier issues, NASA and Industry teamed to form the High-Speed Research (HSR) program. As part of this program, the Critical Propulsion Components (CPC) element was created and assigned the task of developing those propulsion component technologies necessary to: (1) reduce cruise emissions by a factor of 10 and (2) meet the ever-increasing airport noise restrictions with an economically viable propulsion system. The CPC-identified critical components were ultra-low emission combustors, low-noise/high-performance exhaust nozzles, low-noise fans, and stable/high-performance inlets. Propulsion cycle studies (coordinated with NASA Langley Research Center sponsored airplane studies) were conducted throughout this CPC program to help evaluate candidate components and select the best concepts for the more complex and larger scale research efforts. The propulsion cycle and components ultimately selected were a mixed-flow turbofan (MFTF) engine employing a lean, premixed, prevaporized (LPP) combustor coupled to a two-dimensional mixed compression inlet and a two-dimensional mixer/ejector nozzle. Due to the large amount of material presented in this report, it was prepared in four volumes; Volume 1: Summary, Introduction, and Propulsion System Studies, Volume 2: Combustor, Volume 3: Exhaust Nozzle, and Volume 4: Inlet and Fan/ Inlet Acoustic Team.

  14. High volume improves outcomes: The argument for centralization of rectal cancer surgery.

    PubMed

    Aquina, Christopher T; Probst, Christian P; Becerra, Adan Z; Iannuzzi, James C; Kelly, Kristin N; Hensley, Bradley J; Rickles, Aaron S; Noyes, Katia; Fleming, Fergal J; Monson, John R T

    2016-03-01

    Centralization of care to "centers of excellence" in Europe has led to improved oncologic outcomes; however, little is known regarding the impact of nonmandated regionalization of rectal cancer care in the United States. The Statewide Planning and Research Cooperative System (SPARCS) was queried for elective abdominoperineal and low anterior resections for rectal cancer from 2000 to 2011 in New York with the use of International Classification of Diseases, Ninth Revision codes. Surgeon volume and hospital volume were grouped into quartiles, and high-volume surgeons (≥ 10 resections/year) and hospitals (≥ 25 resections/year) were defined as the top quartile of annual caseload of rectal cancer resection and compared with the bottom 3 quartiles during analyses. Bivariate and multilevel regression analyses were performed to assess factors associated with restorative procedures, 30-day mortality, and temporal trends in these endpoints. Among 7,798 rectal cancer resections, the overall rate of no-restorative proctectomy and 30-day mortality decreased by 7.7% and 1.2%, respectively, from 2000 to 2011. In addition, there was a linear increase in the proportion of cases performed by both high-volume surgeons and high-volume hospitals and a decrease in the number of surgeons and hospitals performing rectal cancer surgery. High-volume surgeons at high-volume hospitals were associated independently with both less nonrestorative proctectomies (odds ratio 0.65, 95% confidence interval 0.48-0.89) and mortality (odds ratio 0.43, 95% confidence interval 0.21-0.87) rates. No patterns of significant improvement within the volume strata of the surgeon and hospitals were observed over time. This study suggests that the current trend toward regionalization of rectal cancer care to high-volume surgeons and high-volume centers has led to improved outcomes. These findings have implications regarding the policy of health care delivery in the United States, supporting referral to high-volume centers of excellence. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Relations between brain volumes, neuropsychological assessment and parental questionnaire in prematurely born children.

    PubMed

    Lind, Annika; Haataja, Leena; Rautava, Liisi; Väliaho, Anniina; Lehtonen, Liisa; Lapinleimu, Helena; Parkkola, Riitta; Korkman, Marit

    2010-05-01

    The objective of this study is to assess the relationship between brain volumes at term equivalent age and neuropsychological functions at 5 years of age in very low birth weight (VLBW) children, and to compare the results from a neuropsychological assessment and a parental questionnaire at 5 years of age. The study group included a regional cohort of 97 VLBW children and a control group of 161 children born at term. At term equivalent age, brain magnetic resonance imaging (MRI) was performed on the VLBW children, and analysed for total and regional brain volumes. At 5 years of age, a psychologist assessed the neuropsychological performance with NEPSY II, and parents completed the Five to fifteen (FTF) questionnaire on development and behaviour. The results of the control group were used to give the age-specific reference values. No significant associations were found between the brain volumes and the NEPSY II domains. As for the FTF, significant associations were found between a smaller total brain tissue volume and poorer executive functions, between a smaller cerebellar volume and both poorer executive functions and motor skills, and, surprisingly, between a larger volume of brainstem and poorer language functions. Even after adjustment for total brain tissue volume, the two associations between the cerebellar volume and the FTF domains remained borderline significant (P = 0.05). The NEPSY II domains Executive Functioning, Language and Motor Skills were significantly associated with the corresponding FTF domains. In conclusion, altered brain volumes at term equivalent age appear to affect development still at 5 years of age. The FTF seems to be a good instrument when used in combination with other neuropsychological assessment.

  16. Comparison of optimization strategy and similarity metric in atlas-to-subject registration using statistical deformation model

    NASA Astrophysics Data System (ADS)

    Otake, Y.; Murphy, R. J.; Grupp, R. B.; Sato, Y.; Taylor, R. H.; Armand, M.

    2015-03-01

    A robust atlas-to-subject registration using a statistical deformation model (SDM) is presented. The SDM uses statistics of voxel-wise displacement learned from pre-computed deformation vectors of a training dataset. This allows an atlas instance to be directly translated into an intensity volume and compared with a patient's intensity volume. Rigid and nonrigid transformation parameters were simultaneously optimized via the Covariance Matrix Adaptation - Evolutionary Strategy (CMA-ES), with image similarity used as the objective function. The algorithm was tested on CT volumes of the pelvis from 55 female subjects. A performance comparison of the CMA-ES and Nelder-Mead downhill simplex optimization algorithms with the mutual information and normalized cross correlation similarity metrics was conducted. Simulation studies using synthetic subjects were performed, as well as leave-one-out cross validation studies. Both studies suggested that mutual information and CMA-ES achieved the best performance. The leave-one-out test demonstrated 4.13 mm error with respect to the true displacement field, and 26,102 function evaluations in 180 seconds, on average.

  17. Space tug point design study. Volume 2: Operations, performance and requirements

    NASA Technical Reports Server (NTRS)

    1973-01-01

    A design study to determine the configuration and characteristics of a space tug was conducted. Among the subjects analyzed in the study are: (1) flight and ground operations, (2) vehicle flight performance and performance enhancement techniques, (3) flight requirements, (4) basic design criteria, and (5) functional and procedural interface requirements between the tug and other systems.

  18. High Performance Schools Best Practices Manual. Volume I: Planning [and] Volume II: Design [and] Volume III: Criteria.

    ERIC Educational Resources Information Center

    Eley, Charles, Ed.

    This three-volume manual, focusing on California's K-12 public schools, presents guidelines for establishing schools that are healthy, comfortable, energy efficient, resource efficient, water efficient, secure, adaptable, and easy to operate and maintain. The first volume describes why high performance schools are important, what components are…

  19. Breadth versus volume: Neurology outpatient clinic cases in medical education.

    PubMed

    Albert, Dara V; Blood, Angela D; Park, Yoon Soo; Brorson, James R; Lukas, Rimas V

    2016-06-01

    This study examined how volume in certain patient case types and breadth across patient case types in the outpatient clinic setting are related to Neurology Clerkship student performance. Case logs from the outpatient clinic experience of 486 students from The University of Chicago Pritzker School of Medicine, USA, participating in the 4week Neurology Clerkship from July 2008 to June 2013 were reviewed. A total of 12,381 patient encounters were logged and then classified into 13 diagnostic categories. How volume of cases within categories and the breadth of cases across categories relate to the National Board of Medical Examiners Clinical Subject Examination for Neurology and a Neurology Clerkship Objective Structured Clinical Examination was analyzed. Volume of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.290, p<.001), the Objective Structured Clinical Examination physical examination (r=.236, p=.011), and the Objective Structured Clinical Examination patient note (r=.238, p=.010). Breadth of cases was significantly correlated with the National Board of Medical Examiners Clinical Subject Examination for Neurology (r=.231, p=.017), however was not significantly correlated with any component of the Objective Structured Clinical Examination. Volume of cases correlated with higher performance on measures of specialty knowledge and clinical skill. Fewer relationships emerged correlating breadth of cases and performance on the same measures. This study provides guidance to educators who must decide how much emphasis to place on volume versus breadth of cases in outpatient clinic learning experiences. Copyright © 2016 Elsevier Ltd. All rights reserved.

  20. Conservation Reasoning Ability and Performance on BSCS Blue Version Examinations.

    ERIC Educational Resources Information Center

    Lawson, Anton E.; Nordland, Floyd H.

    Twenty-three high school biology students were individually administered three conservation tasks (weight, volume, volume displacement). During one semester, they were examined over the course material using published Biological Sciences Curriculum Study (BSCS) Blue Version examination questions which were previously classified as requiring either…

  1. Relationships between regional cerebellar volume and sensorimotor and cognitive function in young and older adults

    PubMed Central

    Bernard, Jessica A.; Seidler, Rachael D.

    2013-01-01

    The cerebellum has been implicated in both sensorimotor and cognitive function, but is known to undergo volumetric declines with advanced age. Individual differences in regional cerebellar volume may therefore provide insight into performance variability across the lifespan, as has been shown with other brain structures and behaviors. Here, we investigated whether there are regional age differences in cerebellar volume in young and older adults, and whether these volumes explain, in part, individual differences in sensorimotor and cognitive task performance. We found that older adults had smaller cerebellar volume than young adults; specifically, lobules in the anterior cerebellum were more impacted by age. Multiple regression analyses for both age groups revealed associations between sensorimotor task performance in several domains (balance, choice reaction time, and timing) and regional cerebellar volume. There were also relationships with working memory, but none with measures of general cognitive or executive function. Follow-up analyses revealed several differential relationships with age between regional volume and sensorimotor performance. These relationships were predominantly selective to cerebellar regions that have been implicated in cognitive functions. Therefore, it may be the cognitive aspects of sensorimotor task performance that are best explained by individual differences in regional cerebellar volumes. In sum, our results demonstrate the importance of regional cerebellar volume with respect to both sensorimotor and cognitive performance, and we provide additional insight into the role of the cerebellum in age-related performance declines. PMID:23625382

  2. White matter volume loss in amyotrophic lateral sclerosis: A meta-analysis of voxel-based morphometry studies.

    PubMed

    Chen, Guangxiang; Zhou, Baiwan; Zhu, Hongyan; Kuang, Weihong; Bi, Feng; Ai, Hua; Gu, Zhongwei; Huang, Xiaoqi; Lui, Su; Gong, Qiyong

    2018-04-20

    Structural neuroimaging studies of white matter (WM) volume in amyotrophic lateral sclerosis (ALS) using voxel-based morphometry (VBM) have yielded inconsistent findings. This study aimed to perform a quantitative voxel-based meta-analysis using effect-size signed differential mapping (ES-SDM) to establish a statistical consensus between published studies for WM volume alterations in ALS. The pooled meta-analysis revealed significant WM volume losses in the bilateral supplementary motor areas (SMAs), bilateral precentral gyri (PGs), left middle cerebellar peduncle and right cerebellum in patients with ALS, involving the corticospinal tract (CST), interhemispheric fibers, subcortical arcuate fibers, projection fibers to the striatum and cortico-ponto-cerebellar tract. The meta-regression showed that the ALS functional rating scale-revised (ALSFRS-R) was positively correlated with decreased WM volume in the bilateral SMAs, whereas illness duration was negatively correlated with WM volume reduction in the right SMA. This study provides a thorough profile of WM volume loss in ALS and robust evidence that ALS is a multisystem neurodegenerative disease that involves a variety of subcortical WM tracts extending beyond motor cortex involvement. Copyright © 2018 Elsevier Inc. All rights reserved.

  3. The volume of the cerebellum in the second semester of gestation.

    PubMed

    Vulturar, Damiana; Fărcăşanu, Alexandru; Turcu, Flaviu; Boitor, Dan; Crivii, Carmen

    2018-01-01

    The cerebellum ("little brain"), the largest part of hind brain, lies in the posterior cranial fossa, beneath the occipital lobe and dorsal to the brainstem. It develops over a long period: it is one of the first structures in the brain to begin to differentiate, but one of the last to mature. The use of ultrasonography has significantly improved the evaluation of fetal growth and development and has permitted prenatal diagnosis of a variety of congenital malformations.The aim of our study was to evaluate the cerebellar growth and development using 2 different measuring techniques: microMRI and ultrasound technique. The cerebellum measurements were related to gestational age. We used 14 human fetuses corresponding to 15-28 gestational weeks, immersed in a 9% formalin solution. Magnetic Resonance Imaging (MRI) was performed by employing a Bruker BioSpec 70/16USR scanner (Bruker BioSpin MRI GmbH, Ettlingen, Germany), operated at 7.04 Tesla for cerebellar volume measurement. Ultrasonographic measurements of the cerebellum diameter were performed on 14 pregnant women, 15 - 28 gestational weeks. Ultrasound scan used 5-10 MHZ for transvaginal approach. Taking into consideration the values of the cerebellum dimensions and considering the general shape of the cerebellum as a transverse ellipsoid, the volume of the cerebellum was calculated by a mathematical formula for ellipsoid volume. The study correlates the measurements from the microMRI study with the ultrasounds data and the results are superposable. Both established the exponential volume growth after the 22-23 GW. We used the ellipsoid volume formula for the cerebellar volume using the half of the three diameters of the cerebellum determined by ultrasound measurements:Cerebellar Volume = Ellipsoid volume = 3/4 π r1 r2 r3. There is a linear correlation between the microMRI measurements and ultrasound determinations. Based on all collected data we could apply an easy formula to calculate the volume of cerebellum, a useful criterion in the evaluation of the cerebellar development and the appreciation of the gestational age.

  4. Bronchoscopic Lung Volume Reduction with Endobronchial Valves in Low-FEV1 Patients.

    PubMed

    Darwiche, Kaid; Karpf-Wissel, Rüdiger; Eisenmann, Stephan; Aigner, Clemens; Welter, Stefan; Zarogoulidis, Paul; Hohenforst-Schmidt, Wolfgang; Freitag, Lutz; Oezkan, Filiz

    2016-01-01

    Bronchoscopic lung volume reduction (BLVR) with valves has been shown to improve lung function, exercise capacity, and quality of life in patients with emphysema, but only few patients with forced expiratory volume in 1 s (FEV1) ≤20% predicted have been included in former studies. Although the procedure can be performed safely, pneumothorax is a frequent complication, which can be critical for these very severely diseased patients. The aim of the study was to assess the safety of BLVR in patients with a very advanced stage of emphysema, as indicated by FEV1 ≤20% predicted. Patients in whom BLVR was performed between January 2013 and August 2015 were included in this analysis if their baseline predicted FEV1 was ≤20%. BLVR, performed only if collateral ventilation was absent, achieved complete occlusion of the target lobe. All patients were closely monitored and were not discharged before the fourth day after BLVR. Twenty patients with FEV1 ≤20% predicted were included in the analysis. Lung volume reduction was achieved in 65% of the cases. Pneumothorax occurred in 4 cases (20%). No patient died. Lung function and exercise tolerance improved after 1 and 3 months, respectively. BLVR with valves can be safely performed in patients with FEV1 ≤20% predicted when close postprocedural monitoring is provided. Improvement in lung function and exercise capacity can be achieved. © 2016 S. Karger AG, Basel.

  5. Retinal thinning is uniquely associated with medial temporal lobe atrophy in neurologically normal older adults

    PubMed Central

    Casaletto, Kaitlin B.; Ward, Michael E.; Baker, Nicholas S.; Bettcher, Brianne M.; Gelfand, Jeffrey M.; Li, Yaqiao; Chen, Robert; Dutt, Shubir; Miller, Bruce; Kramer, Joel H.; Green, Ari J.

    2017-01-01

    Given the converging pathologic and epidemiologic data indicating a relationship between retinal integrity and neurodegeneration, including Alzheimer’s disease (AD), we aimed to determine if retinal structure correlates with medial temporal lobe (MTL) structure and function in neurologically normal older adults. Spectral-domain optical coherence tomography, verbal and visual memory testing, and 3T-magnetic resonance imaging of the brain were performed in 79 neurologically normal adults enrolled in a healthy aging cohort study. Retinal nerve fiber thinning and reduced total macular and macular ganglion cell volumes were each associated with smaller MTL volumes (ps < 0.04). Notably, these markers of retinal structure were not associated with primary motor cortex or basal ganglia volumes (regions relatively unaffected in AD) (ps > 0.70), or frontal, precuneus, or temporoparietal volumes (regions affected in later AD Braak staging ps > 0.20). Retinal structure was not significantly associated with verbal or visual memory consolidation performances (ps > 0.14). Retinal structure was associated with MTL volumes, but not memory performances, in otherwise neurologically normal older adults. Given that MTL atrophy is a neuropathological hallmark of AD, retinal integrity may be an early marker of ongoing AD-related brain health. PMID:28068565

  6. Satellite Power Systems (SPS) concept definition study, exhibit C. Volume 2, part 1: System engineering

    NASA Technical Reports Server (NTRS)

    Hanley, G. M.

    1979-01-01

    Volume 2, Part 1, of a seven volume report is presented. Part 1 encompasses Satellite Power Systems (SPS) systems engineering aspects and is divided into three sections. The first section presents descriptions of the various candidate concepts considered and conclusions and recommendations for a preferred concept. The second section presents a summary of results of the various trade studies and analysis conducted during the course of the study. The third section describes the Photovoltaic Satellite Based Satellite Power System (SPS) Point Design as it was defined through studies performed during the period January 1977 through March 1979.

  7. Performance oriented guidance for Mississippi chip seals - volume II.

    DOT National Transportation Integrated Search

    2013-12-01

    A laboratory and field study was conducted related to long term chip seal performance. This reports primary : objective was to initiate development of a long term performance (LTP) test protocol for chip seals focused on : aggregate retention. Key...

  8. A Comparison of Lung Nodule Segmentation Algorithms: Methods and Results from a Multi-institutional Study.

    PubMed

    Kalpathy-Cramer, Jayashree; Zhao, Binsheng; Goldgof, Dmitry; Gu, Yuhua; Wang, Xingwei; Yang, Hao; Tan, Yongqiang; Gillies, Robert; Napel, Sandy

    2016-08-01

    Tumor volume estimation, as well as accurate and reproducible borders segmentation in medical images, are important in the diagnosis, staging, and assessment of response to cancer therapy. The goal of this study was to demonstrate the feasibility of a multi-institutional effort to assess the repeatability and reproducibility of nodule borders and volume estimate bias of computerized segmentation algorithms in CT images of lung cancer, and to provide results from such a study. The dataset used for this evaluation consisted of 52 tumors in 41 CT volumes (40 patient datasets and 1 dataset containing scans of 12 phantom nodules of known volume) from five collections available in The Cancer Imaging Archive. Three academic institutions developing lung nodule segmentation algorithms submitted results for three repeat runs for each of the nodules. We compared the performance of lung nodule segmentation algorithms by assessing several measurements of spatial overlap and volume measurement. Nodule sizes varied from 29 μl to 66 ml and demonstrated a diversity of shapes. Agreement in spatial overlap of segmentations was significantly higher for multiple runs of the same algorithm than between segmentations generated by different algorithms (p < 0.05) and was significantly higher on the phantom dataset compared to the other datasets (p < 0.05). Algorithms differed significantly in the bias of the measured volumes of the phantom nodules (p < 0.05) underscoring the need for assessing performance on clinical data in addition to phantoms. Algorithms that most accurately estimated nodule volumes were not the most repeatable, emphasizing the need to evaluate both their accuracy and precision. There were considerable differences between algorithms, especially in a subset of heterogeneous nodules, underscoring the recommendation that the same software be used at all time points in longitudinal studies.

  9. Sexual dimorphism of canine volume: a pilot study.

    PubMed

    De Angelis, Danilo; Gibelli, Daniele; Gaudio, Daniel; Cipriani Noce, Filippo; Guercini, Nicola; Varvara, Giuseppe; Sguazza, Emanuela; Sforza, Chiarella; Cattaneo, Cristina

    2015-05-01

    Sex assessment is a crucial part of the biological profile in forensic and archaeological context, but it can be hardly performed in cases of commingled and charred human remains where DNA tests often are not applicable. With time literature have analyzed the sexual dimorphism of teeth (and especially canines), but very few articles take into consideration the teeth volume, although with time several technologies have been introduced in order to assess 3D volume (CT-scan, laser scanner, etc.). This study aims at assessing the sexual dimorphism of dental and pulp chamber volumes of a sample of canines. Cone beam computed tomography analyses were performed by 87 patients (41 males and 46 females, aged between 15 and 83 years) for clinical purposes, and were acquired in order to measure canine volumes. Results show that the dental volume amounted to 0.745 cm(3) (SD 0.126 cm(3)) in males, 0.551 cm(3) (SD 0.130 cm(3)) with a statistically significant difference (p<0.01). A diagnostic threshold of 0.619 cm(3) was stated, which provides a percentage of correct answer of 80.5% in the chosen sample. The novel method was then applied with success to 7 archaeological: where in all the cases the results were concordant with those provided by the assessment of the cranium and pelvis. The study adds a contribution to the wide analysis of dental sexual dimorphism confirming the statistically significant differences of volume between males and females and providing a method for the diagnosis of sex applicable to forensic cases. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Advanced transportation system studies technical area 2(TA-2): Heavy lift launch vehicle development. volume 1; Executive summary

    NASA Technical Reports Server (NTRS)

    McCurry, J.

    1995-01-01

    The purpose of the TA-2 contract was to provide advanced launch vehicle concept definition and analysis to assist NASA in the identification of future launch vehicle requirements. Contracted analysis activities included vehicle sizing and performance analysis, subsystem concept definition, propulsion subsystem definition (foreign and domestic), ground operations and facilities analysis, and life cycle cost estimation. This document is part of the final report for the TA-2 contract. The final report consists of three volumes: Volume 1 is the Executive Summary, Volume 2 is Technical Results, and Volume 3 is Program Cost Estimates. The document-at-hand, Volume 1, provides a summary description of the technical activities that were performed over the entire contract duration, covering three distinct launch vehicle definition activities: heavy-lift (300,000 pounds injected mass to low Earth orbit) launch vehicles for the First Lunar Outpost (FLO), medium-lift (50,000-80,000 pounds injected mass to low Earth orbit) launch vehicles, and single-stage-to-orbit (SSTO) launch vehicles (25,000 pounds injected mass to a Space Station orbit).

  11. Advanced transportation system studies technical area 2 (TA-2): Heavy lift launch vehicle development. volume 3; Program Cost estimates

    NASA Technical Reports Server (NTRS)

    McCurry, J. B.

    1995-01-01

    The purpose of the TA-2 contract was to provide advanced launch vehicle concept definition and analysis to assist NASA in the identification of future launch vehicle requirements. Contracted analysis activities included vehicle sizing and performance analysis, subsystem concept definition, propulsion subsystem definition (foreign and domestic), ground operations and facilities analysis, and life cycle cost estimation. The basic period of performance of the TA-2 contract was from May 1992 through May 1993. No-cost extensions were exercised on the contract from June 1993 through July 1995. This document is part of the final report for the TA-2 contract. The final report consists of three volumes: Volume 1 is the Executive Summary, Volume 2 is Technical Results, and Volume 3 is Program Cost Estimates. The document-at-hand, Volume 3, provides a work breakdown structure dictionary, user's guide for the parametric life cycle cost estimation tool, and final report developed by ECON, Inc., under subcontract to Lockheed Martin on TA-2 for the analysis of heavy lift launch vehicle concepts.

  12. Airport Surface Traffic Control Concept Formulation Study : Volume 4. Estimation of Requirements

    DOT National Transportation Integrated Search

    1975-07-01

    A detailed study of requirements was performed and is presented. This requirements effort provided an estimate of the performance requirements of a surveillance sensor that would be required in a TAGS (Tower Automated Ground Surveillance) system for ...

  13. Age accounts for racial differences in ischemic stroke volume in a population-based study.

    PubMed

    Zakaria, Tarek; Lindsell, Christopher J; Kleindorfer, Dawn; Alwell, Kathleen; Moomaw, Charles J; Woo, Daniel; Szaflarski, Jerzy P; Khoury, Jane; Miller, Rosie; Broderick, Joseph P; Kissela, Brett

    2008-01-01

    The stroke volume among black ischemic stroke patients in phase I of the population-based Greater Cincinnati/Northern Kentucky Stroke Study (GCNKSS) was smaller than reported among acute stroke studies, with a median stroke volume of 2.5 cm. However, it is not known if stroke volume was similar between black and white patients within the same study population. Phase II of the GCNKSS identified all ischemic strokes between July 1993 and June 1994. The stroke volume was estimated by study physicians using the modified ellipsoid method. Analysis of stroke volume by race, sex and age was performed for strokes with a measurable lesion of >or=0.5 cm(3). Among verified cases of ischemic stroke, 334 patients were eligible for this analysis. There were 191 whites (57%) and 143 blacks (43%). The mean age was 69.4 years. The median stroke volume for all patients was 8.8 cm(3) (range 0.5-540), with a mean of 36.4 cm(3). Stroke volume was not different between men and women, and it tended to increase with age. Although stroke volume was significantly higher among whites, age was a confounding factor. Subsequent analysis of stroke volume stratified by age showed no difference between blacks and whites in any age group. Our data show that most ischemic stroke lesions, regardless of the race, are of small size, and this may be an important reason for the low percentage of strokes treated currently with tissue-type plasminogen activator. The association of age with stroke volume requires further study. Copyright 2008 S. Karger AG, Basel.

  14. Nonlinear bivariate dependency of price-volume relationships in agricultural commodity futures markets: A perspective from Multifractal Detrended Cross-Correlation Analysis

    NASA Astrophysics Data System (ADS)

    He, Ling-Yun; Chen, Shu-Peng

    2011-01-01

    Nonlinear dependency between characteristic financial and commodity market quantities (variables) is crucially important, especially between trading volume and market price. Studies on nonlinear dependency between price and volume can provide practical insights into market trading characteristics, as well as the theoretical understanding of market dynamics. Actually, nonlinear dependency and its underlying dynamical mechanisms between price and volume can help researchers and technical analysts in understanding the market dynamics by integrating the market variables, instead of investigating them in the current literature. Therefore, for investigating nonlinear dependency of price-volume relationships in agricultural commodity futures markets in China and the US, we perform a new statistical test to detect cross-correlations and apply a new methodology called Multifractal Detrended Cross-Correlation Analysis (MF-DCCA), which is an efficient algorithm to analyze two spatially or temporally correlated time series. We discuss theoretically the relationship between the bivariate cross-correlation exponent and the generalized Hurst exponents for time series of respective variables. We also perform an empirical study and find that there exists a power-law cross-correlation between them, and that multifractal features are significant in all the analyzed agricultural commodity futures markets.

  15. Intranasal Localizability of Odorants: Influence of Stimulus Volume

    PubMed Central

    Frasnelli, J.; Berg, J.; Huang, G.; Doty, R.L.

    2011-01-01

    When an odorant is presented to one side of the nose and air to the other, the ability to localize which side received the odorant depends upon trigeminal nerve stimulation. It has been shown that performance on this lateralization task increases as stimulus concentration increases. In this study, we determined the influences of stimulus volume and sex on the ability to localize each of 8 odorants presented at neat concentrations: anethole, geraniol, limonene, linalool, menthol, methyl salicyclate, phenyl ethanol, and vanillin. At a low stimulus volume (11 mL), only menthol was localized at an above-chance level. At a high stimulus volume (21 mL), above-chance localization occurred for all odorants except vanillin. Women were significantly better than men in localizing menthol. Stimuli rated as most intense were those that were most readily localized. The detection performance measures, as well as rated intensity values, significantly correlated with earlier findings of the trigeminal detectability of odorants presented to anosmic and normosmic subjects. This study suggests that differences in stimulus volume may explain some discrepant findings within the trigeminal chemosensory literature and supports the concept that vanillin may be a “relatively pure” olfactory stimulus. PMID:21310764

  16. Intranasal localizability of odorants: influence of stimulus volume.

    PubMed

    Frasnelli, J; Hummel, T; Berg, J; Huang, G; Doty, R L

    2011-05-01

    When an odorant is presented to one side of the nose and air to the other, the ability to localize which side received the odorant depends upon trigeminal nerve stimulation. It has been shown that performance on this lateralization task increases as stimulus concentration increases. In this study, we determined the influences of stimulus volume and sex on the ability to localize each of 8 odorants presented at neat concentrations: anethole, geraniol, limonene, linalool, menthol, methyl salicylate, phenyl ethanol, and vanillin. At a low stimulus volume (11 mL), only menthol was localized at an above-chance level. At a high stimulus volume (21 mL), above-chance localization occurred for all odorants except vanillin. Women were significantly better than men in localizing menthol. Stimuli rated as most intense were those that were most readily localized. The detection performance measures, as well as rated intensity values, significantly correlated with earlier findings of the trigeminal detectability of odorants presented to anosmic and normosmic subjects. This study suggests that differences in stimulus volume may explain some discrepant findings within the trigeminal chemosensory literature and supports the concept that vanillin may be a "relatively pure" olfactory stimulus.

  17. Senior Dance Experience, Cognitive Performance, and Brain Volume in Older Women.

    PubMed

    Niemann, Claudia; Godde, Ben; Voelcker-Rehage, Claudia

    2016-01-01

    Physical activity is positively related to cognitive functioning and brain volume in older adults. Interestingly, different types of physical activity vary in their effects on cognition and on the brain. For example, dancing has become an interesting topic in aging research, as it is a popular leisure activity among older adults, involving cardiovascular and motor fitness dimensions that can be positively related to cognition. However, studies on brain structure are missing. In this study, we tested the association of long-term senior dance experience with cognitive performance and gray matter brain volume in older women aged 65 to 82 years. We compared nonprofessional senior dancers ( n = 28) with nonsedentary control group participants without any dancing experience ( n = 29), who were similar in age, education, IQ score, lifestyle and health factors, and fitness level. Differences neither in the four tested cognitive domains (executive control, perceptual speed, episodic memory, and long-term memory) nor in brain volume (VBM whole-brain analysis, region-of-interest analysis of the hippocampus) were observed. Results indicate that moderate dancing activity (1-2 times per week, on average) has no additional effects on gray matter volume and cognitive functioning when a certain lifestyle or physical activity and fitness level are reached.

  18. The design of the run Clever randomized trial: running volume, -intensity and running-related injuries.

    PubMed

    Ramskov, Daniel; Nielsen, Rasmus Oestergaard; Sørensen, Henrik; Parner, Erik; Lind, Martin; Rasmussen, Sten

    2016-04-23

    Injury incidence and prevalence in running populations have been investigated and documented in several studies. However, knowledge about injury etiology and prevention is needed. Training errors in running are modifiable risk factors and people engaged in recreational running need evidence-based running schedules to minimize the risk of injury. The existing literature on running volume and running intensity and the development of injuries show conflicting results. This may be related to previously applied study designs, methods used to quantify the performed running and the statistical analysis of the collected data. The aim of the Run Clever trial is to investigate if a focus on running intensity compared with a focus on running volume in a running schedule influences the overall injury risk differently. The Run Clever trial is a randomized trial with a 24-week follow-up. Healthy recreational runners between 18 and 65 years and with an average of 1-3 running sessions per week the past 6 months are included. Participants are randomized into two intervention groups: Running schedule-I and Schedule-V. Schedule-I emphasizes a progression in running intensity by increasing the weekly volume of running at a hard pace, while Schedule-V emphasizes a progression in running volume, by increasing the weekly overall volume. Data on the running performed is collected by GPS. Participants who sustain running-related injuries are diagnosed by a diagnostic team of physiotherapists using standardized diagnostic criteria. The members of the diagnostic team are blinded. The study design, procedures and informed consent were approved by the Ethics Committee Northern Denmark Region (N-20140069). The Run Clever trial will provide insight into possible differences in injury risk between running schedules emphasizing either running intensity or running volume. The risk of sustaining volume- and intensity-related injuries will be compared in the two intervention groups using a competing risks approach. The trial will hopefully result in a better understanding of the relationship between the running performed and possible differences in running-related injury risk and the injuries developed. Clinical Trials NCT02349373 - January 23, 2015.

  19. Trends in radical prostatectomy: centralization, robotics, and access to urologic cancer care.

    PubMed

    Stitzenberg, Karyn B; Wong, Yu-Ning; Nielsen, Matthew E; Egleston, Brian L; Uzzo, Robert G

    2012-01-01

    Robotic surgery has been widely adopted for radical prostatectomy. We hypothesized that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. A population-based observational study of all prostatectomies for cancer in New York, New Jersey, and Pennsylvania from 2000 to 2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to the treating hospital was calculated for each case. Hospitals were contacted to determine the year of acquisition of the first robot. From 2000 to 2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high-volume centers (≥ 106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000 to 2009. By 2009, the 9% (21/244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. The median travel distance increased 54% from 2000 to 2009 (P<.001). The proportion of patients traveling ≥ 15 miles increased from 24% to 40% (P < .001). Over the past decade, the number of radical prostatectomies performed has risen substantially. These procedures have been increasingly centralized at high-volume centers, leading to longer patient travel distances. Few prostatectomies are now performed at hospitals that do not offer robotic surgery. Copyright © 2011 American Cancer Society.

  20. Emotion recognition and theory of mind are related to gray matter volume of the prefrontal cortex in schizophrenia.

    PubMed

    Maat, Arija; van Haren, Neeltje E M; Bartholomeusz, Cali F; Kahn, René S; Cahn, Wiepke

    2016-02-01

    Investigations of social cognition in schizophrenia have demonstrated consistent impairments compared to healthy controls. Functional imaging studies in schizophrenia patients and healthy controls have revealed that social cognitive processing depends critically on the amygdala and the prefrontal cortex (PFC). However, the relationship between social cognition and structural brain abnormalities in these regions in schizophrenia patients is less well understood. Measures of facial emotion recognition and theory of mind (ToM), two key social cognitive abilities, as well as face perception and IQ, were assessed in 166 patients with schizophrenia and 134 healthy controls. MRI brain scans were acquired. Automated parcellation of the brain to determine gray matter volume of the amygdala and the superior, middle, inferior and orbital PFC was performed. Between-group analyses showed poorer recognition of angry faces and ToM performance, and decreased amygdala and PFC gray matter volumes in schizophrenia patients as compared to healthy controls. Moreover, in schizophrenia patients, recognition of angry faces was associated with inferior PFC gray matter volume, particularly the pars triangularis (p=0.006), with poor performance being related to reduced pars triangularis gray matter volume. In addition, ToM ability was related to PFC gray matter volume, particularly middle PFC (p=0.001), in that poor ToM skills in schizophrenia patients were associated with reduced middle PFC gray matter volume. In conclusion, reduced PFC, but not amygdala, gray matter volume is associated with social cognitive deficits in schizophrenia. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

  1. Maritime patrol aircraft engine study, General Electric Derivative Engines. Volume II. Appendix A: performance data, Ge27/T3 study A1 turboprop. Final report, October 1978-April 1979

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

    Hirschkron, R.; Davis, R.H.; Warren, R.E.

    1979-04-30

    This study developed data on General Electric common core derivative engines for use in Maritime Patrol Aircraft (MPA) concept formulation studies. The study included the screening of potential General Electric turbofan and turboprop/turboshaft engines and the preparation of technical and planning information on three of the most promising engine candidates. Screening of General Electric derivative candidates was performed utilizing an analytical MPA model using synthesized mission profiles to rank the candidates in terms of fuel consumption, weight, cost and complexity. The three turboprop engines selected for further study were as follows: TF34 growth derivative version with boost and new LPTmore » (TF34/T7 Study A1), F404 derivative with booster stages and new LPT (F404/T1 Study A1), and GE27 scaled and boosted study engine (GE27/T3 Study A1). Volume I summarizes the screening analysis and contains technical, planning, installation, cost and development data for the three selected turboprop engines. Volumes II, III and IV of this report contain the detailed performance data estimates for the GE27/T3 Study A1, TF34/T7 Study A1 and F404/T1 Study A1 turboprop engines, respectively.« less

  2. Maritime patrol aircraft engine study, General Electric Derivative Engines. Volume IV. Apendix C: performance data, F404/T1 study A1 turboprop. Final report, October 1978-April 1979

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

    Hirschkron, R.; Davis, R.H.; Warren, R.E.

    1979-04-30

    This study developed data on General Electric common core derivative engines for use in Maritime Patrol Aircraft (MPA) concept formulation studies. The study included the screening of potential General Electric turbofan and turboprop/turboshaft engines and the preparation of technical and planning information on three of the most promising engine candidates. Screening of General Electric derivative candidates was performed utilizing an analytical MPA model using synthesized mission profiles to rank the candidates in terms of fuel consumption, weight, cost and complexity. The three turboprop engines selected for further study were as follows: TF34 growth derivative version with boost and new LPTmore » (TF34/T7 Study A1), F404 derivative with booster stages and new LPT (F404/T1 Study A1), and GE27 scaled and boosted study engine (GE27/T3 Study A1). Volume I summarizes the screening analysis and contains technical, planning, installation, cost and development data for the three selected turboprop engines. Volumes II, III and IV of this report contain the detailed performance data estimates for the GE27/T3 Study A1, TF34/T7 Study A1 and F404/T1 Study A1 turboprop engines, respectively.« less

  3. Maritime patrol aircraft engine study, General Electric Derivative Engines. Volume III. Appendix B: performance data, TF 34/T7 study AL turboprop. Final report October 1978-April 1979

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

    Hirschkron, R.; Davis, R.H.; Warren, R.E.

    1979-04-30

    This study developed data on General Electric common core derivative engines for use in Maritime Patrol Aircraft (MPA) concept formulation studies. The study included the screening of potential General Electric turbofan and turboprop/turboshaft engines and the preparation of technical and planning information on three of the most promising engine candidates. Screening of General Electric derivative candidates was performed utilizing an analytical MPA model using synthesized mission profiles to rank the candidates in terms of fuel consumption, weight, cost and complexity. The three turboprop engines selected for further study were as follows: TF34 growth derivative version with boost and new LPTmore » (TF34/T7 Study A1), F404 derivative with booster stages and new LPT (F404/T1 Study A1), and GE27 scaled and boosted study engine (GE27/T3 Study A1). Volume I summarizes the screening analysis and contains technical, planning, installation, cost and development data for the three selected turboprop engines. Volumes II, III and IV of this report contain the detailed performance data estimates for the GE27/T3 Study A1, TF34/T7 Study A1 and F404/T1 Study A1 turboprop engines, respectively.« less

  4. The relation of hippocampal subfield volumes to verbal episodic memory measured by the California Verbal Learning Test II in healthy adults.

    PubMed

    Aslaksen, Per M; Bystad, Martin K; Ørbo, Marte C; Vangberg, Torgil R

    2018-06-08

    Total hippocampal volume has previously been shown to correlate with performance on tests for verbal episodic memory. However, there are sparse evidence on how hippocampal subfield volumes are related to verbal episodic memory in healthy adults. The present study investigated the association between volumes of separate hippocampal subfields and verbal episodic memory performance in healthy volunteers. Forty-seven participants (31 females) between 20 to 71 years age underwent testing with the California Verbal Learning Test II (CVLT II), and the Wechsler Abbreviated Scale of Intelligence (WASI) to obtain an estimate of cognitive functioning. T1-weighted MR images were obtained after cognitive testing, and volumetric estimates adjusted for age and estimated total intracranial volume were calculated in the FreeSurfer 6.0 software suite for cerebral -and hippocampal structures. The sample performed within the statistical normal range on both CVLT II and WASI. Significant correlations adjusted for multiple testing were found between CVLT II subtests of total learning, free immediate recall and free delayed recall and volumes of the left Cornu Ammonis (CA) 1-4 subfields. There were no significant correlations between right hippocampal subfields and CVLT II performance, and no significant correlation between WASI results and hippocampal subfields. The present results suggest that better verbal episodic memory measured by the CVLT II is associated with relative larger volumes of specific left CA hippocampal subfields in healthy adults. Due to the small sample size and large age-span of the participants, the present findings are preliminary and should be confirmed in larger samples. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Development of a wireless MEMS multifunction sensor system and field demonstration of embedded sensors for monitoring concrete pavements, volume II

    DOT National Transportation Integrated Search

    2016-08-01

    This two-pronged study evaluated the performance of commercial off-the-shelf (COTS) micro-electromechanical sensors and systems (MEMS) embedded in concrete pavement (Final Report Volume I) and developed a wireless MEMS multifunctional sensor system f...

  6. Aging, Brain Size, and IQ.

    ERIC Educational Resources Information Center

    Bigler, Erin D.; And Others

    1995-01-01

    Whether cross-sectional rates of decline for brain volume and the Performance Intellectual Quotient of the Wechsler Adult Intelligence Scale-Revised were equivalent over the years 16 to 65 was studied with 196 volunteers. Results indicate remarkably similar rates of decline in perceptual-motor functions and aging brain volume loss. (SLD)

  7. Design and evaluation of high-volume fly ash (HVFA) concrete mixes, report D : creep, shrinkage, and abrasion resistance of HVFA concrete.

    DOT National Transportation Integrated Search

    2012-10-01

    The main objective of this study was to determine the effect on shrinkage, creep, : and abrasion resistance of high-volume fly ash (HVFA) concrete. The HVFA concrete : test program consisted of comparing the shrinkage, creep, and abrasion performance...

  8. A Study of Job Demands and Curriculum Development in Agricultural Training Related to the Muskegon County Wastewater Management System. Final Report. Volume IV. Career Awareness Information.

    ERIC Educational Resources Information Center

    Fisher, Harold S.; And Others

    This is the final volume of a four-volume report of a research project designed to (1) identify job needs for agricultural occupations which will result from the Muskegon County Wastewater Management System and perform a task analysis on each occupation, (2) develop instructional modules and determine their place in either high school or 2-year…

  9. A Study of Job Demands and Curriculum Development in Agricultural Training Related to the Muskegon County Wastewater Management System. Final Report. Volume II. Task Analysis Results.

    ERIC Educational Resources Information Center

    Fisher, Harold S.; And Others

    This is the second volume of a four-volume report of a research project designed to (1) identify job needs for agricultural occupations which will result from the Muskegon County Wastewater Management System and perform a task analysis on each occupation, (2) develop instructional modules and determine their place in either high school or 2-year…

  10. Impact of surgeon volume and specialization on short-term outcomes in colorectal cancer surgery.

    PubMed

    Borowski, D W; Kelly, S B; Bradburn, D M; Wilson, R G; Gunn, A; Ratcliffe, A A

    2007-07-01

    Several studies have shown a relationship between surgeon volume and outcomes in colorectal cancer surgery. The aim of this study was to determine the impact of surgeon volume and specialization on primary tumour resection rate, restoration of bowel continuity following rectal cancer resection, anastomotic leakage and perioperative mortality. The Northern Region Colorectal Cancer Audit Group conducts a population-based audit of patients with colorectal cancer managed by surgeons. This study examined 8219 patients treated between 1998 and 2002. Outcomes were modelled using multivariate logistic regression analysis. Tumour resection was performed in 6949 (93.8 per cent) of 7411 patients. High-volume surgeons with an annual caseload of at least 18.5 (odds ratio (OR) 1.53 (95 per cent confidence interval (c.i.) 1.10 to 2.12); P = 0.012) and colorectal specialists (OR 1.42 (95 per cent c.i. 1.06 to 1.90); P = 0.018) were more likely to perform elective sphincter-saving rectal surgery. In elective surgery, the risk of perioperative death was lower for high-volume surgeons (OR 0.58 (95 per cent c.i. 0.44 to 0.76); P < 0.001), but this was not the case in emergency surgery. High-volume surgeons had lower perioperative mortality rates for elective surgery, and were more likely to use restorative rectal procedures. Copyright (c) 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  11. Testing of state roadside safety systems. Volume I, Technical report

    DOT National Transportation Integrated Search

    1999-04-01

    The purpose of this study is to crash test and evaluate new or modified roadside safety hardware and, where necessary, redesign the devices to improve their impact performance. The three major areas addressed in this study are the impact performance ...

  12. Calibration of automatic performance measures - speed and volume data : volume 1, evaluation of the accuracy of traffic volume counts collected by microwave sensors.

    DOT National Transportation Integrated Search

    2015-09-01

    Over the past few years, the Utah Department of Transportation (UDOT) has developed a system called the : Signal Performance Metrics System (SPMS) to evaluate the performance of signalized intersections. This system : currently provides data summarie...

  13. Critical Propulsion Components. Volume 4; Inlet and Fan/Inlet Accoustics Team

    NASA Technical Reports Server (NTRS)

    2005-01-01

    Several studies have concluded that a supersonic aircraft, if environmentally acceptable and economically viable, could successfully compete in the 21st century marketplace. However, before industry can commit to what is estimated as a 15 to 20 billion dollar investment, several barrier issues must be resolved. In an effort to address these barrier issues, NASA and Industry teamed to form the High-Speed Research (HSR) program. As part of this program, the Critical Propulsion Components (CPC) element was created and assigned the task of developing those propulsion component technologies necessary to: (1) reduce cruise emissions by a factor of 10 and (2) meet the ever-increasing airport noise restrictions with an economically viable propulsion system. The CPC-identified critical components were ultra-low emission combustors, low-noise/high-performance exhaust nozzles, low-noise fans, and stable/high-performance inlets. Propulsion cycle studies (coordinated with NASA Langley Research Center sponsored airplane studies) were conducted throughout this CPC program to help evaluate candidate components and select the best concepts for the more complex and larger scale research efforts. The propulsion cycle and components ultimately selected were a mixed-flow turbofan (MFTF) engine employing a lean, premixed, prevaporized (LPP) combustor coupled to a two-dimensional mixed compression inlet and a two-dimensional mixer/ejector nozzle. Due to the large amount of material presented in this report, it was prepared in four volumes; Volume 1: Summary, Introduction, and Propulsion System Studies, Volume 2: Combustor, Volume 3: Exhaust Nozzle, and Volume 4: Inlet and Fan/Inlet Acoustic Team.

  14. Which echocardiographic parameter is a better marker of volume status in hemodialysis patients?

    PubMed

    Sabaghian, Tahereh; Hajibaratali, Bahareh; Samavat, Shiva

    2016-11-01

    Bio-impedance analysis (BIA) is a preferred method for estimating the volume status. However, it cannot be utilized in daily practice. Since the assessment of the volume status is important and challenging for hemodialysis (HD) patients, the aim of study was to determine the volume status in chronic HD patients using echocardiographic parameters and assess its correlation with BIA. In this cross-sectional analysis, echocardiography and BIA were performed on 30 chronic HD patients 30 min before and 30 min after dialysis. All the cases of dialysis were performed in the middle of the week. This study also assessed the correlation between echocardiographic parameters and BIA parameters. There were significant differences between ECW, TBW, and TBW% (TBW/W) before and after HD. Significant differences were observed between echocardiographic parameters of IVCD, IVCDi min , IVCDi max before and after the HD. LVEDD, LVESD, LA area, mitral valve inflow, E/E', and IVRT, were improved after dialysis, too. There was a significant correlation between IVCDi min as an index of volume status, ECW% and TBW% before HD and IVCDi min change after dialysis had a significant correlation with %ECW change after dialysis. Comparison between hypertensive and non-hypertensive groups indicated IVCDi min was significantly lower in non-hypertensive group after dialysis. Our results showed a correlation between IVCDi min and BIA parameters before HD. So, it seems that IVCDi min can be a good parameter for determining the volume status of HD patients. However, further studies, with larger sample size and with a prospective study design, are required to confirm these results.

  15. "Take the Volume Pledge" may result in disparity in access to care.

    PubMed

    Blanco, Barbara A; Kothari, Anai N; Blackwell, Robert H; Brownlee, Sarah A; Yau, Ryan M; Attisha, John P; Ezure, Yoshiki; Pappas, Sam; Kuo, Paul C; Abood, Gerard J

    2017-03-01

    "Take the Volume Pledge" proposes restricting pancreatectomies to hospitals that perform ≥20 per year. Our purpose was to identify those factors that characterize patients at risk for loss of access to pancreatic cancer care with enforcement of volume standards. Using the Healthcare Cost and Utilization Project State Inpatient Database from Florida, we identified patients who underwent pancreatectomy for pancreatic malignancy from 2007-2011. American Hospital Association and United States Census Bureau data were linked to patient-level data. High-volume hospitals were defined as performing ≥20 pancreatic resections per year. Univariable and multivariable statistics compared patient characteristics and utilization of high-volume hospitals. Classification and Regression Tree modeling was used to predict patients at risk for losing access to care. Our study included 1,663 patients. Five high-volume hospitals were identified, and they treated 1,056 (63.5%) patients. Patients residing far from high-volume hospitals, in areas with the highest population density, non-Caucasian ethnicity, and greater income had decreased odds of obtaining care at high-volume hospitals. Using these factors, we developed a Classification and Regression Tree-based predictive tool to identify these patients. Implementation of "Take the Volume Pledge" is an important step toward improving pancreatectomy outcomes; however, policymakers must consider the potential impact on limiting access and possible health disparities that may arise. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The British Association of Urological Surgeons (BAUS) radical prostatectomy audit 2014/2015 - an update on current practice and outcomes by centre and surgeon case-volume.

    PubMed

    Khadhouri, Sinan; Miller, Catherine; Fowler, Sarah; Hounsome, Luke; McNeill, Alan; Adshead, Jim; McGrath, John S

    2018-02-01

    To describe contemporary radical prostatectomy (RP) practice using the British Association of Urological Surgeons (BAUS) data and audit project and to observe differences in practice in relation to surgeon or centre case-volume. Data on 13 920 RP procedures performed by 179 surgeons across 86 centres were recorded on the BAUS data and audit platform between 1 January 2014 and 31 December 2015. This equates to ~95% of total RPs performed over this period when compared to Hospital Episode Statistics (HES) data. Centre case-volumes were categorised as 'high' (>200), 'medium' (100-200) and 'low' (<100); surgeon case-volumes were categorised as 'high' (>100) and 'low' (<100). Differences in surgical practice and selected outcome measures were observed between groups. All data and volume categories were for the combined 2-year period. The median number of RPs performed over the 2-year period was 63.5 per surgeon and 164 per centre. Overall, surgical approach was robot-assisted laparoscopic RP (RALP) in 65%, laparoscopic RP (LRP) in 23%, and open RP (ORP) in 12%. The dominant approach in high-case-volume centres and by high-case-volume surgeons was RALP (74.3% and 69.2%, respectively). There was a greater percentage of ORPs reported by low-volume surgeons and centres when compared to higher volume equivalents. In all, 51.6% of all patients in this series underwent RP in high-case-volume centres using robot-assisted surgery (RAS). High-case-volume surgeons performed nerve-sparing (NS) procedures on 57.3% of their cases; low-volume surgeons performing NS on 48.2%. Overall, lymph node dissection (LND) rates were very similar across the groups. An 'extended' LND was more commonly performed in high-volume centres (22.1%). The median length of stay (LOS) was lowest in patients undergoing RALP at high-volume centres (1 day) and highest in ORP across all volume categories (3-4 days). Reported pT2 positive surgical margin (PSM) rate varied by technique, centre volume, and surgeon volume. In general, observed PSM rates were lower when RALP was the surgical approach (14.4%) and when high-volume surgeons were compared to low-volume surgeons (13.6% vs 17.7%). Transfusion rates were highest in ORP across all centres and surgeons (2.96-4.49%) compared to techniques using a minimally-invasive approach (0.25-2.41%). Training cases ranged from 0.5% in low-volume centres to 6.0% in high-volume centres. Compliance with data registration for centres and surgeons performing RP is high in the present series. Most RPs were performed in high-case-volume centres and by high-case-volume surgeons, with the most common approaches being minimally invasive and specifically RAS. High-case-volume centres and surgeons reported higher rates of extended LND and training cases. Higher-case-volume surgeons reported lower pT2 PSM rates, whilst the most marked differences in transfusion rates and LOS were seen when ORP was compared to minimally invasive approaches. Caution must be applied when interpreting these differences on the basis of this being registry data - causality cannot be assumed. © 2018 The Authors BJU International © 2018 BJU International Published by John Wiley & Sons Ltd.

  17. Does Stroke Volume Increase During an Incremental Exercise? A Systematic Review

    PubMed Central

    Vieira, Stella S.; Lemes, Brunno; de T. C. de Carvalho, Paulo; N. de Lima, Rafael; S. Bocalini, Danilo; A. S. Junior, José; Arsa, Gisela; A. Casarin, Cezar; L. Andrade, Erinaldo; J. Serra, Andrey

    2016-01-01

    Introduction: Cardiac output increases during incremental-load exercise to meet metabolic skeletal muscle demand. This response requires a fast adjustment in heart rate and stroke volume. The heart rate is well known to increase linearly with exercise load; however, data for stroke volume during incremental-load exercise are unclear. Our objectives were to (a) review studies that have investigated stroke volume on incremental load exercise and (b) summarize the findings for stroke volume, primarily at maximal-exercise load. Methods: A comprehensive review of the Cochrane Library’s, Embase, Medline, SportDiscus, PubMed, and Web of Sci-ence databases was carried out for the years 1985 to the present. The search was performed between February and June 2014 to find studies evaluating changes in stroke volume during incremental-load exercise. Controlled and uncontrolled trials were evaluated for a quality score. Results: The stroke volume data in maximal-exercise load are inconsistent. There is evidence to hypothesis that stroke volume increases during maximal-exercise load, but other lines of evidence indicate that stroke volume reaches a plateau under these circumstances, or even decreases. Conclusion: The stroke volume are unclear, include contradictory evidence. Additional studies with standardized reporting for subjects (e.g., age, gender, physical fitness, and body position), exercise test protocols, and left ventricular function are required to clarify the characteristics of stroke volume during incremental maximal-exercise load. PMID:27347221

  18. Matrix-array 3-dimensional echocardiographic assessment of volumes, mass, and ejection fraction in young pediatric patients with a functional single ventricle: a comparison study with cardiac magnetic resonance.

    PubMed

    Soriano, Brian D; Hoch, Martin; Ithuralde, Alejandro; Geva, Tal; Powell, Andrew J; Kussman, Barry D; Graham, Dionne A; Tworetzky, Wayne; Marx, Gerald R

    2008-04-08

    Quantitative assessment of ventricular volumes and mass in pediatric patients with single-ventricle physiology would aid clinical management, but it is difficult to obtain with 2-dimensional echocardiography. The purpose of the present study was to compare matrix-array 3-dimensional echocardiography (3DE) measurements of single-ventricle volumes, mass, and ejection fraction with those measured by cardiac magnetic resonance (CMR) in young patients. Twenty-nine patients (median age, 7 months) with a functional single ventricle undergoing CMR under general anesthesia were prospectively enrolled. The 3DE images were acquired at the conclusion of the CMR. Twenty-seven of 29 3DE data sets (93%) were optimal for 3DE assessment. Two blinded and independent observers performed 3DE measurements of volume, mass, and ejection fraction. The 3DE end-diastolic volume correlated well (r=0.96) but was smaller than CMR by 9% (P<0.01), and 3DE ejection fraction was smaller than CMR by 11% (P<0.01). There was no significant difference in measurements of end-systolic volume and mass. The 3DE interobserver differences for mass and volumes were not significant except for ejection fraction (8% difference; P<0.05). Intraobserver differences were not significant. In young pediatric patients with a functional single ventricle, matrix-array 3DE measurements of mass and volumes compare well with those obtained by CMR. 3DE will provide an important modality for the serial analysis of ventricular size and performance in young patients with functional single ventricles.

  19. Ocular volumetry using fast high-resolution MRI during visual fixation.

    PubMed

    Tanitame, K; Sone, T; Miyoshi, T; Tanitame, N; Otani, K; Akiyama, Y; Takasu, M; Date, S; Kiuchi, Y; Awai, K

    2013-04-01

    Volumetry may be useful for evaluating treatment response and prognosis of intraocular lesions. Phantom, volunteer, and patient studies were performed to determine whether ocular MR volumetry is reproducible. Half-Fourier single-shot RARE and FSPGR sequences at 1.5T with a 76-mm-diameter surface coil were optimized to obtain still ocular images. Volumetry accuracies of each sequence were compared with simulated subretinal phantom volumes. Ocular volumetry was performed in 15 volunteers twice in 1 week by using contiguous axial images of the globes while the subjects stared at a target, and images were acquired in 2 seconds before the subjects were instructed to blink, with this process repeated as necessary. Imaging, intraobserver, and interobserver reproducibility for volumes of the whole eyeball and anterior chamber were assessed. Ocular volumetry was also performed in 6 patients with intraocular tumors before and after treatment. The phantom study demonstrated that measurement error rates with RARE were significantly lower than with FSPGR (P<.01). The volunteer study demonstrated excellent imaging and intraobserver reproducibility of RARE volumetry for whole eyeballs and anterior chambers (P<.01). Although no interobserver differences were observed in anterior chamber volume measurement (P=.33), there was a significant difference between the 2 observers in eyeball volume measurement (P<.01). Follow-up volumetric data were useful for treatment decisions in all patients. Ocular volumetry from contiguous ultrafast RARE images obtained during visual fixation is feasible in volunteer and patient studies and is superior to FSPGR images.

  20. Efficacy and safety of tolvaptan in heart failure patients with volume overload despite the standard treatment with conventional diuretics: a phase III, randomized, double-blind, placebo-controlled study (QUEST study).

    PubMed

    Matsuzaki, Masunori; Hori, Masatsugu; Izumi, Tohru; Fukunami, Masatake

    2011-12-01

    Diuretics are recommended to treat volume overload with heart failure (HF), however, they may cause serum electrolyte imbalance, limiting their use. Moreover, patients with advanced HF could poorly respond to these diuretics. In this study, we evaluated the efficacy and safety of Tolvaptan, a competitive vasopressin V2-receptor antagonist developed as a new drug to treat volume overload in HF patients. A phase III, multicenter, randomized, double-blind, placebo-controlled parallel study was performed to assess the efficacy and safety of tolvaptan in treating HF patients with volume overload despite the use of conventional diuretics. One hundred and ten patients were randomly assigned to receive either placebo or 15 mg/day tolvaptan for 7 consecutive days. Compared with placebo, tolvaptan administered for 7 days significantly reduced body weight and improved symptoms associated with volume overload. The safety profile of tolvaptan was considered acceptable for clinical use with minimal adverse effects. Tolvaptan reduced volume overload and improved congestive symptoms associated with HF by a potent water diuresis (aquaresis).

  1. A Novel Application for the Cavalieri Principle: A Stereological and Methodological Study

    PubMed Central

    Altunkaynak, Berrin Zuhal; Altunkaynak, Eyup; Unal, Deniz; Unal, Bunyamin

    2009-01-01

    Objective The Cavalieri principle was applied to consecutive pathology sections that were photographed at the same magnification and used to estimate tissue volumes via superimposing a point counting grid on these images. The goal of this study was to perform the Cavalieri method quickly and practically. Materials and Methods In this study, 10 adult female Sprague Dawley rats were used. Brain tissue was removed and sampled both systematically and randomly. Brain volumes were estimated using two different methods. First, all brain slices were scanned with an HP ScanJet 3400C scanner, and their images were shown on a PC monitor. Brain volume was then calculated based on these images. Second, all brain slices were photographed in 10× magnification with a microscope camera, and brain volumes were estimated based on these micrographs. Results There was no statistically significant difference between the volume measurements of the two techniques (P>0.05; Paired Samples t Test). Conclusion This study demonstrates that personal computer scanning of serial tissue sections allows for easy and reliable volume determination based on the Cavalieri method. PMID:25610077

  2. A novel application for the cavalieri principle: a stereological and methodological study.

    PubMed

    Altunkaynak, Berrin Zuhal; Altunkaynak, Eyup; Unal, Deniz; Unal, Bunyamin

    2009-08-01

    The Cavalieri principle was applied to consecutive pathology sections that were photographed at the same magnification and used to estimate tissue volumes via superimposing a point counting grid on these images. The goal of this study was to perform the Cavalieri method quickly and practically. In this study, 10 adult female Sprague Dawley rats were used. Brain tissue was removed and sampled both systematically and randomly. Brain volumes were estimated using two different methods. First, all brain slices were scanned with an HP ScanJet 3400C scanner, and their images were shown on a PC monitor. Brain volume was then calculated based on these images. Second, all brain slices were photographed in 10× magnification with a microscope camera, and brain volumes were estimated based on these micrographs. There was no statistically significant difference between the volume measurements of the two techniques (P>0.05; Paired Samples t Test). This study demonstrates that personal computer scanning of serial tissue sections allows for easy and reliable volume determination based on the Cavalieri method.

  3. Relation of exercise capacity with lung volumes before and after 6-minute walk test in subjects with COPD.

    PubMed

    Wibmer, Thomas; Rüdiger, Stefan; Kropf-Sanchen, Cornelia; Stoiber, Kathrin M; Rottbauer, Wolfgang; Schumann, Christian

    2014-11-01

    There is growing evidence that exercise-induced variation in lung volumes is an important source of ventilatory limitation and is linked to exercise intolerance in COPD. The aim of this study was to compare the correlations of walk distance and lung volumes measured before and after a 6-min walk test (6MWT) in subjects with COPD. Forty-five subjects with stable COPD (mean pre-bronchodilator FEV1: 47 ± 18% predicted) underwent a 6MWT. Body plethysmography was performed immediately pre- and post-6MWT. Correlations were generally stronger between 6-min walk distance and post-6MWT lung volumes than between 6-min walk distance and pre-6MWT lung volumes, except for FEV1. These differences in Pearson correlation coefficients were significant for residual volume expressed as percent of total lung capacity (-0.67 vs -0.58, P = .043), percent of predicted residual volume expressed as percent of total lung capacity (-0.68 vs -0.59, P = .026), inspiratory vital capacity (0.65 vs 0.54, P = .019), percent of predicted inspiratory vital capacity (0.49 vs 0.38, P = .037), and percent of predicted functional residual capacity (-0.62 vs -0.47, P = .023). In subjects with stable COPD, lung volumes measured immediately after 6MWT are more closely related to exercise limitation than baseline lung volumes measured before 6MWT, except for FEV1. Therefore, pulmonary function testing immediately after exercise should be included in future studies on COPD for the assessment of exercise-induced ventilatory constraints to physical performance that cannot be adequately assessed from baseline pulmonary function testing at rest. Copyright © 2014 by Daedalus Enterprises.

  4. Case Studies in Educational Performance Contracting. Part 1. Conclusions and Implications.

    ERIC Educational Resources Information Center

    Carpenter, Polly; Hall, George R.

    This volume presents conclusions and implications derived from five cities' experience with performance contracting in education: Norfolk, Virginia; Texarkana, Arkansas (with Liberty-Eylau, Texas); Gary, Indiana, Gilroy, California; and Grand Rapids, Michigan. The five case studies cover eight programs in 15 schools. While each study is treated in…

  5. Determination of Ammunition Training Rates for Marine Forces Study. Volume 2.

    DTIC Science & Technology

    1983-09-17

    ARD-fl44 430 DETERMINATION OF AMMUNITION TRAINING RATES FOR MARINE i/n FORCES STUDY VOLUME 2(U) MARINE CORPS DEVELOPMENT AND EDUCATION COMMAND... STUDY - VOL II LIEUTENANT COLONEL R. J. YEOMAN C) DEPUTY CHIEF OF STAFF FOR DEVELOPMENTAL COORDINATION MY) DEVELOPMENT CENTER ’ MARINE CORPS...MARINE FORCES STUDY , DECISION S. PERFORMING ORG. REPORT NUMBER MEMORANDUM 7. AUTHOR(#) S. CONTR 4T9M GRANT NUMUER(s) M 00027- -G-0 060 LtCol R. J

  6. Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

    NASA Astrophysics Data System (ADS)

    1995-03-01

    This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

  7. Structural Arrangement Trade Study. Volume 1: Reusable Hydrogen Composite Tank System (RHCTS) and Graphite Composite Primary Structures (GCPS). Executive summary

    NASA Technical Reports Server (NTRS)

    1995-01-01

    This volume is the first of a three volume set that discusses the structural arrangement trade study plan that will identify the most suitable configuration for an SSTO winged vehicle capable of delivering 25,000 lbs to a 220 nm circular orbit at 51.6 deg inclination. The Reusable Hydrogen Composite Tank System (RHCTS), and Graphite Composite Primary Structures most suitable for intertank, wing and thrust structures are identified. This executive summary presents the trade study process, the selection process, requirements used, analysis performed and data generated. Conclusions and recommendations are also presented.

  8. Public Interest in Breast Augmentation: Analysis and Implications of Google Trends Data.

    PubMed

    Wilson, Stelios C; Daar, David A; Sinno, Sammy; Levine, Steven M

    2018-06-01

    Breast augmentation is the most common aesthetic surgery performed in the United States (US) annually. Analysis of Google Trends (GT) data may give plastic surgeons useful information regarding worldwide, national, and regional interest for breast augmentation and other commonly performed aesthetic surgeries. Data were collected using GT for breast augmentation and associated search terms from January 2004 to May 2017. Case volume was obtained from the American Society of Plastic Surgeons (ASPS) annual reports for the calendar year 2005-2016. Trend analysis showed that total search term volume for breast augmentation and breast implants gradually decreased worldwide and in the US over the study period while the search term boob job slowly increased. Univariate linear regression demonstrated a statistically significant positive correlation between average annual Google search volume of "breast augmentation" and the annual volume of breast augmentations performed in the US according to ASPS data (R 2  = 0.44, p = 0.018). There was no significant correlation between national volume of breast augmentations performed and search volume using the terms "breast implants" or "boob job" over time (p = 0.84 and p = 0.07, respectively). In addition, there appears to be country specific variation in interest based on time of year and peaks in interest following specific policies. To our knowledge, this is the first and only analysis of GT data in the plastic surgery literature to date. To that end, this study highlights this large and potentially powerful data set for plastic surgeons both in the US and around the world. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  9. National Hydroelectric Power Resources Study:Regional Assessment: Volume XXIII: Alaska and Hawaii

    DTIC Science & Technology

    1981-09-01

    amount of recoverable geothermal energy is still unknown, a test well (HGP-A) was drilled 6,450 feet into the eastern rift of Kilauea volcano on...US Army Corps of Engineers National Hydroelectric Power Resources Study Volume XXIII September 1 981 Regional Assessment: Alaska and Hawaii ...National Hydroelectric Power Resources Study: Final Regional Assessment; Alaska and Hawaii IS. PERFORMING ORG. REPORT NUMBER IWR 82-𔃻-23 7. AUTHOR(a) 8

  10. "Pulmonary valve replacement diminishes the presence of restrictive physiology and reduces atrial volumes": a prospective study in Tetralogy of Fallot patients.

    PubMed

    Pijuan-Domenech, Antonia; Pineda, Victor; Castro, Miguel Angel; Sureda-Barbosa, Carlos; Ribera, Aida; Cruz, Luz M; Ferreira-Gonzalez, Ignacio; Dos-Subirà, Laura; Subirana-Domènech, Teresa; Garcia-Dorado, David; Casaldàliga-Ferrer, Jaume

    2014-11-15

    Pulmonary valve replacement (PVR) reduces right ventricular (RV) volumes in the setting of long-term pulmonary regurgitation after Tetralogy of Fallot (ToF) repair; however, little is known of its effect on RV diastolic function. Right atrial volumes may reflect the burden of RV diastolic dysfunction. The objective of this paper is to evaluate the clinical, echocardiographic, biochemical and cardiac magnetic resonance (CMR) variables, focusing particularly on right atrial response and right ventricular diastolic function prior to and after elective PVR in adult patients with ToF. This prospective study was conducted from January 2009 to April 2013 in consecutive patients > 18 years of age who had undergone ToF repair in childhood and were accepted for elective PVR. Twenty patients (mean age: 35 years; 70% men) agreed to enter the study. PVR was performed with a bioporcine prosthesis. Concomitant RV reduction was performed in all cases when technically possible. Pulmonary end-diastolic forward flow (EDFF) decreased significantly from 5.4 ml/m(2) to 0.3 ml/m(2) (p < 0.00001), and right atrial four-chamber echocardiographic measurements and volumes by 25% (p = 0.0024): mean indexed diastolic/systolic atrial volumes prior to surgery were 43 ml/m(2) (SD+/-4.6)/63 ml/m(2) (SD+/-5.5), and dropped to 33 ml/m(2) (SD+/-3)/46 ml/m(2) (SD+/-2.55) post-surgery. All patients presented right ventricular diastolic and systolic volume reductions, with a mean volume reduction of 35% (p < 0.00001). Right ventricular diastolic dysfunction was common in a population of severely dilated RV patients long term after ToF repair. Right ventricular diastolic parameters improved as did right atrial volumes in keeping with the known reduction in RV volumes, after PVR. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  11. High-volume resistance training session acutely diminishes respiratory muscle strength.

    PubMed

    Hackett, Daniel A; Johnson, Nathan A; Chow, Chin-Moi

    2012-01-01

    This study investigated the effect of a high-volume compared to a low-volume resistance training session on maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP). Twenty male subjects with resistance training experience (6.2 ± 3.2 y), in a crossover trial, completed two resistance training protocols (high-volume: 5 sets per exercise; low-volume: 2 sets per exercise) and a control session (no exercise) on 3 separate occasions. MIP and MEP decreased by 13.6% (p < 0.01) and 14.7% (p < 0.01) respectively from pre-session MIP and MEP, following the high-volume session. MIP and MEP were unaffected following the low-volume or the control sessions. MIP returned to pre-session values after 40 minutes, whereas MEP remained significantly reduced after 60 minutes post-session by 9.2% compared to pre-session (p < 0.01). The findings suggest that the high-volume session significantly decreased MIP and MEP post-session, implicating a substantially increased demand on the respiratory muscles and that adequate recovery is mandatory following this mode of training. Key pointsRespiratory muscular strength performance is acutely diminished following a high-volume whole-body resistance training session.Greater ventilatory requirements and generation of IAP during the high-volume resistance training session may have contributed to the increased demand placed on the respiratory muscles.Protracted return of respiratory muscular strength performance to baseline levels may have implications for individuals prior to engaging in subsequent exercise bouts.

  12. Longitudinal predictors of aerobic performance in adolescent soccer players.

    PubMed

    Valente-dos-Santos, João; Coelho-e-Silva, Manuel J; Duarte, João; Figueiredo, António J; Liparotti, João R; Sherar, Lauren B; Elferink-Gemser, Marije T; Malina, Robert M

    2012-01-01

    The importance of aerobic performance in youth soccer is well established. The aim of the present study was to evaluate the contributions of chronological age (CA), skeletal age (SA), body size, and training to the longitudinal development of aerobic performance in youth male soccer players aged 10 to 18 years. Players (n=83) were annually followed up during 5 years, resulting in an average of 4.4 observations per player. Decimal CA was calculated, and SA, stature, body weight, and aerobic performance were measured once per year. Fat-free mass (FFM) was estimated from age- and gender-specific anthropometric formulas, and annual volume training was recorded. After testing for multicollinearity, multilevel regression modeling was used to analyze the longitudinal data aligned by CA and SA (Model 1 and 2, respectively) and to develop aerobic performance scores. The following equations provide estimations of the aerobic performance for young soccer players: ŷ(Model 1 [deviance from the null model =388.50; P<0.01]) =57.75+9.06×centered CA-0.57×centered CA(2)+0.03×annual volume training and ŷ(Model 2 [deviance from the null model=327.98; P<0.01])=13.03+4.04×centered SA-0.12×centered SA(2)+0.99×FFM+0.03×annual volume training. The development of aerobic performance in young soccer players was found to be significantly related to CA, biological development, and volume of training.

  13. Some implementational issues of convection schemes for finite volume formulations

    NASA Technical Reports Server (NTRS)

    Thakur, Siddharth; Shyy, Wei

    1993-01-01

    Two higher-order upwind schemes - second-order upwind and QUICK - are examined in terms of their interpretation, implementation as well as performance for a recirculating flow in a lid-driven cavity, in the context of a control volume formulation using the SIMPLE algorithm. The present formulation of these schemes is based on a unified framework wherein the first-order upwind scheme is chosen as the basis, with the remaining terms being assigned to the source term. The performance of these schemes is contrasted with the first-order upwind and second-order central difference schemes. Also addressed in this study is the issue of boundary treatment associated with these higher-order upwind schemes. Two different boundary treatments - one that uses a two-point scheme consistently within a given control volume at the boundary, and the other that maintains consistency of flux across the interior face between the adjacent control volumes - are formulated and evaluated.

  14. Some implementational issues of convection schemes for finite-volume formulations

    NASA Technical Reports Server (NTRS)

    Thakur, Siddharth; Shyy, Wei

    1993-01-01

    Two higher-order upwind schemes - second-order upwind and QUICK - are examined in terms of their interpretation, implementations, as well as performance for a recirculating flow in a lid-driven cavity, in the context of a control-volume formulation using the SIMPLE algorithm. The present formulation of these schemes is based on a unified framework wherein the first-order upwind scheme is chosen as the basis, with the remaining terms being assigned to the source term. The performance of these schemes is contrasted with the first-order upwind and second-order central difference schemes. Also addressed in this study is the issue of boundary treatment associated with these higher-order upwind schemes. Two different boundary treatments - one that uses a two-point scheme consistently within a given control volume at the boundary, and the other that maintains consistency of flux across the interior face between the adjacent control volumes - are formulated and evaluated.

  15. Temporal and geographical external validation study and extension of the Mayo Clinic prediction model to predict eGFR in the younger population of Swiss ADPKD patients.

    PubMed

    Girardat-Rotar, Laura; Braun, Julia; Puhan, Milo A; Abraham, Alison G; Serra, Andreas L

    2017-07-17

    Prediction models in autosomal dominant polycystic kidney disease (ADPKD) are useful in clinical settings to identify patients with greater risk of a rapid disease progression in whom a treatment may have more benefits than harms. Mayo Clinic investigators developed a risk prediction tool for ADPKD patients using a single kidney value. Our aim was to perform an independent geographical and temporal external validation as well as evaluate the potential for improving the predictive performance by including additional information on total kidney volume. We used data from the on-going Swiss ADPKD study from 2006 to 2016. The main analysis included a sample size of 214 patients with Typical ADPKD (Class 1). We evaluated the Mayo Clinic model performance calibration and discrimination in our external sample and assessed whether predictive performance could be improved through the addition of subsequent kidney volume measurements beyond the baseline assessment. The calibration of both versions of the Mayo Clinic prediction model using continuous Height adjusted total kidney volume (HtTKV) and using risk subclasses was good, with R 2 of 78% and 70%, respectively. Accuracy was also good with 91.5% and 88.7% of the predicted within 30% of the observed, respectively. Additional information regarding kidney volume did not substantially improve the model performance. The Mayo Clinic prediction models are generalizable to other clinical settings and provide an accurate tool based on available predictors to identify patients at high risk for rapid disease progression.

  16. Identifying factors that predict the choice and success rate of radial artery catheterisation in contemporary real world cardiology practice: a sub-analysis of the PREVAIL study data.

    PubMed

    Pristipino, Christian; Roncella, Adriana; Trani, Carlo; Nazzaro, Marco S; Berni, Andrea; Di Sciascio, Germano; Sciahbasi, Alessandro; Musarò, Salvatore Donato; Mazzarotto, Pietro; Gioffrè, Gaetano; Speciale, Giulio

    2010-06-01

    To assess: the reasons behind an operator choosing to perform radial artery catheterisation (RAC) as against femoral arterial catheterisation, and to explore why RAC may fail in the real world. A pre-determined analysis of PREVAIL study database was performed. Relevant data were collected in a prospective, observational survey of 1,052 consecutive patients undergoing invasive cardiovascular procedures at nine Italian hospitals over a one month observation period. By multivariate analysis, the independent predictors of RAC choice were having the procedure performed: (1) at a high procedural volume centre; and (2) by an operator who performs a high volume of radial procedures; clinical variables played no statistically significant role. RAC failure was predicted independently by (1) a lower operator propensity to use RAC; and (2) the presence of obstructive peripheral artery disease. A 10-fold lower rate of RAC failure was observed among operators who perform RAC for > 85% of their personal caseload than among those who use RAC < 25% of the time (3.8% vs. 33.0%, respectively); by receiver operator characteristic (ROC) analysis, no threshold value for operator RAC volume predicted RAC failure. A routine RAC in all-comers is superior to a selective strategy in terms of feasibility and success rate.

  17. The power-proportion method for intracranial volume correction in volumetric imaging analysis.

    PubMed

    Liu, Dawei; Johnson, Hans J; Long, Jeffrey D; Magnotta, Vincent A; Paulsen, Jane S

    2014-01-01

    In volumetric brain imaging analysis, volumes of brain structures are typically assumed to be proportional or linearly related to intracranial volume (ICV). However, evidence abounds that many brain structures have power law relationships with ICV. To take this relationship into account in volumetric imaging analysis, we propose a power law based method-the power-proportion method-for ICV correction. The performance of the new method is demonstrated using data from the PREDICT-HD study.

  18. Impact Assessment and Forecasts of Information and Telecommunications Technologies Applied to Education and Training: Volume II--Main Report and Issues Analyses. Analysis for the Orientation of the Work of Sector Actors in the Framework of DELTA.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium).

    This report, the second volume in a three volume set, summarizes the results of a study performed by the DELTA (Developing European Learning through Technological Advance) unit in parallel with the projects underway in the research and development Exploratory Action. The report identifies the key issues, associated requirements and options, and…

  19. Association between CSF biomarkers, hippocampal volume and cognitive function in patients with amnestic mild cognitive impairment (MCI).

    PubMed

    Nathan, Pradeep J; Lim, Yen Ying; Abbott, Rosemary; Galluzzi, Samantha; Marizzoni, Moira; Babiloni, Claudio; Albani, Diego; Bartres-Faz, David; Didic, Mira; Farotti, Lucia; Parnetti, Lucilla; Salvadori, Nicola; Müller, Bernhard W; Forloni, Gianluigi; Girtler, Nicola; Hensch, Tilman; Jovicich, Jorge; Leeuwis, Annebet; Marra, Camillo; Molinuevo, José Luis; Nobili, Flavio; Pariente, Jeremie; Payoux, Pierre; Ranjeva, Jean-Philippe; Rolandi, Elena; Rossini, Paolo Maria; Schönknecht, Peter; Soricelli, Andrea; Tsolaki, Magda; Visser, Pieter Jelle; Wiltfang, Jens; Richardson, Jill C; Bordet, Régis; Blin, Olivier; Frisoni, Giovanni B

    2017-05-01

    Few studies have examined the relationship between CSF and structural biomarkers, and cognitive function in MCI. We examined the relationship between cognitive function, hippocampal volume and cerebrospinal fluid (CSF) Aβ 42 and tau in 145 patients with MCI. Patients were assessed on cognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB), the Geriatric Depression Scale and the Functional Activities Questionnaire. Hippocampal volume was measured using magnetic resonance imaging (MRI), and CSF markers of Aβ 42 , tau and p-tau 181 were also measured. Worse performance on a wide range of memory and sustained attention tasks were associated with reduced hippocampal volume, higher CSF tau and p-tau 181 and increased tau/Aβ 42 ratio. Memory tasks were also associated with lower ability to conduct functional activities of daily living, providing a link between AD biomarkers, memory performance and functional outcome. These results suggest that biomarkers of Aβ and tau are strongly related to cognitive performance as assessed by the CANTAB, and have implications for the early detection and characterization of incipient AD. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Changes in olfactory bulb volume following lateralized olfactory training.

    PubMed

    Negoias, S; Pietsch, K; Hummel, T

    2017-08-01

    Repeated exposure to odors modifies olfactory function. Consequently, "olfactory training" plays a significant role in hyposmia treatment. In addition, numerous studies show that the olfactory bulb (OB) volume changes in disorders associated with olfactory dysfunction. Aim of this study was to investigate whether and how olfactory bulb volume changes in relation to lateralized olfactory training in healthy people. Over a period of 4 months, 97 healthy participants (63 females and 34 males, mean age: 23.74 ± 4.16 years, age range: 19-43 years) performed olfactory training by exposing the same nostril twice a day to 4 odors (lemon, rose, eucalyptus and cloves) while closing the other nostril. Before and after olfactory training, magnetic resonance imaging (MRI) scans were performed to measure OB volume. Furthermore, participants underwent lateralized odor threshold and odor identification testing using the "Sniffin' Sticks" test battery.OB volume increased significantly after olfactory training (11.3 % and 13.1 % respectively) for both trained and untrained nostril. No significant effects of sex, duration and frequency of training or age of the subjects were seen. Interestingly, PEA odor thresholds worsened after training, while olfactory identification remained unchanged.These data show for the first time in humans that olfactory training may involve top-down process, which ultimately lead to a bilateral increase in olfactory bulb volume.

  1. Reduction of Costs for Pelvic Exenteration Performed by High Volume Surgeons: Analysis of the Maryland Health Service Cost Review Commission Database.

    PubMed

    Althumairi, Azah A; Canner, Joseph K; Gorin, Michael A; Fang, Sandy H; Gearhart, Susan L; Wick, Elizabeth C; Safar, Bashar; Bivalacqua, Trinity J; Efron, Jonathan E

    2016-01-01

    High volume hospitals (HVHs) and high volume surgeons (HVSs) have better outcomes after complex procedures, but the association between surgeon and hospital volumes and patient outcomes is not completely understood. Our aim was to evaluate the impact of surgeon and hospital volumes, and their interaction, on postoperative outcomes and costs in patients undergoing pelvic exenteration (PE) in the state of Maryland. A review of the Maryland Health Services Cost Review Commission database between 2000 and 2011 was performed. Patients were compared for demographics and clinical variables. The differences in length of hospital stay , length of intensive care unit (ICU) stay, operating room (OR) cost, and total cost were compared for surgeon volume and hospital volume controlling for all other factors. Surgery performed by HVS at HVH had the shortest ICU stay and lowest OR cost. When PE was performed by a low volume surgeon at an HVH, the OR cost and total cost were the highest and increased by $2,683 (P < 0.0001) and $16,076 (P < 0.0001), respectively. OR costs reduced when surgery was performed by an HVS at an HVH ($-1632, P = 0.008). PE performed by HVS at HVH is significantly associated with lower OR costs and ICU stay. We feel this is indicative of lower complication rates and higher quality care.

  2. Striatal volume predicts level of video game skill acquisition.

    PubMed

    Erickson, Kirk I; Boot, Walter R; Basak, Chandramallika; Neider, Mark B; Prakash, Ruchika S; Voss, Michelle W; Graybiel, Ann M; Simons, Daniel J; Fabiani, Monica; Gratton, Gabriele; Kramer, Arthur F

    2010-11-01

    Video game skills transfer to other tasks, but individual differences in performance and in learning and transfer rates make it difficult to identify the source of transfer benefits. We asked whether variability in initial acquisition and of improvement in performance on a demanding video game, the Space Fortress game, could be predicted by variations in the pretraining volume of either of 2 key brain regions implicated in learning and memory: the striatum, implicated in procedural learning and cognitive flexibility, and the hippocampus, implicated in declarative memory. We found that hippocampal volumes did not predict learning improvement but that striatal volumes did. Moreover, for the striatum, the volumes of the dorsal striatum predicted improvement in performance but the volumes of the ventral striatum did not. Both ventral and dorsal striatal volumes predicted early acquisition rates. Furthermore, this early-stage correlation between striatal volumes and learning held regardless of the cognitive flexibility demands of the game versions, whereas the predictive power of the dorsal striatal volumes held selectively for performance improvements in a game version emphasizing cognitive flexibility. These findings suggest a neuroanatomical basis for the superiority of training strategies that promote cognitive flexibility and transfer to untrained tasks.

  3. Individual Global Navigation Satellite Systems in the Space Service Volume

    NASA Technical Reports Server (NTRS)

    Force, Dale A.

    2015-01-01

    Besides providing position, navigation, and timing (PNT) to terrestrial users, GPS is currently used to provide for precision orbit determination, precise time synchronization, real-time spacecraft navigation, and three-axis control of Earth orbiting satellites. With additional Global Navigation Satellite Systems (GNSS) coming into service (GLONASS, Beidou, and Galileo), it will be possible to provide these services by using other GNSS constellations. The paper, "GPS in the Space Service Volume," presented at the ION GNSS 19th International Technical Meeting in 2006 (Ref. 1), defined the Space Service Volume, and analyzed the performance of GPS out to 70,000 km. This paper will report a similar analysis of the performance of each of the additional GNSS and compare them with GPS alone. The Space Service Volume, defined as the volume between 3,000 km altitude and geosynchronous altitude, as compared with the Terrestrial Service Volume between the surface and 3,000 km. In the Terrestrial Service Volume, GNSS performance will be similar to performance on the Earth's surface. The GPS system has established signal requirements for the Space Service Volume. A separate paper presented at the conference covers the use of multiple GNSS in the Space Service Volume.

  4. Effect of hydration status on atrial and ventricular volumes and function in healthy adult volunteers.

    PubMed

    Schantz, Daryl I; Dragulescu, Andreea; Memauri, Brett; Grotenhuis, Heynric B; Seed, Mike; Grosse-Wortmann, Lars

    2016-10-01

    Assessment of cardiac chamber volumes is a fundamental part of cardiac magnetic resonance (CMR) imaging. While the effects of inter- and intraobserver variability have been studied and have a recognized effect on the comparability of serial cardiac MR imaging studies, the effect of differences in hydration status has not been evaluated. To evaluate the effects of volume administration on cardiac chamber volumes. Thirteen healthy adults underwent a baseline cardiac MR to evaluate cardiac chamber volumes after an overnight fast. They were then given two saline boluses of 10 ml/kg of body weight and the cardiac MR was repeated immediately after each bolus. From the baseline scan to the final scan there was a significant increase in all four cardiac chamber end-diastolic volumes. Right atrial volumes increased 8.0%, from 61.1 to 66.0 ml/m2 (P<0.001), and left atrial volumes increased 10.0%, from 50.0 to 55.0 ml/m2 (P<0.001). Right ventricular volumes increased 6.0%, from 91.1 to 96.5 ml/m2 (P<0.001), and left ventricular volumes increased 3.2%, from 87.0 to 89.8 ml/m2 (P<0.001). Hydration status has a significant effect on the end-diastolic volumes of all cardiac chambers assessed by cardiac MR. Thus, hydration represents a "variable" that should be taken into account when assessing cardiac chamber volumes, especially when performing serial imaging studies in a patient.

  5. Pre-exercise ingestion of pickle juice, hypertonic saline, or water and aerobic performance and thermoregulation.

    PubMed

    Peikert, Jarett; Miller, Kevin C; Albrecht, Jay; Tucker, Jared; Deal, James

    2014-01-01

    Ingesting high-sodium drinks pre-exercise can improve thermoregulation and performance. Athletic trainers (19%) give athletes pickle juice (PJ) prophylactically for cramping. No data exist on whether this practice affects aerobic performance or thermoregulation. To determine if drinking 2 mL/kg body mass of PJ, hypertonic saline, or deionized water (DIW) pre-exercise affects aerobic performance or thermoregulation. Crossover study. Controlled laboratory study. Nine euhydrated men (age = 22 ± 3 years, height = 184.0 ± 8.2 cm, mass = 82.6 ± 16.0 kg) completed testing. Participants rested for 65 minutes. During this period, they ingested 2 mL/kg of PJ, hypertonic saline, or DIW. Next, they drank 5 mL/kg of DIW. Blood was collected before and after ingestion of all fluids. Participants were weighed and ran in the heat (temperature = 38.3°C ± 1°C, relative humidity = 21.1% ± 4.7%) at increasing increments of maximal heart rate (50%, 60%, 70%, 80%, 90%, 95%) until exhaustion or until rectal temperature exceeded 39.5°C. Participants were weighed postexercise so we could calculate sweat volume. Time to exhaustion, rectal temperature, changes in plasma volume, and sweat volume. Time to exhaustion did not differ among drinks (PJ = 77.4 ± 5.9 minutes, hypertonic saline = 77.4 ± 4.0 minutes, DIW = 75.7 ± 3.2 minutes; F2,16 = 1.1, P = .40). Core temperature of participants was similar among drinks (PJ = 38.7°C ± 0.3°C, hypertonic saline = 38.7°C ± 0.4°C, DIW = 38.8°C ± 0.4°C; P = .74) but increased from pre-exercise (36.7°C ± 0.2°C) to postexercise (38.7°C ± 0.4°C) (P < .05). No differences were observed for changes in plasma volume or sweat volume among drinks (P > .05). Ingesting small amounts of PJ or hypertonic saline with water did not affect performance or select thermoregulatory measures. Drinking larger volumes of PJ and water may be more effective at expanding the extracellular space.

  6. More than Just Beliefs: Experience and Beliefs Jointly Contribute to Volume Effects on Metacognitive Judgments

    ERIC Educational Resources Information Center

    Frank, David J.; Kuhlmann, Beatrice G.

    2017-01-01

    Experience-based cues, such as perceptual fluency, have long been thought to influence metacognitive judgments (Kelley & Jacoby, 1996; Koriat, 1997). Studies found that manipulations of perceptual fluency via changes in font and volume alter Judgments of Learning (JOLs) without influencing memory performance (Rhodes & Castel, 2008, 2009).…

  7. Market projections of cellulose nanomaterial-enabled products- Part 1: Applications

    Treesearch

    Jo Anne Shatkin; Theodore H. Wegner; E.M. (Ted) Bilek; John Cowie

    2014-01-01

    Nanocellulose provides a new materials platform for the sustainable production of high-performance nano-enabled products in an array of applications. In this paper, potential applications for cellulose nanomaterials are identified as the first step toward estimating market volume. The overall study, presented in two parts, estimates market volume on the basis of...

  8. Detection of gas leakage

    DOEpatents

    Thornberg, Steven [Peralta, NM; Brown, Jason [Albuquerque, NM

    2012-06-19

    A method of detecting leaks and measuring volumes as well as an apparatus, the Power-free Pump Module (PPM), that is a self-contained leak test and volume measurement apparatus that requires no external sources of electrical power during leak testing or volume measurement, where the invention is a portable, pneumatically-controlled instrument capable of generating a vacuum, calibrating volumes, and performing quantitative leak tests on a closed test system or device, all without the use of alternating current (AC) power. Capabilities include the ability is to provide a modest vacuum (less than 10 Torr), perform a pressure rise leak test, measure the gas's absolute pressure, and perform volume measurements. All operations are performed through a simple rotary control valve which controls pneumatically-operated manifold valves.

  9. Detection of gas leakage

    DOEpatents

    Thornberg, Steven M; Brown, Jason

    2015-02-17

    A method of detecting leaks and measuring volumes as well as a device, the Power-free Pump Module (PPM), provides a self-contained leak test and volume measurement apparatus that requires no external sources of electrical power during leak testing or volume measurement. The PPM is a portable, pneumatically-controlled instrument capable of generating a vacuum, calibrating volumes, and performing quantitative leak tests on a closed test system or device, all without the use of alternating current (AC) power. Capabilities include the ability is to provide a modest vacuum (less than 10 Torr) using a venturi pump, perform a pressure rise leak test, measure the gas's absolute pressure, and perform volume measurements. All operations are performed through a simple rotary control valve which controls pneumatically-operated manifold valves.

  10. Factors influencing the measurement of closing volume.

    PubMed

    Make, B; Lapp, N L

    1975-06-01

    The various factors influencing closing volume were studied by performing the single-breath N2 test on 9 healthy nonsmokers. Time of day, day of the week, and preceding volume history had no effect on either closing volume or alveolar plateau. Slow inspiratory flow resulted in larger ratio of closing volume to vital capacity, ratio of closing capacity to total lung capacity, and change in N2 concentration than fast inspiratory flow. Voluntary regulation of the expiratory flow resulted in smaller ratios of closing volume to vital capacity and closing capacity to total lung capacity than when flow was regulated by a resistance. Prolonged breath holding of the inspired O2 led to larger ratio of closing volume to vital capacity and ratio of closing capacity to total lung capacity. To obtain uniform, comparable closing volumes, it is suggested that the subject inspire slowly, control expiratory flow (preferably voluntarily), and not pause between inspiration and expiration.

  11. Determination of Normal Distribution of Distended Colon Volumes to Guide Performance of Colonic Imaging With Fluid Distention.

    PubMed

    Zheng, Karen S; Small, William C; Mittal, Pardeep K; Cai, Qingpo; Kang, Jian; Moreno, Courtney C

    2016-01-01

    The purpose was to determine the normal distribution of distended colon volumes as a guide for rectal contrast material administration protocols. All computed tomography colonography studies performed at Emory University Hospital, Atlanta, Georgia, between January 2009 and January 2015, were reviewed retrospectively. In total, 85 subjects were included in the analysis (64% [54 of 85] female and 36% [31 of 85] male). Mean patient age was 65 years (range: 42-86y). Distended colon volumes were determined from colon length and transaxial diameter measurements made using a 3-dimensional workstation. Age, sex, race, height, weight, and body mass index were recorded. The normal distributions of distended colon volumes and lengths were determined. Correlations between colonic volume and colonic length, and demographic variables were assessed. Mean colon volume was 2.1L (range: 0.7-4.4L). Nearly, 17% of patients had a distended colonic volume of >3L. Mean colon length was 197cm (range: 118-285cm). A weak negative correlation was found between age and colonic volume (r = -0.221; P = 0.04). A weak positive correlation was found between body mass index and colonic length (r = 0.368; P = 0.007). Otherwise, no significant correlations were found for distended colonic volume or length and demographic variables. In conclusion, an average of approximately 2L of contrast material may be necessary to achieve full colonic opacification. This volume is larger than previously reported volumes (0.8-1.5L) for rectal contrast material administration protocols. Copyright © 2015 Mosby, Inc. All rights reserved.

  12. Three dimensional ultrasonography for advanced neurosonography (Neurosofe-3d). Analysis of acquisition-related factors influencing the quality of the brain volumes.

    PubMed

    Maiz, Nerea; Alonso, Ignacio; Belar, María; Burgos, Jorge; Irasarri, Ana; Molina, Francisca S; de Paco, Catalina; Pijoan, José I; Plasencia, Walter; Rodó, Carlota; Rodríguez, M Angeles; Tajada, Mauricio; Tubau, Albert

    2016-11-01

    To evaluate the acquisition-related factors influencing the quality of the brain volumes for further study of advanced neurosonography. This was a prospective multicentre study. Five centres were asked to include five cases each, acquiring two volumes per case, at different gestational ages. Ten operators performed an advanced neurosonography per case. The potential influence of the following factors on the number of evaluable structures was assessed: vaginal/ abdominal acquisition, position of the head, gestational age, subjective quality of the volume and the acquiring operator itself. Four hundred and thirty-two evaluations were included in the study. A total of 80% of the structures were evaluated satisfactorily in the axial plane, 67.1% and 55.1% in the coronal and sagittal plane, respectively. Sagittal volumes acquired transvaginally had a better quality than those acquired transabdominally. Gestational age affected the quality of axial and sagittal volumes (p < 0.001), and the best quality was obtained between 20 and 27 weeks. In axial and sagittal volumes, the head position influenced the percentage of structures visualized (p < 0.001, p < 0.001). Factors affecting the quality of the volume for advanced neurosonography are gestational age, fetal head position, transvaginal acquisition in sagittal volumes, the acquiring operator and the subjective quality of the volume. © 2016 John Wiley & Sons, Ltd. © 2016 John Wiley & Sons, Ltd.

  13. Infrared Light Structured Sensor 3D Approach to Estimate Kidney Volume: A Validation Study.

    PubMed

    Garisto, Juan; Bertolo, Riccardo; Dagenais, Julien; Kaouk, Jihad

    2018-06-26

    To validate a new procedure for the three-dimensional (3D) estimation of total renal parenchyma volume (RPV) using a structured-light infrared laser sensor. To evaluate the accuracy of the sensor for assessing renal volume, we performed three experiments. Twenty freshly excised porcine kidneys were obtained. Experiment A, the water displacement method was used to obtain a determination of the RPV after immersing every kidney into 0.9% saline. Thereafter a structured sensor (Occipital, San Francisco, CA, USA) was used to scan the kidney. Kidney sample surface was presented initially as a mesh and then imported into MeshLab (Visual Computing Lab, Pisa, Italy) software to obtain the surface volume. Experiment B, a partial excision of the kidney with measurement of the excised volume and remnant was performed. Experiment C, a renorrhaphy of the remnant kidney was performed then measured. Bias and limits of agreement (LOA) were determined using the Bland-Altman method. Reliability was assessed using the intraclass correlation coefficient (ICC). Experiment A, the sensor bias was -1.95 mL (LOA: -19.5 to 15.59, R2= 0.410) with slightly overestimating the volumes. Experiment B, remnant kidney after partial excision and excised kidney volume were measured showing a sensor bias of -0.5 mL (LOA -5.34 to 4.20, R2= 0.490) and -0.6 mL (LOA: -1.97.08 to 0.77, R2= 0.561), respectively. Experiment C, the sensor bias was -0.89 mL (LOA -12.9 to 11.1, R2= 0.888). ICC was 0.9998. The sensor is a reliable method for assessing total renal volume with high levels of accuracy. Copyright © 2018. Published by Elsevier Inc.

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

    Lee, Y; Fullerton, G; Goins, B

    Purpose: In our previous study a preclinical multi-modality quality assurance (QA) phantom that contains five tumor-simulating test objects with 2, 4, 7, 10 and 14 mm diameters was developed for accurate tumor size measurement by researchers during cancer drug development and testing. This study analyzed the errors during tumor volume measurement from preclinical magnetic resonance (MR), micro-computed tomography (micro- CT) and ultrasound (US) images acquired in a rodent tumor model using the preclinical multi-modality QA phantom. Methods: Using preclinical 7-Tesla MR, US and micro-CT scanners, images were acquired of subcutaneous SCC4 tumor xenografts in nude rats (3–4 rats per group;more » 5 groups) along with the QA phantom using the same imaging protocols. After tumors were excised, in-air micro-CT imaging was performed to determine reference tumor volume. Volumes measured for the rat tumors and phantom test objects were calculated using formula V = (π/6)*a*b*c where a, b and c are the maximum diameters in three perpendicular dimensions determined by the three imaging modalities. Then linear regression analysis was performed to compare image-based tumor volumes with the reference tumor volume and known test object volume for the rats and the phantom respectively. Results: The slopes of regression lines for in-vivo tumor volumes measured by three imaging modalities were 1.021, 1.101 and 0.862 for MRI, micro-CT and US respectively. For phantom, the slopes were 0.9485, 0.9971 and 0.9734 for MRI, micro-CT and US respectively. Conclusion: For both animal and phantom studies, random and systematic errors were observed. Random errors were observer-dependent and systematic errors were mainly due to selected imaging protocols and/or measurement method. In the animal study, there were additional systematic errors attributed to ellipsoidal assumption for tumor shape. The systematic errors measured using the QA phantom need to be taken into account to reduce measurement errors during the animal study.« less

  15. Impact of gray matter reductions on theory of mind abilities in patients with schizophrenia.

    PubMed

    Koelkebeck, Katja; Hirao, Kazuyuki; Miyata, Jun; Kawada, Ryosaku; Saze, Teruyasu; Dannlowski, Udo; Ubukata, Shiho; Ohrmann, Patricia; Bauer, Jochen; Pedersen, Anya; Fukuyama, Hidenao; Sawamoto, Nobukatsu; Takahashi, Hidehiko; Murai, Toshiya

    2013-01-01

    To identify the brain regions involved in the interpretation of intentional movement by patients with schizophrenia, we investigated the association between cerebral gray matter (GM) volumes and performance on a theory of mind (ToM) task using voxel-based morphometry. Eighteen patients with schizophrenia and thirty healthy controls participated in the study. Participants were given a moving shapes task that employs the interpretation of intentional movement. Verbal descriptions were rated according to intentionality. ToM performance deficits in patients were found to be positively correlated with GM volume reductions in the superior temporal sulcus and medial prefrontal cortex. Our findings confirm that divergent brain regions contribute to mentalizing abilities and that GM volume reductions impact behavioral deficits in patients with schizophrenia.

  16. Heat Acclimation and Water-Immersion Deconditioning: Responses to Exercise

    NASA Technical Reports Server (NTRS)

    Shvartz, E.; Bhattacharya, A.; Sperinde, S. J.; Brock, P. J.; Sciaraffa, D.; Haines, R. F.; Greenleaf, J. E.

    1977-01-01

    Simulated subgravity conditions, such as bed rest and water immersion, cause a decrease in a acceleration tolerance (3, 4), tilt tolerance (3, 9, 10), work capacity (5, 7), and plasma volume (1, 8-10). Moderate exercise training performed during bed rest (4) and prior to water immersion (5) provides some protection against the adverse effects of deconditioning, but the relationship between exercise and changes due to deconditioning remains unclear. Heat acclimation increases plasma and interstitial volumes, total body water, stroke volume (11), and tilt tolerance (6) and may, therefore, be a more efficient method of ameliorating deconditioning than physical training alone. The present study was undertaken to determine the effects of heat acclimation and moderate physical training, performed in cool conditions, on water-immersion deconditioning.

  17. Effects of moisture content and initial pH in composting process on heavy metal removal characteristics of grass clipping compost used for stormwater filtration.

    PubMed

    Khan, Eakalak; Khaodhir, Sutha; Ruangrote, Darin

    2009-10-01

    Heavy metals are common contaminants in stormwater runoff. One of the devices that can be used to effectively and economically remove heavy metals from runoff is a yard waste compost stormwater filter. The primary goal of composting is to reduce waste volume rather than to produce stormwater filter media. Moisture content (MC) and initial pH, the two important parameters in composting, were studied for their effects on yard waste volume reduction and heavy metal adsorption performances of the compost. The main objective of this investigation was to examine whether the conditions that provided high yard waste volume reduction would also result in compost with good heavy metal removal performances. Manila grass was composted at different initial pHs (5-9) and MCs (30-70%) and the composts were used to adsorb cadmium, copper, lead and zinc from water. Results indicated that MC is more critical than initial pH for both volume reduction and production of compost with high metal adsorption performances. The most optimal conditions for the two attributes were not exactly the same but lower MCs of 30-40% and pH 7 or higher tended to satisfy both high volume reduction and effective metal adsorption.

  18. Trends in Radical Prostatectomy: Centralization, Robotics, and Access to Urologic Cancer Care

    PubMed Central

    Stitzenberg, Karyn B.; Wong, Yu-Ning; Nielsen, Matthew E.; Egleston, Brian L.; Uzzo, Robert G.

    2011-01-01

    Background Robotic surgery has been widely adopted for radical prostatectomy. We hypothesize that this change is rapidly shifting procedures away from hospitals that do not offer robotics and consequently increasing patient travel. Methods A population-based observational study of all prostatectomies for cancer in NY, NJ, and PA from 2000–2009 was performed using hospital discharge data. Hospital procedure volume was defined as the number of prostatectomies performed for cancer in a given year. Straight-line travel distance to treating hospital was calculated for each case. Hospitals were contacted to determine year of acquisition of first robot. Results From 2000–2009, the total number of prostatectomies performed annually increased substantially. The increase occurred almost entirely at the very high volume centers (≥106 prostatectomies/year). The number of hospitals performing prostatectomy fell 37% from 2000–2009. By 2009, the 9% (21/244) of hospitals that had very high volume performed 57% of all prostatectomies, and the 35% (86/244) of hospitals with a robot performed 85% of all prostatectomies. Median travel increased 54% from 2000–2009, p<0.001. The proportion of patients traveling ≥15 miles increased from 24% to 40%, p<0.001. Conclusions Over the past decade, the number of radical prostatectomies performed has risen substantially. These procedures have been increasingly centralized at high volume centers, leading to longer patient travel distances. Few prostatectomies are now performed at hospitals that do not offer robotic surgery. Future work should focus on the impact of these trends on cancer control, functional outcomes, access to care and cost. PMID:21717436

  19. Anatomical-based partial volume correction for low-dose dedicated cardiac SPECT/CT

    NASA Astrophysics Data System (ADS)

    Liu, Hui; Chan, Chung; Grobshtein, Yariv; Ma, Tianyu; Liu, Yaqiang; Wang, Shi; Stacy, Mitchel R.; Sinusas, Albert J.; Liu, Chi

    2015-09-01

    Due to the limited spatial resolution, partial volume effect has been a major degrading factor on quantitative accuracy in emission tomography systems. This study aims to investigate the performance of several anatomical-based partial volume correction (PVC) methods for a dedicated cardiac SPECT/CT system (GE Discovery NM/CT 570c) with focused field-of-view over a clinically relevant range of high and low count levels for two different radiotracer distributions. These PVC methods include perturbation geometry transfer matrix (pGTM), pGTM followed by multi-target correction (MTC), pGTM with known concentration in blood pool, the former followed by MTC and our newly proposed methods, which perform the MTC method iteratively, where the mean values in all regions are estimated and updated by the MTC-corrected images each time in the iterative process. The NCAT phantom was simulated for cardiovascular imaging with 99mTc-tetrofosmin, a myocardial perfusion agent, and 99mTc-red blood cell (RBC), a pure intravascular imaging agent. Images were acquired at six different count levels to investigate the performance of PVC methods in both high and low count levels for low-dose applications. We performed two large animal in vivo cardiac imaging experiments following injection of 99mTc-RBC for evaluation of intramyocardial blood volume (IMBV). The simulation results showed our proposed iterative methods provide superior performance than other existing PVC methods in terms of image quality, quantitative accuracy, and reproducibility (standard deviation), particularly for low-count data. The iterative approaches are robust for both 99mTc-tetrofosmin perfusion imaging and 99mTc-RBC imaging of IMBV and blood pool activity even at low count levels. The animal study results indicated the effectiveness of PVC to correct the overestimation of IMBV due to blood pool contamination. In conclusion, the iterative PVC methods can achieve more accurate quantification, particularly for low count cardiac SPECT studies, typically obtained from low-dose protocols, gated studies, and dynamic applications.

  20. Efficacy of High-volume Evacuator in Aerosol Reduction: Truth or Myth? A Clinical and Microbiological Study.

    PubMed

    Desarda, Hitesh; Gurav, Abhijit; Dharmadhikari, Chandrakant; Shete, Abhijeet; Gaikwad, Subodh

    2014-01-01

    Background and aims. Basic periodontal treatment aims at eliminating supra- and sub-gingival plaque and establishing conditions which will allow effective self-performed plaque control. This aim is primarily achieved with sonic and ultrasonic scalers. However, generation of bacterial aerosols during these procedures is of great concern to patients, the dentist and the dental assistant. The aim of this study was to compare the reduction in aerosol with and without high-volume evacuator through a microbiological study. Materials and methods. For this clinical study a fumigated closed operatory was selected. Maxillary incisors and canines were selected as an area for scaling. Piezoelectric ultrasonic scaling was performed in the absence and in the presence of a high-volume evacuator at 12 and 20 inches from the patient's oral cavity. In both groups scaling was carried out for 10 minutes. Nutrient agar plates were exposed for a total of 20 minutes. After this procedure, nutrient agar plates were incubated in an incubator at 37°C for 24 hours. The next day the nutrient agar plates were examined for colony forming units by a single microbiologist. Results. The results showed no statistically significant differences in colony forming units (CFU) with and without the use of a high-volume evacuator either at 12 or 20 inches from the patient's oral cavity. Conclusion. It was concluded that high-volume evacuator, when used as a separate unit without any modification, is not effective in reducing aerosol counts and environmental contamination.

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

    Endres, Michael G.; Shindler, Andrea; Tiburzi, Brian C.

    The commonly adopted approach for including electromagnetic interactions in lattice QCD simulations relies on using finite volume as the infrared regularization for QED. The long-range nature of the electromagnetic interaction, however, implies that physical quantities are susceptible to power-law finite volume corrections, which must be removed by performing costly simulations at multiple lattice volumes, followed by an extrapolation to the infinite volume limit. In this work, we introduce a photon mass as an alternative means for gaining control over infrared effects associated with electromagnetic interactions. We present findings for hadron mass shifts due to electromagnetic interactions (i.e., for the proton,more » neutron, charged and neutral kaon) and corresponding mass splittings, and compare the results with those obtained from conventional QCD+QED calculations. Results are reported for numerical studies of three flavor electroquenched QCD using ensembles corresponding to 800 MeV pions, ensuring that the only appreciable volume corrections arise from QED effects. The calculations are performed with three lattice volumes with spatial extents ranging from 3.4 - 6.7 fm. As a result, we find that for equal computing time (not including the generation of the lattice configurations), the electromagnetic mass shifts can be extracted from computations on a single (our smallest) lattice volume with comparable or better precision than the conventional approach.« less

  2. Massive photons: An infrared regularization scheme for lattice QCD + QED

    DOE PAGES

    Endres, Michael G.; Shindler, Andrea; Tiburzi, Brian C.; ...

    2016-08-10

    The commonly adopted approach for including electromagnetic interactions in lattice QCD simulations relies on using finite volume as the infrared regularization for QED. The long-range nature of the electromagnetic interaction, however, implies that physical quantities are susceptible to power-law finite volume corrections, which must be removed by performing costly simulations at multiple lattice volumes, followed by an extrapolation to the infinite volume limit. In this work, we introduce a photon mass as an alternative means for gaining control over infrared effects associated with electromagnetic interactions. We present findings for hadron mass shifts due to electromagnetic interactions (i.e., for the proton,more » neutron, charged and neutral kaon) and corresponding mass splittings, and compare the results with those obtained from conventional QCD+QED calculations. Results are reported for numerical studies of three flavor electroquenched QCD using ensembles corresponding to 800 MeV pions, ensuring that the only appreciable volume corrections arise from QED effects. The calculations are performed with three lattice volumes with spatial extents ranging from 3.4 - 6.7 fm. As a result, we find that for equal computing time (not including the generation of the lattice configurations), the electromagnetic mass shifts can be extracted from computations on a single (our smallest) lattice volume with comparable or better precision than the conventional approach.« less

  3. Overuse of surgery in patients with pancreatic cancer. A nationwide analysis in Italy

    PubMed Central

    Balzano, Gianpaolo; Capretti, Giovanni; Callea, Giuditta; Cantù, Elena; Carle, Flavia; Pezzilli, Raffaele

    2016-01-01

    Background According to current guidelines, pancreatic cancer patients should be strictly selected for surgery, either palliative or resective. Methods Population-based study, including all patients undergoing surgery for pancreatic cancer in Italy between 2010 and 2012. Hospitals were divided into five volume groups (quintiles), to search for differences among volume categories. Results There were 544 hospitals performing 10 936 pancreatic cancer operations. The probability of undergoing palliative/explorative surgery was inversely related to volume, being 24.4% in very high-volume hospitals and 62.5% in very low-volume centres (adjusted OR 5.175). Contrarily, the resection rate in patients without metastases decreased from 86.9% to 46.1% (adjusted OR 7.429). As for resections, the mortality of non-resective surgery was inversely related to volume (p < 0.001). Surprisingly, mortality of non-resective surgery was higher than that for resections (8.2% vs. 6.7%; p < 0.01). Approximately 9% of all resections were performed on patients with distant metastases, irrespective of hospital volume group. The excess cost for the National Health System from surgery overuse was estimated at 12.5 million euro. Discussion. Discrepancies between guidelines on pancreatic cancer treatment and surgical practice were observed. An overuse of surgery was detected, with serious clinical and economic consequences. PMID:27154812

  4. Effects of various drugs on canine tracheal mucociliary transport

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

    Giordano, A.; Holsclaw, D.; Litt, M.

    1978-07-01

    A study of the effects of dehydration, atropine, terbutaline and N-acetylcysteine on canine tracheobronchial mucus is presented. Mucociliary clearance rates, mucus secretion volumes and mucus rheologic properties were studied. Clearance rates were studied by a radioisotope technique mucus collected by a canine Tracheal pouch method and rheologic studies performed on a microrheometer. Clearance rate was unaffected by dehydration and terbutaline, increased by N-acetylcysteine and decreased by atropine. Secretion volume was increased by terbutaline while dehydration and atropine were without effect. Rheologic factors were increased by dehydration and atropine while terbutaline was without an effect. The effects of N-acetylcysteine on secretionmore » volume and rheologic properties could not be studied because of the nature of the techniques employed.« less

  5. Comprehensive integrated spirometry using raised volume passive and forced expirations and multiple-breath nitrogen washout in infants

    PubMed Central

    Morris, Mohy G.

    2009-01-01

    With the rapid somatic growth and development in infants, simultaneous accurate measurements of lung volume and airway function are essential. Raised volume rapid thoracoabdominal compression (RTC) is widely used to generate forced expiration from an airway opening pressure of 30 cm H2O (V30). The (dynamic) functional residual capacity (FRCdyn) remains the lung volume most routinely measured. The aim of this study was to develop comprehensive integrated spirometry that included all subdivisions of lung volume at V30 or total lung capacity (TLC30). Measurements were performed on seventeen healthy infants aged 8.6–119.7 weeks. A commercial system for multiple-breath nitrogen washout (MBNW) to measure lung volumes and a custom made system to perform RTC were used in unison. A refined automated raised volume RTC and the following two novel single maneuvers with dual volume measurements were performed from V30 during a brief post-hyperventilation apneic pause: (1) the passive expiratory flow was integrated to produce the inspiratory capacity (IC) and the static (passive) FRC (FRCst) was estimated by initiating MBNW after end-passive expiration; (2) RTC was initiated late during passive expiration, flow was integrated to produce the slow vital capacity (jSVC) and the residual volume (RV) was measured by initiating MBNW after end-expiration while the jacket (j) was inflated. Intrasubject FRCdyn and FRCst measurements overlapped (p= 0.6420) but neither did with the RV (p<0.0001). Means (95% confidence interval) of FRCdyn, IC, FRCst, jSVC, RV, forced vital capacity and tidal volume were 21.2 (19.7–22.7), 36.7 (33.0–40.4), 21.2 (19.6–22.8), 40.7 (37.2–44.2), 18.1 (16.6–19.7), 40.7 (37.1–44.2) and 10.2 (9.6–10.7) ml/kg, respectively. Static lung volumes and capacities at V30 and variables from the best forced expiratory flow-volume curve were dependent on age, body length and weight. In conclusion, we developed a comprehensive physiologically-integrated approach for in-depth investigation of lung function at V30 in infants. PMID:19897058

  6. Macular thickness and volume after uncomplicated phacoemulsification surgery evaluated by optical coherence tomography. A one-year follow-up.

    PubMed

    Kecik, Dariusz; Makowiec-Tabernacka, Marta; Golebiewska, Joanna; Moneta-Wielgos, Joanna; Kasprzak, Jan

    2009-01-01

    To evaluate changes in the macular thickness and volume using optical coherence tomography in patients after phacoemulsification and intracapsular implantation of a foldable intraocular lens. The study included 82 patients (37 males and 45 females) after phacoemulsification and intracapsular implantaion of the same type of a foldable intraocular lens, without any other eye disease. Phacoemulsification was performed with an INFINITI machine. In all patients, macular thickness and volume were measured with an optical coherence tomograph (Stratus OCT) using the Fast Macular Thickness Map. The OCT evaluation was performed on days 1, 7, 30 and 90 postoperatively. In 58 patients (71%), it was additionally performed at 12 months after surgery and in 52 patients (63%) the macular parameters in the healthy and operated eyes were compared. A statistically significant increase in the minimal retinal thickness was observed on days 30 (p<0.0005) and 90 (p<0.005) postoperatively compared to post-operative day 1. A statistically significant increase in the foveal volume was seen on days 30 (p<0.00005) and 90 (p<0.0005). A statistically significant increase in the volume of the entire macula was found on days 7, 30 and 90 (p<0.00005). Uncomplicated cataract phacoemulsification is followed by increases in the central retinal thickness, foveal volume and volume of the entire macula on days 30 and 90 and at 12 months postoperatively. Further observation of patients is required to confirm whether the macular parameters will return to their values on day 1 postoperatively and if so, when this will occur.

  7. System cost performance analysis (study 2.3). Volume 1: Executive summary. [unmanned automated payload programs and program planning

    NASA Technical Reports Server (NTRS)

    Campbell, B. H.

    1974-01-01

    A study is described which was initiated to identify and quantify the interrelationships between and within the performance, safety, cost, and schedule parameters for unmanned, automated payload programs. The result of the investigation was a systems cost/performance model which was implemented as a digital computer program and could be used to perform initial program planning, cost/performance tradeoffs, and sensitivity analyses for mission model and advanced payload studies. Program objectives and results are described briefly.

  8. Study of Adaptive Mathematical Models for Deriving Automated Pilot Performance Measurement Techniques. Volume II. Appendices. Final Report.

    ERIC Educational Resources Information Center

    Connelly, E. M.; And Others

    A new approach to deriving human performance measures and criteria for use in automatically evaluating trainee performance is described. Ultimately, this approach will allow automatic measurement of pilot performance in a flight simulator or from recorded in-flight data. An efficient method of representing performance data within a computer is…

  9. Outcomes of Cryoballoon Ablation in High- and Low-Volume Atrial Fibrillation Ablation Centres: A Russian Pilot Survey

    PubMed Central

    Mikhaylov, Evgeny N.; Lebedev, Dmitry S.; Pokushalov, Evgeny A.; Davtyan, Karapet V.; Ivanitskii, Eduard A.; Nechepurenko, Anatoly A.; Kosonogov, Alexey Ya.; Kolunin, Grigory V.; Morozov, Igor A.; Termosesov, Sergey A.; Maykov, Evgeny B.; Khomutinin, Dmitry N.; Eremin, Sergey A.; Mayorov, Igor M.; Romanov, Alexander B.; Shabanov, Vitaliy V.; Shatakhtsyan, Victoria; Tsivkovskii, Viktor; Revishvili, Amiran Sh.; Shlyakhto, Evgeny V.

    2015-01-01

    Purpose. The results of cryoballoon ablation (CBA) procedure have been mainly derived from studies conducted in experienced atrial fibrillation (AF) ablation centres. Here, we report on CBA efficacy and complications resulting from real practice of this procedure at both high- and low-volume centres. Methods. Among 62 Russian centres performing AF ablation, 15 (24%) used CBA technology for pulmonary vein isolation. The centres were asked to provide a detailed description of all CBA procedures performed and complications, if encountered. Results. Thirteen sites completed interviews on all CBAs in their centres (>95% of CBAs in Russia). Six sites were high-volume AF ablation (>100 AF cases/year) centres, and 7 were low-volume AF ablation. There was no statistical difference in arrhythmia-free rates between high- and low-volume centres (64.6 versus 60.8% at 6 months). Major complications developed in 1.5% of patients and were equally distributed between high- and low-volume centres. Minor procedure-related events were encountered in 8% of patients and were more prevalent in high-volume centres. Total event and vascular access site event rates were higher in women than in men. Conclusions. CBA has an acceptable efficacy profile in real practice. In less experienced AF ablation centres, the major complication rate is equal to that in high-volume centres. PMID:26640789

  10. Reliability of the Inverse Water Volumetry Method to Measure the Volume of the Upper Limb.

    PubMed

    Beek, Martinus A; te Slaa, Alexander; van der Laan, Lijckle; Mulder, Paul G H; Rutten, Harm J T; Voogd, Adri C; Luiten, Ernest J T; Gobardhan, Paul D

    2015-06-01

    Lymphedema of the upper extremity is a common side effect of lymph node dissection or irradiation of the axilla. Several techniques are being applied in order to examine the presence and severity of lymphedema. Measurement of circumference of the upper extremity is most frequently performed. An alternative is the water-displacement method. The aim of this study was to determine the reliability and the reproducibility of the "Inverse Water Volumetry apparatus" (IWV-apparatus) for the measurement of arm volumes. The IWV-apparatus is based on the water-displacement method. Measurements were performed by three breast cancer nurse practitioners on ten healthy volunteers in three weekly sessions. The intra-class correlation coefficient, defined as the ratio of the subject component to the total variance, equaled 0.99. The reliability index is calculated as 0.14 kg. This indicates that only changes in a patient's arm volume measurement of more than 0.14 kg would represent a true change in arm volume, which is about 6% of the mean arm volume of 2.3 kg. The IWV-apparatus proved to be a reliable and reproducible method to measure arm volume.

  11. Total lung capacity, residual volume and predicted residual volume in a densitometric study of older men.

    PubMed Central

    Latin, R W; Ruhling, R O

    1986-01-01

    Results of investigations using various lung volumes for hydrostatic weighing determinations (HWD) appear to be inconclusive. Often, these lung volumes are predicted and not clinically determined. For this reason, total lung capacity (TLC), a measured residual volume (RV), and a predicted residual volume (PRV) were used during HWDs to compare the techniques. Twenty-five older men, 56 to 70 years (means +/- 62.1 + 4.2 years) performed HWDs at RV (10 trials) and at TLC (3-5 trials). Values for body density and fat free mass were not significantly different between RV and TLC; both values were, however, significantly different from those derived using PRV. There were statistically significant differences (p less than 0.05) between all 3 per cent body fat values but the 1.1 per cent difference between TLC and RV may not be physiologically important. It was concluded that TLC and RV may be used comparably during HWDs, but a PRV may produce significantly different values. Since HWD at TLC is easily performed and circumvents the difficulties associated with the RV technique, it may be the preferred method for older subjects. PMID:3730758

  12. Senior Dance Experience, Cognitive Performance, and Brain Volume in Older Women

    PubMed Central

    Niemann, Claudia; Godde, Ben

    2016-01-01

    Physical activity is positively related to cognitive functioning and brain volume in older adults. Interestingly, different types of physical activity vary in their effects on cognition and on the brain. For example, dancing has become an interesting topic in aging research, as it is a popular leisure activity among older adults, involving cardiovascular and motor fitness dimensions that can be positively related to cognition. However, studies on brain structure are missing. In this study, we tested the association of long-term senior dance experience with cognitive performance and gray matter brain volume in older women aged 65 to 82 years. We compared nonprofessional senior dancers (n = 28) with nonsedentary control group participants without any dancing experience (n = 29), who were similar in age, education, IQ score, lifestyle and health factors, and fitness level. Differences neither in the four tested cognitive domains (executive control, perceptual speed, episodic memory, and long-term memory) nor in brain volume (VBM whole-brain analysis, region-of-interest analysis of the hippocampus) were observed. Results indicate that moderate dancing activity (1-2 times per week, on average) has no additional effects on gray matter volume and cognitive functioning when a certain lifestyle or physical activity and fitness level are reached. PMID:27738528

  13. Advanced controls for airbreathing engines, volume 3: Allison gas turbine

    NASA Technical Reports Server (NTRS)

    Bough, R. M.

    1993-01-01

    The application of advanced control concepts to airbreathing engines may yield significant improvements in aircraft/engine performance and operability. Screening studies of advanced control concepts for airbreathing engines were conducted by three major domestic aircraft engine manufacturers to determine the potential impact of concepts on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed advanced control concepts was formulated and evaluated in a two-phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation specific aircraft/engine combinations were considered: a Military High Performance Fighter mission, a High Speed Civil Transport mission, and a Civil Tiltrotor mission. Each of the advanced control concepts considered in the study are defined and described. The concept potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts are determined. Finally, the concepts are ranked with respect to the target aircraft/engine missions. A final report describing the screening studies was prepared by each engine manufacturer. Volume 3 of these reports describes the studies performed by the Allison Gas Turbine Division.

  14. Advanced control for airbreathing engines, volume 1: Pratt and Whitney

    NASA Technical Reports Server (NTRS)

    Ralph, J. A.

    1993-01-01

    The application of advanced control concepts to air breathing engines may yield significant improvements in aircraft/engine performance and operability. Screening studies of advanced control concepts for air breathing engines were conducted by three major domestic aircraft engine manufacturers to determine the potential impact of concepts on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed advanced control concepts was formulated and evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation specific aircraft/engine combinations were considered: a Military High Performance Fighter mission, a High Speed Civil Transport mission, and a Civil Tiltrotor mission. Each of the advanced control concepts considered in the study are defined and described. The concept potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts are determined. Finally, the concepts are ranked with respect to the target aircraft/engine missions. A final report describing the screening studies was prepared by each engine manufacturer. Volume 1 of these reports describes the studies performed by Pratt & Whitney.

  15. Advanced control for airbreathing engines, volume 2: General Electric aircraft engines

    NASA Technical Reports Server (NTRS)

    Bansal, Indar

    1993-01-01

    The application of advanced control concepts to air breathing engines may yield significant improvements in aircraft/engine performance and operability. Screening studies of advanced control concepts for air breathing engines were conducted by three major domestic aircraft engine manufacturers to determine the potential impact of concepts on turbine engine performance and operability. The purpose of the studies was to identify concepts which offered high potential yet may incur high research and development risk. A target suite of proposed advanced control concepts was formulated and evaluated in a two phase study to quantify each concept's impact on desired engine characteristics. To aid in the evaluation specific aircraft/engine combinations were considered: a Military High Performance Fighter mission, a High Speed Civil Transport mission, and a Civil Tiltrotor mission. Each of the advanced control concepts considered in the study are defined and described. The concept potential impact on engine performance was determined. Relevant figures of merit on which to evaluate the concepts are determined. Finally, the concepts are ranked with respect to the target aircraft/engine missions. A final report describing the screening studies was prepared by each engine manufacturer. Volume 2 of these reports describes the studies performed by GE Aircraft Engines.

  16. Impact Assessment and Forecasts of Information and Telecommunications Technologies Applied to Education and Training: Volume III--Annex & Glossary. Analysis of Key Issues for the Orientation of the Work of Sector Actors in the Framework of DELTA.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium).

    This annex to the main report, the third volume in a three volume set, is based on a study performed by the DELTA (Developing European Learning through Technological Advance) unit in parallel with the projects underway in the research and development Exploratory Action. It provides an assessment of the world situation in flexible and distance…

  17. High Performance Computing Technologies for Modeling the Dynamics and Dispersion of Ice Chunks in the Arctic Ocean

    DTIC Science & Technology

    2016-08-23

    SECURITY CLASSIFICATION OF: Hybrid finite element / finite volume based CaMEL shallow water flow solvers have been successfully extended to study wave...effects on ice floes in a simplified 10 sq-km ocean domain. Our solver combines the merits of both the finite element and finite volume methods and...ES) U.S. Army Research Office P.O. Box 12211 Research Triangle Park, NC 27709-2211 sea ice dynamics, shallow water, finite element , finite volume

  18. Effect of volume fraction of alpha and transformed beta on the high cycle fatigue properties of bimodal Ti6Al4V alloy

    NASA Astrophysics Data System (ADS)

    Jadhav, Shital; Powar, Amit; Patil, Sandip; Supare, Ashish; Farane, Bhagwan; Singh, Rajkumar, Dr.

    2017-05-01

    The present study was performed to investigate the effect of volume fraction of alpha and transformed beta phase on the high-cycle fatigue (HCF) properties of the bimodal titanium Ti6Al4V alloy. The effect of such morphology on mechanical properties was studied using tensile and rotating bending fatigue test as per ASTM standards. Microstructures and fractography of the specimens were studied using optical and scanning electron microscopy (SEM) respectively.Ti6Al4V alloy samples were heat treated to have three distinctive volume fractions of alpha and transformed beta phase. With an increase in quench delay from 30,50 and 70 sec during quenching after solutionizing temperature of 967°C, the volume fraction of alpha was found to be increased from 20% to 67%. Tests on tensile and rotating bending fatigue showed that the specimen with 20% volume fraction of alpha phase exhibited the highest tensile and fatigue strength, however the properties gets deteriorate with increase in volume fraction of alpha.

  19. Surgical outcomes for low-volume vs high-volume surgeons in gynecology surgery: a systematic review and meta-analysis.

    PubMed

    Mowat, Alex; Maher, Christopher; Ballard, Emma

    2016-07-01

    The aim of this study was to determine the impact of gynecological surgeon volumes on patient outcomes. Eligible studies were selected through an electronic literature search from database inception up until September 2015 and references in published studies. Search terms included surgical volume, surgeon volume, low-volume or high-volume, and gynecology or hysterectomy or sling or pelvic floor repair or continence procedure. The literature search was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We defined a low-volume surgeon (LVS) as one performing the procedure once a month or less, and studies were excluded if their definition of LVS was > ±33% of our definition. Primary outcomes were total complications, intraoperative complications, and postoperative complications. All outcome data for individual studies were entered into systematic review software. When 2 or more studies evaluated a designated outcome, a meta-analysis of the entered data was undertaken as per the Cochrane database methodology. Data analysis was entered into a software product, which generated a summary of findings table that included structured and qualified grading (very low to high) of the quality for the evidence of the individual outcomes and provided a measure of effect. Fourteen peer-reviewed studies with 741,760 patients were included in the systematic review. For gynecology the LVS group had an increased rate of total complications (odds ratio [OR], 1.3, 95% confidence interval [CI], 1.2-1.5), intraoperative complications (OR, 1.6, 95% CI, 1.2-2.1), and postoperative complications (OR, 1.4 95% CI, 1.3-1.4). In gynecological oncology, the LVS group had higher mortality (OR, 1.9, 95% CI, 1.3-2.6). In the urogynecology group, a single study reported that the LVS group had a higher rate of any complication (risk ratio [RR], 1.4, 95% CI, -1.2-1.6). Another single study found that LVS had higher rates of reoperation for mesh complications after midurethral sling procedures (RR, 1.4, 95% CI, 1.2-1.5). The evidence is of moderate to very low quality. Gynecologists performing procedures approximately once a month or less were found to have higher rates of adverse outcomes in gynecology, gynecological oncology, and urogynecology, with higher mortality in gynecological oncology. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  20. Subcortical volumetric changes across the adult lifespan: subregional thalamic atrophy accounts for age-related sensorimotor performance declines.

    PubMed

    Serbruyns, Leen; Leunissen, Inge; Huysmans, Toon; Cuypers, Koen; Meesen, Raf L; van Ruitenbeek, Peter; Sijbers, Jan; Swinnen, Stephan P

    2015-04-01

    Even though declines in sensorimotor performance during healthy aging have been documented extensively, its underlying neural mechanisms remain unclear. Here, we explored whether age-related subcortical atrophy plays a role in sensorimotor performance declines, and particularly during bimanual manipulative performance (Purdue Pegboard Test). The thalamus, putamen, caudate and pallidum of 91 participants across the adult lifespan (ages 20-79 years) were automatically segmented. In addition to studying age-related changes in the global volume of each subcortical structure, local deformations within these structures, indicative of subregional volume changes, were assessed by means of recently developed shape analyses. Results showed widespread age-related global and subregional atrophy, as well as some notable subregional expansion. Even though global atrophy failed to explain the observed performance declines with aging, shape analyses indicated that atrophy in left and right thalamic subregions, specifically subserving connectivity with the premotor, primary motor and somatosensory cortical areas, mediated the relation between aging and performance decline. It is concluded that subregional volume assessment by means of shape analyses offers a sensitive tool with high anatomical resolution in the search for specific age-related associations between brain structure and behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Validation of ultrasonography of the thyroid gland for epidemiological purposes.

    PubMed

    Knudsen, N; Bols, B; Bülow, I; Jørgensen, T; Perrild, H; Ovesen, L; Laurberg, P

    1999-11-01

    Ultrasonography of the thyroid is often used in epidemiological surveys, thus thorough characterization of the interobserver variation of the different parameters obtained is important. Various methods have been used for measuring thyroid volume, and different formulas have been used for calculation of thyroid volume from the measured dimensions. In this article, two principles of thyroid volume measurement are described in detail: the wellknown method based on the three axes of each lobe and a new principle based on planimetry in two planes. The interobserver variation of the examination and the measuring procedure in itself were tested on 25 participants in a population study. A comparison of postmortem ultrasonography of the thyroid and results of an autopsy was performed. Good correlation and agreement between observers was found for thyroid volume (r = 0.98) and prevalence of thyroid nodules (kappa = 0.72), whereas echogenecity and echopattern showed little agreement. The correlation of thyroid volume by ultrasonography to autopsy results was satisfactory (r = 0.93), but the volume tended to be slightly underestimated even when using the formula pi/6(= 0.52)*length*width*depth. No major differences were found between the performance of the two principles of volume calculation. We conclude that when the measuring procedure is well defined, results of ultrasonography are comparable between observers for thyroid volume and prevalence of thyroid nodules, but not for echogenecity or echopattern. The formula of length*depth*width*pi/6 is suitable for thyroid volume measurement.

  2. Differential regional gray matter volumes in patients with on-line game addiction and professional gamers

    PubMed Central

    Han, Doug Hyun; Lyoo, In Kyoon; Renshaw, Perry F.

    2015-01-01

    Patients with on-line game addiction (POGA) and professional video game players play video games for extended periods of time, but experience very different consequences for their on-line game play. Brain regions consisting of anterior cingulate, thalamus and occpito-temporal areas may increase the likelihood of becoming a pro-gamer or POGA. Twenty POGA, seventeen pro-gamers, and eighteen healthy comparison subjects (HC) were recruited. All magnetic resonance imaging (MRI) was performed on a 1.5 Tesla Espree MRI scanner (SIEMENS, Erlangen, Germany). Voxel-wise comparisons of gray matter volume were performed between the groups using the two-sample t-test with statistical parametric mapping (SPM5). Compared to HC, the POGA group showed increased impulsiveness and perseverative errors, and volume in left thalamus gray matter, but decreased gray matter volume in both inferior temporal gyri, right middle occipital gyrus, and left inferior occipital gyrus, compared with HC. Pro-gamers showed increased gray matter volume in left cingulate gyrus, but decreased gray matter volume in left middle occipital gyrus and right inferior temporal gyrus compared with HC. Additionally, the pro-gamer group showed increased gray matter volume in left cingulate gyrus and decreased left thalamus gray matter volume compared with the POGA group. The current study suggests that increased gray matter volumes of the left cingulate gyrus in pro-gamers and of the left thalamus in POGA may contribute to the different clinical characteristics of pro-gamers and POGA. PMID:22277302

  3. Michigan urban trunkline segments safety performance functions (SPFs) : final report.

    DOT National Transportation Integrated Search

    2016-07-01

    This study involves the development of safety performance functions (SPFs) for urban and suburban trunkline segments in the : state of Michigan. Extensive databases were developed through the integration of traffic crash information, traffic volumes,...

  4. Non-invasive volumetric analysis of asymptomatic hands using a 3-D scanner

    PubMed Central

    Shinkai, Hiroki; Yamamoto, Michiro; Tatebe, Masahiro; Iwatsuki, Katsuyuki; Kurimoto, Shigeru; Hirata, Hitoshi

    2017-01-01

    Hand swelling is one of the symptoms often seen in practice, but none of the available morphometric methods can quickly and efficiently quantify hand volume in an objective manner, and the current gold-standard volume measurement requires immersion in water, which can be difficult to use. Therefore, we aimed to analyze the accuracy of using 3-dimensional (3-D) scanning to measure hand volume. First, we compared the hand volume calculated using the 3-D scanner to that calculated from the conventional method among 109 volunteers to determine the reliability of 3-D measurements. We defined the beginning of the hand as the distal wrist crease, and 3-D forms of the hands were captured by the 3-D scanning system. Second, 238 volunteers (87 men, 151 women) with no disease or history of hand surgery underwent 3-D scanning. Data collected included age, height, weight, and shoe size. The wrist circumference (WC) and the distance between distal wrist crease and tip of middle finger (DDT) were measured. Statistical analyses were performed using linear regression to investigate the relationship between the hand volume and these parameters. In the first study, a significantly strong positive correlation was observed [R = 0.98] between the hand volume calculated via 3-D scanning and that calculated via the conventional method. In the second study, no significant differences between the volumes, WC or DDT of right and left hands were found. The correlations of hand volume with weight, WC, and DDT were strong. We created a formula to predict the hand volume using these parameters; these variables explained approximately 80% of the predicted volume. We confirmed that the new 3-D scanning method, which is performed without touching the hand and can record the form of the hand, yields an accurate volumetric analysis of an asymptomatic hand. PMID:28796816

  5. Prognostic Factors for Hormone Sensitive Metastatic Prostate Cancer: Impact of Disease Volume

    PubMed

    Alhanafy, Alshimaa Mahmoud; Zanaty, Fouad; Ibrahem, Reda; Omar, Suzan

    2018-04-27

    Background and Aim: The optimal management of metastatic hormone-sensitive prostate cancer has been controversial in recent years with introduction of upfront chemohormonal treatment based on results of several Western studies. This changing landscape has renewed interest in the concept “disease volume”, the focus of the present study is the Egyptian patients. Methods: Patients with hormone sensitive metastatic prostate cancer presenting at Menoufia University Hospital, Egypt, during the period from June 2013 to May 2016, were enrolled. All received hormonal treatment. Radiologic images were evaluated and patients were stratified according to their disease volume into high or low, other clinical and pathological data that could affect survival also being collected and analyzed. Results: A total of 128 patients were included, with a median age of 70 years (53.9% ≥70). About 46% had co-morbidities, 62% having high volume disease. During the median follow up period of 28 months about half of the patients progressed and one third received chemotherapy. On univariate analysis, disease volume, performance status (PS), prostate specific antigen level (PSA) and presence of pain at presentation were identified as factors influencing overall survival. Multivariate analysis revealed the independent predictor factors for survival to be PS, PSA and disease volume. The median overall survival with 27 months was high volume versus 49 with low volume disease (hazard ratio 2.1; 95% CI 1.2 - 4.4; P=0.02). Median progression free survival was 19 months in the high volume, as compared with 48 months in the low volume disease patients (hazard ratio, 2.44; 95% CI, 1.42 – 7.4; P=0.009). Conclusions: Disease volume is a reliable predictor of survival which should be incorporated with other important factors as; patient performance status and comorbidities in treatment decision-making. Creative Commons Attribution License

  6. The effect of respiratory motion on pulmonary nodule location during electromagnetic navigation bronchoscopy.

    PubMed

    Chen, Alexander; Pastis, Nicholas; Furukawa, Brian; Silvestri, Gerard A

    2015-05-01

    Electromagnetic navigation has improved the diagnostic yield of peripheral bronchoscopy for pulmonary nodules. For these procedures, a thin-slice chest CT scan is performed prior to bronchoscopy at full inspiration and is used to create virtual airway reconstructions that are used as a map during bronchoscopy. Movement of the lung occurs with respiratory variation during bronchoscopy, and the location of pulmonary nodules during procedures may differ significantly from their location on the initial planning full-inspiratory chest CT scan. This study was performed to quantify pulmonary nodule movement from full inspiration to end-exhalation during tidal volume breathing in patients undergoing electromagnetic navigation procedures. A retrospective review of electromagnetic navigation procedures was performed for which two preprocedure CT scans were performed prior to bronchoscopy. One CT scan was performed at full inspiration, and a second CT scan was performed at end-exhalation during tidal volume breathing. Pulmonary lesions were identified on both CT scans, and distances between positions were recorded. Eighty-five pulmonary lesions were identified in 46 patients. Average motion of all pulmonary lesions was 17.6 mm. Pulmonary lesions located in the lower lobes moved significantly more than upper lobe nodules. Size and distance from the pleura did not significantly impact movement. Significant movement of pulmonary lesions occurs between full inspiration and end-exhalation during tidal volume breathing. This movement from full inspiration on planning chest CT scan to tidal volume breathing during bronchoscopy may significantly affect the diagnostic yield of electromagnetic navigation bronchoscopy procedures.

  7. Evidence for the changes of pituitary volumes in patients with post-traumatic stress disorder.

    PubMed

    Atmaca, Murad; Ozer, Omer; Korkmaz, Sevda; Taskent, Ismail; Yildirim, Hanefi

    2017-02-28

    In pubertal and postpubertal patients with post-traumatic stress disorder (PTSD), significantly greater pituitary gland volumes have been reported. Moving from this point, in the present study, we aimed to investigate pituitary gland volumes in patients with PTSD and hypothesized that volumes of the gland would be structurally changed. Volumetric magnetic resonance imaging of the pituitary gland was performed among sixteen patients with PTSD and fifteen healthy control subjects. We found that the mean volume of the pituitary gland was statistically significant and smaller than that of healthy subjects (0.69±0.08cm 3 for patient group and 0.83±0.21 for control subjects). Consequently, in the present study, we found that patients with PTSD had smaller pituitary gland volumes than those of healthy controls like other anxiety disorders. It is important to provide support for this finding in future longitudinal investigations. Copyright © 2016. Published by Elsevier B.V.

  8. Hospital esophagectomy volume and postoperative length of stay: A systematic review and meta-analysis.

    PubMed

    Giwa, Femi; Salami, Aitua; Abioye, Ajibola I

    2018-01-01

    Much attention in the volume-outcomes literature has focused on the empirical impact of surgical caseload on outcomes. However, relevant studies on the association between surgical volume and variables that potentially contribute to healthcare costs are limited. The objective of this study was to systematically elucidate a contemporary analysis of the empirical relationship between hospital esophagectomy volume and postoperative length of stay, a cost-related outcome. OvidSP, PubMed, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL), ISI Web of Science and OpenGrey were searched for relevant articles published from 2000 to 2016. High hospital esophagectomy volume was associated with reduced postoperative length of stay (mean: 3 days; 95%CI: 2.8, 3.2) and risk of prolonged length of stay (RR: 0.80, 95%CI: 0.74, 0.87) in a dose-response fashion. Complex surgeries performed at high surgical volume centers may be associated with overall decrease in postoperative length of stay, a cost-related outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Translational MRI volumetry with NeuroQuant: Effects of version and normative data on relationships with memory performance in healthy older adults and patients with mild cognitive impairment

    PubMed Central

    Stelmokas, Julija; Yassay, Lance; Giordani, Bruno; Dodge, Hiroko H.; Dinov, Ivo D.; Bhaumik, Arijit; Sathian, K.; Hampstead, Benjamin M.

    2018-01-01

    NeuroQuant (NQ) is a fully-automated program that overcomes several existing limitations in the clinical translation of MRI-derived volumetry. The current study characterized differences between the original (NQ1) and an updated NQ version (NQ2) by (i) replicating previously identified relationships between neuropsychological test performance and medial temporal lobe volumes, (ii) evaluating the level of agreement between NQ versions, and (iii) determining if the addition of NQ2 age-/sex-based z-scores hold greater clinical utility for prediction of memory impairment than standard percent of intracranial volume (%ICV) values. Sixty-seven healthy older adults and 65 MCI patients underwent structural MRI and completed cognitive testing, including the Immediate and Delayed Memory indices from the RBANS. Results generally replicated previous relationships between key medial temporal lobe regions and memory test performance, though comparison of NQ regions revealed statistically different values that were biased toward one version or the other depending on the region. NQ2 hippocampal z-scores explained additional variance in memory performance relative to %ICV values. Findings indicate that NQ1/2 medial temporal lobe volumes, especially age- and sex-based z-scores, hold clinical value, though caution is warranted when directly comparing volumes across NQ versions. PMID:29060939

  10. The Impact of Hospital/Surgeon Volume on Acute Renal Failure and Mortality in Liver Transplantation: A Nationwide Cohort Study.

    PubMed

    Cheng, Chih-Wen; Liu, Fu-Chao; Lin, Jr-Rung; Tsai, Yung-Fong; Chen, Hsiu-Pin; Yu, Huang-Ping

    2016-01-01

    The aim of this study was to assess whether the case volume of surgeons and hospitals affects the rates of postoperative complications and survival after liver transplantation. This population-based retrospective cohort study included 2938 recipients of liver transplantation performed between 1998 and 2012, enrolled from the Taiwan National Health Insurance Research Database. They were divided into two groups, according to the cumulative case volume of their operating surgeons and the case volume of their hospitals. The duration of intensive care unit stay and post-transplantation hospitalization, postoperative complications, and mortality were analyzed. The results showed that, in the low and high case volume surgeons groups, respectively, acute renal failure occurred at the rate of 14.11% and 5.86% (p<0.0001), and the overall mortality rates were 19.61% and 12.44% (p<0.0001). In the low and high case volume hospital groups, respectively, acute renal failure occurred in 11% and 7.11% of the recipients (p = 0.0004), and the overall mortality was 18.44% and 12.86% (p<0.0001). These findings suggest that liver transplantation recipients operated on higher case volume surgeons or in higher case volume hospitals have a lower rate of acute renal failure and mortality.

  11. Climatological Study to Determine the Impact of Icing on the Low Level Windshear Alert System. Volume II. Statistics.

    DOT National Transportation Integrated Search

    1989-01-01

    The climatological study was performed to determine the impact of icing on the performance of the Low Level Winshear Alert System (LLWAS). : This report Presents the Icing Statisctical profile in the form of data tables and histograms of 106 LLWAS si...

  12. Testing of state roadside safety systems. Volume XI, Appendix J -- Crash testing and evaluation of existing guardrail systems

    DOT National Transportation Integrated Search

    1999-04-01

    The purpose of this study is to crash test and evaluate new or modified roadside safety hardware and, where necessary, redesign the devices to improve their impact performance. The three major areas addressed in this study are the impact performance ...

  13. Climatological Study to Determine the Impact of Icing on the Low Level Windshear Alert System. Volume I. Analysis.

    DOT National Transportation Integrated Search

    1989-09-01

    The climatological study was performed to determine the impact of icing on the performance of Low Level Windshear Alert System (LLWAS). : This report presents the icing statistical profile in the form of data tables and histograms of 106 LLWAS sites....

  14. How large is the typical subarachnoid hemorrhage? A review of current neurosurgical knowledge.

    PubMed

    Whitmore, Robert G; Grant, Ryan A; LeRoux, Peter; El-Falaki, Omar; Stein, Sherman C

    2012-01-01

    Despite the morbidity and mortality of subarachnoid hemorrhage (SAH), the average volume of a typical hemorrhage is not well defined. Animal models of SAH often do not accurately mimic the human disease process. The purpose of this study is to estimate the average SAH volume, allowing standardization of animal models of the disease. We performed a MEDLINE search of SAH volume and erythrocyte counts in human cerebrospinal fluid as well as for volumes of blood used in animal injection models of SAH, from 1956 to 2010. We polled members of the American Association of Neurological Surgeons (AANS) for estimates of typical SAH volume. Using quantitative data from the literature, we calculated the total volume of SAH as equal to the volume of blood clotted in basal cisterns plus the volume of dispersed blood in cerebrospinal fluid. The results of the AANS poll confirmed our estimates. The human literature yielded 322 publications and animal literature, 237 studies. Four quantitative human studies reported blood clot volumes ranging from 0.2 to 170 mL, with a mean of ∼20 mL. There was only one quantitative study reporting cerebrospinal fluid red blood cell counts from serial lumbar puncture after SAH. Dispersed blood volume ranged from 2.9 to 45.9 mL, and we used the mean of 15 mL for our calculation. Therefore, total volume of SAH equals 35 mL. The AANS poll yielded 176 responses, ranging from 2 to 350 mL, with a mean of 33.9 ± 4.4 mL. Based on our estimate of total SAH volume of 35 mL, animal injection models may now become standardized for more accurate portrayal of the human disease process. Copyright © 2012 Elsevier Inc. All rights reserved.

  15. Surgeon and Hospital Volume as Quality Indicators for CABG in Taiwan: Examining Hazard to Mortality and Accounting for Unobserved Heterogeneity

    PubMed Central

    Hockenberry, Jason M; Lien, Hsien-Ming; Chou, Shin-Yi

    2010-01-01

    Objective To investigate whether provider volume has an impact on the hazard of mortality for coronary artery bypass grafting (CABG) patients in Taiwan. Data Sources/Study Setting Multiple sources of linked data from the National Health Insurance Program in Taiwan. Study Design The linked data were used to identify 27,463 patients who underwent CABG without concomitant angioplasty or valve procedures and the surgeon and hospital volumes. Generalized estimating equations and hazard models were estimated to assess the impact of volume on mortality. The hazard modeling technique used accounts for bias stemming from unobserved heterogeneity. Principal Findings Both surgeon and hospital volume quartiles are inversely related to the hazard of mortality after CABG. Patients whose surgeon is in the three higher volume quartiles have lower 1-, 3-, 6-, and 12-month mortality after CABG, while only those having their procedure performed at the highest quartile of volume hospitals have lower mortality outcomes. Conclusions Mortality outcomes are related to provider CABG volume in Taiwan. Unobserved heterogeneity is a concern in the volume–outcome relationship; after accounting for it, surgeon volume effects on short-term mortality are large. Using models controlling for unobserved heterogeneity and examining longer term mortality may still differentiate provider quality by volume. PMID:20662948

  16. Three-Dimensional Analysis of Long-Term Midface Volume Change After Vertical Vector Deep-Plane Rhytidectomy.

    PubMed

    Jacono, Andrew A; Malone, Melanie H; Talei, Benjamin

    2015-07-01

    Facial aging is a complicated process that includes volume loss and soft tissue descent. This study provides quantitative 3-dimensional (3D) data on the long-term effect of vertical vector deep-plane rhytidectomy on restoring volume to the midface. To determine if primary vertical vector deep-plane rhytidectomy resulted in long-term volume change in the midface. We performed a prospective study on patients undergoing primary vertical vector deep-plane rhytidectomy to quantitate 3D volume changes in the midface. Quantitative analysis of volume changes was made using the Vectra 3D imaging software (Canfield Scientific, Inc, Fairfield, New Jersey) at a minimum follow-up of 1 year. Forty-three patients (86 hemifaces) were analyzed. The average volume gained in each hemi-midface after vertical vector deep-plane rhytidectomy was 3.2 mL. Vertical vector deep-plane rhytidectomy provides significant long-term augmentation of volume in the midface. These quantitative data demonstrate that some midface volume loss is related to gravitational descent of the cheek fat compartments and that vertical vector deep-plane rhytidectomy may obviate the need for other volumization procedures such as autologous fat grafting in selected cases. 4 Therapeutic. © 2015 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

  17. Lattice study of finite volume effect in HVP for muon g-2

    NASA Astrophysics Data System (ADS)

    Izubuchi, Taku; Kuramashi, Yoshinobu; Lehner, Christoph; Shintani, Eigo

    2018-03-01

    We study the finite volume effect of the hadronic vacuum polarization contribution to muon g-2, aμhvp, in lattice QCD by comparison with two different volumes, L4 = (5.4)4 and (8.1)4 fm4, at physical pion. We perform the lattice computation of highly precise vector-vector current correlator with optimized AMA technique on Nf = 2 + 1 PACS gauge configurations in Wilson-clover fermion and stout smeared gluon action at one lattice cut-off, a-1 = 2.33 GeV. We compare two integrals of aμhvp, momentum integral and time-slice summation, on the lattice and numerically show that the different size of finite volume effect appears between two methods. We also discuss the effect of backward-state propagation into the result of aμhvp with the different boundary condition. Our model-independent study suggest that the lattice computation at physical pion is important for correct estimate of finite volume and other lattice systematics in aμhvp.

  18. Memory and anatomical change in severe non missile traumatic brain injury: ∼1 vs. ∼8 years follow-up.

    PubMed

    Tomaiuolo, Francesco; Bivona, Umberto; Lerch, Jason P; Di Paola, Margherita; Carlesimo, Giovanni A; Ciurli, Paola; Matteis, Mariella; Cecchetti, Luca; Forcina, Antonio; Silvestro, Daniela; Azicnuda, Eva; Sabatini, Umberto; Di Giacomo, Dina; Caltagirone, Carlo; Petrides, Michael; Formisano, Rita

    2012-03-10

    In previous studies, we investigated a group of subjects who had suffered from a severe non missile traumatic brain injury (nmTBI) without macroscopic focal lesions and we found brain atrophy involving the hippocampus, fornix, corpus callosum, optic chiasm, and optic radiations. Memory test scores correlated mainly with fornix volumes [37,38]. In the present study, we re-examined 11 of these nmTBI subjects approximately 8 yr later. High-spatial resolution T1 weighted magnetic resonance images of the brain (1mm(3)) and standardised memory tests were performed once more in order to compare brain morphology and memory performance originally assessed 3-13 months after head injury (first study) and after 8-10 yr (present study). An overall improvement of memory test performance was demonstrated in the latest assessment, indicating that cognitive recovery in severe nmTBI subjects had not been completed within 3-13 months post-injury. It is notable that the volumes of the fornix and the hippocampus were reduced significantly from normal controls, but these volumes do not differ appreciatively between nmTBI subjects at first (after ∼1 yr) and at second (after ∼8 yr) scans. On the contrary, a clear reduction in the volume of the corpus callosus can be observed after ∼1 yr and a further significant reduction is evident after ∼8 yr, indicating that the neural degeneration in severe nmTBI continues long after the head trauma and relates to specific structures and not to the overall brain. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. 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

  20. Creatine Kinase Activity Weakly Correlates to Volume Completed Following Upper Body Resistance Exercise

    ERIC Educational Resources Information Center

    Machado, Marco; Willardson, Jeffrey M.; Silva, Dailson P.; Frigulha, Italo C.; Koch, Alexander J.; Souza, Sergio C.

    2012-01-01

    In the current study, we examined the relationship between serum creatine kinase (CK) activity following upper body resistance exercise with a 1- or 3-min rest between sets. Twenty men performed two sessions, each consisting of four sets with a 10-repetition maximum load. The results demonstrated significantly greater volume for the 3-min…

  1. Sex Differences in Parietal Lobe Morphology: Relationship to Mental Rotation Performance

    ERIC Educational Resources Information Center

    Koscik, Tim; O'Leary, Dan; Moser, David J.; Andreasen, Nancy C.; Nopoulos, Peg

    2009-01-01

    Structural magnetic resonance imaging (MRI) studies of the human brain have reported evidence for sexual dimorphism. In addition to sex differences in overall cerebral volume, differences in the proportion of gray matter (GM) to white matter (WM) volume have been observed, particularly in the parietal lobe. To our knowledge there have been no…

  2. Skylab Experiments, Volume 5, Astronomy and Space Physics.

    ERIC Educational Resources Information Center

    National Aeronautics and Space Administration, Washington, DC.

    Basic knowledge about Skylab experiments is presented in this book, one of a series, for the purpose of informing high school teachers about scientific research performed in orbit and enabling the teachers to broaden their basis for material selection. This fifth volume is concerned with studies of our own and other galaxies and effects of solar…

  3. Exploiting the capabilities of the Sentinel-2 multi spectral instrument for predicting growing stock volume in forest ecosystems

    NASA Astrophysics Data System (ADS)

    Mura, Matteo; Bottalico, Francesca; Giannetti, Francesca; Bertani, Remo; Giannini, Raffaello; Mancini, Marco; Orlandini, Simone; Travaglini, Davide; Chirici, Gherardo

    2018-04-01

    The spatial prediction of growing stock volume is one of the most frequent application of remote sensing for supporting the sustainable management of forest ecosystems. For such a purpose data from active or passive sensors are used as predictor variables in combination with measures taken in the field in sampling plots. The Sentinel-2 (S2) satellites are equipped with a Multi Spectral Instrument (MSI) capable of acquiring 13 bands in the visible and infrared domains with a spatial resolution varying between 10 and 60 m. The present study aimed at evaluating the performance of the S2-MSI imagery for estimating the growing stock volume of forest ecosystems. To do so we used 240 plots measured in two study areas in Italy. The imputation was carried out with eight k-Nearest Neighbours (k-NN) methods available in the open source YaImpute R package. In order to evaluate the S2-MSI performance we repeated the experimental protocol also with two other sets of images acquired by two well-known satellites equipped with multi spectral instruments: Landsat 8 OLI and RapidEye scanner. We found that S2 worked better than Landsat in 37.5% of the cases and in 62.5% of the cases better than RapidEye. In one study area the best performance was obtained with Landsat OLI (RMSD = 6.84%) and in the other with S2 (RMSD = 22.94%), both with the k-NN system based on a distance matrix calculated with the Random Forest algorithm. The results confirmed that S2 images are suitable for predicting growing stock volume obtaining good performances (average RMSD for both the test areas of less than 19%).

  4. Breast volume assessment: comparing five different techniques.

    PubMed

    Bulstrode, N; Bellamy, E; Shrotria, S

    2001-04-01

    Breast volume assessment is not routinely performed pre-operatively because as yet there is no accepted technique. There have been a variety of methods published, but this is the first study to compare these techniques. We compared volume measurements obtained from mammograms (previously compared to mastectomy specimens) with estimates of volume obtained from four other techniques: thermoplastic moulding, magnetic resonance imaging, Archimedes principle and anatomical measurements. We also assessed the acceptability of each method to the patient. Measurements were performed on 10 women, which produced results for 20 breasts. We were able to calculate regression lines between volume measurements obtained from mammography to the other four methods: (1) magnetic resonance imaging (MRI), 379+(0.75 MRI) [r=0.48], (2) Thermoplastic moulding, 132+(1.46 Thermoplastic moulding) [r=0.82], (3) Anatomical measurements, 168+(1.55 Anatomical measurements) [r=0.83]. (4) Archimedes principle, 359+(0.6 Archimedes principle) [r=0.61] all units in cc. The regression curves for the different techniques are variable and it is difficult to reliably compare results. A standard method of volume measurement should be used when comparing volumes before and after intervention or between individual patients, and it is unreliable to compare volume measurements using different methods. Calculating the breast volume from mammography has previously been compared to mastectomy samples and shown to be reasonably accurate. However we feel thermoplastic moulding shows promise and should be further investigated as it gives not only a volume assessment but a three-dimensional impression of the breast shape, which may be valuable in assessing cosmesis following breast-conserving-surgery.

  5. Estimated maximal and current brain volume predict cognitive ability in old age

    PubMed Central

    Royle, Natalie A.; Booth, Tom; Valdés Hernández, Maria C.; Penke, Lars; Murray, Catherine; Gow, Alan J.; Maniega, Susana Muñoz; Starr, John; Bastin, Mark E.; Deary, Ian J.; Wardlaw, Joanna M.

    2013-01-01

    Brain tissue deterioration is a significant contributor to lower cognitive ability in later life; however, few studies have appropriate data to establish how much influence prior brain volume and prior cognitive performance have on this association. We investigated the associations between structural brain imaging biomarkers, including an estimate of maximal brain volume, and detailed measures of cognitive ability at age 73 years in a large (N = 620), generally healthy, community-dwelling population. Cognitive ability data were available from age 11 years. We found positive associations (r) between general cognitive ability and estimated brain volume in youth (male, 0.28; females, 0.12), and in measured brain volume in later life (males, 0.27; females, 0.26). Our findings show that cognitive ability in youth is a strong predictor of estimated prior and measured current brain volume in old age but that these effects were the same for both white and gray matter. As 1 of the largest studies of associations between brain volume and cognitive ability with normal aging, this work contributes to the wider understanding of how some early-life factors influence cognitive aging. PMID:23850342

  6. Effect of prolonged space flight on cardiac function and dimensions

    NASA Technical Reports Server (NTRS)

    Henry, W. L.; Epstein, S. E.; Griffith, J. M.; Goldstein, R. E.; Redwood, D. R.

    1974-01-01

    Echocardiographic studies were performed preflight 5 days before launch and on recovery day and 1, 2, 4, 11, 31 and 68 days postflight. From these echocardiograms measurements were made. From these primary measurements, left ventricular end-diastolic volume, end-systolic volume, stroke volume, and mass were derived using the accepted assumptions. Findings in the Scientist Pilot and Pilot resemble those seen in trained distance runners. Wall thickness measurements were normal in all three crewmembers preflight. Postflight basal studies were unchanged in the Commander on recovery day through 68 days postflight in both the Scientist Pilot and Pilot, however, the left ventricular end-diastolic volume, stroke volume, and mass were decreased slightly. Left ventricular function curves were constructed for the Commander and Pilot by plotting stroke volume versus end-diastolic volume. In both astronauts, preflight and postflight data fell on the same straight line demonstrating that no deterioration in cardiac function had occurred. These data indicate that the cardiovascular system adapts well to prolonged weightlessness and suggest that alterations in cardiac dimensions and function are unlikely to limit man's future in space.

  7. SU-F-T-40: Can CBCT Images Be Used for Volume Studies of Prostate Seed Implants for Boost Treatment?

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

    Xu, H; Lee, S; Diwanji, T

    Purpose: In our clinic, the planning CT is used for definitive and boost low-dose-rate (LDR) brachytherapy treatments to determine the ultrasound volume in the operating room (OR) at the time of the implant. While the CT overestimation of OR volume is known, a larger estimation discrepancy has been observed for boost treatments. A possible reason is the prostate size reduction during EBRT for boost patients. Since cone-beam CT (CBCT) is often used as routine imaging guidance of EBRT, this prostate volume change may be captured. This study investigates if CBCT taken during EBRT includes the volume change information and thereforemore » beats CT in estimating the prostate OR volumes. Methods: 9 prostate patients treated with EBRT (45Gy in 1.8Gy per fractions to the whole pelvis) and I-125 seed implants (108Gy) were involved in this study. During EBRT, CBCT image guidance was performed on a weekly basis. For each patient, the prostate volumes on the first and the last available CBCT images were manually contoured by a physician. These volumes were then compared to each other and with the contoured volumes from the planning CT and from the ultrasound images in the OR. Results: The first and the last CBCT images did not show significant prostate volume change. Their average +/− standard deviation of prostate volumes were 24.4cc+/−14.6cc and 29.9cc+/−16.1cc, respectively (T-test p=0.68). The ratio of the OR volume to the last CBCT (0.71+/−0.21) was not significantly different from the ratio of OR volumes to the planning CT (0.61+/−0.13) (p=0.25). Conclusion: In this study, CBCT does not show significant prostate volume changes during EBRT. CBCT and CT volumes are quite consistent and no improvement of volume estimation using CBCT is observed. The advantage of CBCT as a replacement of CT for volume study of boost LDR brachytherapy is limited.« less

  8. Decreased Cognitive Functioning After Electroconvulsive Therapy Is Related to Increased Hippocampal Volume: Exploring the Role of Brain Plasticity.

    PubMed

    van Oostrom, Iris; van Eijndhoven, Philip; Butterbrod, Elke; van Beek, Maria H; Janzing, Joost; Donders, Rogier; Schene, Aart; Tendolkar, Indira

    2018-06-01

    Electroconvulsive therapy (ECT) is still the most effective treatment of severe and therapy-refractory major depressive disorder. Cognitive side effects are the major disadvantage of ECT. Cognitive deficits are generally temporary in nature and may be mediated by the hippocampus. Recent studies have shown a temporary increase in hippocampal volume and a temporary decrease in cognitive functioning post-ECT compared with pre-ECT. This study investigates whether these volumetric changes are related to changes in cognitive functioning after ECT. Nineteen medication-free patients with treatment-resistant major depressive disorder underwent a whole-brain magnetic resonance imaging scan and a neuropsychological examination (including the Rey auditory verbal learning task, Wechsler Memory Scale Visual Reproduction, fluency, Trail Making Task) within 1 week before and within 1 week after the course of ECT. Electroconvulsive therapy was administered twice a week bitemporally with a brief pulse. A matched healthy control group (n = 18) received the same neuropsychological examination and at a similar interval to that of the patients. Hippocampal volumes increased significantly from pretreatment to posttreatment in patients. Mean performance on cognitive tasks declined, or remained stable, whereas performance in controls generally improved because of retesting effects. The increase in hippocampal volume was related to changes in cognitive performance, indicating that this increase co-occurred with a decrease in cognitive functioning. Our findings tentatively suggest that the temporal increase in hippocampal volume after treatment, which may result from neurotrophic processes and is thought to be crucial for the antidepressive effect, is also related to the temporary cognitive side effects of ECT.

  9. Relationship between sample volumes and modulus of human vertebral trabecular bone in micro-finite element analysis.

    PubMed

    Wen, Xin-Xin; Xu, Chao; Zong, Chun-Lin; Feng, Ya-Fei; Ma, Xiang-Yu; Wang, Fa-Qi; Yan, Ya-Bo; Lei, Wei

    2016-07-01

    Micro-finite element (μFE) models have been widely used to assess the biomechanical properties of trabecular bone. How to choose a proper sample volume of trabecular bone, which could predict the real bone biomechanical properties and reduce the calculation time, was an interesting problem. Therefore, the purpose of this study was to investigate the relationship between different sample volumes and apparent elastic modulus (E) calculated from μFE model. 5 Human lumbar vertebral bodies (L1-L5) were scanned by micro-CT. Cubic concentric samples of different lengths were constructed as the experimental groups and the largest possible volumes of interest (VOI) were constructed as the control group. A direct voxel-to-element approach was used to generate μFE models and steel layers were added to the superior and inferior surface to mimic axial compression tests. A 1% axial strain was prescribed to the top surface of the model to obtain the E values. ANOVA tests were performed to compare the E values from the different VOIs against that of the control group. Nonlinear function curve fitting was performed to study the relationship between volumes and E values. The larger cubic VOI included more nodes and elements, and more CPU times were needed for calculations. E values showed a descending tendency as the length of cubic VOI decreased. When the volume of VOI was smaller than (7.34mm(3)), E values were significantly different from the control group. The fit function showed that E values approached an asymptotic values with increasing length of VOI. Our study demonstrated that apparent elastic modulus calculated from μFE models were affected by the sample volumes. There was a descending tendency of E values as the length of cubic VOI decreased. Sample volume which was not smaller than (7.34mm(3)) was efficient enough and timesaving for the calculation of E. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. On the suitability of the copula types for the joint modelling of flood peaks and volumes along the Danube River

    NASA Astrophysics Data System (ADS)

    Kohnová, Silvia; Papaioannou, George; Bacigál, Tomáš; Szolgay, Ján; Hlavčová, Kamila; Loukas, Athanasios; Výleta, Roman

    2017-04-01

    Flood frequency analysis is often performed as a univariate analysis of flood peaks using a suitable theoretical probability distribution of the annual maximum flood peaks or peak over threshold values. However, also other flood attributes, such as flood volume and duration, are often necessary for the design of hydrotechnical structures and projects. In this study, the suitability of various copula families for a bivariate analysis of peak discharges and flood volumes has been tested on the streamflow data from gauging stations along the whole Danube River. Kendall's rank correlation coefficient (tau) quantifies the dependence between flood peak discharge and flood volume settings. The methodology is tested on two different data samples: 1) annual maximum flood (AMF) peaks with corresponding flood volumes, which is a typical choice for engineering studies and 2). annual maximum flood (AMF) peaks combined with annual maximum flow volumes of fixed durations at 5, 10, 15, 20, 25, 30 and 60 days, which can be regarded as a regime analysis of the dependence between the extremes of both variables in a given year. The bivariate modelling of the peak discharge - flood volume couples is achieved with the use of the the following copulas: Ali-Mikhail-Haq (AMH), Clayton, Frank, Joe, Gumbel, HuslerReiss, Galambos, Tawn, Normal, Plackett and FGM, respectively. Scatterplots of the observed and simulated peak discharge - flood volume pairs and goodness-of-fit tests have been used to assess the overall applicability of the copulas as well as observing any changes in suitable models along the Danube River. The results indicate that, almost all of the considered Archimedean class copulas (e.g. Frank, Clayton and Ali-Mikhail-Haq) perform better than the other copula families selected for this study, and that for the second data samples mostly the upper-tail-flat copulas were suitable.

  11. Greater cerebellar gray matter volume in car drivers: an exploratory voxel-based morphometry study

    PubMed Central

    Sakai, Hiroyuki; Ando, Takafumi; Sadato, Norihiro; Uchiyama, Yuji

    2017-01-01

    Previous functional neuroimaging studies have identified multiple brain areas associated with distinct aspects of car driving in simulated traffic environments. Few studies, however, have examined brain morphology associated with everyday car-driving experience in real traffic. Thus, the aim of the current study was to identify gray matter volume differences between drivers and non-drivers. We collected T1-weighted structural brain images from 73 healthy young adults (36 drivers and 37 non-drivers). We performed a whole-brain voxel-based morphometry analysis to examine between-group differences in regional gray matter volume. Compared with non-drivers, drivers showed significantly greater gray matter volume in the left cerebellar hemisphere, which has been associated with cognitive rather than motor functioning. In contrast, we found no brain areas with significantly greater gray matter volume in non-drivers compared with drivers. Our findings indicate that experience with everyday car driving in real traffic is associated with greater gray matter volume in the left cerebellar hemisphere. This brain area may be involved in abilities that are critical for driving a car, but are not commonly or frequently used during other daily activities. PMID:28417971

  12. Greater cerebellar gray matter volume in car drivers: an exploratory voxel-based morphometry study.

    PubMed

    Sakai, Hiroyuki; Ando, Takafumi; Sadato, Norihiro; Uchiyama, Yuji

    2017-04-18

    Previous functional neuroimaging studies have identified multiple brain areas associated with distinct aspects of car driving in simulated traffic environments. Few studies, however, have examined brain morphology associated with everyday car-driving experience in real traffic. Thus, the aim of the current study was to identify gray matter volume differences between drivers and non-drivers. We collected T1-weighted structural brain images from 73 healthy young adults (36 drivers and 37 non-drivers). We performed a whole-brain voxel-based morphometry analysis to examine between-group differences in regional gray matter volume. Compared with non-drivers, drivers showed significantly greater gray matter volume in the left cerebellar hemisphere, which has been associated with cognitive rather than motor functioning. In contrast, we found no brain areas with significantly greater gray matter volume in non-drivers compared with drivers. Our findings indicate that experience with everyday car driving in real traffic is associated with greater gray matter volume in the left cerebellar hemisphere. This brain area may be involved in abilities that are critical for driving a car, but are not commonly or frequently used during other daily activities.

  13. Depressed left ventricular performance. Response to volume infusion in patients with sepsis and septic shock

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

    Ognibene, F.P.; Parker, M.M.; Natanson, C.

    Volume infusion, to increase preload and to enhance ventricular performance, is accepted as initial management of septic shock. Recent evidence has demonstrated depressed myocardial function in human septic shock. We analyzed left ventricular performance during volume infusion using serial data from simultaneously obtained pulmonary artery catheter hemodynamic measurements and radionuclide cineangiography. Critically ill control subjects (n = 14), patients with sepsis but without shock (n = 21), and patients with septic shock (n = 21) had prevolume infusion hemodynamic measurements determined and received statistically similar volumes of fluid resulting in similar increases in pulmonary capillary wedge pressure. There was amore » strong trend (p = 0.004) toward less of a change in left ventricular stroke work index (LVSWI) after volume infusion in patients with sepsis and septic shock compared with control subjects. The LVSWI response after volume infusion was significantly less in patients with septic shock when compared with critically ill control subjects (p less than 0.05). These data demonstrate significantly altered ventricular performance, as measured by LVSWI, in response to volume infusion in patients with septic shock.« less

  14. Embryonic cardiac morphometry in Carnegie stages 15-23, from the Complutense University of Madrid Institute of Embryology Human Embryo Collection.

    PubMed

    Arráez-Aybar, L A; Turrero-Nogués, A; Marantos-Gamarra, D G

    2008-01-01

    We performed a morphometric study of cardiac development on human embryos to complement the scarce data on human embryonic cardiac morphometry and to attempt to establish, from these, algorithms describing cardiac growth during the second month of gestation. Thirty human embryos from Carnegie stages 15-23 were included in the study. Shrinkage and compression effects from fixation and inclusion in paraffin were considered in our calculations. Growth of the cardiac (whole heart) volume and volume of ventricular myocardium through the Carnegie stages were analysed by ANOVA. Linear correlation was used to describe the relationship between the ventricular myocardium and cardiac volumes. Comparisons of models were carried out through the R2 statistic. The relationship volume of ventricular myocardium versus cardiac volume is expressed by the equation: cardiac volume = 0.6266 + 2.4778 volume of ventricular myocardium. The relationship cardiac volume versus crown-rump length is expressed by the equation: cardiac volume = 1.3 e(0.126 CR length), where e is the base of natural logarithms. At a clinical level, these results can contribute towards the establishment of a normogram for cardiac development, useful for the design of strategies for early diagnosis of congenital heart disease. They can also help in the study of embryogenesis, for example in the discussion of ventricular trabeculation. Copyright 2007 S. Karger AG, Basel.

  15. The role of Area 10 (BA10) in human multitasking and in social cognition: a lesion study.

    PubMed

    Roca, María; Torralva, Teresa; Gleichgerrcht, Ezequiel; Woolgar, Alexandra; Thompson, Russell; Duncan, John; Manes, Facundo

    2011-11-01

    A role for rostral prefrontal cortex (BA10) has been proposed in multitasking, in particular, the selection and maintenance of higher order internal goals while other sub-goals are being performed. BA10 has also been implicated in the ability to infer someone else's feelings and thoughts, often referred to as theory of mind. While most of the data to support these views come from functional neuroimaging studies, lesion studies are scant. In the present study, we compared the performance of a group of frontal patients whose lesions involved BA10, a group of frontal patients whose lesions did not affect this area (nonBA10), and a group of healthy controls on tests requiring multitasking and complex theory of mind judgments. Only the group with lesions involving BA10 showed deficits on multitasking and theory of mind tasks when compared with control subjects. NonBA10 patients performed more poorly than controls on an executive function screening tool, particularly on measures of response inhibition and abstract reasoning, suggesting that theory of mind and multitasking deficits following lesions to BA10 cannot be explained by a general worsening of executive function. In addition, we searched for correlations between performance and volume of damage within different subregions of BA10. Significant correlations were found between multitasking performance and volume of damage in right lateral BA10, and between theory of mind and total BA10 lesion volume. These findings stress the potential pivotal role of BA10 in higher order cognitive functions. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Gas-Grain Simulation Facility: Fundamental studies of particle formation and interactions. Volume 2: Abstracts, candidate experiments and feasibility study

    NASA Technical Reports Server (NTRS)

    Fogleman, Guy (Editor); Huntington, Judith L. (Editor); Schwartz, Deborah E. (Editor); Fonda, Mark L. (Editor)

    1989-01-01

    An overview of the Gas-Grain Simulation Facility (GGSF) project and its current status is provided. The proceedings of the Gas-Grain Simulation Facility Experiments Workshop are recorded. The goal of the workshop was to define experiments for the GGSF--a small particle microgravity research facility. The workshop addressed the opportunity for performing, in Earth orbit, a wide variety of experiments that involve single small particles (grains) or clouds of particles. Twenty experiments from the fields of exobiology, planetary science, astrophysics, atmospheric science, biology, physics, and chemistry were described at the workshop and are outlined in Volume 2. Each experiment description included specific scientific objectives, an outline of the experimental procedure, and the anticipated GGSF performance requirements. Since these experiments represent the types of studies that will ultimately be proposed for the facility, they will be used to define the general science requirements of the GGSF. Also included in the second volume is a physics feasibility study and abstracts of example Gas-Grain Simulation Facility experiments and related experiments in progress.

  17. Education as Experimentation: A Planned Variation Model. Volume IV-B: Effects of Follow Through Models. Volume IV-C: Appendices, Part I and Part II.

    ERIC Educational Resources Information Center

    Bock, Geoffrey; And Others

    This segment of the national evaluation study of the Follow Through Planned Variation Model describes each of the 17 models represented in the study and reports the results of analyses of 4 years of student performance data for each model. First a purely descriptive synthesis of findings is presented for each model, with interpretation of the data…

  18. The Impact of Hospital Size on CMS Hospital Profiling.

    PubMed

    Sosunov, Eugene A; Egorova, Natalia N; Lin, Hung-Mo; McCardle, Ken; Sharma, Vansh; Gelijns, Annetine C; Moskowitz, Alan J

    2016-04-01

    The Centers for Medicare & Medicaid Services (CMS) profile hospitals using a set of 30-day risk-standardized mortality and readmission rates as a basis for public reporting. These measures are affected by hospital patient volume, raising concerns about uniformity of standards applied to providers with different volumes. To quantitatively determine whether CMS uniformly profile hospitals that have equal performance levels but different volumes. Retrospective analysis of patient-level and hospital-level data using hierarchical logistic regression models with hospital random effects. Simulation of samples including a subset of hospitals with different volumes but equal poor performance (hospital effects=+3 SD in random-effect logistic model). A total of 1,085,568 Medicare fee-for-service patients undergoing 1,494,993 heart failure admissions in 4930 hospitals between July 1, 2005 and June 30, 2008. CMS methodology was used to determine the rank and proportion (by volume) of hospitals reported to perform "Worse than US National Rate." Percent of hospitals performing "Worse than US National Rate" was ∼40 times higher in the largest (fifth quintile by volume) compared with the smallest hospitals (first quintile). A similar gradient was seen in a cohort of 100 hospitals with simulated equal poor performance (0%, 0%, 5%, 20%, and 85% in quintiles 1 to 5) effectively leaving 78% of poor performers undetected. Our results illustrate the disparity of impact that the current CMS method of hospital profiling has on hospitals with higher volumes, translating into lower thresholds for detection and reporting of poor performance.

  19. Cogeneration Technology Alternatives Study (CTAS). Volume 6: Computer data. Part 2: Residual-fired nocogeneration process boiler

    NASA Technical Reports Server (NTRS)

    Knightly, W. F.

    1980-01-01

    Computer generated data on the performance of the cogeneration energy conversion system are presented. Performance parameters included fuel consumption and savings, capital costs, economics, and emissions of residual fired process boilers.

  20. Commercial Vehicle Architecture Systems Study, Volume II: Task Reports

    DOT National Transportation Integrated Search

    1993-10-01

    WEIGH-IN-MOTION OR WIM, DRIVER PERFORMANCE MONITORING, ELECTRONIC DATA INTERCHANGE OR EDI, COMMERCIAL VEHICLE OPERATIONS OR CVO : THIS REPORT DETAILS PROGRESS TO DATE ON A SET OF TASKS BEING PERFORMED BY SANDIA NATIONAL LABORATORIES (SNL) FOR THE ...

  1. Pineal gland volume in primary insomnia and healthy controls: a magnetic resonance imaging study.

    PubMed

    Bumb, Jan M; Schilling, Claudia; Enning, Frank; Haddad, Leila; Paul, Franc; Lederbogen, Florian; Deuschle, Michael; Schredl, Michael; Nolte, Ingo

    2014-06-01

    Little is known about the relation between pineal volume and insomnia. Melatonin promotes sleep processes and, administered as a drug, it is suitable to improve primary and secondary sleep disorders in humans. Recent magnetic resonance imaging studies suggest that human plasma and saliva melatonin levels are partially determined by the pineal gland volume. This study compares the pineal volume in a group of patients with primary insomnia to a group of healthy people without sleep disturbance. Pineal gland volume (PGV) was measured on the basis of high-resolution 3 Tesla MRI (T1-magnetization prepared rapid gradient echo) in 23 patients and 27 controls, matched for age, gender and educational status. Volume measurements were performed conventionally by manual delineation of the pineal borders in multi-planar reconstructed images. Pineal gland volume was significantly smaller (P < 0.001) in patients (48.9 ± 26.6 mm(3) ) than in controls (79 ± 30.2 mm(3) ). In patients PGV correlated negatively with age (r = -0.532; P = 0.026). Adjusting for the effect of age, PGV and rapid eye movement (REM) latency showed a significant positive correlation (rS  = 0.711, P < 0.001) in patients. Pineal volume appears to be reduced in patients with primary insomnia compared to healthy controls. Further studies are needed to clarify whether low pineal volume is the basis or the consequence of functional sleep changes to elucidate the molecular pathology for the pineal volume loss in primary insomnia. © 2014 European Sleep Research Society.

  2. Paediatric ECMO at low-volume paediatric cardiac centres in the Nordic countries.

    PubMed

    Veien, M; Lindberg, L; Tynkkynen, P; Ravn, H B

    2015-03-01

    Extracorporeal membrane oxygenation (ECMO) is a life-saving resource-intensive technology for patients with respiratory and/or circulatory failure. We aimed to evaluate outcome data from three Nordic paediatric centres comparing with data from the International Registry of the Extracorporeal Life Support Organization (ELSO) and selected high-volume single-centre studies. One-hundred nineteen patients < 19 years from 2002 to 2012 were enrolled. Data on demographics and outcome were collected using a standardised registration form. Outcome data were compared with the ELSO registry and high-volume single-centre studies. Demographics, indications and diagnosis were similar to the ELSO register. Survival after ECMO was similar to outcome data from the ELSO register, apart from paediatric cardiac ECMO, where a significantly better survival to discharge was seen in the Nordic centres (68% vs. 49%; P = 0.03). Comparison with high-volume centres in the period after 2005 demonstrated a significantly better survival after cardiac ECMO in a single high-volume centre study, whereas four studies had significantly lower survival after cardiac ECMO. No significant difference was seen in children receiving respiratory ECMO in the Nordic centres and high-volume centres. Survival after ECMO in three low-volume Nordic centres demonstrated comparable outcome data with ELSO data and data from high-volume centres. We believe regular quality assurance surveys, as the present study, should be performed in order to maintain excellent therapy within the individual ECMO centres. © 2015 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  3. The validity of ultrasound estimation of muscle volumes.

    PubMed

    Infantolino, Benjamin W; Gales, Daniel J; Winter, Samantha L; Challis, John H

    2007-08-01

    The purpose of this study was to validate ultrasound muscle volume estimation in vivo. To examine validity, vastus lateralis ultrasound images were collected from cadavers before muscle dissection; after dissection, the volumes were determined by hydrostatic weighing. Seven thighs from cadaver specimens were scanned using a 7.5-MHz ultrasound probe (SSD-1000, Aloka, Japan). The perimeter of the vastus lateralis was identified in the ultrasound images and manually digitized. Volumes were then estimated using the Cavalieri principle, by measuring the image areas of sets of parallel two-dimensional slices through the muscles. The muscles were then dissected from the cadavers, and muscle volume was determined via hydrostatic weighing. There was no statistically significant difference between the ultrasound estimation of muscle volume and that estimated using hydrostatic weighing (p > 0.05). The mean percentage error between the two volume estimates was 0.4% +/- 6.9. Three operators all performed four digitizations of all images from one randomly selected muscle; there was no statistical difference between operators or trials and the intraclass correlation was high (>0.8). The results of this study indicate that ultrasound is an accurate method for estimating muscle volumes in vivo.

  4. Aerobic Fitness is Associated With Hippocampal Volume in Elderly Humans

    PubMed Central

    Erickson, Kirk I.; Prakash, Ruchika S.; Voss, Michelle W.; Chaddock, Laura; Hu, Liang; Morris, Katherine S.; White, Siobhan M.; Wójcicki, Thomas R.; McAuley, Edward; Kramer, Arthur F.

    2010-01-01

    Deterioration of the hippocampus occurs in elderly individuals with and without dementia, yet individual variation exists in the degree and rate of hippocampal decay. Determining the factors that influence individual variation in the magnitude and rate of hippocampal decay may help promote lifestyle changes that prevent such deterioration from taking place. Aerobic fitness and exercise are effective at preventing cortical decay and cognitive impairment in older adults and epidemiological studies suggest that physical activity can reduce the risk for developing dementia. However, the relationship between aerobic fitness and hippocampal volume in elderly humans is unknown. In this study, we investigated whether individuals with higher levels of aerobic fitness displayed greater volume of the hippocampus and better spatial memory performance than individuals with lower fitness levels. Furthermore, in exploratory analyses, we assessed whether hippocampal volume mediated the relationship between fitness and spatial memory. Using a region-of-interest analysis on magnetic resonance images in 165 nondemented older adults, we found a triple association such that higher fitness levels were associated with larger left and right hippocampi after controlling for age, sex, and years of education, and larger hippocampi and higher fitness levels were correlated with better spatial memory performance. Furthermore, we demonstrated that hippocampal volume partially mediated the relationship between higher fitness levels and enhanced spatial memory. Our results clearly indicate that higher levels of aerobic fitness are associated with increased hippocampal volume in older humans, which translates to better memory function. PMID:19123237

  5. Tissue microstructure features derived from anomalous diffusion measurements in magnetic resonance imaging.

    PubMed

    Yu, Qiang; Reutens, David; O'Brien, Kieran; Vegh, Viktor

    2017-02-01

    Tissue microstructure features, namely axon radius and volume fraction, provide important information on the function of white matter pathways. These parameters vary on the scale much smaller than imaging voxels (microscale) yet influence the magnetic resonance imaging diffusion signal at the image voxel scale (macroscale) in an anomalous manner. Researchers have already mapped anomalous diffusion parameters from magnetic resonance imaging data, but macroscopic variations have not been related to microscale influences. With the aid of a tissue model, we aimed to connect anomalous diffusion parameters to axon radius and volume fraction using diffusion-weighted magnetic resonance imaging measurements. An ex vivo human brain experiment was performed to directly validate axon radius and volume fraction measurements in the human brain. These findings were validated using electron microscopy. Additionally, we performed an in vivo study on nine healthy participants to map axon radius and volume fraction along different regions of the corpus callosum projecting into various cortical areas identified using tractography. We found a clear relationship between anomalous diffusion parameters and axon radius and volume fraction. We were also able to map accurately the trend in axon radius along the corpus callosum, and in vivo findings resembled the low-high-low-high behaviour in axon radius demonstrated previously. Axon radius and volume fraction measurements can potentially be used in brain connectivity studies and to understand the implications of white matter structure in brain diseases and disorders. Hum Brain Mapp 38:1068-1081, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  6. Reliability of Vibrating Mesh Technology.

    PubMed

    Gowda, Ashwin A; Cuccia, Ann D; Smaldone, Gerald C

    2017-01-01

    For delivery of inhaled aerosols, vibrating mesh systems are more efficient than jet nebulizers are and do not require added gas flow. We assessed the reliability of a vibrating mesh nebulizer (Aerogen Solo, Aerogen Ltd, Galway Ireland) suitable for use in mechanical ventilation. An initial observational study was performed with 6 nebulizers to determine run time and efficiency using normal saline and distilled water. Nebulizers were run until cessation of aerosol production was noted, with residual volume and run time recorded. Three controllers were used to assess the impact of the controller on nebulizer function. Following the observational study, a more detailed experimental protocol was performed using 20 nebulizers. For this analysis, 2 controllers were used, and time to cessation of aerosol production was noted. Gravimetric techniques were used to measure residual volume. Total nebulization time and residual volume were recorded. Failure was defined as premature cessation of aerosol production represented by residual volume of > 10% of the nebulizer charge. In the initial observational protocol, an unexpected sporadic failure rate was noted of 25% in 55 experimental runs. In the experimental protocol, a failure rate was noted of 30% in 40 experimental runs. Failed runs in the experimental protocol exhibited a wide range of retained volume averaging ± SD 36 ± 21.3% compared with 3.2 ± 1.5% (P = .001) in successful runs. Small but significant differences existed in nebulization time between controllers. Aerogen Solo nebulization was often randomly interrupted with a wide range of retained volumes. Copyright © 2017 by Daedalus Enterprises.

  7. The safe volume threshold for chest drain removal following pulmonary resection.

    PubMed

    Yap, Kok Hooi; Soon, Jia Lin; Ong, Boon Hean; Loh, Yee Jim

    2017-11-01

    A best evidence topic in thoracic surgery was written according to a structured protocol. The question addressed was 'In patients undergoing pulmonary resection, is there a safe drainage volume threshold for chest drain removal?' Altogether 1054 papers were found, of which 5 papers represented the best evidence. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Chest drainage threshold, where used, ranged from 250 to 500 ml/day. Both randomized controlled trials showed no significant difference in reintervention rates with a higher chest drainage volume threshold. Four studies that performed analysis on other complications showed no statistical significant difference with a higher chest drainage volume threshold. Four studies evaluating length of hospital stay showed reduced or no difference in the length of stay with a higher chest drainage volume threshold. Two cohort studies reported the mortality rate of 0-0.01% with a higher chest drainage volume threshold. We conclude that early chest drain removal after pulmonary resection, accepting a higher chest drainage volume threshold of 250-500 ml/day is safe, and may result in shorter hospital stay without increasing reintervention, morbidity or mortality. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  8. Automated linking of suspicious findings between automated 3D breast ultrasound volumes

    NASA Astrophysics Data System (ADS)

    Gubern-Mérida, Albert; Tan, Tao; van Zelst, Jan; Mann, Ritse M.; Karssemeijer, Nico

    2016-03-01

    Automated breast ultrasound (ABUS) is a 3D imaging technique which is rapidly emerging as a safe and relatively inexpensive modality for screening of women with dense breasts. However, reading ABUS examinations is very time consuming task since radiologists need to manually identify suspicious findings in all the different ABUS volumes available for each patient. Image analysis techniques to automatically link findings across volumes are required to speed up clinical workflow and make ABUS screening more efficient. In this study, we propose an automated system to, given the location in the ABUS volume being inspected (source), find the corresponding location in a target volume. The target volume can be a different view of the same study or the same view from a prior examination. The algorithm was evaluated using 118 linkages between suspicious abnormalities annotated in a dataset of ABUS images of 27 patients participating in a high risk screening program. The distance between the predicted location and the center of the annotated lesion in the target volume was computed for evaluation. The mean ± stdev and median distance error achieved by the presented algorithm for linkages between volumes of the same study was 7.75±6.71 mm and 5.16 mm, respectively. The performance was 9.54±7.87 and 8.00 mm (mean ± stdev and median) for linkages between volumes from current and prior examinations. The proposed approach has the potential to minimize user interaction for finding correspondences among ABUS volumes.

  9. Grey matter volume in the cerebellum is related to the processing of grammatical rules in a second language: a structural voxel-based morphometry study.

    PubMed

    Pliatsikas, Christos; Johnstone, Tom; Marinis, Theodoros

    2014-02-01

    The experience of learning and using a second language (L2) has been shown to affect the grey matter (GM) structure of the brain. Importantly, GM density in several cortical and subcortical areas has been shown to be related to performance in L2 tasks. Here, we show that bilingualism can lead to increased GM volume in the cerebellum, a structure that has been related to the processing of grammatical rules. Additionally, the cerebellar GM volume of highly proficient L2 speakers is correlated to their performance in a task tapping on grammatical processing in an L2, demonstrating the importance of the cerebellum for the establishment and use of grammatical rules in an L2.

  10. Heat Transfer Characteristics of Fan Coil Unit (FCU) Under The Effect of Chilled Water Volume Flowrate

    NASA Astrophysics Data System (ADS)

    Wijaya Sunu, Putu; Anakottapary, Daud Simon; Mulawarman, A. A. N. B.; Cipta Santosa, I. D. M.; Putu Sastra Negara, I.

    2018-01-01

    In this paper, the volume flowrate of chilled water in the water chiller simulation apparatus was optimized using experimental studied. The experimental analysis was performed on the fan coil unit (FCU) of the system. The chilled water flows in tube side and the air as a hot fluid flows throughout the tube and fin of FCU. The thermal performance and analysis of the heat transfer is examined using various chilled water flowrate e.g. 11, 12, 13, 14, 15 lpm. The effect of the flowrate to the important parameter such as LMTD temperature, heat absorb used for investigate the heat transfer characteristics. The result showed that the heat transfer characteristics has been increased with the increased of chilled water volume flowrate.

  11. Better diet quality relates to larger brain tissue volumes: The Rotterdam Study.

    PubMed

    Croll, Pauline H; Voortman, Trudy; Ikram, M Arfan; Franco, Oscar H; Schoufour, Josje D; Bos, Daniel; Vernooij, Meike W

    2018-05-16

    To investigate the relation of diet quality with structural brain tissue volumes and focal vascular lesions in a dementia-free population. From the population-based Rotterdam Study, 4,447 participants underwent dietary assessment and brain MRI scanning between 2005 and 2015. We excluded participants with an implausible energy intake, prevalent dementia, or cortical infarcts, leaving 4,213 participants for the current analysis. A diet quality score (0-14) was calculated reflecting adherence to Dutch dietary guidelines. Brain MRI was performed to obtain information on brain tissue volumes, white matter lesion volume, lacunes, and cerebral microbleeds. The associations of diet quality score and separate food groups with brain structures were assessed using multivariable linear and logistic regression. We found that better diet quality related to larger brain volume, gray matter volume, white matter volume, and hippocampal volume. Diet quality was not associated with white matter lesion volume, lacunes, or microbleeds. High intake of vegetables, fruit, whole grains, nuts, dairy, and fish and low intake of sugar-containing beverages were associated with larger brain volumes. A better diet quality is associated with larger brain tissue volumes. These results suggest that the effect of nutrition on neurodegeneration may act via brain structure. More research, in particular longitudinal research, is needed to unravel direct vs indirect effects between diet quality and brain health. © 2018 American Academy of Neurology.

  12. Structural neural correlates of multitasking: A voxel-based morphometry study.

    PubMed

    Zhang, Rui-Ting; Yang, Tian-Xiao; Wang, Yi; Sui, Yuxiu; Yao, Jingjing; Zhang, Chen-Yuan; Cheung, Eric F C; Chan, Raymond C K

    2016-12-01

    Multitasking refers to the ability to organize assorted tasks efficiently in a short period of time, which plays an important role in daily life. However, the structural neural correlates of multitasking performance remain unclear. The present study aimed at exploring the brain regions associated with multitasking performance using global correlation analysis. Twenty-six healthy participants first underwent structural brain scans and then performed the modified Six Element Test, which required participants to attempt six subtasks in 10 min while obeying a specific rule. Voxel-based morphometry of the whole brain was used to detect the structural correlates of multitasking ability. Grey matter volume of the anterior cingulate cortex (ACC) was positively correlated with the overall performance and time monitoring in multitasking. In addition, white matter volume of the anterior thalamic radiation (ATR) was also positively correlated with time monitoring during multitasking. Other related brain regions associated with multitasking included the superior frontal gyrus, the inferior occipital gyrus, the lingual gyrus, and the inferior longitudinal fasciculus. No significant correlation was found between grey matter volume of the prefrontal cortex (Brodmann Area 10) and multitasking performance. Using a global correlation analysis to examine various aspects of multitasking performance, this study provided new insights into the structural neural correlates of multitasking ability. In particular, the ACC was identified as an important brain region that played both a general and a specific time-monitoring role in multitasking, extending the role of the ACC from lesioned populations to healthy populations. The present findings also support the view that the ATR may influence multitasking performance by affecting time-monitoring abilities. © 2016 The Institute of Psychology, Chinese Academy of Sciences and John Wiley & Sons Australia, Ltd.

  13. Relationships between cognitive performance, neuroimaging, and vascular disease: the DHS-Mind Study

    PubMed Central

    Hsu, Fang-Chi; Raffield, Laura M.; Hugenschmidt, Christina E.; Cox, Amanda; Xu, Jianzhao; Carr, J. Jeffery; Freedman, Barry I.; Maldjian, Joseph A.; Williamson, Jeff D.; Bowden, Donald W.

    2015-01-01

    Background Type 2 diabetes mellitus increases risk for cognitive decline and dementia; elevated burdens of vascular disease are hypothesized to contribute to this risk. These relationships were examined in the Diabetes Heart Study-Mind using a battery of cognitive tests, neuroimaging measures, and subclinical cardiovascular disease (CVD) burden assessed by coronary artery calcified plaque (CAC). We hypothesized that CAC would attenuate the association between neuroimaging measures and cognition performance. Methods Associations were examined using marginal models in this family-based cohort of 572 European Americans from 263 families. All models were adjusted for age, gender, education, type 2 diabetes, and hypertension, with some neuroimaging measures additionally adjusted for intracranial volume. Results Higher total brain volume (TBV) was associated with better performance on the Digit Symbol Substitution Task (DSST) and Semantic Fluency (both p≤7.0 x 10−4). Higher gray matter volume (GMV) was associated with better performance on the Modified Mini-Mental State Examination and Semantic Fluency (both p≤9.0 x 10−4). Adjusting for CAC caused minimal changes to the results. Conclusions Relationships exist between neuroimaging measures and cognitive performance in a type 2 diabetes-enriched European American cohort. Associations were minimally attenuated after adjusting for subclinical CVD. Additional work is needed to understand how subclinical CVD burden interacts with other factors and impacts relationships between neuroimaging and cognitive testing measures. PMID:26185004

  14. Emergency department imaging: are weather and calendar factors associated with imaging volume?

    PubMed

    Burns, K; Chernyak, V; Scheinfeld, M H

    2016-12-01

    To identify weather and calendar factors that would enable prediction of daily emergency department (ED) imaging volume to aid appropriate scheduling of imaging resources for efficient ED function. Daily ED triage and imaging volumes for radiography, computed tomography (CT), and ultrasound were obtained from hospital databases for the period between January 2011 and December 2013 at a large tertiary urban hospital with a Level II trauma centre. These data were tabulated alongside daily weather conditions (temperature, wind and precipitation), day of week, season, and holidays. Multivariate analysis was performed. Pearson correlations were used to measure the association between number of imaging studies performed and ED triage volume. For every additional 50 triaged patients, the odds of having high (imaging volume ≥90th percentile) radiography, CT, and ultrasound volume increased by 4.3 times (p<0.001), 1.5 times (p=0.02), and 1.4 times (p=0.02), respectively. Tuesday was an independent predictor of high radiography volume (odds ratio=2.8) and Monday was an independent predictor of high CT volume (odds ratio=3.0). Weekday status was an independent factor increasing the odds of a high US volume compared to Saturday (odds ratios ranging from 5.6-9.8). Weather factors and other calendar variables were not independent predictors of high imaging volume. Using Pearson correlations, ED triage volume correlated with number of radiographs, CT, and ultrasound examinations with r=0.73, 0.37, and 0.41, respectively (p<0.0001). As ED triage volume was found to be the only factor associated with imaging volume for all techniques, analysis of predictors of ED triage volumes at a particular healthcare facility would be useful to determine imaging needs. Although calendar and weather factors were found to be minor or non-significant independent predictors of ED imaging utilisation, these may be important in influencing the actual number of ED triages. Copyright © 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  15. Study of Adaptive Mathematical Models for Deriving Automated Pilot Performance Measurement Techniques. Volume I. Model Development.

    ERIC Educational Resources Information Center

    Connelly, Edward A.; And Others

    A new approach to deriving human performance measures and criteria for use in automatically evaluating trainee performance is documented in this report. The ultimate application of the research is to provide methods for automatically measuring pilot performance in a flight simulator or from recorded in-flight data. An efficient method of…

  16. Partial volume correction using cortical surfaces

    NASA Astrophysics Data System (ADS)

    Blaasvær, Kamille R.; Haubro, Camilla D.; Eskildsen, Simon F.; Borghammer, Per; Otzen, Daniel; Ostergaard, Lasse R.

    2010-03-01

    Partial volume effect (PVE) in positron emission tomography (PET) leads to inaccurate estimation of regional metabolic activities among neighbouring tissues with different tracer concentration. This may be one of the main limiting factors in the utilization of PET in clinical practice. Partial volume correction (PVC) methods have been widely studied to address this issue. MRI based PVC methods are well-established.1 Their performance depend on the quality of the co-registration of the MR and PET dataset, on the correctness of the estimated point-spread function (PSF) of the PET scanner and largely on the performance of the segmentation method that divide the brain into brain tissue compartments.1, 2 In the present study a method for PVC is suggested, that utilizes cortical surfaces, to obtain detailed anatomical information. The objectives are to improve the performance of PVC, facilitate a study of the relationship between metabolic activity in the cerebral cortex and cortical thicknesses, and to obtain an improved visualization of PET data. The gray matter metabolic activity after performing PVC was recovered by 99.7 - 99.8 % , in relation to the true activity when testing on simple simulated data with different PSFs and by 97.9 - 100 % when testing on simulated brain PET data at different cortical thicknesses. When studying the relationship between metabolic activities and anatomical structures it was shown on simulated brain PET data, that it is important to correct for PVE in order to get the true relationship.

  17. Single-breath diffusing capacity for carbon monoxide instrument accuracy across 3 health systems.

    PubMed

    Hegewald, Matthew J; Markewitz, Boaz A; Wilson, Emily L; Gallo, Heather M; Jensen, Robert L

    2015-03-01

    Measuring diffusing capacity of the lung for carbon monoxide (DLCO) is complex and associated with wide intra- and inter-laboratory variability. Increased D(LCO) variability may have important clinical consequences. The objective of the study was to assess instrument performance across hospital pulmonary function testing laboratories using a D(LCO) simulator that produces precise and repeatable D(LCO) values. D(LCO) instruments were tested with CO gas concentrations representing medium and high range D(LCO) values. The absolute difference between observed and target D(LCO) value was used to determine measurement accuracy; accuracy was defined as an average deviation from the target value of < 2.0 mL/min/mm Hg. Accuracy of inspired volume measurement and gas sensors were also determined. Twenty-three instruments were tested across 3 healthcare systems. The mean absolute deviation from the target value was 1.80 mL/min/mm Hg (range 0.24-4.23) with 10 of 23 instruments (43%) being inaccurate. High volume laboratories performed better than low volume laboratories, although the difference was not significant. There was no significant difference among the instruments by manufacturers. Inspired volume was not accurate in 48% of devices; mean absolute deviation from target value was 3.7%. Instrument gas analyzers performed adequately in all instruments. D(LCO) instrument accuracy was unacceptable in 43% of devices. Instrument inaccuracy can be primarily attributed to errors in inspired volume measurement and not gas analyzer performance. D(LCO) instrument performance may be improved by regular testing with a simulator. Caution should be used when comparing D(LCO) results reported from different laboratories. Copyright © 2015 by Daedalus Enterprises.

  18. Factors that influence minority use of high-volume hospitals for colorectal cancer care.

    PubMed

    Huang, Lyen C; Tran, Thuy B; Ma, Yifei; Ngo, Justine V; Rhoads, Kim F

    2015-05-01

    Previous studies suggest that minorities cluster in low-quality hospitals despite living close to better performing hospitals. This may contribute to persistent disparities in cancer outcomes. The purpose of this work was to examine how travel distance, insurance status, and neighborhood socioeconomic factors influenced minority underuse of high-volume hospitals for colorectal cancer. The study was a retrospective, cross-sectional, population-based study. All hospitals in California from 1996 to 2006 were included. Patients with colorectal cancer diagnosed and treated in California between 1996 and 2006 were identified using California Cancer Registry data. Multivariable logistic regression models predicting high-volume hospital use were adjusted for age, sex, race, stage, comorbidities, insurance status, and neighborhood socioeconomic factors. A total of 79,231 patients treated in 417 hospitals were included in the study. High-volume hospitals were independently associated with an 8% decrease in the hazard of death compared with other settings. A lower proportion of minorities used high-volume hospitals despite a higher proportion living nearby. Although insurance status and socioeconomic factors were independently associated with high-volume hospital use, only socioeconomic factors attenuated differences in high-volume hospital use of black and Hispanic patients compared with white patients. The use of cross-sectional data and racial and ethnic misclassifications were limitations in this study. Minority patients do not use high-volume hospitals despite improved outcomes and geographic access. Low socioeconomic status predicts low use of high-volume settings in select minority groups. Our results provide a roadmap for developing interventions to increase the use of and access to higher quality care and outcomes. Increasing minority use of high-volume hospitals may require community outreach programs and changes in physician referral practices.

  19. Comparison of the treatment performance of hybrid constructed wetlands treating stormwater runoff.

    PubMed

    Choi, J Y; Maniquiz-Redillas, M C; Hong, J S; Lee, S Y; Kim, L H

    2015-01-01

    This study was conducted to compare the treatment performance of two hybrid constructed wetlands (CWs) in treating stormwater runoff. The hybrid CWs were composed of a combination of free water surface (FWS) and horizontal subsurface flow (HSSF) CWs. Based on the results, strong correlation exists between potential runoff impacts and stormwater characteristics; however, the low correlations also suggest that not only the monitored parameters contribute to stormwater event mean concentrations (EMC) of pollutants, but other factors should also be considered as well. In the hydraulic and treatment performance of the hybrid CWs, a small surface area to catchment area (SA/CA) ratio, receiving a high concentration of influent EMC, will find it hard to achieve great removal efficiency; also a large SA/CA ratio, receiving low concentration of influent EMC, will find it hard to achieve great removal efficiency. With this, SA/CA ratio and influent characteristics such as EMC or load should be considered among the design factors of CWs. The performance data of the two CWs were used to consider the most cost-effective design of a hybrid CW. The optimum facility capacity (ratio of total runoff volume to storage volume) that is applicable for a target volume reduction and removal efficiency was provided in this study.

  20. Brain volume reduction after whole-brain radiotherapy: quantification and prognostic relevance.

    PubMed

    Hoffmann, Christian; Distel, Luitpold; Knippen, Stefan; Gryc, Thomas; Schmidt, Manuel Alexander; Fietkau, Rainer; Putz, Florian

    2018-01-22

    Recent studies have questioned the value of adding whole-brain radiotherapy (WBRT) to stereotactic radiosurgery (SRS) for brain metastasis treatment. Neurotoxicity, including radiation-induced brain volume reduction, could be one reason why not all patients benefit from the addition of WBRT. In this study, we quantified brain volume reduction after WBRT and assessed its prognostic significance. Brain volumes of 91 patients with cerebral metastases were measured during a 150-day period after commencing WBRT and were compared with their pretreatment volumes. The average daily relative change in brain volume of each patient, referred to as the "brain volume reduction rate," was calculated. Univariate and multivariate Cox regression analyses were performed to assess the prognostic significance of the brain volume reduction rate, as well as of 3 treatment-related and 9 pretreatment factors. A one-way analysis of variance was used to compare the brain volume reduction rate across recursive partitioning analysis (RPA) classes. On multivariate Cox regression analysis, the brain volume reduction rate was a significant predictor of overall survival after WBRT (P < 0.001), as well as the number of brain metastases (P = 0.002) and age (P = 0.008). Patients with a relatively favorable prognosis (RPA classes 1 and 2) experienced significantly less brain volume decrease after WBRT than patients with a poor prognosis (RPA class 3) (P = 0.001). There was no significant correlation between delivered radiation dose and brain volume reduction rate (P = 0.147). In this retrospective study, a smaller decrease in brain volume after WBRT was an independent predictor of longer overall survival. © The Author(s) 2017. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  1. [Liver volume, intrahepatic fat and body weight in the course of a lifestyle interventional study: Analysis with quantitative MR-based methods].

    PubMed

    Bongers, M N; Stefan, N; Fritsche, A; Häring, H-U; Nikolaou, K; Schick, F; Machann, J

    2015-04-01

    The aim of this study was to investigate potential associations between changes in liver volume, the amount of intrahepatic lipids (IHL) and body weight during lifestyle interventions. In a prospective study 150 patients with an increased risk for developing type 2 diabetes mellitus were included who followed a caloric restriction diet for 6 months. In the retrospective analysis 18 women and 9 men (age range 22-71 years) with an average body mass index (BMI) of 32 kg/m(2) were enrolled. The liver volume was determined at the beginning and after 6 months by three-dimensional magnetic resonance imaging (3D-MRI, echo gradient, opposed-phase) and IHLs were quantified by volume-selective MR spectroscopy in single voxel stimulated echo acquisition mode (STEAM). Univariable and multivariable correlation analyses between changes of liver volume (Δliver volume), intrahepatic lipids (ΔIHL) and body weight (ΔBW) were performed. Univariable correlation analysis in the whole study cohort showed associations between ΔIHL and ΔBW (r = 0.69; p < 0.0001), ΔIHL and Δliver volume (r = 0.66; p = 0.0002) as well as ΔBW and Δliver volume (r = 0.5; p = 0.0073). Multivariable correlation analysis revealed that changes of liver volume are primarily determined by changes in IHL independent of changes in body weight (β = 0.0272; 95% CI: 0.0155-0.034; p < 0.0001). Changes of liver volume during lifestyle interventions are independent of changes of body weight primarily determined by changes of IHL. These results show the reversibility of augmented liver volume in steatosis if it is possible to reduce IHLs during lifestyle interventions.

  2. Evaluation of Morphological Plasticity in the Cerebella of Basketball Players with MRI

    PubMed Central

    Park, In Sung; Han, Jong Woo; Lee, Kea Joo; Lee, Nam Joon; Lee, Won Teak; Park, Kyung Ah

    2006-01-01

    Cerebellum is a key structure involved in motor learning and coordination. In animal models, motor skill learning increased the volume of molecular layer and the number of synapses on Purkinje cells in the cerebellar cortex. The aim of this study is to investigate whether the analogous change of cerebellar volume occurs in human population who learn specialized motor skills and practice them intensively for a long time. Magnetic resonance image (MRI)-based cerebellar volumetry was performed in basketball players and matched controls with V-works image software. Total brain volume, absolute and relative cerebellar volumes were compared between two groups. There was no significant group difference in the total brain volume, the absolute and the relative cerebellar volume. Thus we could not detect structural change in the cerebellum of this athlete group in the macroscopic level. PMID:16614526

  3. Orbit Transfer Vehicle (OTV) engine, phase A study. Volume 2: Study

    NASA Technical Reports Server (NTRS)

    Mellish, J. A.

    1979-01-01

    The hydrogen oxygen engine used in the orbiter transfer vehicle is described. The engine design is analyzed and minimum engine performance and man rating requirements are discussed. Reliability and safety analysis test results are presented and payload, risk and cost, and engine installation parameters are defined. Engine tests were performed including performance analysis, structural analysis, thermal analysis, turbomachinery analysis, controls analysis, and cycle analysis.

  4. Effect of Radiologists’ Diagnostic Work-up Volume on Interpretive Performance

    PubMed Central

    Anderson, Melissa L.; Smith, Robert A.; Carney, Patricia A.; Miglioretti, Diana L.; Monsees, Barbara S.; Sickles, Edward A.; Taplin, Stephen H.; Geller, Berta M.; Yankaskas, Bonnie C.; Onega, Tracy L.

    2014-01-01

    Purpose To examine radiologists’ screening performance in relation to the number of diagnostic work-ups performed after abnormal findings are discovered at screening mammography by the same radiologist or by different radiologists. Materials and Methods In an institutional review board–approved HIPAA-compliant study, the authors linked 651 671 screening mammograms interpreted from 2002 to 2006 by 96 radiologists in the Breast Cancer Surveillance Consortium to cancer registries (standard of reference) to evaluate the performance of screening mammography (sensitivity, false-positive rate [FPRfalse-positive rate], and cancer detection rate [CDRcancer detection rate]). Logistic regression was used to assess the association between the volume of recalled screening mammograms (“own” mammograms, where the radiologist who interpreted the diagnostic image was the same radiologist who had interpreted the screening image, and “any” mammograms, where the radiologist who interpreted the diagnostic image may or may not have been the radiologist who interpreted the screening image) and screening performance and whether the association between total annual volume and performance differed according to the volume of diagnostic work-up. Results Annually, 38% of radiologists performed the diagnostic work-up for 25 or fewer of their own recalled screening mammograms, 24% performed the work-up for 0–50, and 39% performed the work-up for more than 50. For the work-up of recalled screening mammograms from any radiologist, 24% of radiologists performed the work-up for 0–50 mammograms, 32% performed the work-up for 51–125, and 44% performed the work-up for more than 125. With increasing numbers of radiologist work-ups for their own recalled mammograms, the sensitivity (P = .039), FPRfalse-positive rate (P = .004), and CDRcancer detection rate (P < .001) of screening mammography increased, yielding a stepped increase in women recalled per cancer detected from 17.4 for 25 or fewer mammograms to 24.6 for more than 50 mammograms. Increases in work-ups for any radiologist yielded significant increases in FPRfalse-positive rate (P = .011) and CDRcancer detection rate (P = .001) and a nonsignificant increase in sensitivity (P = .15). Radiologists with a lower annual volume of any work-ups had consistently lower FPRfalse-positive rate, sensitivity, and CDRcancer detection rate at all annual interpretive volumes. Conclusion These findings support the hypothesis that radiologists may improve their screening performance by performing the diagnostic work-up for their own recalled screening mammograms and directly receiving feedback afforded by means of the outcomes associated with their initial decision to recall. Arranging for radiologists to work up a minimum number of their own recalled cases could improve screening performance but would need systems to facilitate this workflow. © RSNA, 2014 Online supplemental material is available for this article. PMID:24960110

  5. Effect of radiologists' diagnostic work-up volume on interpretive performance.

    PubMed

    Buist, Diana S M; Anderson, Melissa L; Smith, Robert A; Carney, Patricia A; Miglioretti, Diana L; Monsees, Barbara S; Sickles, Edward A; Taplin, Stephen H; Geller, Berta M; Yankaskas, Bonnie C; Onega, Tracy L

    2014-11-01

    To examine radiologists' screening performance in relation to the number of diagnostic work-ups performed after abnormal findings are discovered at screening mammography by the same radiologist or by different radiologists. In an institutional review board-approved HIPAA-compliant study, the authors linked 651 671 screening mammograms interpreted from 2002 to 2006 by 96 radiologists in the Breast Cancer Surveillance Consortium to cancer registries (standard of reference) to evaluate the performance of screening mammography (sensitivity, false-positive rate [ FPR false-positive rate ], and cancer detection rate [ CDR cancer detection rate ]). Logistic regression was used to assess the association between the volume of recalled screening mammograms ("own" mammograms, where the radiologist who interpreted the diagnostic image was the same radiologist who had interpreted the screening image, and "any" mammograms, where the radiologist who interpreted the diagnostic image may or may not have been the radiologist who interpreted the screening image) and screening performance and whether the association between total annual volume and performance differed according to the volume of diagnostic work-up. Annually, 38% of radiologists performed the diagnostic work-up for 25 or fewer of their own recalled screening mammograms, 24% performed the work-up for 0-50, and 39% performed the work-up for more than 50. For the work-up of recalled screening mammograms from any radiologist, 24% of radiologists performed the work-up for 0-50 mammograms, 32% performed the work-up for 51-125, and 44% performed the work-up for more than 125. With increasing numbers of radiologist work-ups for their own recalled mammograms, the sensitivity (P = .039), FPR false-positive rate (P = .004), and CDR cancer detection rate (P < .001) of screening mammography increased, yielding a stepped increase in women recalled per cancer detected from 17.4 for 25 or fewer mammograms to 24.6 for more than 50 mammograms. Increases in work-ups for any radiologist yielded significant increases in FPR false-positive rate (P = .011) and CDR cancer detection rate (P = .001) and a nonsignificant increase in sensitivity (P = .15). Radiologists with a lower annual volume of any work-ups had consistently lower FPR false-positive rate , sensitivity, and CDR cancer detection rate at all annual interpretive volumes. These findings support the hypothesis that radiologists may improve their screening performance by performing the diagnostic work-up for their own recalled screening mammograms and directly receiving feedback afforded by means of the outcomes associated with their initial decision to recall. Arranging for radiologists to work up a minimum number of their own recalled cases could improve screening performance but would need systems to facilitate this workflow.

  6. Voxel-based morphometry in Alzheimers disease and mild cognitive impairment: Systematic review of studies addressing the frontal lobe.

    PubMed

    Ribeiro, Luís Gustavo; Busatto, Geraldo

    2016-01-01

    Voxel-based morphometry (VBM) is a useful approach for investigating neurostructural brain changes in dementia. We systematically reviewed VBM studies of Alzheimer's disease (AD) and mild cognitive impairment (MCI), specifically focusing on grey matter (GM) atrophy in the frontal lobe. Two searches were performed on the Pubmed database. A set of exclusion criteria was applied to ensure the selection of only VBM studies that directly investigated GM volume abnormalities in AD and/or MCI patients compared to cognitively normal controls. From a total of 46 selected articles, 35 VBM studies reported GM volume reductions in the frontal lobe. The frontal subregions, where most of the volume reductions were reported, included the inferior, superior and middle frontal gyri, as well as the anterior cingulate gyrus. We also found studies in which reduced frontal GM was detected in MCI patients who converted to AD. In a minority of studies, correlations between frontal GM volumes and behavioural changes or cognitive deficits in AD patients were investigated, with variable findings. Results of VBM studies indicate that the frontal lobe should be regarded as an important brain area when investigating GM volume deficits in association with AD. Frontal GM loss might not be a feature specific to late AD only. Future VBM studies involving large AD samples are warranted to further investigate correlations between frontal volume deficits and both cognitive impairment and neuropsychiatric symptoms.

  7. Consistency in seroma contouring for partial breast radiotherapy: Impact of guidelines

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

    Wong, Elaine K.; Truong, Pauline T.; Kader, Hosam A.

    2006-10-01

    Purpose: Inconsistencies in contouring target structures can undermine the precision of conformal radiation therapy (RT) planning and compromise the validity of clinical trial results. This study evaluated the impact of guidelines on consistency in target volume contouring for partial breast RT planning. Methods and Materials: Guidelines for target volume definition for partial breast radiation therapy (PBRT) planning were developed by members of the steering committee for a pilot trial of PBRT using conformal external beam planning. In phase 1, delineation of the breast seroma in 5 early-stage breast cancer patients was independently performed by a 'trained' cohort of four radiationmore » oncologists who were provided with these guidelines and an 'untrained' cohort of four radiation oncologists who contoured without guidelines. Using automated planning software, the seroma target volume (STV) was expanded into a clinical target volume (CTV) and planning target volume (PTV) for each oncologist. Means and standard deviations were calculated, and two-tailed t tests were used to assess differences between the 'trained' and 'untrained' cohorts. In phase 2, all eight radiation oncologists were provided with the same contouring guidelines, and were asked to delineate the seroma in five new cases. Data were again analyzed to evaluate consistency between the two cohorts. Results: The 'untrained' cohort contoured larger seroma volumes and had larger CTVs and PTVs compared with the 'trained' cohort in three of five cases. When seroma contouring was performed after review of contouring guidelines, the differences in the STVs, CTVs, and PTVs were no longer statistically significant. Conclusion: Guidelines can improve consistency among radiation oncologists performing target volume delineation for PBRT planning.« less

  8. Preoperative sclerotherapy of facial venous malformations: impact on surgical parameters and long-term follow-up.

    PubMed

    James, Charles A; Braswell, Leah E; Wright, Lonnie B; Roberson, Paula K; Moore, Mary B; Waner, Milton; Buckmiller, Lisa M

    2011-07-01

    To analyze the operative benefit of preoperative sclerotherapy of facial venous malformations and assess long-term patient outcome. Preoperative sclerotherapy was performed in 24 consecutive patients referred before resection of facial venous malformation. Pretreatment imaging was reviewed for malformation dimensions (length, width, and height), and volumes were estimated. Sclerotherapy was performed with 3% sodium tetradecyl in the first 15 patients and 98% dehydrated alcohol in the remaining 9 patients. Operative blood loss, operative time, transfusion requirement, and hospital stay were recorded. Operative time per lesion volume and operative blood loss per lesion volume were calculated. Results were compared with 15 historical control patients who underwent resection of facial venous malformations without preoperative sclerotherapy. Long-term follow-up of study and control patients was performed. Compared with controls, patients undergoing preoperative venous sclerotherapy were significantly older (P = .0206) and had larger lesions in all three dimensions (height, P = .0002; length, P = .0010; width, P = .0004). Patients receiving sclerotherapy had shorter operative time per lesion volume (P < .0001) and reduced blood loss per lesion volume (P < .0001). Neither hospital stay nor the need for blood transfusion differed from the control patients (P = .2449 and P = .6857). Mild periprocedural complications were encountered in 12.5% of cases, and nerve paresis occurred in 8.3% of cases. Long-term follow-up revealed retreatment was required in 2 of 24 patients (8.3%). Preoperative sclerotherapy of venous malformations was associated with less operative time per lesion volume and less operative blood loss per lesion volume. Long-term follow-up revealed a low need for retreatment. Copyright © 2011 SIR. Published by Elsevier Inc. All rights reserved.

  9. Effects of horizontal plyometric training volume on soccer players' performance.

    PubMed

    Yanci, Javier; Los Arcos, Asier; Camara, Jesús; Castillo, Daniel; García, Alberto; Castagna, Carlo

    2016-01-01

    The aim of this study was to examine the dose response effect of strength and conditioning programmes, involving horizontally oriented plyometric exercises, on relevant soccer performance variables. Sixteen soccer players were randomly allocated to two 6-week plyometric training groups (G1 and G2) differing by imposed (twice a week) training volume. Post-training G1 (4.13%; d = 0.43) and G2 (2.45%; d = 0.53) moderately improved their horizontal countermovement jump performance. Significant between-group differences (p < 0.01) in the vertical countermovement jump for force production time (T2) were detected post-training. No significant and practical (p > 0.05, d = trivial or small) post-training improvements in sprint, change of direction ability (CODA) and horizontal arm swing countermovement jump were reported in either group. Horizontal plyometric training was effective in promoting improvement in injury prevention variables. Doubling the volume of a horizontal plyometric training protocol was shown to have no additional effect over functional aspects of soccer players' performance.

  10. Ku-band antenna acquisition and tracking performance study, volume 4

    NASA Technical Reports Server (NTRS)

    Huang, T. C.; Lindsey, W. C.

    1977-01-01

    The results pertaining to the tradeoff analysis and performance of the Ku-band shuttle antenna pointing and signal acquisition system are presented. The square, hexagonal and spiral antenna trajectories were investigated assuming the TDRS postulated uncertainty region and a flexible statistical model for the location of the TDRS within the uncertainty volume. The scanning trajectories, shuttle/TDRS signal parameters and dynamics, and three signal acquisition algorithms were integrated into a hardware simulation. The hardware simulation is quite flexible in that it allows for the evaluation of signal acquisition performance for an arbitrary (programmable) antenna pattern, a large range of C/N sub O's, various TDRS/shuttle a priori uncertainty distributions, and three distinct signal search algorithms.

  11. Metabolically active tumour volume segmentation from dynamic [(18)F]FLT PET studies in non-small cell lung cancer.

    PubMed

    Hoyng, Lieke L; Frings, Virginie; Hoekstra, Otto S; Kenny, Laura M; Aboagye, Eric O; Boellaard, Ronald

    2015-01-01

    Positron emission tomography (PET) with (18)F-3'-deoxy-3'-fluorothymidine ([(18)F]FLT) can be used to assess tumour proliferation. A kinetic-filtering (KF) classification algorithm has been suggested for segmentation of tumours in dynamic [(18)F]FLT PET data. The aim of the present study was to evaluate KF segmentation and its test-retest performance in [(18)F]FLT PET in non-small cell lung cancer (NSCLC) patients. Nine NSCLC patients underwent two 60-min dynamic [(18)F]FLT PET scans within 7 days prior to treatment. Dynamic scans were reconstructed with filtered back projection (FBP) as well as with ordered subsets expectation maximisation (OSEM). Twenty-eight lesions were identified by an experienced physician. Segmentation was performed using KF applied to the dynamic data set and a source-to-background corrected 50% threshold (A50%) was applied to the sum image of the last three frames (45- to 60-min p.i.). Furthermore, several adaptations of KF were tested. Both for KF and A50% test-retest (TRT) variability of metabolically active tumour volume and standard uptake value (SUV) were evaluated. KF performed better on OSEM- than on FBP-reconstructed PET images. The original KF implementation segmented 15 out of 28 lesions, whereas A50% segmented each lesion. Adapted KF versions, however, were able to segment 26 out of 28 lesions. In the best performing adapted versions, metabolically active tumour volume and SUV TRT variability was similar to those of A50%. KF misclassified certain tumour areas as vertebrae or liver tissue, which was shown to be related to heterogeneous [(18)F]FLT uptake areas within the tumour. For [(18)F]FLT PET studies in NSCLC patients, KF and A50% show comparable tumour volume segmentation performance. The KF method needs, however, a site-specific optimisation. The A50% is therefore a good alternative for tumour segmentation in NSCLC [(18)F]FLT PET studies in multicentre studies. Yet, it was observed that KF has the potential to subsegment lesions in high and low proliferative areas.

  12. Surgical volume-to-outcome relationship and monitoring of technical performance in pediatric cardiac surgery.

    PubMed

    Kalfa, David; Chai, Paul; Bacha, Emile

    2014-08-01

    A significant inverse relationship of surgical institutional and surgeon volumes to outcome has been demonstrated in many high-stakes surgical specialties. By and large, the same results were found in pediatric cardiac surgery, for which a more thorough analysis has shown that this relationship depends on case complexity and type of surgical procedures. Lower-volume programs tend to underperform larger-volume programs as case complexity increases. High-volume pediatric cardiac surgeons also tend to have better results than low-volume surgeons, especially at the more complex end of the surgery spectrum (e.g., the Norwood procedure). Nevertheless, this trend for lower mortality rates at larger centers is not universal. All larger programs do not perform better than all smaller programs. Moreover, surgical volume seems to account for only a small proportion of the overall between-center variation in outcome. Intraoperative technical performance is one of the most important parts, if not the most important part, of the therapeutic process and a critical component of postoperative outcome. Thus, the use of center-specific, risk-adjusted outcome as a tool for quality assessment together with monitoring of technical performance using a specific score may be more reliable than relying on volume alone. However, the relationship between surgical volume and outcome in pediatric cardiac surgery is strong enough that it ought to support adapted and well-balanced health care strategies that take advantage of the positive influence that higher center and surgeon volumes have on outcome.

  13. Digital 3D Microstructure Analysis of Concrete using X-Ray Micro Computed Tomography SkyScan 1173: A Preliminary Study

    NASA Astrophysics Data System (ADS)

    Latief, F. D. E.; Mohammad, I. H.; Rarasati, A. D.

    2017-11-01

    Digital imaging of a concrete sample using high resolution tomographic imaging by means of X-Ray Micro Computed Tomography (μ-CT) has been conducted to assess the characteristic of the sample’s structure. A standard procedure of image acquisition, reconstruction, image processing of the method using a particular scanning device i.e., the Bruker SkyScan 1173 High Energy Micro-CT are elaborated. A qualitative and a quantitative analysis were briefly performed on the sample to deliver some basic ideas of the capability of the system and the bundled software package. Calculation of total VOI volume, object volume, percent of object volume, total VOI surface, object surface, object surface/volume ratio, object surface density, structure thickness, structure separation, total porosity were conducted and analysed. This paper should serve as a brief description of how the device can produce the preferred image quality as well as the ability of the bundled software packages to help in performing qualitative and quantitative analysis.

  14. GEOSAT Follow-On (GFO) Altimeter Document Series, Volume 8: GFO Altimeter Engineering Assessment Report Update:The First 109 Cycles Since Acceptance November 29, 2000 to December 26, 2005. Version 1, Volume 8

    NASA Technical Reports Server (NTRS)

    Conger, A. M.; Hancock, D. W., III; Hayne, G. S.; Brooks, R. L.

    2006-01-01

    The purpose of this document is to present and document GFO performance analyses and results. This is the fifth Assessment Report since the initial report. This report extends the performance assessment since acceptance to 26 December 2005. The initial GFO Altimeter Engineering Assessment Report, March 2001 (NASA/TM-2001-209984/Ver.1/Vol.1) covered the GFO performance from Launch to Acceptance (10 February 1998 to 29 November 2000). The second of the series covered the performance from Acceptance to the end of Cycle 20 (29 November 2000 to 21 November 2001). The third of the series covered the performance from Acceptance to the end of Cycle 42 (29 November 2000 to 30 November 2002). The fourth of the series covered the performance from Acceptance to the end of Cycle 64 (29 November 2000 to 17 December 2003). The fifth of the series covered performance from Acceptance to the end of Cycle 86 (29 November 2000 to 17 December 2004). Since launch, we have performed a variety of GFO performance studies; an accumulative index of those studies is provided in Appendix A.

  15. Mechanistic-Empirical Pavement Design Guide Flexible Pavement Performance Prediction Models Volume II Reference Manual

    DOT National Transportation Integrated Search

    2007-08-01

    The objective of this research study was to develop performance characteristics or variables (e.g., ride quality, rutting, : fatigue cracking, transverse cracking) of flexible pavements in Montana, and to use these characteristics in the : implementa...

  16. Gas Flow in the Capillary of the Atmosphere-to-Vacuum Interface of Mass Spectrometers

    NASA Astrophysics Data System (ADS)

    Skoblin, Michael; Chudinov, Alexey; Soulimenkov, Ilia; Brusov, Vladimir; Kozlovskiy, Viacheslav

    2017-10-01

    Numerical simulations of a gas flow through a capillary being a part of mass spectrometer atmospheric interface were performed using a detailed laminar flow model. The simulated interface consisted of atmospheric and forevacuum volumes connected via a thin capillary. The pressure in the forevacuum volume where the gas was expanding after passing through the capillary was varied in the wide range from 10 to 900 mbar in order to study the volume flow rate as well as the other flow parameters as functions of the pressure drop between the atmospheric and forevacuum volumes. The capillary wall temperature was varied in the range from 24 to 150 °C. Numerical integration of the complete system of Navier-Stokes equations for a viscous compressible gas taking into account the heat transfer was performed using the standard gas dynamic simulation software package ANSYS CFX. The simulation results were compared with experimental measurements of gas flow parameters both performed using our experimental setup and taken from the literature. The simulated volume flow rates through the capillary differed no more than by 10% from the measured ones over the entire pressure and temperatures ranges. A conclusion was drawn that the detailed digital laminar model is able to quantitatively describe the measured gas flow rates through the capillaries under conditions considered. [Figure not available: see fulltext.

  17. Gas Flow in the Capillary of the Atmosphere-to-Vacuum Interface of Mass Spectrometers.

    PubMed

    Skoblin, Michael; Chudinov, Alexey; Soulimenkov, Ilia; Brusov, Vladimir; Kozlovskiy, Viacheslav

    2017-10-01

    Numerical simulations of a gas flow through a capillary being a part of mass spectrometer atmospheric interface were performed using a detailed laminar flow model. The simulated interface consisted of atmospheric and forevacuum volumes connected via a thin capillary. The pressure in the forevacuum volume where the gas was expanding after passing through the capillary was varied in the wide range from 10 to 900 mbar in order to study the volume flow rate as well as the other flow parameters as functions of the pressure drop between the atmospheric and forevacuum volumes. The capillary wall temperature was varied in the range from 24 to 150 °C. Numerical integration of the complete system of Navier-Stokes equations for a viscous compressible gas taking into account the heat transfer was performed using the standard gas dynamic simulation software package ANSYS CFX. The simulation results were compared with experimental measurements of gas flow parameters both performed using our experimental setup and taken from the literature. The simulated volume flow rates through the capillary differed no more than by 10% from the measured ones over the entire pressure and temperatures ranges. A conclusion was drawn that the detailed digital laminar model is able to quantitatively describe the measured gas flow rates through the capillaries under conditions considered. Graphical Abstract ᅟ.

  18. BDNF is Associated With Age-Related Decline in Hippocampal Volume

    PubMed Central

    Erickson, Kirk I.; Prakash, Ruchika Shaurya; Voss, Michelle W.; Chaddock, Laura; Heo, Susie; McLaren, Molly; Pence, Brandt D.; Martin, Stephen A.; Vieira, Victoria J.; Woods, Jeffrey A.; Kramer, Arthur F.

    2010-01-01

    Hippocampal volume shrinks in late adulthood, but the neuromolecular factors that trigger hippocampal decay in aging humans remains a matter of speculation. In rodents, brain derived neurotrophic factor (BDNF) promotes the growth and proliferation of cells in the hippocampus and is important in long-term potentiation and memory formation. In humans, circulating levels of BDNF decline with advancing age and a genetic polymorphism for BDNF has been related to gray matter volume loss in old age. In this study, we tested whether age-related reductions in serum levels of BDNF would be related to shrinkage of the hippocampus and memory deficits in older adults. Hippocampal volume was acquired by automated segmentation of magnetic resonance images in 142 older adults without dementia. The caudate nucleus was also segmented and examined in relation to levels of serum BDNF. Spatial memory was tested using a paradigm in which memory load was parametrically increased. We found that increasing age was associated with smaller hippocampal volumes, reduced levels of serum BDNF, and poorer memory performance. Lower levels of BDNF were associated with smaller hippocampi and poorer memory, even when controlling for the variation related to age. In an exploratory mediation analysis, hippocampal volume mediated the age-related decline in spatial memory and BDNF mediated the age-related decline in hippocampal volume. Caudate nucleus volume was unrelated to BDNF levels or spatial memory performance. Our results identify serum BDNF as a significant factor related to hippocampal shrinkage and memory decline in late adulthood. PMID:20392958

  19. Birth weight and neonatal adiposity prediction using fractional limb volume obtained with 3D ultrasound.

    PubMed

    O'Connor, Clare; O'Higgins, Amy; Doolan, Anne; Segurado, Ricardo; Stuart, Bernard; Turner, Michael J; Kennelly, Máireád M

    2014-01-01

    The objective of this investigation was to study fetal thigh volume throughout gestation and explore its correlation with birth weight and neonatal body composition. This novel technique may improve birth weight prediction and lead to improved detection rates for fetal growth restriction. Fractional thigh volume (TVol) using 3D ultrasound, fetal biometry and soft tissue thickness were studied longitudinally in 42 mother-infant pairs. The percentages of neonatal body fat, fat mass and fat-free mass were determined using air displacement plethysmography. Correlation and linear regression analyses were performed. Linear regression analysis showed an association between TVol and birth weight. TVol at 33 weeks was also associated with neonatal fat-free mass. There was no correlation between TVol and neonatal fat mass. Abdominal circumference, estimated fetal weight (EFW) and EFW centile showed consistent correlations with birth weight. Thigh volume demonstrated an additional independent contribution to birth weight prediction when added to the EFW centile from the 38-week scan (p = 0.03). Fractional TVol performed at 33 weeks gestation is correlated with birth weight and neonatal lean body mass. This screening test may highlight those at risk of fetal growth restriction or macrosomia.

  20. Structural neural correlates of impaired mobility and subsequent decline in executive functions: A 12-month prospective study

    PubMed Central

    Hsu, Chun Liang; Best, John R.; Chiu, Bryan K.; Nagamatsu, Lindsay S; Voss, Michelle W.; Handy, Todd C.; Bolandzadeh, Niousha; Liu-Ambrose, Teresa

    2016-01-01

    Impaired mobility, such as falls, may be an early biomarker of subsequent cognitive decline and is associated with subclinical alterations in both brain structure and function. In this 12-month prospective study, we examined whether there are volumetric differences in gray matter and subcortical regions, as well as cerebral white matter, between older fallers and non-fallers. In addition, we assessed whether these baseline volumetric differences are associated with changes in cognitive function over 12 months. A total of 66 community-dwelling older adults were recruited and categorized by their falls status. Magnetic resonance imaging occurred at baseline and participants’ physical and cognitive performances were assessed at baseline and 12-months. At baseline, fallers showed significantly lower volumes in gray matter, subcortical regions, and cerebral white matter compared with non-fallers. Notably, fallers had significantly lower left lateral orbitofrontal white matter volume. Moreover, lower left lateral orbitofrontal white matter volume at baseline was associated with greater decline in set-shifting performance over 12 months. Our data suggest that falls may indicate subclinical alterations in regional brain volume that are associated with subsequent decline in executive functions. PMID:27079333

  1. Effects of Information Availability on Command-and-Control Decision Making: Performance, Trust, and Situation Awareness.

    PubMed

    Marusich, Laura R; Bakdash, Jonathan Z; Onal, Emrah; Yu, Michael S; Schaffer, James; O'Donovan, John; Höllerer, Tobias; Buchler, Norbou; Gonzalez, Cleotilde

    2016-03-01

    We investigated how increases in task-relevant information affect human decision-making performance, situation awareness (SA), and trust in a simulated command-and-control (C2) environment. Increased information is often associated with an improvement of SA and decision-making performance in networked organizations. However, previous research suggests that increasing information without considering the task relevance and the presentation can impair performance. We used a simulated C2 task across two experiments. Experiment 1 varied the information volume provided to individual participants and measured the speed and accuracy of decision making for task performance. Experiment 2 varied information volume and information reliability provided to two participants acting in different roles and assessed decision-making performance, SA, and trust between the paired participants. In both experiments, increased task-relevant information volume did not improve task performance. In Experiment 2, increased task-relevant information volume reduced self-reported SA and trust, and incorrect source reliability information led to poorer task performance and SA. These results indicate that increasing the volume of information, even when it is accurate and task relevant, is not necessarily beneficial to decision-making performance. Moreover, it may even be detrimental to SA and trust among team members. Given the high volume of available and shared information and the safety-critical and time-sensitive nature of many decisions, these results have implications for training and system design in C2 domains. To avoid decrements to SA, interpersonal trust, and decision-making performance, information presentation within C2 systems must reflect human cognitive processing limits and capabilities. © 2016, Human Factors and Ergonomics Society.

  2. Dietary sodium and plasma volume levels with exercise.

    PubMed

    Luetkemeier, M J; Coles, M G; Askew, E W

    1997-05-01

    Sodium is the major cation of the extracellular fluid and has a potent influence on fluid movement. Sodium has been likened to a sponge that draws fluids into the extracellular space, including the plasma volume, to equalize gradients in concentration. Conventional wisdom suggests limiting dietary intake of Na+ to decrease risk of hypertension. However, there are some extreme occupational or exercise-related conditions where sweat losses are great and Na+ losses may exceed normal dietary intake. This can occur acutely such as in an ultra-endurance event or chronically as in hard manual work in the hear. In such cases, additional Na+ in the form of a higher Na+ diet or adding Na+ to beverages used for fluid replacement may be warranted. A higher Na+ diet also appears to accelerate the cardiovascular and thermoregulatory adaptations that accompany heat acclimation or short term exercise training. Saline ingestion before exercise causes an expansion of plasma volume at rest and throughout the subsequent exercise bout. This expansion of plasma volume alters cardiovascular and thermoregulatory responses to exercise in ways that may lead to beneficial changes in endurance exercise performance. Plasma volume expansion also occurs with saline infusion during exercise, but exercise performance advantages have yet to be reported. The purpose of this article is to review the literature concerning dietary sodium and its influence on fluid balance, plasma volume and thermoregulation during exercise. It contains 2 major sections. First, we will discuss manipulations in daily Na+ intake initiated before or throughout an exercise regime. Second, we will examine studies where an acute Na+ load was administered immediately before or during an exercise trial. The dependent variables that we will discuss pertain to: (i) body water compartments, i.e. plasma volume; (ii) thermoregulatory variables, i.e. core temperature and sweat rate; (iii) cardiovascular variables, i.e. heart rate and stroke volume; and (iv) performance, i.e. time trial performance and time to exhaustion. Particular attention will be given to the route by which Na+ was administered, the environmental conditions, the level of acclimation of the participants and specifics relating to Na+ administration such as the osmolality of the Na(+)-containing beverage.

  3. Effect of carbohydrate composition on fluid balance, gastric emptying, and exercise performance.

    PubMed

    Cole, K J; Grandjean, P W; Sobszak, R J; Mitchell, J B

    1993-12-01

    This study examined the effects of serial feedings of different carbohydrate (CHO) solutions on plasma volume, gastric emptying (GE), and performance during prolonged cycling exercise. Solutions containing 6 g% glucose-sucrose (CHO-6GS), 8.3 g% high fructose corn syrup (CHO-8HF), 6.3 g% high fructose corn syrup + 2 g% glucose polymer (CHO-8HP), and a water placebo (WP) were compared. Ten trained male cyclists performed four cycling trials consisting of 105 min at 70% VO2max followed by a 15-min all-out, self-paced performance ride. Every 15 min the men consumed one of the four test solutions. Blood samples were taken before, during, and after exercise to determine blood glucose and plasma volume changes. There were no significant differences in performance, GE, or plasma volume changes between trials. Blood glucose was significantly elevated at the 105-min time-point in all CHO trials when compared to WP. The CHO-8HF and CHO-8HP drinks resulted in a significantly higher delivery of CHO to the intestine. Higher rates of CHO oxidation during the steady-state ride were observed only with the CHO-6GS drink.

  4. Urban area and green space: volume estimation using medium resolution satellite imagery

    NASA Astrophysics Data System (ADS)

    Handayani, H. H.

    2017-12-01

    The latest revision of the UN World Urbanization Prospects predicts the world's urban population to increase by 1.4 billion between 2010 and 2030, 60% of the population will live in cities. Consequently, this expansion affects the existence of ecosystem services in the context of sustainability environment. Green space is a focal point of the ecological system and is affected by the urbanization process. The green space has essential functions in cleaning the water, adjusting the microclimate, eliminating noise, and beautifying the surrounding makes the green quantity as well as quality very vital to its existence. The urban expansion leads the growth into vertical development. Therefore, the third dimension using urban volume as an indicator of vertical development is introduced. Therefore, this study estimates the urban and green volume by using medium resolution remote sensing. Surabaya is used as a case study since the city has grown up significantly in both of population and capital investment in this decade. Here, urban and green volume is investigated by ALOS datasets with urban referring built-up. Also, we examine the area with low and high green volume by performing hot and cold spots analysis. The average of built-up volume reaches 173.05 m3/pixel presented by the building for a residential single house with the height less than 7m. The average of green volume is 14.74m3/pixel performed by the vegetation with the height generally 0.6 to 1m which is frequently planted in the backyard of house. However, the ratio of green volume to the built-up volume shows a small portion which is around 8.52%. Therefore, we identify the hot and cold spots, we evaluate 5 areas having cold spot regarding lack of green volume. The two locations of cold spot are located in the northern part and another is in the southern part. Those areas have high number of built-up volume which is in particularly as sub-CBD area. We emphasize that the improvement of green quantity is needed in those areas, in order to enhance the green quantity and also for the city's image improvement.

  5. Dyslexia and voxel-based morphometry: correlations between five behavioural measures of dyslexia and gray and white matter volumes.

    PubMed

    Tamboer, Peter; Scholte, H Steven; Vorst, Harrie C M

    2015-10-01

    In voxel-based morphometry studies of dyslexia, the relation between causal theories of dyslexia and gray matter (GM) and white matter (WM) volume alterations is still under debate. Some alterations are consistently reported, but others failed to reach significance. We investigated GM alterations in a large sample of Dutch students (37 dyslexics and 57 non-dyslexics) with two analyses: group differences in local GM and total GM and WM volume and correlations between GM and WM volumes and five behavioural measures. We found no significant group differences after corrections for multiple comparisons although total WM volume was lower in the group of dyslexics when age was partialled out. We presented an overview of uncorrected clusters of voxels (p < 0.05, cluster size k > 200) with reduced or increased GM volume. We found four significant correlations between factors of dyslexia representing various behavioural measures and the clusters found in the first analysis. In the whole sample, a factor related to performances in spelling correlated negatively with GM volume in the left posterior cerebellum. Within the group of dyslexics, a factor related to performances in Dutch-English rhyme words correlated positively with GM volume in the left and right caudate nucleus and negatively with increased total WM volume. Most of our findings were in accordance with previous reports. A relatively new finding was the involvement of the caudate nucleus. We confirmed the multiple cognitive nature of dyslexia and suggested that experience greatly influences anatomical alterations depending on various subtypes of dyslexia, especially in a student sample.

  6. First experiences with model based iterative reconstructions influence on quantitative plaque volume and intensity measurements in coronary computed tomography angiography.

    PubMed

    Precht, H; Kitslaar, P H; Broersen, A; Gerke, O; Dijkstra, J; Thygesen, J; Egstrup, K; Lambrechtsen, J

    2017-02-01

    Investigate the influence of adaptive statistical iterative reconstruction (ASIR) and the model-based IR (Veo) reconstruction algorithm in coronary computed tomography angiography (CCTA) images on quantitative measurements in coronary arteries for plaque volumes and intensities. Three patients had three independent dose reduced CCTA performed and reconstructed with 30% ASIR (CTDI vol at 6.7 mGy), 60% ASIR (CTDI vol 4.3 mGy) and Veo (CTDI vol at 1.9 mGy). Coronary plaque analysis was performed for each measured CCTA volumes, plaque burden and intensities. Plaque volume and plaque burden show a decreasing tendency from ASIR to Veo as median volume for ASIR is 314 mm 3 and 337 mm 3 -252 mm 3 for Veo and plaque burden is 42% and 44% for ASIR to 39% for Veo. The lumen and vessel volume decrease slightly from 30% ASIR to 60% ASIR with 498 mm 3 -391 mm 3 for lumen volume and vessel volume from 939 mm 3 to 830 mm 3 . The intensities did not change overall between the different reconstructions for either lumen or plaque. We found a tendency of decreasing plaque volumes and plaque burden but no change in intensities with the use of low dose Veo CCTA (1.9 mGy) compared to dose reduced ASIR CCTA (6.7 mGy & 4.3 mGy), although more studies are warranted. Copyright © 2016 The College of Radiographers. Published by Elsevier Ltd. All rights reserved.

  7. Differential regional gray matter volumes in patients with on-line game addiction and professional gamers.

    PubMed

    Han, Doug Hyun; Lyoo, In Kyoon; Renshaw, Perry F

    2012-04-01

    Patients with on-line game addiction (POGA) and professional video game players play video games for extended periods of time, but experience very different consequences for their on-line game play. Brain regions consisting of anterior cingulate, thalamus and occpito-temporal areas may increase the likelihood of becoming a pro-gamer or POGA. Twenty POGA, seventeen pro-gamers, and eighteen healthy comparison subjects (HC) were recruited. All magnetic resonance imaging (MRI) was performed on a 1.5 Tesla Espree MRI scanner (SIEMENS, Erlangen, Germany). Voxel-wise comparisons of gray matter volume were performed between the groups using the two-sample t-test with statistical parametric mapping (SPM5). Compared to HC, the POGA group showed increased impulsiveness and perseverative errors, and volume in left thalamus gray matter, but decreased gray matter volume in both inferior temporal gyri, right middle occipital gyrus, and left inferior occipital gyrus, compared with HC. Pro-gamers showed increased gray matter volume in left cingulate gyrus, but decreased gray matter volume in left middle occipital gyrus and right inferior temporal gyrus compared with HC. Additionally, the pro-gamer group showed increased gray matter volume in left cingulate gyrus and decreased left thalamus gray matter volume compared with the POGA group. The current study suggests that increased gray matter volumes of the left cingulate gyrus in pro-gamers and of the left thalamus in POGA may contribute to the different clinical characteristics of pro-gamers and POGA. Copyright © 2012 Elsevier Ltd. All rights reserved.

  8. Focal Gray Matter Plasticity as a Function of Long Duration Head-down Tilt Bed Rest

    NASA Technical Reports Server (NTRS)

    Koppelmans, V.; DeDios, Y. E.; Wood, S. J.; Reuter-Lorenz, P. A.; Kofman, I.; Bloomberg, J. J.; Mulavara, A. P.; Koppelmans, V.

    2014-01-01

    Long duration spaceflight (i.e., > or = 22 days) has been associated with changes in sensorimotor systems, resulting in difficulties that astronauts experience with posture control, locomotion, and manual control. The microgravity environment is an important causal factor for spaceflight induced sensorimotor changes. Whether these sensorimotor changes may be related to structural and functional brain changes is yet unknown. However, experimental studies revealed changes in the gray matter (GM) of the brain after simulated microgravity. Thus, it is possible that spaceflight may affect brain structure and thereby cognitive functioning and motor behavior. Long duration head-down tilt bed rest has been suggested as an exclusionary analog to study microgravity effects on the sensorimotor system. Bed rest mimics microgravity in body unloading and bodily fluid shifts. In consideration of the health and performance of crewmembers both in- and post-flight, we are conducting a prospective longitudinal 70-day bed rest study as an analog to investigate the effects of microgravity on the brain. VBM analysis revealed a progressive decrease from pre- to in- bed rest in GM volume in bilateral areas including the frontal medial cortex, the insular cortex and the caudate. Over the same time period, there was a progressive increase in GM volume in the cerebellum, occipital-, and parietal cortex, including the precuneus. The majority of these changes did not fully recover during the post-bed rest period. Analysis of lobular GM volumes obtained with BRAINS showed significantly increased volume from pre-bed rest to in-bed rest in GM of the parietal lobe and the third ventricle. Temporal GM volume at 70 days in bed rest was smaller than that at the first pre-bed rest measurement. Trend analysis showed significant positive linear and negative quadratic relationships between parietal GM and time, a positive linear relationship between third ventricle volume and time, and a negative linear relationship between cerebellar GM volume and time. FM performance improved from pre-bed rest session 1 to session 2. From the second pre-bed rest measure to the last-day-in-bed rest, there was a significant decrease in performance that only partially recovered post-bed rest. No significant association was observed between changes in brain volume and changes in functional mobility. Extended bed rest, which is an analog for microgravity, can result in local volumetric GM increase and decrease and adversely affect functional mobility. These changes in brain structure and performance were not related in this sample. Whether the effects of bed rest dissipate at longer times post-bed rest, and if they are associated with behavior are important questions that warrant further research including more subjects and longer follow-up times.

  9. Impact Assessment and Forecasts of Information and Telecommunications Technologies Applied to Education and Training. R&D in Information and Communication Based Learning Technology. Analysis of Key Issues for the Orientation of the Work of Sector Actors in the Framework of DELTA. Volume I--Executive Summary.

    ERIC Educational Resources Information Center

    Commission of the European Communities, Brussels (Belgium).

    This report, the first volume in a three volume set, summarizes the results of a study performed by the DELTA (Developing European Learning through Technological Advance) Unit in parallel with the projects underway in the research and development Exploratory Action. The report identifies the key issues, associated requirements and options, and…

  10. Influence of operator experience and PCI volume on transfemoral access techniques: A collaboration of international cardiovascular societies.

    PubMed

    Nelson, Daniel W; Damluji, Abdulla A; Patel, Nish; Valgimigli, Marco; Windecker, Stephan; Byrne, Robert; Nolan, James; Patel, Tejas; Brilakis, Emmanouil; Banerjee, Subhash; Mayol, Jorge; Cantor, Warren J; Alfonso, Carlos E; Rao, Sunil V; Moscucci, Mauro; Cohen, Mauricio G

    2018-03-01

    Transfemoral access (TFA) is widely used for coronary angiography and percutaneous coronary intervention (PCI). The influence of operator age, gender, experience, and procedural volume on performance of femoral arterial access has not been studied. A survey instrument was developed and distributed via e-mail from professional societies to interventional cardiologists worldwide from March to December 2016. A total of 988 physicians from 88 countries responded to the survey. TFA is the preferred approach for patients with cardiogenic shock, left main or bifurcation PCI, and procedures with mechanical circulatory support. Older (<50years: 56.4%; ≥50years: 66.8%, p<0.0039) and high PCI volume operators (<100 PCI: 57.3%; 100-299 PCI: 58.7%; ≥300 PCI: 64.3%, p<0.134) preferred palpation only without imaging (fluoroscopy or ultrasound (US)) for TFA. Most respondents preferred not to use micropuncture needle to puncture the femoral artery. Older (≥50years: 64.4%; <50years: 71.5%, p<0.04) and high PCI volume operators (≥300 PCI: 64.1%; 100-299 PCI: 72.6%; <100 PCI: 67.9%, p<0.072) tended not to perform femoral angiography (FA). Of those performing FA, the majority opted to do it at the end of the procedure. Despite best practice guideline recommendations, older and high PCI volume interventional cardiologists prefer not to use imaging for femoral access or perform femoral angiography during TF procedures. These data highlight opportunities to further reduce TFA complications. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. Temporal lobe structures and facial emotion recognition in schizophrenia patients and nonpsychotic relatives.

    PubMed

    Goghari, Vina M; Macdonald, Angus W; Sponheim, Scott R

    2011-11-01

    Temporal lobe abnormalities and emotion recognition deficits are prominent features of schizophrenia and appear related to the diathesis of the disorder. This study investigated whether temporal lobe structural abnormalities were associated with facial emotion recognition deficits in schizophrenia and related to genetic liability for the disorder. Twenty-seven schizophrenia patients, 23 biological family members, and 36 controls participated. Several temporal lobe regions (fusiform, superior temporal, middle temporal, amygdala, and hippocampus) previously associated with face recognition in normative samples and found to be abnormal in schizophrenia were evaluated using volumetric analyses. Participants completed a facial emotion recognition task and an age recognition control task under time-limited and self-paced conditions. Temporal lobe volumes were tested for associations with task performance. Group status explained 23% of the variance in temporal lobe volume. Left fusiform gray matter volume was decreased by 11% in patients and 7% in relatives compared with controls. Schizophrenia patients additionally exhibited smaller hippocampal and middle temporal volumes. Patients were unable to improve facial emotion recognition performance with unlimited time to make a judgment but were able to improve age recognition performance. Patients additionally showed a relationship between reduced temporal lobe gray matter and poor facial emotion recognition. For the middle temporal lobe region, the relationship between greater volume and better task performance was specific to facial emotion recognition and not age recognition. Because schizophrenia patients exhibited a specific deficit in emotion recognition not attributable to a generalized impairment in face perception, impaired emotion recognition may serve as a target for interventions.

  12. Associations of Early Kidney Disease With Brain Magnetic Resonance Imaging and Cognitive Function in African Americans With Type 2 Diabetes Mellitus.

    PubMed

    Freedman, Barry I; Sink, Kaycee M; Hugenschmidt, Christina E; Hughes, Timothy M; Williamson, Jeff D; Whitlow, Christopher T; Palmer, Nicholette D; Miller, Michael E; Lovato, Laura C; Xu, Jianzhao; Smith, S Carrie; Launer, Lenore J; Barzilay, Joshua I; Cohen, Robert M; Sullivan, Mark D; Bryan, R Nick; Wagner, Benjamin C; Bowden, Donald W; Maldjian, Joseph A; Divers, Jasmin

    2017-11-01

    Relationships between early kidney disease, neurocognitive function, and brain anatomy are poorly defined in African Americans with type 2 diabetes mellitus (T2DM). Cross-sectional associations were assessed between cerebral anatomy and cognitive performance with estimated glomerular filtration rate (eGFR) and urine albumin-creatinine ratio (UACR) in African Americans with T2DM. African Americans with cognitive testing and cerebral magnetic resonance imaging (MRI) in the African American-Diabetes Heart Study Memory in Diabetes (AA-DHS MIND; n=512; 480 with MRI) and Action to Control Cardiovascular Risk in Diabetes (ACCORD) MIND (n=484; 104 with MRI) studies. eGFR (CKD-EPI creatinine equation), spot UACR. MRI-based cerebral white matter volume (WMV), gray matter volume (GMV), and white matter lesion volume; cognitive performance (Mini-Mental State Examination, Digit Symbol Coding, Stroop Test, and Rey Auditory Verbal Learning Test). Multivariable models adjusted for age, sex, body mass index, scanner, intracranial volume, education, diabetes duration, hemoglobin A 1c concentration, low-density lipoprotein cholesterol concentration, smoking, hypertension, and cardiovascular disease were used to test for associations between kidney phenotypes and the brain in each study; a meta-analysis was performed. Mean participant age was 60.1±7.9 (SD) years; diabetes duration, 12.1±7.7 years; hemoglobin A 1c concentration, 8.3%±1.7%; eGFR, 88.7±21.6mL/min/1.73m 2 ; and UACR, 119.2±336.4mg/g. In the fully adjusted meta-analysis, higher GMV associated with lower UACR (P<0.05), with a trend toward association with higher eGFR. Higher white matter lesion volume was associated with higher UACR (P<0.05) and lower eGFR (P<0.001). WMV was not associated with either kidney parameter. Higher UACR was associated with lower Digit Symbol Coding performance (P<0.001) and a trend toward association with higher Stroop interference; eGFR was not associated with cognitive tests. Cross-sectional; single UACR measurement. In African Americans with T2DM, mildly high UACR and mildly low eGFR were associated with smaller GMV and increased white matter lesion volume. UACR was associated with poorer processing speed and working memory. Copyright © 2017 National Kidney Foundation, Inc. All rights reserved.

  13. Greater Cincinnati/Northern Kentucky Stroke Study: volume of first-ever ischemic stroke among blacks in a population-based study.

    PubMed

    Kissela, B; Broderick, J; Woo, D; Kothari, R; Miller, R; Khoury, J; Brott, T; Pancioli, A; Jauch, E; Gebel, J; Shukla, R; Alwell, K; Tomsick, T

    2001-06-01

    The volume of ischemic stroke on CT scans has been studied in a standardized fashion in acute stroke therapy trials with median volumes between 10.5 to 55 cm(3). The volume of first-ever ischemic stroke in the population is not known. The first phase of the population-based Greater Cincinnati/Northern Kentucky Stroke Study identified all ischemic strokes occurring in blacks in the greater Cincinnati region between January and June of 1993. The patients in this phase of the study who had a first-ever ischemic clinical stroke were identified, and the volume of ischemic stroke was measured. There were 257 verified clinical cases of ischemic stroke, of which 181 had a first-ever ischemic infarct. Imaging was available for 150 of these patients, and 79 had an infarct on the CT or MRI study that was definitely or possibly related to the clinical symptoms. For these patients, volumetric measurements were performed by means of the modified ellipsoid method. The median volume of first-ever ischemic stroke for the 79 patients was 2.5 cm(3) (interquartile range, 0.5 to 8.8 cm(3)). There was a significant relation between location of lesion and infarct size (P<0.001) and between volume and mechanism of stroke (P=0.001). The volume of first-ever ischemic stroke among blacks in our population-based study is smaller than has been previously reported in acute stroke therapy trials. The large proportion of small, mild strokes in blacks may be an important reason for the low percentage of patients who meet the inclusion criteria for tissue plasminogen activator. Further study is necessary to see if these results are generalizable to a multiracial population.

  14. Thermal imager for dismounted infantry

    NASA Astrophysics Data System (ADS)

    Bigwood, Christopher R.; Eccles, Lee; Jones, Arwyn O.; Jones, Berwyn; Meakin, David L.; Rickard, Steve; Robinson, Rob

    2004-12-01

    Thermal Imager for Dismounted Infantry (TIDI), is a UK MOD / Thales Optics Ltd. joint funded technology demonstrator programme and is part of the overall programme managed by QinetiQ. The aim of this programme is to evaluate and demonstrate a cost effective route to equipping the infantry soldier with a small, lightweight, rugged, short range, weapon mounted thermal imaging sight; intended for mass deployment. TIDI is an unusual programme in that the requirement was not rigidly defined in terms of a detailed specification. Instead, the requirement was expressed in terms of the question 'What weapon sight performance can be achieved for a volume production cost of 5000 Euro?' This requirement was subject to the constraints that the sight mass should be less than 500 g and the volume should be less than 500 ml. To address the requirements of this programme, Thales Optics Ltd. have performed a detailed trade-off analysis considering alternative uncooled LWIR sensor formats and technologies. The effect of using alternative sensors on the sight cost, mass, volume, power and performance has been compared. A design study has been performed concentrating on simplification of the optics, mechanics and electronics to minimise the overall sight complexity. Based on this analysis, a demonstrator sight has been designed that is cost effective and suitable for volume manufacture, whilst still offering useful performance to the user. Six technical demonstrator units based on this design have been manufactured and evaluated. This paper will give an overview of the work completed to date on the TIDI program, including a description of the demonstrator hardware and its performance.

  15. The Regionalization of Total Ankle Arthroplasties and Ankle Fusions in New York State: A 10-Year Comparative Analysis.

    PubMed

    Buza, John A; Liu, James X; Jancuska, Jeffrey; Bosco, Joseph A

    2017-06-01

    Total ankle arthroplasty (TAA) provides an alternative to ankle fusion (AF). The purpose of this study is to (1) determine the extent of TAA regionalization, as well as examine the growth of TAA performed at high-, medium-, and low-volume New York State institutions and (2) compare this regionalization and growth with AF. The New York Statewide Planning and Research Cooperative System (SPARCS) administrative data were used to identify 737 primary TAA and 7453 AF from 2005 to 2014. The volume of TAA and AF surgery in New York State was mapped according to patient and hospital 3-digit zip code. The number of TAA per year grew 1500% (from 11 to 177) from 2005 to 2014, while there was a 35.6% reduction (from 895 to 576) in yearly AF procedures. TAA recipients were widely distributed throughout the state, while TAA procedures were regionalized to a few select metropolitan centers. AF procedures were performed more uniformly than TAA. The number of TAA has continued to increase at high- (15 to 91) and medium-volume (14 to 67) institutions where it has decreased at low-volume institutions (44 to 19). The increased utilization of TAA is attributed to relatively few high-volume centers located in major metropolitan centers. Level IV: well-designed case-control or cohort studies.

  16. Pre-Exercise Ingestion of Pickle Juice, Hypertonic Saline, or Water and Aerobic Performance and Thermoregulation

    PubMed Central

    Peikert, Jarett; Miller, Kevin C.; Albrecht, Jay; Tucker, Jared; Deal, James

    2014-01-01

    Context: Ingesting high-sodium drinks pre-exercise can improve thermoregulation and performance. Athletic trainers (19%) give athletes pickle juice (PJ) prophylactically for cramping. No data exist on whether this practice affects aerobic performance or thermoregulation. Objective: To determine if drinking 2 mL/kg body mass of PJ, hypertonic saline, or deionized water (DIW) pre-exercise affects aerobic performance or thermoregulation. Design: Crossover study. Setting: Controlled laboratory study. Patients or Other Participants: Nine euhydrated men (age = 22 ± 3 years, height = 184.0 ± 8.2 cm, mass = 82.6 ± 16.0 kg) completed testing. Intervention(s): Participants rested for 65 minutes. During this period, they ingested 2 mL/kg of PJ, hypertonic saline, or DIW. Next, they drank 5 mL/kg of DIW. Blood was collected before and after ingestion of all fluids. Participants were weighed and ran in the heat (temperature = 38.3°C ± 1°C, relative humidity = 21.1% ± 4.7%) at increasing increments of maximal heart rate (50%, 60%, 70%, 80%, 90%, 95%) until exhaustion or until rectal temperature exceeded 39.5°C. Participants were weighed postexercise so we could calculate sweat volume. Main Outcome Measure(s): Time to exhaustion, rectal temperature, changes in plasma volume, and sweat volume. Results: Time to exhaustion did not differ among drinks (PJ = 77.4 ± 5.9 minutes, hypertonic saline = 77.4 ± 4.0 minutes, DIW = 75.7 ± 3.2 minutes; F2,16 = 1.1, P = .40). Core temperature of participants was similar among drinks (PJ = 38.7°C ± 0.3°C, hypertonic saline = 38.7°C ± 0.4°C, DIW = 38.8°C ± 0.4°C; P = .74) but increased from pre-exercise (36.7°C ± 0.2°C) to postexercise (38.7°C ± 0.4°C) (P < .05). No differences were observed for changes in plasma volume or sweat volume among drinks (P > .05). Conclusions: Ingesting small amounts of PJ or hypertonic saline with water did not affect performance or select thermoregulatory measures. Drinking larger volumes of PJ and water may be more effective at expanding the extracellular space. PMID:24568225

  17. Association Between Hospital Case Volume and the Use of Bronchoscopy and Esophagoscopy During Head and Neck Cancer Diagnostic Evaluation

    PubMed Central

    Sun, Gordon H.; Aliu, Oluseyi; Moloci, Nicholas M.; Mondschein, Joshua K.; Burke, James F.; Hayward, Rodney A.

    2013-01-01

    Background There are no clinical guidelines on best practices for the use of bronchoscopy and esophagoscopy in diagnosing head and neck cancer. This retrospective cohort study examined variation in the use of bronchoscopy and esophagoscopy across hospitals in Michigan. Patients and Methods We identified 17,828 head and neck cancer patients in the 2006–2010 Michigan State Ambulatory Surgery Databases. We used hierarchical, mixed-effect logistic regression to examine whether a hospital’s risk-adjusted rate of concurrent bronchoscopy or esophagoscopy was associated with its case volume (<100, 100–999, or ≥1000 cases/hospital) for those undergoing diagnostic laryngoscopy. Results Of 9,218 patients undergoing diagnostic laryngoscopy, 1,191 (12.9%) received concurrent bronchoscopy and 1,675 (18.2%) underwent concurrent esophagoscopy. The median hospital rate of bronchoscopy was 2.7% (range 0–61.1%), and low-volume (OR 27.1 [95% CI 1.9, 390.7]) and medium-volume (OR 28.1 [95% CI 2.0, 399.0]) hospitals were more likely to perform concurrent bronchoscopy compared to high-volume hospitals. The median hospital rate of esophagoscopy was 5.1% (range 0–47.1%), and low-volume (OR 9.8 [95% CI 1.5, 63.7]) and medium-volume (OR 8.5 [95% CI 1.3, 55.0]) hospitals were significantly more likely to perform concurrent esophagoscopy relative to high-volume hospitals. Conclusions Head and neck cancer patients undergoing diagnostic laryngoscopy are much more likely to undergo concurrent bronchoscopy and esophagoscopy at low- and medium-volume hospitals than at high-volume hospitals. Whether this represents over-use of concurrent procedures or appropriate care that leads to earlier diagnosis and better outcomes merits further investigation. PMID:24114146

  18. A whole brain volumetric approach in overweight/obese children: Examining the association with different physical fitness components and academic performance. The ActiveBrains project.

    PubMed

    Esteban-Cornejo, Irene; Cadenas-Sanchez, Cristina; Contreras-Rodriguez, Oren; Verdejo-Roman, Juan; Mora-Gonzalez, Jose; Migueles, Jairo H; Henriksson, Pontus; Davis, Catherine L; Verdejo-Garcia, Antonio; Catena, Andrés; Ortega, Francisco B

    2017-10-01

    Obesity, as compared to normal weight, is associated with detectable structural differences in the brain. To the best of our knowledge, no previous study has examined the association of physical fitness with gray matter volume in overweight/obese children using whole brain analyses. Thus, the aim of this study was to examine the association between the key components of physical fitness (i.e. cardiorespiratory fitness, speed-agility and muscular fitness) and brain structural volume, and to assess whether fitness-related changes in brain volumes are related to academic performance in overweight/obese children. A total of 101 overweight/obese children aged 8-11 years were recruited from Granada, Spain. The physical fitness components were assessed following the ALPHA health-related fitness test battery. T1-weighted images were acquired with a 3.0 T S Magnetom Tim Trio system. Gray matter tissue was calculated using Diffeomorphic Anatomical Registration Through Exponentiated Lie algebra (DARTEL). Academic performance was assessed by the Batería III Woodcock-Muñoz Tests of Achievement. All analyses were controlled for sex, peak high velocity offset, parent education, body mass index and total brain volume. The statistical threshold was calculated with AlphaSim and further Hayasaka adjusted to account for the non-isotropic smoothness of structural images. The main results showed that higher cardiorespiratory fitness was related to greater gray matter volumes (P < 0.001, k = 64) in 7 clusters with β ranging from 0.493 to 0.575; specifically in frontal regions (i.e. premotor cortex and supplementary motor cortex), subcortical regions (i.e. hippocampus and caudate), temporal regions (i.e. inferior temporal gyrus and parahippocampal gyrus) and calcarine cortex. Three of these regions (i.e. premotor cortex, supplementary motor cortex and hippocampus) were related to better academic performance (β ranging from 0.211 to 0.352; all P < 0.05). Higher speed-agility was associated with greater gray matter volumes (P < 0.001, k = 57) in 2 clusters (i.e. the inferior frontal gyrus and the superior temporal gyrus) with β ranging from 0.564 to 0.611. Both clusters were related to better academic performance (β ranging from 0.217 to 0.296; both P < 0.05). Muscular fitness was not independently associated with greater gray matter volume in any brain region. Furthermore, there were no statistically significant negative association between any component of physical fitness and gray matter volume in any region of the brain. In conclusion, cardiorespiratory fitness and speed-agility, but not muscular fitness, may independently be associated with greater volume of numerous cortical and subcortical brain structures; besides, some of these brain structures may be related to better academic performance. Importantly, the identified associations of fitness and gray matter volume were different for each fitness component. These findings suggest that increases in cardiorespiratory fitness and speed-agility may positively influence the development of distinctive brain regions and academic indicators, and thus counteract the harmful effect of overweight and obesity on brain structure during childhood. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. The effect of balance holes to centrifugal pump performance

    NASA Astrophysics Data System (ADS)

    Babayigit, O.; Ozgoren, M.; Aksoy, M. H.; Kocaaslan, O.

    2017-07-01

    The aim of this study is to analyze of a centrifugal pump with and without balance holes by using ANSYS-Fluent software. The pump used in the study is a commercial centrifugal pump consisting of two stages that is a model of Sempa Pump Company. Firstly, models of impeller, diffuser, suction and discharge sections of the centrifugal pump were separately drawn using Ansys and Solidworks software. Later, grid structures were generated on the flow volume of the pump. Turbulent flow volume was numerically solved by realizable k-є turbulence model. The flow analyses were focused on the centrifugal pump performance and the flow characteristics under different operational conditions with/without balance holes. Distributions of flow characteristics such as velocity and pressure distributions in the flow volume were also determined, numerically. The results of Computational Fluid Dynamics (CFD) with/without balance holes for the pump head and hydraulic efficiency on the design flow rate of 80 m3/h were found to be 81.5/91.3 m and 51.9/65.3%, respectively.

  20. Age estimation by assessment of pulp chamber volume: a Bayesian network for the evaluation of dental evidence.

    PubMed

    Sironi, Emanuele; Taroni, Franco; Baldinotti, Claudio; Nardi, Cosimo; Norelli, Gian-Aristide; Gallidabino, Matteo; Pinchi, Vilma

    2017-11-14

    The present study aimed to investigate the performance of a Bayesian method in the evaluation of dental age-related evidence collected by means of a geometrical approximation procedure of the pulp chamber volume. Measurement of this volume was based on three-dimensional cone beam computed tomography images. The Bayesian method was applied by means of a probabilistic graphical model, namely a Bayesian network. Performance of that method was investigated in terms of accuracy and bias of the decisional outcomes. Influence of an informed elicitation of the prior belief of chronological age was also studied by means of a sensitivity analysis. Outcomes in terms of accuracy were adequate with standard requirements for forensic adult age estimation. Findings also indicated that the Bayesian method does not show a particular tendency towards under- or overestimation of the age variable. Outcomes of the sensitivity analysis showed that results on estimation are improved with a ration elicitation of the prior probabilities of age.

  1. Delayed recall, hippocampal volume and Alzheimer neuropathology: findings from the Nun Study.

    PubMed

    Mortimer, J A; Gosche, K M; Riley, K P; Markesbery, W R; Snowdon, D A

    2004-02-10

    To examine the associations of hippocampal volume and the severity of neurofibrillary lesions determined at autopsy with delayed verbal recall performance evaluated an average of 1 year prior to death. Hippocampal volumes were computed using postmortem brain MRI from the first 56 scanned participants of the Nun Study. Quantitative neuropathologic studies included lesion counts, Braak staging, and determination of whether neuropathologic criteria for Alzheimer disease (AD) were met. Multiple regression was used to assess the association of hippocampal volume and neuropathologic lesions with the number of words (out of 10) recalled on the Consortium to Establish a Registry for Alzheimer's Disease Delayed Word Recall Test administered an average of 1 year prior to death. When entered separately, hippocampal volume, Braak stage, and the mean neurofibrillary tangle counts in the CA-1 region of the hippocampus and the subiculum were strongly associated with the number of words recalled after a delay, adjusting for age and education. When hippocampal volume was entered together with each neuropathologic index, only hippocampal volume retained a significant association with the delayed recall measure. The association between hippocampal volume and the number of words recalled was present in both demented and nondemented individuals as well as in those with and without substantial AD neurofibrillary pathology. The association of neurofibrillary tangles with delayed verbal recall may reflect associated hippocampal atrophy.

  2. Scan-rescan reproducibility of CT densitometric measures of emphysema

    NASA Astrophysics Data System (ADS)

    Chong, D.; van Rikxoort, E. M.; Kim, H. J.; Goldin, J. G.; Brown, M. S.

    2011-03-01

    This study investigated the reproducibility of HRCT densitometric measures of emphysema in patients scanned twice one week apart. 24 emphysema patients from a multicenter study were scanned at full inspiration (TLC) and expiration (RV), then again a week later for four scans total. Scans for each patient used the same scanner and protocol, except for tube current in three patients. Lung segmentation with gross airway removal was performed on the scans. Volume, weight, mean lung density (MLD), relative area under -950HU (RA-950), and 15th percentile (PD-15) were calculated for TLC, and volume and an airtrapping mask (RA-air) between -950 and -850HU for RV. For each measure, absolute differences were computed for each scan pair, and linear regression was performed against volume difference in a subgroup with volume difference <500mL. Two TLC scan pairs were excluded due to segmentation failure. The mean lung volumes were 5802 +/- 1420mL for TLC, 3878 +/- 1077mL for RV. The mean absolute differences were 169mL for TLC volume, 316mL for RV volume, 14.5g for weight, 5.0HU for MLD, 0.66p.p. for RA-950, 2.4HU for PD-15, and 3.1p.p. for RA-air. The <500mL subgroup had 20 scan pairs for TLC and RV. The R2 values were 0.8 for weight, 0.60 for MLD, 0.29 for RA-950, 0.31 for PD-15, and 0.64 for RA-air. Our results indicate that considerable variability exists in densitometric measures over one week that cannot be attributed to breathhold or physiology. This has implications for clinical trials relying on these measures to assess emphysema treatment efficacy.

  3. Telemedicine in the management of chronic pain: a cost analysis study.

    PubMed

    Pronovost, Antoine; Peng, Philip; Kern, Ralph

    2009-08-01

    Telemedicine provides patients with easy and remote access to consultant expertise irrespective of geographic location. In a randomized controlled trial, this study has applied a rigorous costing methodology to the use of telemedicine in chronic pain management. We performed a randomized two-period crossover trial comparing in-person (IP) consultation with telemedicine (TM) consultation in the management of chronic pain. Over an 18-month period, 26 patients each completed two diaries capturing their direct and indirect travel costs, daily pain scores, and satisfaction with physician consultation. Costing models were developed to account for direct, indirect, fixed, and variable costs in order to perform break-even analyses. Sensitivity analysis was performed over a broad range of assumptions. Direct patient costs were significantly lower in the TM group than in the IP group, with median cost and interquartile range 133 dollars (28-377) vs 443 dollars (292-1075), respectively (P = 0.001). More patients were highly satisfied with the TM consultation than with the IP consultation (56 and 24%, respectively; P < 0.05). Break-even annual patient volume was estimated at 57 patients. A two-way sensitivity analysis controlling for annual patient volume and round-trip distance indicated that TM remains cost-effective at volumes >50 patients/year or at round-trip distances >200 km. Telemedicine is cost-effective over a broad range of assumptions, including annual patient volumes, travel distance, fuel costs, amortization, and discount rates. This study provides data from a real-world setting to determine relevant thresholds and targets for establishing a TM program for patients who are undergoing chronic pain therapy.

  4. Amygdalar, hippocampal, and thalamic volumes in youth at high risk for development of bipolar disorder

    PubMed Central

    Karchemskiy, Asya; Garrett, Amy; Howe, Meghan; Adleman, Nancy; Simeonova, Diana I.; Alegria, Dylan; Reiss, Allan; Chang, Kiki

    2011-01-01

    Children of parents with bipolar disorder (BD), especially those with attention deficit hyperactivity disorder (ADHD) and symptoms of depression or mania, are significantly at high-risk for developing BD. As we have previously shown amygdalar reductions in pediatric BD, the current study examined amygdalar volumes in offspring of parents with (BD offspring) who have not yet developed a full manic episode. Youth participating in the study included 22 BD offspring and 22 healthy controls of comparable age, gender, handedness, and IQ. Subjects had no history of a manic episode, but met criteria for ADHD and moderate mood symptoms. MRI was performed on a 3T GE scanner, using a 3D volumetric spoiled gradient echo series. Amygdalae were manually traced using BrainImage Java software on positionally normalized brain stacks. Bipolar offspring had similar amygdalar volumes compared to the control group. Exploratory analyses yielded no differences in hippocampal or thalamic volumes. Bipolar offspring do not show decreased amygdala volume, possibly because these abnormalities occur after more prolonged illness rather than as a preexisting risk factor. Longitudinal studies are needed to determine whether amygdalar volumes change during and after the development of BD. PMID:22041532

  5. Amygdalar, hippocampal, and thalamic volumes in youth at high risk for development of bipolar disorder.

    PubMed

    Karchemskiy, Asya; Garrett, Amy; Howe, Meghan; Adleman, Nancy; Simeonova, Diana I; Alegria, Dylan; Reiss, Allan; Chang, Kiki

    2011-12-30

    Children of parents with bipolar disorder (BD), especially those with attention deficit hyperactivity disorder (ADHD) and symptoms of depression or mania, are at significantly high risk for developing BD. As we have previously shown amygdalar reductions in pediatric BD, the current study examined amygdalar volumes in offspring of parents (BD offspring) who have not yet developed a full manic episode. Youth participating in the study included 22 BD offspring and 22 healthy controls of comparable age, gender, handedness, and IQ. Subjects had no history of a manic episode, but met criteria for ADHD and moderate mood symptoms. MRI was performed on a 3T GE scanner, using a 3D volumetric spoiled gradient echo series. Amygdalae were manually traced using BrainImage Java software on positionally normalized brain stacks. Bipolar offspring had similar amygdalar volumes compared to the control group. Exploratory analyses yielded no differences in hippocampal or thalamic volumes. Bipolar offspring do not show decreased amygdalar volume, possibly because these abnormalities occur after more prolonged illness rather than as a preexisting risk factor. Longitudinal studies are needed to determine whether amygdalar volumes change during and after the development of BD. 2011 Elsevier Ireland Ltd. All rights reserved.

  6. Theoretical design and evaluation of endoluminal ultrasound applicators for thermal therapy of pancreatic cancer under image guidance

    NASA Astrophysics Data System (ADS)

    Adams, Matthew; Scott, Serena; Salgaonkar, Vasant; Sommer, Graham; Diederich, Chris

    2017-03-01

    An image-guided endoluminal ultrasound applicator has been proposed for palliative and potential curative thermal therapy of pancreatic tumors. By considering a directional transducer array of planar, tubular, or curvilinear transducers, this design offers the potential for fast volumetric therapy and 3D spatial control over the energy deposition profile. Treatment of pancreatic tumor tissue would be performed in a minimally invasive fashion with the applicator positioned in the gastrointestinal (GI) lumen, and sparing of the luminal wall would be achieved with a water-cooled balloon surrounding the transducers. A theoretical evaluation of this design was performed by developing a 3D acoustic and bioheat transfer model, with temperature and thermal dose solutions obtained using a FEM solver (COMSOL Multiphysics). Parametric studies were performed on a generalized anatomical model of the pancreas, tumor, and adjacent luminal wall to determine preferred transducer configurations and frequencies for maximizing lesion volume and penetration while sparing the luminal wall. Patient-specific models of pancreatic tumors were generated from CT studies and used to assess the feasibility of performing thermal ablation or hyperthermia on small (˜2 cm diameter) pancreatic head tumors with an endoluminal applicator positioned within the duodenum. Simulation results indicate lower transducer operating frequencies (1-3 MHz) are necessary to mitigate damage to the luminal wall, and a tradeoff between penetration depth and lesion volume emerges as the degree of focusing increases. For patient-specific ablation modeling of tumors within 30 mm of the luminal wall, approximately 95% of the volume could be ablated within 15 min using a planar or lightly focused transducer configuration without duodenal damage. Over 90% of the volume could be elevated above 40°C at steady state for hyperthermia applications (e.g., radiation sensitization, drug delivery) using a tubular transducer. For tumors extending deeper into the pancreas (˜35 mm), strongly focused curvilinear transducers could ablate over 80% of the tumor volume within 15 min while minimizing damage to nearby sensitive structures.

  7. Comprehensive integrated spirometry using raised volume passive and forced expirations and multiple-breath nitrogen washout in infants.

    PubMed

    Morris, Mohy G

    2010-02-28

    With the rapid somatic growth and development in infants, simultaneous accurate measurements of lung volume and airway function are essential. Raised volume rapid thoracoabdominal compression (RTC) is widely used to generate forced expiration from an airway opening pressure of 30 cmH(2)O (V(30)). The (dynamic) functional residual capacity (FRC(dyn)) remains the lung volume most routinely measured. The aim of this study was to develop comprehensive integrated spirometry that included all subdivisions of lung volume at V(30) or total lung capacity (TLC(30)). Measurements were performed on 17 healthy infants aged 8.6-119.7 weeks. A commercial system for multiple-breath nitrogen washout (MBNW) to measure lung volumes and a custom made system to perform RTC were used in unison. A refined automated raised volume RTC and the following two novel single maneuvers with dual volume measurements were performed from V(30) during a brief post-hyperventilation apneic pause: (1) the passive expiratory flow was integrated to produce the inspiratory capacity (IC) and the static (passive) FRC (FRC(st)) was estimated by initiating MBNW after end-passive expiration; (2) RTC was initiated late during passive expiration, flow was integrated to produce the slow vital capacity ((j)SVC) and the residual volume (RV) was measured by initiating MBNW after end-expiration while the jacket (j) was inflated. Intrasubject FRC(dyn) and FRC(st) measurements overlapped (p=0.6420) but neither did with the RV (p<0.0001). Means (95% confidence interval) of FRC(dyn), IC, FRC(st), (j)SVC, RV, forced vital capacity and tidal volume were 21.2 (19.7-22.7), 36.7 (33.0-40.4), 21.2 (19.6-22.8), 40.7 (37.2-44.2), 18.1 (16.6-19.7), 40.7 (37.1-44.2) and 10.2 (9.6-10.7)ml/kg, respectively. Static lung volumes and capacities at V(30) and variables from the best forced expiratory flow-volume curve were dependent on age, body length and weight. In conclusion, we developed a comprehensive physiologically integrated approach for in-depth investigation of lung function at V(30) in infants. Copyright 2009 Elsevier B.V. All rights reserved.

  8. 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.

  9. Comparing surgical trays with redundant instruments with trays with reduced instruments: a cost analysis

    PubMed Central

    John-Baptiste, A.; Sowerby, L.J.; Chin, C.J.; Martin, J.; Rotenberg, B.W.

    2016-01-01

    Background: When prearranged standard surgical trays contain instruments that are repeatedly unused, the redundancy can result in unnecessary health care costs. Our objective was to estimate potential savings by performing an economic evaluation comparing the cost of surgical trays with redundant instruments with surgical trays with reduced instruments ("reduced trays"). Methods: We performed a cost-analysis from the hospital perspective over a 1-year period. Using a mathematical model, we compared the direct costs of trays containing redundant instruments to reduced trays for 5 otolaryngology procedures. We incorporated data from several sources including local hospital data on surgical volume, the number of instruments on redundant and reduced trays, wages of personnel and time required to pack instruments. From the literature, we incorporated instrument depreciation costs and the time required to decontaminate an instrument. We performed 1-way sensitivity analyses on all variables, including surgical volume. Costs were estimated in 2013 Canadian dollars. Results: The cost of redundant trays was $21 806 and the cost of reduced trays was $8803, for a 1-year cost saving of $13 003. In sensitivity analyses, cost savings ranged from $3262 to $21 395, based on the surgical volume at the institution. Variation in surgical volume resulted in a wider range of estimates, with a minimum of $3253 for low-volume to a maximum of $52 012 for high-volume institutions. Interpretation: Our study suggests moderate savings may be achieved by reducing surgical tray redundancy and, if applied to other surgical specialties, may result in savings to Canadian health care systems. PMID:27975045

  10. Comparing surgical trays with redundant instruments with trays with reduced instruments: a cost analysis.

    PubMed

    John-Baptiste, A; Sowerby, L J; Chin, C J; Martin, J; Rotenberg, B W

    2016-01-01

    When prearranged standard surgical trays contain instruments that are repeatedly unused, the redundancy can result in unnecessary health care costs. Our objective was to estimate potential savings by performing an economic evaluation comparing the cost of surgical trays with redundant instruments with surgical trays with reduced instruments ("reduced trays"). We performed a cost-analysis from the hospital perspective over a 1-year period. Using a mathematical model, we compared the direct costs of trays containing redundant instruments to reduced trays for 5 otolaryngology procedures. We incorporated data from several sources including local hospital data on surgical volume, the number of instruments on redundant and reduced trays, wages of personnel and time required to pack instruments. From the literature, we incorporated instrument depreciation costs and the time required to decontaminate an instrument. We performed 1-way sensitivity analyses on all variables, including surgical volume. Costs were estimated in 2013 Canadian dollars. The cost of redundant trays was $21 806 and the cost of reduced trays was $8803, for a 1-year cost saving of $13 003. In sensitivity analyses, cost savings ranged from $3262 to $21 395, based on the surgical volume at the institution. Variation in surgical volume resulted in a wider range of estimates, with a minimum of $3253 for low-volume to a maximum of $52 012 for high-volume institutions. Our study suggests moderate savings may be achieved by reducing surgical tray redundancy and, if applied to other surgical specialties, may result in savings to Canadian health care systems.

  11. Change of the human taste bud volume over time.

    PubMed

    Srur, Ehab; Stachs, Oliver; Guthoff, Rudolf; Witt, Martin; Pau, Hans Wilhelm; Just, Tino

    2010-08-01

    The specific aim of this study is to measure the taste volume in healthy human subjects over a 2.5-month period and to demonstrate morphological changes of the peripheral taste organs. Eighteen human taste buds in four fungiform papillae (fPap) were examined over a 10-week period. The fungiform papillae investigated were selected based on the form of the papillae or the arrangement of surface taste pores. Measurements were performed over 10 consecutive weeks, with five scans in a day once a week. The following parameters were measured: height and diameter of the taste bud, diameter of the fungiform papilla and diameter of the taste pore. The findings of this exploratory study indicated that (1) taste bud volumes changed over a 10-week period, (2) the interval between two volume maxima within the 10-week period was 3-5 weeks, and (3) the diameter of the fPap did not correlate with the volume of a single taste bud or with the volume of all taste buds in the fPap within the 10-week period. This exploratory in vivo study revealed changes in taste bud volumes in healthy humans with age-related gustatory sensitivity. These findings need to be considered when studying the effect of denervation of fungiform papillae in vivo using confocal microscopy. Crown Copyright 2009. Published by Elsevier Ireland Ltd. All rights reserved.

  12. Mechanistic-Empirical Pavement Design Guide Flexible Pavement Performance Prediction Models Volume I Executive Research Summary

    DOT National Transportation Integrated Search

    2007-08-01

    The objective of this research study was to develop performance characteristics or variables (e.g., ride quality, rutting, : fatigue cracking, transverse cracking) of flexible pavements in Montana, and to use these characteristics in the : implementa...

  13. A molecular dynamics study of lithium-containing aprotic heterocyclic ionic liquid electrolytes

    NASA Astrophysics Data System (ADS)

    Lourenço, Tuanan C.; Zhang, Yong; Costa, Luciano T.; Maginn, Edward J.

    2018-05-01

    Classical molecular dynamics simulations were performed on twelve different ionic liquids containing aprotic heterocyclic anions doped with Li+. These ionic liquids have been shown to be promising electrolytes for lithium ion batteries. Self-diffusivities, lithium transference numbers, densities, and free volumes were computed as a function of lithium concentration. The dynamics and free volume decreased with increasing lithium concentration, and the trends were rationalized by examining the changes to the liquid structure. Of those examined in the present work, it was found that (methyloxymethyl)triethylphosphonium triazolide ionic liquids have the overall best performance.

  14. Translational MRI Volumetry with NeuroQuant: Effects of Version and Normative Data on Relationships with Memory Performance in Healthy Older Adults and Patients with Mild Cognitive Impairment.

    PubMed

    Stelmokas, Julija; Yassay, Lance; Giordani, Bruno; Dodge, Hiroko H; Dinov, Ivo D; Bhaumik, Arijit; Sathian, K; Hampstead, Benjamin M

    2017-01-01

    NeuroQuant (NQ) is a fully-automated program that overcomes several existing limitations in the clinical translation of MRI-derived volumetry. The current study characterized differences between the original (NQ1) and an updated NQ version (NQ2) by 1) replicating previously identified relationships between neuropsychological test performance and medial temporal lobe volumes, 2) evaluating the level of agreement between NQ versions, and 3) determining if the addition of NQ2 age-/sex-based z-scores hold greater clinical utility for prediction of memory impairment than standard percent of intracranial volume (% ICV) values. Sixty-seven healthy older adults and 65 mild cognitive impairment patients underwent structural MRI and completed cognitive testing, including the Immediate and Delayed Memory indices from the Repeatable Battery for the Assessment of Neuropsychological Status. Results generally replicated previous relationships between key medial temporal lobe regions and memory test performance, though comparison of NQ regions revealed statistically different values that were biased toward one version or the other depending on the region. NQ2 hippocampal z-scores explained additional variance in memory performance relative to % ICV values. Findings indicate that NQ1/2 medial temporal lobe volumes, especially age- and sex-based z-scores, hold clinical value, though caution is warranted when directly comparing volumes across NQ versions.

  15. Regional Availability of Mechanical Embolectomy for Acute Ischemic Stroke in California, 2009 to 2010

    PubMed Central

    Choi, Jay Chol; Hsia, Renee Y.

    2015-01-01

    Background and Purpose— We sought to assess the geographic proximity of patients with stroke in California to centers that performed specific threshold volumes of mechanical embolectomy procedures each year. Methods— We identified all patients who were hospitalized for acute ischemic stroke at all nonfederal acute care hospitals in California from 2009 to 2010, and all hospitals that performed any mechanical embolectomy procedures by case volume during the same period, using nonpublic data from the Office of Statewide Health Planning and Development. We computed geographic service areas around each hospital on the basis of prespecified ground transport distance thresholds. We then calculated the proportion of hospitalized patients with stroke who lived within service areas for centers that performed a low volume and high volume of mechanical embolectomy procedures each year. Results— During the 2-year study period, 15% (53/360) of hospitals performed at least 1 mechanical embolectomy for acute stroke, but only 19% (10/53) performed >10 cases per year. Most hospitalized patients with stroke (94%) lived within a 2-hour transport time (65 miles) to a hospital that performed ≥1 procedure during the 2-year period. Approximately 93% of the patients with stroke who received mechanical embolectomy lived within 20 miles from an embolectomy-capable hospital compared with 7% of those who lived >20 miles. Conclusions— In California, most patients with stroke lived within reasonable ground transport distances from centers that performed ≥1 mechanical embolectomy in a 2-year period. The probability of receiving mechanical embolectomy for acute ischemic stroke was associated with living in close geographic proximity to these hospitals. PMID:25657180

  16. Experimental determination of the effect of detector size on profile measurements in narrow photon beams.

    PubMed

    Pappas, E; Maris, T G; Papadakis, A; Zacharopoulou, F; Damilakis, J; Papanikolaou, N; Gourtsoyiannis, N

    2006-10-01

    The aim of this work is to investigate experimentally the detector size effect on narrow beam profile measurements. Polymer gel and magnetic resonance imaging dosimetry was used for this purpose. Profile measurements (Pm(s)) of a 5 mm diameter 6 MV stereotactic beam were performed using polymer gels. Eight measurements of the profile of this narrow beam were performed using correspondingly eight different detector sizes. This was achieved using high spatial resolution (0.25 mm) two-dimensional measurements and eight different signal integration volumes A X A X slice thickness, simulating detectors of different size. "A" ranged from 0.25 to 7.5 mm, representing the detector size. The gel-derived profiles exhibited increased penumbra width with increasing detector size, for sizes >0.5 mm. By extrapolating the gel-derived profiles to zero detector size, the true profile (Pt) of the studied beam was derived. The same polymer gel data were also used to simulate a small-volume ion chamber profile measurement of the same beam, in terms of volume averaging. The comparison between these results and actual corresponding small-volume chamber profile measurements performed in this study, reveal that the penumbra broadening caused by both volume averaging and electron transport alterations (present in actual ion chamber profile measurements) is a lot more intense than that resulted by volume averaging effects alone (present in gel-derived profiles simulating ion chamber profile measurements). Therefore, not only the detector size, but also its composition and tissue equivalency is proved to be an important factor for correct narrow beam profile measurements. Additionally, the convolution kernels related to each detector size and to the air ion chamber were calculated using the corresponding profile measurements (Pm(s)), the gel-derived true profile (Pt), and convolution theory. The response kernels of any desired detector can be derived, allowing the elimination of the errors associated with narrow beam profile measurements.

  17. Effect of provider volume on resource utilization for surgical procedures of the knee.

    PubMed

    Jain, Nitin; Pietrobon, Ricardo; Guller, Ulrich; Shankar, Anoop; Ahluwalia, Ajit S; Higgins, Laurence D

    2005-05-01

    Operating-room time and patient disposition on discharge are important determinants of healthcare resource utilization and cost. We examined the relation between these determinants and hospital/surgeon volume for anterior cruciate ligament (ACL) reconstruction and meniscectomy procedures. Patients undergoing ACL reconstruction (18,390 cases) and meniscectomy (123,012 cases) were extracted from the State Ambulatory Surgery Databases for the years 1997-2000. Surgeon and hospital volume were divided into low-, intermediate-, and high-volume categories. Multivariate logistic regression models were used to estimate the adjusted association between surgeon and hospital volume and patient discharge status and operating-room time. Patients undergoing ACL reconstruction or meniscectomy performed by low-volume surgeons were significantly more likely to be non-routinely discharged as compared to high-volume surgeons (adjusted odds ratio 3.5, 95% confidence interval 1.7-7.2 for ACL reconstruction; adjusted odds ratio 2.0, 95% confidence interval 1.6-2.3 for meniscectomy). The mean operating-room time for performing ACL reconstruction or meniscectomy was significantly higher in low- and intermediate-volume surgeons and hospitals as compared to high-volume surgeons and hospitals (p < or = 0.001). High-volume providers utilize healthcare resources more efficiently. Our findings may help surgeons and hospitals in optimizing resource utilization and cost for routinely-performed ambulatory surgery procedures.

  18. Estimation of gas and tissue lung volumes by MRI: functional approach of lung imaging.

    PubMed

    Qanadli, S D; Orvoen-Frija, E; Lacombe, P; Di Paola, R; Bittoun, J; Frija, G

    1999-01-01

    The purpose of this work was to assess the accuracy of MRI for the determination of lung gas and tissue volumes. Fifteen healthy subjects underwent MRI of the thorax and pulmonary function tests [vital capacity (VC) and total lung capacity (TLC)] in the supine position. MR examinations were performed at inspiration and expiration. Lung volumes were measured by a previously validated technique on phantoms. Both individual and total lung volumes and capacities were calculated. MRI total vital capacity (VC(MRI)) was compared with spirometric vital capacity (VC(SP)). Capacities were correlated to lung volumes. Tissue volume (V(T)) was estimated as the difference between the total lung volume at full inspiration and the TLC. No significant difference was seen between VC(MRI) and VC(SP). Individual capacities were well correlated (r = 0.9) to static volume at full inspiration. The V(T) was estimated to be 836+/-393 ml. This preliminary study demonstrates that MRI can accurately estimate lung gas and tissue volumes. The proposed approach appears well suited for functional imaging of the lung.

  19. Abstracts of Remediation Case Studies, Volume 9

    EPA Pesticide Factsheets

    This report, published by the Federal Remediation Technologies Roundtable (FRTR), is a collection of recently published abstracts summarizing 13 cost and performance case studies on the use of remediation technologies at contaminated sites.

  20. In-hospital mortality for children with hypoplastic left heart syndrome after stage I surgical palliation: teaching versus nonteaching hospitals.

    PubMed

    Berry, Jay G; Cowley, Collin G; Hoff, Charles J; Srivastava, Rajendu

    2006-04-01

    Teaching hospitals are perceived to provide a higher quality of care for the treatment of rare disease and complex patients. A substantial proportion of stage I palliation for hypoplastic left heart syndrome (HLHS) may be performed in nonteaching hospitals. This study compares the in-hospital mortality of stage I palliation between teaching and nonteaching hospitals. The authors conducted a retrospective cohort study using the Kids' Inpatient Database 1997 and 2000. Patients with HLHS undergoing stage I palliation were identified using International Classification of Diseases, Ninth Revision, Clinical Modification diagnostic and procedural codes. Seven hundred fifty-four and 880 discharges of children with HLHS undergoing stage I palliation in 1997 and 2000, respectively, were identified. The in-hospital mortality for the study population was 28% in 1997 and 24% in 2000. Twenty percent of stage I palliation operations were performed in nonteaching hospitals in 1997. Two percent of operations were performed in nonteaching hospitals in 2000. In 1997 only, in-hospital mortality remained higher in nonteaching hospitals after controlling for stage I palliation hospital volume and condition-severity diagnoses. Low-volume hospitals performing stage I palliation were associated with increased in-hospital mortality in 1997 and 2000. Patients with HLHS undergoing stage I palliation in nonteaching hospitals experienced increased in-hospital mortality in 1997. A significant reduction in the number of stage I palliation procedures performed in nonteaching hospitals occurred between 1997 and 2000. This centralization of stage I palliation into teaching hospitals, along with advances in postoperative medical and surgical care for these children, was associated with a decrease in mortality. Patients in low-volume hospitals performing stage I palliation continued to experience increased mortality in 2000.

  1. Cerebral gray matter volume in patients with chronic migraine: correlations with clinical features.

    PubMed

    Coppola, Gianluca; Petolicchio, Barbara; Di Renzo, Antonio; Tinelli, Emanuele; Di Lorenzo, Cherubino; Parisi, Vincenzo; Serrao, Mariano; Calistri, Valentina; Tardioli, Stefano; Cartocci, Gaia; Ambrosini, Anna; Caramia, Francesca; Di Piero, Vittorio; Pierelli, Francesco

    2017-12-08

    To date, few MRI studies have been performed in patients affected by chronic migraine (CM), especially in those without medication overuse. Here, we performed magnetic resonance imaging (MRI) voxel-based morphometry (VBM) analyses to investigate the gray matter (GM) volume of the whole brain in patients affected by CM. Our aim was to investigate whether fluctuations in the GM volumes were related to the clinical features of CM. Twenty untreated patients with CM without a past medical history of medication overuse underwent 3-Tesla MRI scans and were compared to a group of 20 healthy controls (HCs). We used SPM12 and the CAT12 toolbox to process the MRI data and to perform VBM analyses of the structural T1-weighted MRI scans. The GM volume of patients was compared to that of HCs with various corrected and uncorrected thresholds. To check for possible correlations, patients' clinical features and GM maps were regressed. Initially, we did not find significant differences in the GM volume between patients with CM and HCs (p < 0.05 corrected for multiple comparisons). However, using more-liberal uncorrected statistical thresholds, we noted that compared to HCs, patients with CM exhibited clusters of regions with lower GM volumes including the cerebellum, left middle temporal gyrus, left temporal pole/amygdala/hippocampus/pallidum/orbitofrontal cortex, and left occipital areas (Brodmann areas 17/18). The GM volume of the cerebellar hemispheres was negatively correlated with the disease duration and positively correlated with the number of tablets taken per month. No gross morphometric changes were observed in patients with CM when compared with HCs. However, using more-liberal uncorrected statistical thresholds, we observed that CM is associated with subtle GM volume changes in several brain areas known to be involved in nociception/antinociception, multisensory integration, and analgesic dependence. We speculate that these slight morphometric impairments could lead, at least in a subgroup of patients, to the development and continuation of maladaptive acute medication usage.

  2. Is There a Minimum Number of Thyroidectomies a Surgeon Should Perform to Optimize Patient Outcomes?

    PubMed

    Adam, Mohamed Abdelgadir; Thomas, Samantha; Youngwirth, Linda; Hyslop, Terry; Reed, Shelby D; Scheri, Randall P; Roman, Sanziana A; Sosa, Julie A

    2017-02-01

    To determine the number of total thyroidectomies per surgeon per year associated with the lowest risk of complications. The surgeon volume-outcome association has been established for thyroidectomy; however, a threshold number of cases defining a "high-volume" surgeon remains unclear. Adults undergoing total thyroidectomy were identified from the Health Care Utilization Project-National Inpatient Sample (1998-2009). Multivariate logistic regression with restricted cubic splines was utilized to examine the association between the number of annual total thyroidectomies per surgeon and risk of complications. Among 16,954 patients undergoing total thyroidectomy, 47% had thyroid cancer and 53% benign disease. Median annual surgeon volume was 7 cases; 51% of surgeons performed 1 case/y. Overall, 6% of the patients experienced complications. After adjustment, the likelihood of experiencing a complication decreased with increasing surgeon volume up to 26 cases/y (P < 0.01). Among all patients, 81% had surgery by low-volume surgeons (≤25 cases/y). With adjustment, patients undergoing surgery by low-volume surgeons were more likely to experience complications (odds ratio 1.51, P = 0.002) and longer hospital stays (+12%, P = 0.006). Patients had an 87% increase in the odds of having a complication if the surgeon performed 1 case/y, 68% for 2 to 5 cases/y, 42% for 6 to 10 cases/y, 22% for 11 to 15 cases/y, 10% for 16 to 20 cases/y, and 3% for 21 to 25 cases/y. This is the first study to identify a surgeon volume threshold (>25 total thyroidectomies/y) that is associated with improved patient outcomes. Identifying a threshold number of cases defining a high-volume thyroid surgeon is important, as it has implications for quality improvement, criteria for referral and reimbursement, and surgical education.

  3. Prospective and Episodic Memory in Relation to Hippocampal Volume in Adults with Spina Bifida Myelomeningocele

    PubMed Central

    Treble-Barna, Amery; Juranek, Jenifer; Stuebing, Karla K.; Cirino, Paul T.; Dennis, Maureen; Fletcher, Jack M.

    2014-01-01

    The present study examined prospective and episodic memory in relation to age, functional independence, and hippocampal volume in younger to middle-aged adults with spina bifida myelomeningocele (SBM) and typically developing (TD) adults. Prospective and episodic memory, as well as hippocampal volume, were reduced in adults with SBM relative to TD adults. Neither memory performance nor hippocampal volume showed greater decrements in older adults. Lower hippocampal volume was associated with reduced prospective memory in adults with SBM, and this relation was specific to the hippocampus and not to a contrast structure, the amygdala. Prospective memory mediated the relation between hippocampal volume and functional independence in adults with SBM. The results add to emerging evidence for reduced memory function in adults with SBM, and provide quantitative evidence for compromised hippocampal macrostructure as a neural correlate of reduced memory in this population. PMID:25068670

  4. Determination of fractional flow reserve (FFR) based on scaling laws: a simulation study

    NASA Astrophysics Data System (ADS)

    Wong, Jerry T.; Molloi, Sabee

    2008-07-01

    Fractional flow reserve (FFR) provides an objective physiological evaluation of stenosis severity. A technique that can measure FFR using only angiographic images would be a valuable tool in the cardiac catheterization laboratory. To perform this, the diseased blood flow can be measured with a first pass distribution analysis and the theoretical normal blood flow can be estimated from the total coronary arterial volume based on scaling laws. A computer simulation of the coronary arterial network was used to gain a better understanding of how hemodynamic conditions and coronary artery disease can affect blood flow, arterial volume and FFR estimation. Changes in coronary arterial flow and volume due to coronary stenosis, aortic pressure and venous pressure were examined to evaluate the potential use of flow and volume for FFR determination. This study showed that FFR can be estimated using arterial volume and a scaling coefficient corrected for aortic pressure. However, variations in venous pressure were found to introduce some error in FFR estimation. A relative form of FFR was introduced and was found to cancel out the influence of pressure on coronary flow, arterial volume and FFR estimation. The use of coronary flow and arterial volume for FFR determination appears promising.

  5. Estimated maximal and current brain volume predict cognitive ability in old age.

    PubMed

    Royle, Natalie A; Booth, Tom; Valdés Hernández, Maria C; Penke, Lars; Murray, Catherine; Gow, Alan J; Maniega, Susana Muñoz; Starr, John; Bastin, Mark E; Deary, Ian J; Wardlaw, Joanna M

    2013-12-01

    Brain tissue deterioration is a significant contributor to lower cognitive ability in later life; however, few studies have appropriate data to establish how much influence prior brain volume and prior cognitive performance have on this association. We investigated the associations between structural brain imaging biomarkers, including an estimate of maximal brain volume, and detailed measures of cognitive ability at age 73 years in a large (N = 620), generally healthy, community-dwelling population. Cognitive ability data were available from age 11 years. We found positive associations (r) between general cognitive ability and estimated brain volume in youth (male, 0.28; females, 0.12), and in measured brain volume in later life (males, 0.27; females, 0.26). Our findings show that cognitive ability in youth is a strong predictor of estimated prior and measured current brain volume in old age but that these effects were the same for both white and gray matter. As 1 of the largest studies of associations between brain volume and cognitive ability with normal aging, this work contributes to the wider understanding of how some early-life factors influence cognitive aging. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Accuracy of surgical wound drainage measurements: an analysis and comparison.

    PubMed

    Yue, Brian; Nizzero, Danielle; Zhang, Chunxiao; van Zyl, Natasha; Ting, Jeannette

    2015-05-01

    Surgical drain tube readings can influence the clinical management of the post-operative patient. The accuracy of these readings has not been documented in the current literature and this experimental study aims to address this paucity. Aliquots (10, 25, 40 and 90 mL) of black tea solution prepared to mimic haemoserous fluid were injected into UnoVac, RedoVac and Jackson-Pratt drain tubes. Nursing and medical staff from a tertiary hospital were asked to estimate drain volumes by direct observation; analysis of variance was performed on the results and significance level was set at 0.05. Doctors and nurses are equally accurate in estimating drain tube volumes. Jackson-Pratt systems were found to be the most accurate for intermediate volumes of 25 and 40 mL. For extreme of volumes (both high and low), all drainage systems were inaccurate. This study suggests that for intermediate volumes (25 and 40 mL), Jackson-Pratt is the drainage system of choice. The accuracy of volume measurement is diminished at the extremes of drain volumes; emptying of drainage systems is recommended to avoid overfilling of drainage systems. © 2014 Royal Australasian College of Surgeons.

  7. The evolution of self-control

    PubMed Central

    MacLean, Evan L.; Hare, Brian; Nunn, Charles L.; Addessi, Elsa; Amici, Federica; Anderson, Rindy C.; Aureli, Filippo; Baker, Joseph M.; Bania, Amanda E.; Barnard, Allison M.; Boogert, Neeltje J.; Brannon, Elizabeth M.; Bray, Emily E.; Bray, Joel; Brent, Lauren J. N.; Burkart, Judith M.; Call, Josep; Cantlon, Jessica F.; Cheke, Lucy G.; Clayton, Nicola S.; Delgado, Mikel M.; DiVincenti, Louis J.; Fujita, Kazuo; Herrmann, Esther; Hiramatsu, Chihiro; Jacobs, Lucia F.; Jordan, Kerry E.; Laude, Jennifer R.; Leimgruber, Kristin L.; Messer, Emily J. E.; de A. Moura, Antonio C.; Ostojić, Ljerka; Picard, Alejandra; Platt, Michael L.; Plotnik, Joshua M.; Range, Friederike; Reader, Simon M.; Reddy, Rachna B.; Sandel, Aaron A.; Santos, Laurie R.; Schumann, Katrin; Seed, Amanda M.; Sewall, Kendra B.; Shaw, Rachael C.; Slocombe, Katie E.; Su, Yanjie; Takimoto, Ayaka; Tan, Jingzhi; Tao, Ruoting; van Schaik, Carel P.; Virányi, Zsófia; Visalberghi, Elisabetta; Wade, Jordan C.; Watanabe, Arii; Widness, Jane; Young, Julie K.; Zentall, Thomas R.; Zhao, Yini

    2014-01-01

    Cognition presents evolutionary research with one of its greatest challenges. Cognitive evolution has been explained at the proximate level by shifts in absolute and relative brain volume and at the ultimate level by differences in social and dietary complexity. However, no study has integrated the experimental and phylogenetic approach at the scale required to rigorously test these explanations. Instead, previous research has largely relied on various measures of brain size as proxies for cognitive abilities. We experimentally evaluated these major evolutionary explanations by quantitatively comparing the cognitive performance of 567 individuals representing 36 species on two problem-solving tasks measuring self-control. Phylogenetic analysis revealed that absolute brain volume best predicted performance across species and accounted for considerably more variance than brain volume controlling for body mass. This result corroborates recent advances in evolutionary neurobiology and illustrates the cognitive consequences of cortical reorganization through increases in brain volume. Within primates, dietary breadth but not social group size was a strong predictor of species differences in self-control. Our results implicate robust evolutionary relationships between dietary breadth, absolute brain volume, and self-control. These findings provide a significant first step toward quantifying the primate cognitive phenome and explaining the process of cognitive evolution. PMID:24753565

  8. Mechanical Properties and Shear Strengthening Capacity of High Volume Fly Ash-Cementitious Composite

    NASA Astrophysics Data System (ADS)

    Joseph, Aswin K.; Anand, K. B.

    2018-02-01

    This paper discusses development of Poly Vinyl Alcohol (PVA) fibre reinforced cementitious composites taking into account environmental sustainability. Composites with fly ash to cement ratios from 0 to 3 are investigated in this study. The mechanical properties of HVFA-cement composite are discussed in this paper at PVA fiber volume fraction maintained at 1% of total volume of composite. The optimum replacement of cement with fly ash was found to be 75%, i.e. fly ash to cement ratio (FA/C) of 3. The increase in fiber content from 1% to 2% showed better mechanical performance. A strain capacity of 2.38% was obtained for FA/C ratio of 3 with 2% volume fraction of fiber. With the objective of evaluating the performance of cementitious composites as a strengthening material in reinforced concrete beams, the beams deficient in shear capacity were strengthened with optimal mix having 2% volume fraction of fiber as the strengthening material and tested under four-point load. The reinforced concrete beams designed as shear deficient were loaded to failure and retrofitted with the composite in order to assess the efficiency as a repair material under shear.

  9. Radiological study to evaluate the spreading of two volumes (10 vs. 20ml) of radiological contrast in the block of cutaneous branches of intercostal nerves in medial axillary line (BRILMA) in a porcine experimental model.

    PubMed

    Varela, O; Melone, A; López-Menchaca, R; Sevilla, R; Callejo, D; López-Álvarez, S; Román Fernández, A; García, S; Mantilla, I; Zaballos, M

    2018-06-07

    Interfascial blocks of the thoracic wall are being developed as an alternative to central blocks in breast surgery. However, there are few studies that have evaluated the anatomical extension of the local anaesthetic. The objective of this study was to analyse, using fluoroscopy, the spreading of two volumes (10 vs. 20ml) of radiological contrast in the serratus-intercostal plane block in an experimental pig model. Ten Large-White breed pigs were selected to have a bilateral ultrasound serratus-intercostal plane block performed, with the administering of 10ml and 20ml of iopamidol in the right and left hemithorax, respectively. The spreading of contrast was analysed by fluoroscopy. The Spearman test correlation was used to evaluate the relationship between the administered volume and radiological spreading. A value of P<.05 was considered significant. Twenty anaesthetic blocks were performed, being able to analyse 18 of them. The administration of 10ml of contrast was associated with a mean spreading of 2.28±0.31 (95% CI; 2.01-2.54) intercostal spaces, while the administration of 20ml showed a spreading of 3±0.25 (95% CI; 2.81-3.18) intercostal spaces. There was a significant correlation between the injected volume and the spreading of the contrast (Spearman correlation coefficient of 0.81; P=.0001). The results showed a spreading of volume subject to the serratus-intercostal plane block, although not maintaining a 1:1 ratio. Doubling the volume increased the blocked segments by 31%. These findings, if corroborated in the clinical practice, would allow a more precise adjustment in the anaesthetic volume administered. Copyright © 2018 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Volume accumulator design analysis computer codes

    NASA Technical Reports Server (NTRS)

    Whitaker, W. D.; Shimazaki, T. T.

    1973-01-01

    The computer codes, VANEP and VANES, were written and used to aid in the design and performance calculation of the volume accumulator units (VAU) for the 5-kwe reactor thermoelectric system. VANEP computes the VAU design which meets the primary coolant loop VAU volume and pressure performance requirements. VANES computes the performance of the VAU design, determined from the VANEP code, at the conditions of the secondary coolant loop. The codes can also compute the performance characteristics of the VAU's under conditions of possible modes of failure which still permit continued system operation.

  11. Relative strengths of the calf muscles based on MRI volume measurements.

    PubMed

    Jeng, Clifford L; Thawait, Gaurav K; Kwon, John Y; Machado, Antonio; Boyle, James W; Campbell, John; Carrino, John A

    2012-05-01

    In 1985, Silver et al. published a cadaver study which determined the relative order of strength of the muscles in the calf. Muscle strength, which is proportional to volume, was obtained by dissecting out the individual muscles, weighing them, and then multiplying by the specific gravity. No similar studies have been performed using {\\it in vivo} measurements of muscle volume. Ten normal subjects underwent 3-Tesla MRI's of both lower extremities using non-fat-saturated T2 SPACE sequences. The volume for each muscle was determined by tracing the muscle contour on sequential axial images and then interpolating the volume using imaging software. The results from this study differ from Silver's original article. The lateral head of the gastrocnemius was found to be stronger than the tibialis anterior muscle. The FHL and EDL muscles were both stronger than the peroneus longus. There was no significant difference in strength between the peroneus longus and brevis muscles. This revised order of muscle strengths in the calf based on in vivo MRI findings may assist surgeons in determining the optimal tendons to transfer in order to address muscle weakness and deformity.

  12. Accomplishing Shipyard Work for the United States Navy; Institutions, Systems and Operations. Volume 2. Appendixes

    DTIC Science & Technology

    1975-08-01

    side #I MOC0ede.V en.d 14119111Iy by 61leek number) Ths study examines factors relating to acconrmlish-ment of Navy ship work- ~ .loads in navtal and...concludes with recomnendations to improve the cost-effectiveness of performance of shipyard work and identifies several key areas for further study . Volume 2...documents related to subjects covered by this study . r• "I. . " r . SECURITY CO OF ° P Ova’" 0.... ......:i • #0 PAPER P-1 13 2 ACCOMPLISHING SHIPYARD WORK

  13. Regional volumes in brain stem and cerebellum are associated with postural impairments in young brain-injured patients.

    PubMed

    Drijkoningen, David; Leunissen, Inge; Caeyenberghs, Karen; Hoogkamer, Wouter; Sunaert, Stefan; Duysens, Jacques; Swinnen, Stephan P

    2015-12-01

    Many patients with traumatic brain injury (TBI) suffer from postural control impairments that can profoundly affect daily life. The cerebellum and brain stem are crucial for the neural control of posture and have been shown to be vulnerable to primary and secondary structural consequences of TBI. The aim of this study was to investigate whether morphometric differences in the brain stem and cerebellum can account for impairments in static and dynamic postural control in TBI. TBI patients (n = 18) and healthy controls (n = 30) completed three challenging postural control tasks on the EquiTest® system (Neurocom). Infratentorial grey matter (GM) and white matter (WM) volumes were analyzed with cerebellum-optimized voxel-based morphometry using the spatially unbiased infratentorial toolbox. Volume loss in TBI patients was revealed in global cerebellar GM, global infratentorial WM, middle cerebellar peduncles, pons and midbrain. In the TBI group and across both groups, lower postural control performance was associated with reduced GM volume in the vermal/paravermal regions of lobules I-IV, V and VI. Moreover, across all participants, worse postural control performance was associated with lower WM volume in the pons, medulla, midbrain, superior and middle cerebellar peduncles and cerebellum. This is the first study in TBI patients to demonstrate an association between postural impairments and reduced volume in specific infratentorial brain areas. Volumetric measures of the brain stem and cerebellum may be valuable prognostic markers of the chronic neural pathology, which complicates rehabilitation of postural control in TBI. © 2015 Wiley Periodicals, Inc.

  14. A simplified CT-based definition of the supraclavicular and infraclavicular nodal volumes in breast cancer.

    PubMed

    Atean, I; Pointreau, Y; Ouldamer, L; Monghal, C; Bougnoux, A; Bera, G; Barillot, I

    2013-02-01

    The available contouring guidelines for the supraclavicular and infraclavicular lymph nodes appeared to be inadequate for their delineation on non-enhanced computed tomography (CT) scans. For this purpose, we developed delineation guidelines for the clinical target volumes (CTV) of these lymph nodes on non-enhanced CT-slices performed in the treatment position of breast cancer. A fresh female cadaver study as well as delineation and an anatomical descriptions review were performed to propose a simplified definition of the supra- and infraclavicular lymph nodes using readily identifiable anatomical structures. This definition was developed jointly by breast radiologists, breast surgeons, and radiation oncologists. To validate these guidelines, the primary investigator and seven radiation oncologists (observers) independently delineated 10 different nodal CTVs. The primary investigator contours were considered to be the gold standard contours. Contour accuracy and concordance were evaluated. Written guidelines for the delineation of supra- and infraclavicular lymph nodes CTVs were developed. Consistent contours with minimal variability existed between the delineated volumes; the mean kappa index was 0.83. The mean common contoured and additional contoured volumes were 84.6% and 18.5%, respectively. The mean overlap volume ratio was 0.71. Simplified CT-based atlas for delineation of the supra- and infraclavicular lymph nodes for locoregional irradiation of the breast on non-enhanced CT-scan, have been developed in this study. This atlas provides a consistent set of guidelines for delineating these volumes. Copyright © 2012 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  15. Management of Portal Hypertension After Liver Transplantation.

    PubMed

    Korda, D; Deák, P Á; Kiss, G; Gerlei, Z; Kóbori, L; Görög, D; Fehérvári, I; Piros, L; Máthé, Z; Doros, A

    2017-09-01

    Post-transplantation portal hypertension has severe complications, such as esophageal varix bleeding, therapy refractory ascites, extreme splenomegaly, and graft dysfunction. The aim of our study was to analyze the effectiveness of the therapeutic strategies and how to visualize the procedure. A retrospective study involving liver transplantation patients from the Semmelweis University Department of Transplantation and Surgery was performed between 2005 and 2015. The prevalence, etiology, and leading complications of the condition were determined. The applied interventions' effects on the patients' ascites volume, splenic volume, and the occurrence of variceal bleeding were determined. Mean portal blood flow velocity and congestion index values were calculated using Doppler ultrasonography. The prevalence of post-transplantation portal hypertension requiring intervention was 2.8%. The most common etiology of the disease was portal anastomotic stenosis. The most common complications were esophageal varix bleeding and therapy refractory ascites. The patients' ascites volume decreased significantly (2923.3 ± 1893.2 mL vs. 423.3 ± 634.3 mL; P < .05), their splenic volume decreased markedly. After the interventions, only one case of recurrent variceal bleeding was reported. The calculated Doppler parameters were altered in the opposite direction in cases of pre-hepatic versus intra- or post-hepatic portal hypertension. After the interventions, these parameters shifted towards the physiologic ranges. The interventions performed in our clinic were effective in most cases. The patients' ascites volume, splenic volume, and the prevalence of variceal bleeding decreased after the treatment. Doppler ultrasonography has proved to be a valuable imaging modality in the diagnosis and the follow-up of post-transplantation portal hypertension. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Clinical evaluation of the reproducibility of volume measurements of pulmonary nodules

    NASA Astrophysics Data System (ADS)

    Wormanns, Dag; Kohl, Gerhard; Klotz, Ernst; Heindel, Walter; Diederich, Stefan

    2002-05-01

    High reproducibility of volumetric measurements is an important prerequisite for follow-up of small lung nodules in order to differentiate malignant from benign lesions in a lung cancer screening setting. This study was aimed to evaluate the measurement reproducibility of a new software tool for pulmonary nodule volumetry. In an ongoing study, 147 pulmonary nodules (size 1.6-17.5 mm) were examined with low-dose multidetector CT (Siemens Somatom Volume Zoom, 120 kVp, 20 mAs, detector collimation 4x1 mm, normalized pitch 1.75, slice thickness 1.25 mm, reconstruction increment 0.8 mm). Two consecutive low-dose scans covering the whole lung volume were performed within a few minutes. Between both scans, patients were asked to leave the CT scanner, and the second scan was planned independently from the first one. For all visually detected pulmonary nodules with a diameter <20 mm nodule volume was determined on both scans using a software prototype containing segmentation and volumetry algorithms. Results from both scans were compared. Nodule volume differences were determined as difference between the first and second measurement and ranged from 169 to 87%. The performance of the diagnostic test was measured using ROC analysis. For the detection of a volume doubling the area under curve (Az) was 0.98, for a growth of 50% the Az was 0.89. Further refinement of the segmentation algorithm should lead to more consistent measurements in ill-defined nodules. In conclusion, volumetric measurement of pulmonary nodules in multislice CT data sets is a reliable tool for the detection of growth in small pulmonary nodules.

  17. Space shuttle/food system study. Volume 2, appendix E: Alternate flight systems analysis

    NASA Technical Reports Server (NTRS)

    1974-01-01

    The functional requirements of stowage, preparation, serving, consumption, and cleanup were applied to each of the five food mixes selected for study in terms of the overall design of the space shuttle food system. The analysis led to a definition of performance requirements for each food mix, along with a definition of equipment to meet those requirements. Weight and volume data for all five systems, in terms of food and packaging, support equipment, and galley installation penalties, are presented.

  18. [Effects of performance-volume limit on the institutional financing of the Clinical Centre of the University of Pécs, Hungary].

    PubMed

    Endrei, Dóra; Kollár, Lajos; Bódis, József; Imhof, Gábor; Zemplényi, Antal; Vas, Gábor; Boncz, Imre

    2010-08-01

    The aim of our study is to demonstrate the effects of performance-volume limit (PVL) on the institutional financing of the Clinical Centre of the University of Pécs (CC UP). The data involved in the analysis are based on the reports towards the National Health Insurance Fund Administration (NHIFA), concerning the active inpatient care by specialist in the period between 2004 and 2008. We determined the real NHIFA reimbursement per weighted case number and the financial loss caused by the PVL. We analyzed the proportion of local health care obligation and urgency cases in comparison of various clinics. The reimbursement per weighted case number of CC UP has been less than the pre-announced NHIFA amounts after the installation of PVL. During the examined 5 years, i.e. 2004-2008, the loss in case of CC UP has been up to 3.256 million HUF due to the PVL. Concerning the whole of CC UP it means that 25.3 % of the treated cases and 24.5 % of the executed weighted case number has been out of local health care obligation. Studying the ratio of urgency cases inside the total volume of medical attendance, it is represented that 31.5 % of the cases and 36.1 % of the weighted case numbers came from the treatment of urgency cases. The introduction of performance-volume limit considerably reduced the health insurance financing of CC UP between 2004 and 2008.

  19. High-throughput, fully-automated volumetry for prediction of MMSE and CDR decline in mild cognitive impairment

    PubMed Central

    Kovacevic, Sanja; Rafii, Michael S.; Brewer, James B.

    2008-01-01

    Medial temporal lobe (MTL) atrophy is associated with increased risk for conversion to Alzheimer's disease (AD), but manual tracing techniques and even semi-automated techniques for volumetric assessment are not practical in the clinical setting. In addition, most studies that examined MTL atrophy in AD have focused only on the hippocampus. It is unknown the extent to which volumes of amygdala and temporal horn of the lateral ventricle predict subsequent clinical decline. This study examined whether measures of hippocampus, amygdala, and temporal horn volume predict clinical decline over the following 6-month period in patients with mild cognitive impairment (MCI). Fully-automated volume measurements were performed in 269 MCI patients. Baseline volumes of the hippocampus, amygdala, and temporal horn were evaluated as predictors of change in Mini-mental State Exam (MMSE) and Clinical Dementia Rating Sum of Boxes (CDR SB) over a 6-month interval. Fully-automated measurements of baseline hippocampus and amygdala volumes correlated with baseline delayed recall scores. Patients with smaller baseline volumes of the hippocampus and amygdala or larger baseline volumes of the temporal horn had more rapid subsequent clinical decline on MMSE and CDR SB. Fully-automated and rapid measurement of segmental MTL volumes may help clinicians predict clinical decline in MCI patients. PMID:19474571

  20. Discriminant musculo-skeletal leg characteristics between sprint and endurance elite Caucasian runners.

    PubMed

    Bex, T; Iannaccone, F; Stautemas, J; Baguet, A; De Beule, M; Verhegghe, B; Aerts, P; De Clercq, D; Derave, W

    2017-03-01

    Excellence in either sprinting or endurance running requires specific musculo-skeletal characteristics of the legs. This study aims to investigate the morphology of the leg of sprinters and endurance runners of Caucasian ethnicity. Eight male sprinters and 11 male endurance runners volunteered to participate in this cross-sectional study. They underwent magnetic resonance imaging and after data collection, digital reconstruction was done to calculate muscle volumes and bone lengths. Sprinters have a higher total upper leg volume compared to endurance runners (7340 vs 6265 cm 3 ). Specifically, the rectus femoris, vastus lateralis, and hamstrings showed significantly higher muscle volumes in the sprint group. For the lower leg, only a higher muscle volume was found in the gastrocnemius lateralis for the sprinters. No differences were found in muscle volume distribution, center of mass in the different muscles, or relative bone lengths. There was a significant positive correlation between ratio hamstrings/quadriceps volume and best running performance in the sprint group. Sprinters and endurance runners of Caucasian ethnicity showed the greatest distinctions in muscle volumes, rather than in muscle distributions or skeletal measures. Sprinters show higher volumes in mainly the proximal and lateral leg muscles than endurance runners. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  1. Computer Program (HEVSIM) for Heavy Duty Vehicle Fuel Economy and Performance Simulation. Volume III.

    DOT National Transportation Integrated Search

    1981-09-01

    Volume III is the third and last volume of a three volume document describing the computer program HEVSIM. This volume includes appendices which list the HEVSIM program, sample part data, some typical outputs and updated nomenclature.

  2. Particle shape effect on heat transfer performance in an oscillating heat pipe.

    PubMed

    Ji, Yulong; Wilson, Corey; Chen, Hsiu-Hung; Ma, Hongbin

    2011-04-05

    The effect of alumina nanoparticles on the heat transfer performance of an oscillating heat pipe (OHP) was investigated experimentally. A binary mixture of ethylene glycol (EG) and deionized water (50/50 by volume) was used as the base fluid for the OHP. Four types of nanoparticles with shapes of platelet, blade, cylinder, and brick were studied, respectively. Experimental results show that the alumina nanoparticles added in the OHP significantly affect the heat transfer performance and it depends on the particle shape and volume fraction. When the OHP was charged with EG and cylinder-like alumina nanoparticles, the OHP can achieve the best heat transfer performance among four types of particles investigated herein. In addition, even though previous research found that these alumina nanofluids were not beneficial in laminar or turbulent flow mode, they can enhance the heat transfer performance of an OHP.

  3. Particle shape effect on heat transfer performance in an oscillating heat pipe

    PubMed Central

    2011-01-01

    The effect of alumina nanoparticles on the heat transfer performance of an oscillating heat pipe (OHP) was investigated experimentally. A binary mixture of ethylene glycol (EG) and deionized water (50/50 by volume) was used as the base fluid for the OHP. Four types of nanoparticles with shapes of platelet, blade, cylinder, and brick were studied, respectively. Experimental results show that the alumina nanoparticles added in the OHP significantly affect the heat transfer performance and it depends on the particle shape and volume fraction. When the OHP was charged with EG and cylinder-like alumina nanoparticles, the OHP can achieve the best heat transfer performance among four types of particles investigated herein. In addition, even though previous research found that these alumina nanofluids were not beneficial in laminar or turbulent flow mode, they can enhance the heat transfer performance of an OHP. PMID:21711830

  4. Right ventricular volumes assessed by echocardiographic three-dimensional knowledge-based reconstruction compared with magnetic resonance imaging in a clinical setting.

    PubMed

    Neukamm, Christian; Try, Kirsti; Norgård, Gunnar; Brun, Henrik

    2014-01-01

    A technique that uses two-dimensional images to create a knowledge-based, three-dimensional model was tested and compared to magnetic resonance imaging. Measurement of right ventricular volumes and function is important in the follow-up of patients after pulmonary valve replacement. Magnetic resonance imaging is the gold standard for volumetric assessment. Echocardiographic methods have been validated and are attractive alternatives. Thirty patients with tetralogy of Fallot (25 ± 14 years) after pulmonary valve replacement were examined. Magnetic resonance imaging volumetric measurements and echocardiography-based three-dimensional reconstruction were performed. End-diastolic volume, end-systolic volume, and ejection fraction were measured, and the results were compared. Magnetic resonance imaging measurements gave coefficient of variation in the intraobserver study of 3.5, 4.6, and 5.3 and in the interobserver study of 3.6, 5.9, and 6.7 for end-diastolic volume, end-systolic volume, and ejection fraction, respectively. Echocardiographic three-dimensional reconstruction was highly feasible (97%). In the intraobserver study, the corresponding values were 6.0, 7.0, and 8.9 and in the interobserver study 7.4, 10.8, and 13.4. In comparison of the methods, correlations with magnetic resonance imaging were r = 0.91, 0.91, and 0.38, and the corresponding coefficient of variations were 9.4, 10.8, and 14.7. Echocardiography derived volumes (mL/m(2)) were significantly higher than magnetic resonance imaging volumes in end-diastolic volume 13.7 ± 25.6 and in end-systolic volume 9.1 ± 17.0 (both P < .05). The knowledge-based three-dimensional right ventricular volume method was highly feasible. Intra and interobserver variabilities were satisfactory. Agreement with magnetic resonance imaging measurements for volumes was reasonable but unsatisfactory for ejection fraction. Knowledge-based reconstruction may replace magnetic resonance imaging measurements for serial follow-up, whereas magnetic resonance imaging should be used for surgical decision making.

  5. Learning curve in transradial cardiac catheterization: procedure-related parameters stratified by operators' transradial volume.

    PubMed

    Kasasbeh, Ehab S; Parvez, Babar; Huang, Robert L; Hasselblad, Michele Marie; Glazer, Mark D; Salloum, Joseph G; Cleator, John H; Zhao, David X

    2012-11-01

    To determine whether radial artery access is associated with a reduction in fluoroscopy time, procedure time, and other procedural variables over a 27-month period during which the radial artery approach was incorporated in a single academic Medical Center. Although previous studies have demonstrated a relationship between increased volume and decreased procedural time, no studies have looked at the integration of radial access over time. Data were collected from consecutive patients who presented to the Vanderbilt University Medical Center cardiac catheterization laboratory from January 1, 2009 to April 1, 2011. Patients who underwent radial access diagnostic catheterization with and without percutaneous coronary intervention were included in this study. A total of 1112 diagnostic cardiac catheterizations through the radial access site were analyzed. High-volume, intermediate-volume, and low-volume operators were grouped based on the percentage of procedures performed through a radial approach. From 2009 to 2011, there was a significant decrease in fluoroscopy time in all operator groups for diagnostic catheterization (P=.035). The high-volume operator group had 1.88 and 3.66 minute reductions in fluoroscopy time compared to the intermediate- and low-volume operator groups, respectively (both P<.001). Likewise, the intermediate-volume operator group had a 1.77 minute improvement compared to the low-volume operator group, but this did not reach statistical significance (P=.102). The improvement in fluoroscopy time and other procedure-related parameters was seen after approximately 25 cases with further improvement after 75 cases. The incorporation of the radial access approach in the cardiac catheterization laboratory led to a decrease in fluoroscopy time for each operator and operator group over the last 3 years. Our data demonstrated that higher-volume radial operators have better procedure, room, and fluoroscopy times when compared to intermediate- and low-volume operators. However, lower-volume operators have a reduction in procedure-related parameters with increased radial cases. Number of procedures needed to become sufficient was demonstrated in the current study.

  6. Performance of exchange-correlation functionals in density functional theory calculations for liquid metal: A benchmark test for sodium.

    PubMed

    Han, Jeong-Hwan; Oda, Takuji

    2018-04-14

    The performance of exchange-correlation functionals in density-functional theory (DFT) calculations for liquid metal has not been sufficiently examined. In the present study, benchmark tests of Perdew-Burke-Ernzerhof (PBE), Armiento-Mattsson 2005 (AM05), PBE re-parameterized for solids, and local density approximation (LDA) functionals are conducted for liquid sodium. The pair correlation function, equilibrium atomic volume, bulk modulus, and relative enthalpy are evaluated at 600 K and 1000 K. Compared with the available experimental data, the errors range from -11.2% to 0.0% for the atomic volume, from -5.2% to 22.0% for the bulk modulus, and from -3.5% to 2.5% for the relative enthalpy depending on the DFT functional. The generalized gradient approximation functionals are superior to the LDA functional, and the PBE and AM05 functionals exhibit the best performance. In addition, we assess whether the error tendency in liquid simulations is comparable to that in solid simulations, which would suggest that the atomic volume and relative enthalpy performances are comparable between solid and liquid states but that the bulk modulus performance is not. These benchmark test results indicate that the results of liquid simulations are significantly dependent on the exchange-correlation functional and that the DFT functional performance in solid simulations can be used to roughly estimate the performance in liquid simulations.

  7. Performance of exchange-correlation functionals in density functional theory calculations for liquid metal: A benchmark test for sodium

    NASA Astrophysics Data System (ADS)

    Han, Jeong-Hwan; Oda, Takuji

    2018-04-01

    The performance of exchange-correlation functionals in density-functional theory (DFT) calculations for liquid metal has not been sufficiently examined. In the present study, benchmark tests of Perdew-Burke-Ernzerhof (PBE), Armiento-Mattsson 2005 (AM05), PBE re-parameterized for solids, and local density approximation (LDA) functionals are conducted for liquid sodium. The pair correlation function, equilibrium atomic volume, bulk modulus, and relative enthalpy are evaluated at 600 K and 1000 K. Compared with the available experimental data, the errors range from -11.2% to 0.0% for the atomic volume, from -5.2% to 22.0% for the bulk modulus, and from -3.5% to 2.5% for the relative enthalpy depending on the DFT functional. The generalized gradient approximation functionals are superior to the LDA functional, and the PBE and AM05 functionals exhibit the best performance. In addition, we assess whether the error tendency in liquid simulations is comparable to that in solid simulations, which would suggest that the atomic volume and relative enthalpy performances are comparable between solid and liquid states but that the bulk modulus performance is not. These benchmark test results indicate that the results of liquid simulations are significantly dependent on the exchange-correlation functional and that the DFT functional performance in solid simulations can be used to roughly estimate the performance in liquid simulations.

  8. Job Performance Tests for CH-53E Helicopter Mechanics. Volume 2: Administrative Duties and Job Knowledge Tests

    DTIC Science & Technology

    1992-01-01

    SUBTmI.E 5 FU.NDING NUMBERS Job Performance Tests for CII-53E Helicopter Miechanacs - Volume I1: Admiutstrative Duties and Job Knowlede Tests C - N...performance measures to Marine Corps personnel managers . training instructors, and interested researchers who may find them useful. This work comprises...Corps personnel managers , training instructors, and interested researchers who may find them useful. 3. This work comprises two parts: volume I

  9. Voxel-based morphometry in Alzheimers disease and mild cognitive impairment: Systematic review of studies addressing the frontal lobe

    PubMed Central

    Ribeiro, Luís Gustavo; Busatto, Geraldo

    2016-01-01

    ABSTRACT Voxel-based morphometry (VBM) is a useful approach for investigating neurostructural brain changes in dementia. We systematically reviewed VBM studies of Alzheimer's disease (AD) and mild cognitive impairment (MCI), specifically focusing on grey matter (GM) atrophy in the frontal lobe. Methods: Two searches were performed on the Pubmed database. A set of exclusion criteria was applied to ensure the selection of only VBM studies that directly investigated GM volume abnormalities in AD and/or MCI patients compared to cognitively normal controls. Results: From a total of 46 selected articles, 35 VBM studies reported GM volume reductions in the frontal lobe. The frontal subregions, where most of the volume reductions were reported, included the inferior, superior and middle frontal gyri, as well as the anterior cingulate gyrus. We also found studies in which reduced frontal GM was detected in MCI patients who converted to AD. In a minority of studies, correlations between frontal GM volumes and behavioural changes or cognitive deficits in AD patients were investigated, with variable findings. Conclusion: Results of VBM studies indicate that the frontal lobe should be regarded as an important brain area when investigating GM volume deficits in association with AD. Frontal GM loss might not be a feature specific to late AD only. Future VBM studies involving large AD samples are warranted to further investigate correlations between frontal volume deficits and both cognitive impairment and neuropsychiatric symptoms. PMID:29213441

  10. Preliminary Measures of Instructor Learning in Teaching Junctional Tourniquet Users.

    PubMed

    Kragh, John F; Aden, James K; Shackelford, Stacy; Dubick, Michael A

    2016-01-01

    The objective of the present study was to assess the effect of instructor learning on student performance in use of junctional tourniquets. From a convenience sample of data available after another study, we used a manikin for assessment of control of bleeding from a right groin gunshot wound. Blood loss was measured by the instructor while training users. The data set represented a group of 30 persons taught one at a time. The first measure was a plot of mean blood loss volumes for the sequential users. The second measure was a plot of the cumulative sum (CUSUM) of mean blood loss (BL) volumes for users. Mean blood loss trended down as the instructor gained experience with each newly instructed user. User performance continually improved as the instructor gained more experience with teaching. No plateau effect was observed within the 30 users. The CUSUM plot illustrated a turning point or cusp at the seventh user. The prior portion of the plot (users 1-7) had the greatest improvement; performance did not improve as much thereafter. The improvement after the seventh user was the only change detected in the instructor's trend of performance. The instructor's teaching experience appeared to directly affect user performance; in a model of junctional hemorrhage, the volume of blood loss from the manikin during junctional tourniquet placement was a useful metric of instructor learning. The CUSUM technique detected a small but meaningful change in trend where the instructor learning curve was greatest while working with the first seven users. 2016.

  11. Assessment of liver volume with computed tomography and comparison of findings with ultrasonography.

    PubMed

    Bora, Aydın; Alptekin, Cem; Yavuz, Alpaslan; Batur, Abdussamet; Akdemir, Zülküf; Berköz, Mehmet

    2014-12-01

    In this study, we aimed to investigate the impact of non-alcoholic hepatic steatosis on the liver volume. As investigating hepatic steatosis, we utilized computed tomography (CT) to determine the degree of steatosis and we utilized hepatobiliary ultrasonography (USG) for densitometry and correlation. As hepatosteatosis group, 35 patients over 18 years of age and whose abdominal CT scans were requested by several clinics and performed routinely were included in this study, and as control group, 40 healthy subjects without hepatosteatosis (clinically and radiologically) and correlated with hepatosteatosis group in terms of age and gender were included in this study. CT densitometry and liver attenuation index (LAI) of all individuals who participated in our study were calculated, and contrast images of patients were transferred to CT-Volume Software (Siemens Syngo Multimodality Workplace; Version VE52A). In this study, interactive and automated volume measurement techniques were used together. The volumes were measured separately in patient and control group. In this study for each stage in USG, there was found a direct correlation in terms of LAI and volume, and this correlation was statistically significant (p < 0.01). Furthermore, statistical significance between size and USG stage draws attention (p < 0.05). A significance relationship between USG stage and age could not be determined. As a result, we have reached the conclusion that CT densitometry can be used as an assistive technique along with USG to determine the degree of steatosis in the non-alcoholic fatty liver disease, and there is a positive linear correlation between the liver size and volume, and liver volume increases in the non-alcoholic fatty liver disease.

  12. Trends in Penile Prosthetics: Influence of Patient Demographics, Surgeon Volume, and Hospital Volume on Type of Penile Prosthesis Inserted in New York State.

    PubMed

    Kashanian, James A; Golan, Ron; Sun, Tianyi; Patel, Neal A; Lipsky, Michael J; Stahl, Peter J; Sedrakyan, Art

    2018-02-01

    Penile prostheses (PPs) are a discrete, well-tolerated treatment option for men with medical refractory erectile dysfunction. Despite the increasing prevalence of erectile dysfunction, multiple series evaluating inpatient data have found a decrease in the frequency of PP surgery during the past decade. To investigate trends in PP surgery and factors affecting the choice of different PPs in New York State. This study used the New York State Department of Health Statewide Planning and Research Cooperative (SPARCS) data cohort that includes longitudinal information on hospital discharges, ambulatory surgery, emergency department visits, and outpatient services. Patients older than 18 years who underwent inflatable or non-inflatable PP insertion from 2000 to 2014 were included in the study. Influence of patient demographics, surgeon volume, and hospital volume on type of PP inserted. Since 2000, 14,114 patients received PP surgery in New York State; 12,352 PPs (88%) were inflatable and 1,762 (12%) were non-inflatable, with facility-level variation from 0% to 100%. There was an increasing trend in the number of annual procedures performed, with rates of non-inflatable PP insertion decreasing annually (P < .01). More procedures were performed in the ambulatory setting over time (P < .01). Important predictors of device choice were insurance type, year of insertion, hospital and surgeon volume, and the presence of comorbidities. Major influences in choice of PP inserted include racial and socioeconomic factors and surgeon and hospital surgical volume. Use of the SPARCS database, which captures inpatient and outpatient services, allows for more accurate insight into trends in contrast to inpatient sampling alone. However, SPARCS is limited to patients within New York State and the results might not be generalizable to men in other states. Also, patient preference was not accounted for in these analyses, which can play a role in PP selection. During the past 14 years, there has been an increasing trend in inflatable PP surgery for the management of erectile dysfunction. Most procedures are performed in the ambulatory setting and not previously captured by prior studies using inpatient data. Kashanian JA, Golan R, Sun T, et al. Trends in Penile Prosthetics: Influence of Patient Demographics, Surgeon Volume, and Hospital Volume on Type of Penile Prosthesis Inserted in New York State. J Sex Med 2018;15:245-250. Copyright © 2017 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

  13. Forceps Delivery Volumes in Teaching and Nonteaching Hospitals: Are Volumes Sufficient for Physicians to Acquire and Maintain Competence?

    PubMed Central

    Kyser, Kathy L.; Lu, Xin; Santillan, Donna; Santillan, Mark; Caughey, Aaron B.; Wilson, Mark C.; Cram, Peter

    2015-01-01

    Purpose The decline in the use of forceps in operative deliveries over the last two decades raises questions about teaching hospitals' ability to provide trainees with adequate experience in the use of forceps. The authors examined: (1) the number of operative deliveries performed in teaching and nonteaching hospitals, and (2) whether teaching hospitals performed a sufficient number of forceps deliveries for physicians to acquire and maintain competence. Method The authors used State Inpatient Data from nine states to identify all women hospitalized for childbirth in 2008. They divided hospitals into three categories: major teaching, minor teaching, and nonteaching. They calculated delivery volumes (total operative, cesarean, vacuum, forceps, two or more methods) for each hospital and compared data across hospital categories. Results The sample included 1,344,305 childbirths in 835 hospitals. The mean cesarean volumes for major teaching, minor teaching, and nonteaching hospitals were 969.8, 757.8, and 406.9. The mean vacuum volumes were 301.0, 304.2, and 190.4, and the mean forceps volumes were 25.2, 15.3, and 8.9. In 2008, 31 hospitals (3.7% of all hospitals) performed no vacuum extractions, and 320 (38.3%) performed no forceps deliveries. In 2008, 13 (23%) major teaching and 44 (44%) minor teaching hospitals performed five or fewer forceps deliveries. Conclusions Low forceps delivery volumes may preclude many trainees from acquiring adequate experience and proficiency. These findings highlighted broader challenges, faced by many specialties, in ensuring that trainees and practicing physicians acquire and maintain competence in infrequently performed, highly technical procedures. PMID:24280847

  14. Suitability of frequency modulated thermal wave imaging for skin cancer detection-A theoretical prediction.

    PubMed

    Bhowmik, Arka; Repaka, Ramjee; Mulaveesala, Ravibabu; Mishra, Subhash C

    2015-07-01

    A theoretical study on the quantification of surface thermal response of cancerous human skin using the frequency modulated thermal wave imaging (FMTWI) technique has been presented in this article. For the first time, the use of the FMTWI technique for the detection and the differentiation of skin cancer has been demonstrated in this article. A three dimensional multilayered skin has been considered with the counter-current blood vessels in individual skin layers along with different stages of cancerous lesions based on geometrical, thermal and physical parameters available in the literature. Transient surface thermal responses of melanoma during FMTWI of skin cancer have been obtained by integrating the heat transfer model for biological tissue along with the flow model for blood vessels. It has been observed from the numerical results that, flow of blood in the subsurface region leads to a substantial alteration on the surface thermal response of the human skin. The alteration due to blood flow further causes a reduction in the performance of the thermal imaging technique during the thermal evaluation of earliest melanoma stages (small volume) compared to relatively large volume. Based on theoretical study, it has been predicted that the method is suitable for detection and differentiation of melanoma with comparatively large volume than the earliest development stages (small volume). The study has also performed phase based image analysis of the raw thermograms to resolve the different stages of melanoma volume. The phase images have been found to be clearly individuate the different development stages of melanoma compared to raw thermograms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Evaluating Spatiotemporal Image Correlation Technology as a Tool for Training Nonexpert Sonographers to Perform Examinations of the Fetal Heart.

    PubMed

    Avnet, Hagai; Mazaaki, Eyal; Shen, Ori; Cohen, Sarah; Yagel, Simcha

    2016-01-01

    We aimed to evaluate the use of spatiotemporal image correlation (STIC) as a tool for training nonexpert examiners to perform screening examinations of the fetal heart by acquiring and examining STIC volumes according to a standardized questionnaire based on the 5 transverse planes of the fetal heart. We conducted a prospective study at 2 tertiary care centers. Two sonographers without formal training in fetal echocardiography received theoretical instruction on the 5 fetal echocardiographic transverse planes, as well as STIC technology. Only women with conditions allowing 4-dimensional STIC volume acquisitions (grayscale and Doppler) were included in the study. Acquired volumes were evaluated offline according to a standardized protocol that required the trainee to mark 30 specified structures on 5 required axial planes. Volumes were then reviewed by an expert examiner for quality of acquisition and correct identification of specified structures. Ninety-six of 112 pregnant women examined entered the study. Patients had singleton pregnancies between 20 and 32 weeks' gestation. After an initial learning curve of 20 examinations, trainees succeeded in identifying 97% to 98% of structures, with a highly significant degree of agreement with the expert's analysis (P < .001). A median of 2 STIC volumes for each examination was necessary for maximal structure identification. Acquisition quality scores were high (8.6-8.7 of a maximal score of 10) and were found to correlate with identification rates (P = .017). After an initial learning curve and under expert guidance, STIC is an excellent tool for trainees to master extended screening examinations of the fetal heart.

  16. Pre- and postoperative radiotherapy for extremity soft tissue sarcoma: Evaluation of inter-observer target volume contouring variability among French sarcoma group radiation oncologists.

    PubMed

    Sargos, P; Charleux, T; Haas, R L; Michot, A; Llacer, C; Moureau-Zabotto, L; Vogin, G; Le Péchoux, C; Verry, C; Ducassou, A; Delannes, M; Mervoyer, A; Wiazzane, N; Thariat, J; Sunyach, M P; Benchalal, M; Laredo, J D; Kind, M; Gillon, P; Kantor, G

    2018-04-01

    The purpose of this study was to evaluate, during a national workshop, the inter-observer variability in target volume delineation for primary extremity soft tissue sarcoma radiation therapy. Six expert sarcoma radiation oncologists (members of French Sarcoma Group) received two extremity soft tissue sarcoma radiation therapy cases 1: one preoperative and one postoperative. They were distributed with instructions for contouring gross tumour volume or reconstructed gross tumour volume, clinical target volume and to propose a planning target volume. The preoperative radiation therapy case was a patient with a grade 1 extraskeletal myxoid chondrosarcoma of the thigh. The postoperative case was a patient with a grade 3 pleomorphic undifferentiated sarcoma of the thigh. Contour agreement analysis was performed using kappa statistics. For the preoperative case, contouring agreement regarding GTV, gross tumour volume GTV, clinical target volume and planning target volume were substantial (kappa between 0.68 and 0.77). In the postoperative case, the agreement was only fair for reconstructed gross tumour volume (kappa: 0.38) but moderate for clinical target volume and planning target volume (kappa: 0.42). During the workshop discussion, consensus was reached on most of the contour divergences especially clinical target volume longitudinal extension. The determination of a limited cutaneous cover was also discussed. Accurate delineation of target volume appears to be a crucial element to ensure multicenter clinical trial quality assessment, reproducibility and homogeneity in delivering RT. radiation therapy RT. Quality assessment process should be proposed in this setting. We have shown in our study that preoperative radiation therapy of extremity soft tissue sarcoma has less inter-observer contouring variability. Copyright © 2018 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  17. Impact of donor- and collection-related variables on product quality in ex utero cord blood banking.

    PubMed

    Askari, Sabeen; Miller, John; Chrysler, Gayl; McCullough, Jeffrey

    2005-02-01

    Optimizing product quality is a current focus in cord blood banking. This study evaluates the role of selected donor- and collection-related variables. Retrospective review was performed of cord blood units (CBUs) collected ex utero between February 1, 2000, and February 28, 2002. Preprocessing volume and total nucleated cell (TNC) counts and postprocessing CD34 cell counts were used as product quality indicators. Of 2084 CBUs, volume determinations and TNC counts were performed on 1628 and CD34+ counts on 1124 CBUs. Mean volume and TNC and CD34+ counts were 85.2 mL, 118.9 x 10(7), and 5.2 x 10(6), respectively. In univariate analysis, placental weight of greater than 500 g and meconium in amniotic fluid correlated with better volume and TNC and CD34+ counts. Greater than 40 weeks' gestation predicted enhanced volume and TNC count. Cesarean section, two- versus one-person collection, and not greater than 5 minutes between placental delivery and collection produced superior volume. Increased TNC count was also seen in Caucasian women, primigravidae, female newborns, and collection duration of more than 5 minutes. A time between delivery of newborn and placenta of not greater than 10 minutes predicted better volume and CD34+ count. By regression analysis, collection within not greater than 5 minutes of placental delivery produced superior volume and TNC count. Donor selection and collection technique modifications may improve product quality. TNC count appears to be more affected by different variables than CD34+ count.

  18. Concept for a Satellite-Based Advanced Air Traffic Management System : Volume 5. System Performance.

    DOT National Transportation Integrated Search

    1974-02-01

    The volume presents the results of the performance evaluation of the Satellite-Based Advanced Air Traffic Management System (SAATMS). The evaluation established the capacity, safety, and delay performance of the system for the Los Angeles Basin termi...

  19. Neuroanatomical correlates of intelligence in healthy young adults: the role of basal ganglia volume.

    PubMed

    Rhein, Cosima; Mühle, Christiane; Richter-Schmidinger, Tanja; Alexopoulos, Panagiotis; Doerfler, Arnd; Kornhuber, Johannes

    2014-01-01

    In neuropsychiatric diseases with basal ganglia involvement, higher cognitive functions are often impaired. In this exploratory study, we examined healthy young adults to gain detailed insight into the relationship between basal ganglia volume and cognitive abilities under non-pathological conditions. We investigated 137 healthy adults that were between the ages of 21 and 35 years with similar educational backgrounds. Magnetic resonance imaging (MRI) was performed, and volumes of basal ganglia nuclei in both hemispheres were calculated using FreeSurfer software. The cognitive assessment consisted of verbal, numeric and figural aspects of intelligence for either the fluid or the crystallised intelligence factor using the intelligence test Intelligenz-Struktur-Test (I-S-T 2000 R). Our data revealed significant correlations of the caudate nucleus and pallidum volumes with figural and numeric aspects of intelligence, but not with verbal intelligence. Interestingly, figural intelligence associations were dependent on sex and intelligence factor; in females, the pallidum volumes were correlated with crystallised figural intelligence (r = 0.372, p = 0.01), whereas in males, the caudate volumes were correlated with fluid figural intelligence (r = 0.507, p = 0.01). Numeric intelligence was correlated with right-lateralised caudate nucleus volumes for both females and males, but only for crystallised intelligence (r = 0.306, p = 0.04 and r = 0.459, p = 0.04, respectively). The associations were not mediated by prefrontal cortical subfield volumes when controlling with partial correlation analyses. The findings of our exploratory analysis indicate that figural and numeric intelligence aspects, but not verbal aspects, are strongly associated with basal ganglia volumes. Unlike numeric intelligence, the type of figural intelligence appears to be related to distinct basal ganglia nuclei in a sex-specific manner. Subcortical brain structures thus may contribute substantially to cognitive performance.

  20. Effects of body position and extension of the neck and extremities on lung volume measured via computed tomography in red-eared slider turtles (Trachemys scripta elegans).

    PubMed

    Mans, Christoph; Drees, Randi; Sladky, Kurt K; Hatt, Jean-Michel; Kircher, Patrick R

    2013-10-15

    To determine the effects of body position and extension of the neck and extremities on CT measurements of ventilated lung volume in red-eared slider turtles (Trachemys scripta elegans). Prospective crossover-design study. 14 adult red-eared slider turtles. CT was performed on turtles in horizontal ventral recumbent and vertical left lateral recumbent, right lateral recumbent, and caudal recumbent body positions. In sedated turtles, evaluations were performed in horizontal ventral recumbent body position with and without extension of the neck and extremities. Lung volumes were estimated from helical CT images with commercial software. Effects of body position, extremity and neck extension, sedation, body weight, and sex on lung volume were analyzed. Mean ± SD volume of dependent lung tissue was significantly decreased in vertical left lateral (18.97 ± 14.65 mL), right lateral (24.59 ± 19.16 mL), and caudal (9.23 ± 12.13 mL) recumbent positions, compared with the same region for turtles in horizontal ventral recumbency (48.52 ± 20.08 mL, 50.66 ± 18.08 mL, and 31.95 ± 15.69 mL, respectively). Total lung volume did not differ among positions because of compensatory increases in nondependent lung tissue. Extension of the extremities and neck significantly increased total lung volume (127.94 ± 35.53 mL), compared with that in turtles with the head, neck, and extremities withdrawn into the shell (103.24 ± 40.13 mL). Vertical positioning of red-eared sliders significantly affected lung volumes and could potentially affect interpretation of radiographs obtained in these positions. Extension of the extremities and neck resulted in the greatest total lung volume.

  1. Interspecies scaling: predicting volumes, mean residence time and elimination half-life. Some suggestions.

    PubMed

    Mahmood, I

    1998-05-01

    Extrapolation of animal data to assess pharmacokinetic parameters in man is an important tool in drug development. Clearance, volume of distribution and elimination half-life are the three most frequently extrapolated pharmacokinetic parameters. Extensive work has been done to improve the predictive performance of allometric scaling for clearance. In general there is good correlation between body weight and volume, hence volume in man can be predicted with reasonable accuracy from animal data. Besides the volume of distribution in the central compartment (Vc), two other volume terms, the volume of distribution by area (Vbeta) and the volume of distribution at steady state (VdSS), are also extrapolated from animals to man. This report compares the predictive performance of allometric scaling for Vc, Vbeta and VdSS in man from animal data. The relationship between elimination half-life (t(1/2)) and body weight across species results in poor correlation, most probably because of the hybrid nature of this parameter. To predict half-life in man from animal data, an indirect method (CL=VK, where CL=clearance, V is volume and K is elimination rate constant) has been proposed. This report proposes another indirect method which uses the mean residence time (MRT). After establishing that MRT can be predicted across species, it was used to predict half-life using the equation MRT=1.44 x t(1/2). The results of the study indicate that Vc is predicted more accurately than Vbeta and VdSS in man. It should be emphasized that for first-time dosing in man, Vc is a more important pharmacokinetic parameter than Vbeta or VdSS. Furthermore, MRT can be predicted reasonably well for man and can be used for prediction of half-life.

  2. Cone beam computed tomography images fusion in predicting lung ablation volumes: a feasibility study.

    PubMed

    Ierardi, Anna Maria; Petrillo, Mario; Xhepa, Genti; Laganà, Domenico; Piacentino, Filippo; Floridi, Chiara; Duka, Ejona; Fugazzola, Carlo; Carrafiello, Gianpaolo

    2016-02-01

    Recently different software with the ability to plan ablation volumes have been developed in order to minimize the number of attempts of positioning electrodes and to improve a safe overall tumor coverage. To assess the feasibility of three-dimensional cone beam computed tomography (3D CBCT) fusion imaging with "virtual probe" positioning, to predict ablation volume in lung tumors treated percutaneously. Pre-procedural computed tomography contrast-enhanced scans (CECT) were merged with a CBCT volume obtained to plan the ablation. An offline tumor segmentation was performed to determine the number of antennae and their positioning within the tumor. The volume of ablation obtained, evaluated on CECT performed after 1 month, was compared with the pre-procedural predicted one. Feasibility was assessed on the basis of accuracy evaluation (visual evaluation [VE] and quantitative evaluation [QE]), technical success (TS), and technical effectiveness (TE). Seven of the patients with lung tumor treated by percutaneous thermal ablation were selected and treated on the basis of the 3D CBCT fusion imaging. In all cases the volume of ablation predicted was in accordance with that obtained. The difference in volume between predicted ablation volumes and obtained ones on CECT at 1 month was 1.8 cm(3) (SD ± 2, min. 0.4, max. 0.9) for MW and 0.9 cm(3) (SD ± 1.1, min. 0.1, max. 0.7) for RF. Use of pre-procedural 3D CBCT fusion imaging could be useful to define expected ablation volumes. However, more patients are needed to ensure stronger evidence. © The Foundation Acta Radiologica 2015.

  3. Process compressor technology. Volume 2: TI-59 manual for estimating centrifugal compressor performance

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

    Lapina, R.P.

    1983-01-01

    This volume provides the performance-estimating procedures of Volume 1 in the from of calculator programs. Each chapter contains one program and is divided into five parts: the background (which develops the technology and equations); the program description; user instructions; sample problems; and the program listing. More than 25 programs are included.

  4. Analytical performance evaluation of a high-volume hematology laboratory utilizing sigma metrics as standard of excellence.

    PubMed

    Shaikh, M S; Moiz, B

    2016-04-01

    Around two-thirds of important clinical decisions about the management of patients are based on laboratory test results. Clinical laboratories are required to adopt quality control (QC) measures to ensure provision of accurate and precise results. Six sigma is a statistical tool, which provides opportunity to assess performance at the highest level of excellence. The purpose of this study was to assess performance of our hematological parameters on sigma scale in order to identify gaps and hence areas of improvement in patient care. Twelve analytes included in the study were hemoglobin (Hb), hematocrit (Hct), red blood cell count (RBC), mean corpuscular volume (MCV), red cell distribution width (RDW), total leukocyte count (TLC) with percentages of neutrophils (Neutr%) and lymphocytes (Lymph %), platelet count (Plt), mean platelet volume (MPV), prothrombin time (PT), and fibrinogen (Fbg). Internal quality control data and external quality assurance survey results were utilized for the calculation of sigma metrics for each analyte. Acceptable sigma value of ≥3 was obtained for the majority of the analytes included in the analysis. MCV, Plt, and Fbg achieved value of <3 for level 1 (low abnormal) control. PT performed poorly on both level 1 and 2 controls with sigma value of <3. Despite acceptable conventional QC tools, application of sigma metrics can identify analytical deficits and hence prospects for the improvement in clinical laboratories. © 2016 John Wiley & Sons Ltd.

  5. Robustness and optimal use of design principles of arthropod exoskeletons studied by ab initio-based multiscale simulations.

    PubMed

    Nikolov, S; Fabritius, H; Petrov, M; Friák, M; Lymperakis, L; Sachs, C; Raabe, D; Neugebauer, J

    2011-02-01

    Recently, we proposed a hierarchical model for the elastic properties of mineralized lobster cuticle using (i) ab initio calculations for the chitin properties and (ii) hierarchical homogenization performed in a bottom-up order through all length scales. It has been found that the cuticle possesses nearly extremal, excellent mechanical properties in terms of stiffness that strongly depend on the overall mineral content and the specific microstructure of the mineral-protein matrix. In this study, we investigated how the overall cuticle properties changed when there are significant variations in the properties of the constituents (chitin, amorphous calcium carbonate (ACC), proteins), and the volume fractions of key structural elements such as chitin-protein fibers. It was found that the cuticle performance is very robust with respect to variations in the elastic properties of chitin and fiber proteins at a lower hierarchy level. At higher structural levels, variations of design parameters such as the volume fraction of the chitin-protein fibers have a significant influence on the cuticle performance. Furthermore, we observed that among the possible variations in the cuticle ingredients and volume fractions, the experimental data reflect an optimal use of the structural variations regarding the best possible performance for a given composition due to the smart hierarchical organization of the cuticle design. Copyright © 2011. Elsevier Ltd. All rights reserved.

  6. Space transfer vehicle concepts and requirements. Volume 3: Program cost estimates

    NASA Technical Reports Server (NTRS)

    1991-01-01

    The Space Transfer Vehicle (STV) Concepts and Requirements Study has been an eighteen-month study effort to develop and analyze concepts for a family of vehicles to evolve from an initial STV system into a Lunar Transportation System (LTS) for use with the Heavy Lift Launch Vehicle (HLLV). The study defined vehicle configurations, facility concepts, and ground and flight operations concepts. This volume reports the program cost estimates results for this portion of the study. The STV Reference Concept described within this document provides a complete LTS system that performs both cargo and piloted Lunar missions.

  7. [Real-time three-dimensional (4D) ultrasound-guided prostatic biopsies on a phantom. Comparative study versus 2D guidance].

    PubMed

    Long, Jean-Alexandre; Daanen, Vincent; Moreau-Gaudry, Alexandre; Troccaz, Jocelyne; Rambeaud, Jean-Jacques; Descotes, Jean-Luc

    2007-11-01

    The objective of this study was to determine the added value of real-time three-dimensional (4D) ultrasound guidance of prostatic biopsies on a prostate phantom in terms of the precision of guidance and distribution. A prostate phantom was constructed. A real-time 3D ultrasonograph connected to a transrectal 5.9 MHz volumic transducer was used. Fourteen operators performed 336 biopsies with 2D guidance then 4D guidance according to a 12-biopsy protocol. Biopsy tracts were modelled by segmentation in a 3D ultrasound volume. Specific software allowed visualization of biopsy tracts in the reference prostate and evaluated the zone biopsied. A comparative study was performed to determine the added value of 4D guidance compared to 2D guidance by evaluating the precision of entry points and target points. The distribution was evaluated by measuring the volume investigated and by a redundancy ratio of the biopsy points. The precision of the biopsy protocol was significantly improved by 4D guidance (p = 0.037). No increase of the biopsy volume and no improvement of the distribution of biopsies were observed with 4D compared to 2D guidance. The real-time 3D ultrasound-guided prostate biopsy technique on a phantom model appears to improve the precision and reproducibility of a biopsy protocol, but the distribution of biopsies does not appear to be improved.

  8. Evaluation of 1.0 mm i.d. column performances on ultra high pressure liquid chromatography instrumentation.

    PubMed

    Lestremau, François; Wu, Di; Szücs, Roman

    2010-07-23

    The present study focuses on the evaluation of 1.0 mm i.d. (internal diameter) columns on a commercial Ultra-High Pressure system. These systems have been developed specifically to operate columns with small volumes, typically 2.1 mm i.d., by reducing extra-column volume dispersion. The use of columns with smaller i.d. results in a reduced solvent consumption and required sample volume. The evaluation of the columns was carried out with samples containing neutral and pharmaceutical compounds. In isocratic mode, the extra-column volume produced additional band broadening leading to poor performances compared to equivalent 2.1 mm i.d. columns. By increasing the length of the column, the influence of the extra-column bandspreading could be reduced and 75,000 plates were obtained when four columns were coupled. In gradient mode, the effect of the extra-column contribution on efficiency was limited and about 80% of the performance of the 2.1 mm i.d. columns was obtained. Optimum conditions in gradient mode were further investigated by changing flow rate, gradient time and column length. A different approach of the calculation of peak capacity was also considered for the comparison of the influence of these different parameters. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  9. MR brain volumetric measurements are predictive of neurobehavioral impairment in the HIV-1 transgenic rat.

    PubMed

    Casas, Rafael; Muthusamy, Siva; Wakim, Paul G; Sinharay, Sanhita; Lentz, Margaret R; Reid, William C; Hammoud, Dima A

    2018-01-01

    HIV infection is known to be associated with brain volume loss, even in optimally treated patients. In this study, we assessed whether dynamic brain volume changes over time are predictive of neurobehavorial performance in the HIV-1 transgenic (Tg) rat, a model of treated HIV-positive patients. Cross-sectional brain MRI imaging was first performed comparing Tg and wild type (WT) rats at 3 and 19 months of age. Longitudinal MRI and neurobehavioral testing of another group of Tg and WT rats was then performed from 5 to 23 weeks of age. Whole brain and subregional image segmentation was used to assess the rate of brain growth over time. We used repeated-measures mixed models to assess differences in brain volumes and to establish how predictive the volume differences are of specific neurobehavioral deficits. Cross-sectional imaging showed smaller whole brain volumes in Tg compared to WT rats at 3 and at 19 months of age. Longitudinally, Tg brain volumes were smaller than age-matched WT rats at all time points, starting as early as 5 weeks of age. The Tg striatal growth rate delay between 5 and 9 weeks of age was greater than that of the whole brain. Striatal volume in combination with genotype was the most predictive of rota-rod scores and in combination with genotype and age was the most predictive of total exploratory activity scores in the Tg rats. The disproportionately delayed striatal growth compared to whole brain between 5 and 9 weeks of age and the role of striatal volume in predicting neurobehavioral deficits suggest an important role of the dopaminergic system in HIV associated neuropathology. This might explain problems with motor coordination and executive decisions in this animal model. Smaller brain and subregional volumes and neurobehavioral deficits were seen as early as 5 weeks of age, suggesting an early brain insult in the Tg rat. Neuroprotective therapy testing in this model should thus target this early stage of development, before brain damage becomes irreversible.

  10. Availability of epidemiologic data on humans exposed to animal carcinogens. II. Chemical uses and production volume

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

    Karstadt, M.; Bobal, R.

    1982-01-01

    We report further findings of a survey of manufacturers, processors, and importers of chemicals determined by the International Agency for Research on Cancer (IARC) to be animal carcinogens, but whose carcinogenicity in humans was considered uncertain because of inadequate epidemiologic data. We requested epidemiologic studies from the companies marketing or using any of the 75 IARC animal carcinogens in commerce in the United States. Eighteen of the 75 IARC animal carcinogens had volumes listed of 10(6) lb/year or greater, with 8 of the 13 chemicals for which studies had been completed or are in progress in this ''high volume'' category.more » The use category with the largest number of chemicals was drugs--19 of the 75 IARC animal carcinogens were in this category. However, none of the 13 chemicals included in epidemiologic studies was a drug. Seven of the 13 chemicals included in studies were used primarily as pesticides. We received little information on dyes and dye intermediates, experimental carcinogens, and drugs, all of which are produced in relatively low volumes; these categories represent 42 of the 75 IARC animal carcinogens. Low volumes and declining usage/production appear to be barriers to performance of epidemiologic studies. Information we received suggests that sometimes the problem of low production volume may be avoided by studying users rather than production workers. Overall, however, we expect few additional epidemiologic studies of the 75 IARC animal carcinogens.« less

  11. Thermodynamic properties of deep eutectic solvent and ionic liquid mixtures at temperatures from 293.15 K to 343.15 K

    NASA Astrophysics Data System (ADS)

    Achsah, R. S.; Shyam, S.; Mayuri, N.; Anantharaj, R.

    2018-04-01

    Deep eutectic solvents (DES) and ionic liquids (ILs) have their applications in various fields of research and in industries due to their attractive physiochemical properties. In this study, the combined thermodynamic properties of DES (choline chloride-glycerol) + IL1 (1-butyl-3-methylimiazolium acetate) and DES(choline chloride-glycerol) + IL2 (1-ethyl-3-methylimadzolium ethyl sulphate) have been studied. The thermodynamic properties such as excess molar volume, partial molar volume, excess partial molar volume and apparent molar volume were calculated for different mole fractions ranging from 0 to 1 and varying temperatures from 293.15 K to 343.15 K. In order to know the solvent properties of DESs and ILs mixtures at different temperatures and their molecular interactions to enhance the solvent performance and process efficiency at fixed composition and temperature the thermodynamic properties were analyzed.

  12. Evaluating the accuracy of wear formulae for acetabular cup liners.

    PubMed

    Wu, James Shih-Shyn; Hsu, Shu-Ling; Chen, Jian-Horng

    2010-02-01

    This study proposes two methods for exploring the wear volume of a worn liner. The first method is a numerical method, in which SolidWorks software is used to create models of the worn out regions of liners at various wear directions and depths. The second method is an experimental one, in which a machining center is used to mill polyoxymethylene to manufacture worn and unworn liner models, then the volumes of the models are measured. The results show that the SolidWorks software is a good tool for presenting the wear pattern and volume of a worn liner. The formula provided by Ilchmann is the most suitable for computing liner volume loss, but is not accurate enough. This study suggests that a more accurate wear formula is required. This is crucial for accurate evaluation of the performance of hip components implanted in patients, as well as for designing new hip components.

  13. Computer Program (HEVSIM) for Heavy Duty Vehicle Fuel Economy and Performance Simulation. Volume III: Appendices A through F

    DOT National Transportation Integrated Search

    1981-09-01

    Volume III is the third and last volume of a three volume document describing the computer program HEVSIM. This volume includes appendices which list the HEVSIM program, sample part data, some typical outputs and updated nomenclature.

  14. Contrast administration and techniques of digital subtraction angiography performance.

    PubMed

    Saddekni, S; Sos, T A; Srur, M; Cohn, D J

    1985-06-01

    Optimal IV-DSA performance depends equally on the digital system, the patient, and the radiologist. Through enhancement and subtraction, the digital system increases contrast sensitivity, thus compensating for the relatively low spatial resolution and for the loss in contrast (density) that results from dilution of the contrast medium by injecting it on the venous side. The degree of this dilution is governed by the patient's cardiac output and the size of the central blood volume. The lower the cardiac output and the larger the central blood volume, the less opacification (more dilution) and longer transit time (more likelihood for artifacts) will result. The role of the radiologist is to optimize the available conditions. He can prevent measures that decrease cardiac output (Valsalva maneuver) or he can take measures to decrease the degree of dilution by choosing optimal contrast administration methods, such as injecting in the right atrium at a high rate and thus allowing more latitude to decrease the total volume per injection and to increase the number of injections per examination. The radiologist also attempts to combat all the sources of noninformation or misinformation resulting from voluntary or involuntary patient motion, which degrades subtraction. By observing studies in real time, the radiologist may recognize motion during the injection, and by increasing the number of exposures, he may have a late mask to save the study. On immediate review of an injection, he may recognize the need to increase the volume per injection to obtain better opacification or, conversely, to reduce the volume if it is apparent that it could be done without compromise to the study and yet allow more injections to be performed, or he may recognize a finding that requires more than the usual routine views and may obtain a better one. IV-DSA can be performed with peripheral injections of contrast medium if the area of interest is limited and superior opacification is not essential, especially if a larger image intensifier (12- to 16-inch field) is available. However, whether peripheral injections are the least invasive, depends on whether one thinks that 200 to 240 ml of Renografin-76 for four views in an outpatient is invasive or not. The notion that IV-DSA can be performed by a nurse who places the IV needle or angiocatheter, a technician who shoots the pictures, and a computer that will do the rest, while the radiologist is peripherally involved and to hope for consistently good studies, is far from realistic.(ABSTRACT TRUNCATED AT 400 WORDS)

  15. Optimization of the performance of the polymerase chain reaction in silicon-based microstructures.

    PubMed Central

    Taylor, T B; Winn-Deen, E S; Picozza, E; Woudenberg, T M; Albin, M

    1997-01-01

    We have demonstrated the ability to perform real-time homogeneous, sequence specific detection of PCR products in silicon microstructures. Optimal design/ processing result in equivalent performance (yield and specificity) for high surface-to-volume silicon structures as compared to larger volume reactions in polypropylene tubes. Amplifications in volumes as small as 0.5 microl and thermal cycling times reduced as much as 5-fold from that of conventional systems have been demonstrated for the microstructures. PMID:9224619

  16. Comparison of urodynamic volume measurements using room and body temperature saline: a double-blinded randomized crossover study design.

    PubMed

    Gehrich, Alan Paul; Hill, Micah J; McWilliams, Grant D E; Larsen, Wilma; McCartin, Tamarin

    2012-01-01

    Urodynamic studies, routinely performed in women with lower urinary tract symptoms, have a large impact on clinical decision making. Unfortunately, these studies are insensitive in reproducing idiopathic detrusor overactivity (IDO). We set out to examine whether serial cystometry with different distending fluid temperatures could better reproduce symptoms. Eighty-six women were enrolled in a double-blinded, randomized, crossover study. Two cystometries were performed in series, starting with either body temperature fluid (BTF) or room temperature fluid (RTF) and then repeating cystometry with the other temperature fluid. Primary outcomes included first sensation, first urge, and maximum cystometric capacity. Secondary outcomes included subjective sensation of bladder discomfort and the incidence of IDO. In aggregate, the temperature of the fluid did not affect volumes of bladder sensation. There were no differences in self-reported bladder irritation or IDO between the different temperature fluids. There was a significant carryover effect with BTF. BTF administered first reached sensory thresholds at lower volumes than when it was administered second after RTF. Room temperature fluid cystometry showed no statistical difference in volume between first fill and second fill. Idiopathic detrusor overactivity contractions were seen in 9% of studies and were not affected by period or temperature. These data suggest that BTF and RTF independently do not affect bladder sensory thresholds. The periodicity in combination with varying fluid temperature is of greater impact. This study documents that changes in temperature of the distending fluid from BTF to RTF or vice versa likely do not provoke IDO contractions.

  17. 4D computed tomography scans for conformal thoracic treatment planning: is a single scan sufficient to capture thoracic tumor motion?

    NASA Astrophysics Data System (ADS)

    Tseng, Yolanda D.; Wootton, Landon; Nyflot, Matthew; Apisarnthanarax, Smith; Rengan, Ramesh; Bloch, Charles; Sandison, George; St. James, Sara

    2018-01-01

    Four dimensional computed tomography (4DCT) scans are routinely used in radiation therapy to determine the internal treatment volume for targets that are moving (e.g. lung tumors). The use of these studies has allowed clinicians to create target volumes based upon the motion of the tumor during the imaging study. The purpose of this work is to determine if a target volume based on a single 4DCT scan at simulation is sufficient to capture thoracic motion. Phantom studies were performed to determine expected differences between volumes contoured on 4DCT scans and those on the evaluation CT scans (slow scans). Evaluation CT scans acquired during treatment of 11 patients were compared to the 4DCT scans used for treatment planning. The images were assessed to determine if the target remained within the target volume determined during the first 4DCT scan. A total of 55 slow scans were compared to the 11 planning 4DCT scans. Small differences were observed in phantom between the 4DCT volumes and the slow scan volumes, with a maximum of 2.9%, that can be attributed to minor differences in contouring and the ability of the 4DCT scan to adequately capture motion at the apex and base of the motion trajectory. Larger differences were observed in the patients studied, up to a maximum volume difference of 33.4%. These results demonstrate that a single 4DCT scan is not adequate to capture all thoracic motion throughout treatment.

  18. Heat transfer analysis of radiator using graphene oxide nanofluids

    NASA Astrophysics Data System (ADS)

    Rao Ponangi, Babu; Sumanth, S.; Krishna, V.; Seetharam, T. R.; Seetharamu, K. N.

    2018-04-01

    As the technology is developing day by day, there is a requirement for enhancement in performance of automobile radiator to have a better performance of the IC Engine and fuel effectiveness. One of the major and recent approach to upgrade the performance of a radiator is that nanoparticles must be suspended in the general coolant (Ethylene Glycol – Water) which form nanofluids. Present work has been carried out by suspending graphene oxide nanoparticles in 50:50 Ethylene Glycol and RO-Water as base fluid. Experimentation is carried out by using three volume concentrations of the nanofluid (0.02%, 0.03% and 0.04%) and at different volumetric flow rates ranging from 3 to 6 LPM. Effect of volume concentration, inlet temperature and flow rate on Effectiveness, pressure drop and friction factor has been studied experimentally. Effectiveness versus NTU curves are plotted for further design calculations. The results show that the nanofluids will enhance the performance of an automobile radiator when compared with base fluid. Results also shows a maximum of 56.45% and 41.47% improvement in effectiveness for 0.03% volume concentration and 5 LPM flow rate at 40°C and 50°C inlet temperatures respectively.

  19. Gray matter volume is associated with rate of subsequent skill learning after a long term training intervention

    PubMed Central

    Sampaio-Baptista, Cassandra; Scholz, Jan; Jenkinson, Mark; Thomas, Adam G.; Filippini, Nicola; Smit, Gabrielle; Douaud, Gwenaëlle; Johansen-Berg, Heidi

    2014-01-01

    The ability to predict learning performance from brain imaging data has implications for selecting individuals for training or rehabilitation interventions. Here, we used structural MRI to test whether baseline variations in gray matter (GM) volume correlated with subsequent performance after a long-term training of a complex whole-body task. 44 naïve participants were scanned before undertaking daily juggling practice for 6 weeks, following either a high intensity or a low intensity training regime. To assess performance across the training period participants' practice sessions were filmed. Greater GM volume in medial occipito-parietal areas at baseline correlated with steeper learning slopes. We also tested whether practice time or performance outcomes modulated the degree of structural brain change detected between the baseline scan and additional scans performed immediately after training and following a further 4 weeks without training. Participants with better performance had higher increases in GM volume during the period following training (i.e., between scans 2 and 3) in dorsal parietal cortex and M1. When contrasting brain changes between the practice intensity groups, we did not find any straightforward effects of practice time though practice modulated the relationship between performance and GM volume change in dorsolateral prefrontal cortex. These results suggest that practice time and performance modulate the degree of structural brain change evoked by long-term training regimes. PMID:24680712

  20. Effects of strength training, detraining and retraining in muscle strength, hypertrophy and functional tasks in older female adults.

    PubMed

    Correa, Cleiton S; Cunha, Giovani; Marques, Nise; Oliveira-Reischak, Ãlvaro; Pinto, Ronei

    2016-07-01

    Previous studies presented different results regarding the maintenance time of muscular adaptations after strength training and the ability to resume the gains on muscular performance after resumption of the training programme. This study aimed to verify the effect of strength training on knee extensors and elbow flexor muscle strength, rectus femoris muscle volume and functional performance in older female adults after 12 weeks of strength training, 1 year of detraining and followed by 12 weeks of retraining. Twelve sedentary older women performed 12 weeks of strength training, 1 year of detraining and 12 weeks of retraining. The strength training was performed twice a week, and the assessment was made four times: at the baseline, after the strength training, after the detraining and after the retraining. The knee extensor and elbow flexor strength, rectus femoris muscle volume and functional task were assessed. Strength of knee extensor and elbow flexor muscles, rectus femoris muscle volume and 30-s sit-to-stand increased from baseline to post-training (respectively, 40%, 70%, 38% and 46%), decreased after detraining (respectively, -36%, -64%, -35% and -43%) and increased again these parameters after retraining (35%, 68%, 36% and 42%). Strength training induces gains on strength and hypertrophy, also increased the performance on functional tasks after the strength training. The stoppage of the strength caused strength loss and reduction of functional performance. The resumption of the strength training promoted the same gains of muscular performance in older female adults. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

  1. Analytical Comparison of In Vitro-Spiked Human Serum and Plasma for PCR-Based Detection of Aspergillus fumigatus DNA: a Study by the European Aspergillus PCR Initiative

    PubMed Central

    Mengoli, Carlo; Springer, Jan; Bretagne, Stéphane; Cuenca-Estrella, Manuel; Klingspor, Lena; Lagrou, Katrien; Melchers, Willem J. G.; Morton, C. Oliver; Barnes, Rosemary A.; Donnelly, J. Peter; White, P. Lewis

    2015-01-01

    The use of serum or plasma for Aspergillus PCR testing facilitates automated and standardized technology. Recommendations for serum testing are available, and while serum and plasma are regularly considered interchangeable for use in fungal diagnostics, differences in galactomannan enzyme immunoassay (GM-EIA) performance have been reported and are attributed to clot formation. Therefore, it is important to assess plasma PCR testing to determine if previous recommendations for serum are applicable and also to compare analytical performance with that of serum PCR. Molecular methods testing serum and plasma were compared through multicenter distribution of quality control panels, with additional studies to investigate the effect of clot formation and blood fractionation on DNA availability. Analytical sensitivity and time to positivity (TTP) were compared, and a regression analysis was performed to identify variables that enhanced plasma PCR performance. When testing plasma, sample volume, preextraction-to-postextraction volume ratio, PCR volume, duplicate testing, and the use of an internal control for PCR were positively associated with performance. When whole-blood samples were spiked and then fractionated, the analytical sensitivity and TTP were superior when testing plasma. Centrifugation had no effect on DNA availability, whereas the presence of clot material significantly lowered the concentration (P = 0.028). Technically, there are no major differences in the molecular processing of serum and plasma, but the formation of clot material potentially reduces available DNA in serum. During disease, Aspergillus DNA burdens in blood are often at the limits of PCR performance. Using plasma might improve performance while maintaining the methodological simplicity of serum testing. PMID:26085614

  2. Analytical Comparison of In Vitro-Spiked Human Serum and Plasma for PCR-Based Detection of Aspergillus fumigatus DNA: a Study by the European Aspergillus PCR Initiative.

    PubMed

    Loeffler, Juergen; Mengoli, Carlo; Springer, Jan; Bretagne, Stéphane; Cuenca-Estrella, Manuel; Klingspor, Lena; Lagrou, Katrien; Melchers, Willem J G; Morton, C Oliver; Barnes, Rosemary A; Donnelly, J Peter; White, P Lewis

    2015-09-01

    The use of serum or plasma for Aspergillus PCR testing facilitates automated and standardized technology. Recommendations for serum testing are available, and while serum and plasma are regularly considered interchangeable for use in fungal diagnostics, differences in galactomannan enzyme immunoassay (GM-EIA) performance have been reported and are attributed to clot formation. Therefore, it is important to assess plasma PCR testing to determine if previous recommendations for serum are applicable and also to compare analytical performance with that of serum PCR. Molecular methods testing serum and plasma were compared through multicenter distribution of quality control panels, with additional studies to investigate the effect of clot formation and blood fractionation on DNA availability. Analytical sensitivity and time to positivity (TTP) were compared, and a regression analysis was performed to identify variables that enhanced plasma PCR performance. When testing plasma, sample volume, preextraction-to-postextraction volume ratio, PCR volume, duplicate testing, and the use of an internal control for PCR were positively associated with performance. When whole-blood samples were spiked and then fractionated, the analytical sensitivity and TTP were superior when testing plasma. Centrifugation had no effect on DNA availability, whereas the presence of clot material significantly lowered the concentration (P = 0.028). Technically, there are no major differences in the molecular processing of serum and plasma, but the formation of clot material potentially reduces available DNA in serum. During disease, Aspergillus DNA burdens in blood are often at the limits of PCR performance. Using plasma might improve performance while maintaining the methodological simplicity of serum testing. Copyright © 2015 Loeffler et al.

  3. The volume threshold of 300 versus 100 ml/day for chest tube removal after pulmonary lobectomy: a meta-analysis.

    PubMed

    Zhang, Tian-Xiang; Zhang, Ye; Liu, Zhi-Dong; Zhou, Shi-Jie; Xu, Shao-Fa

    2018-05-07

    In this meta-analysis, we conducted a pooled analysis of clinical studies comparing the efficacy of a volume threshold of 300 ml/day before removing a chest tube (CT) versus 100 ml/day after a lobectomy. According to the recommendations of the Cochrane Collaboration, we established a rigorous study protocol. We performed a systematic electronic search of PubMed, Embase, Cochrane Library, Web of Science databases, CNKI, the Wanfang database, CBMdisc and Google Scholar to identify articles to include in our meta-analysis. A literature search was performed using relevant keywords. A meta-analysis was performed using RevMan© software. Five studies, published between 2014 and 2015, including 615 patients (314 patients who had the CT removed when daily drainage was <300 ml and 301 patients who had the CT removed when daily drainage was <100 ml) met the selection criteria. From the available data, the patients using the volume threshold of 300 ml/day had a significantly decreased duration of drainage [MD = -44.07; 95% confidence interval (CI) -64.45 to -23.68; P < 0.0001] and hospital stay after operation (MD = -2.25; 95% CI -3.52 to -0.97; P = 0.0006) compared with patients using a volume threshold of 100 ml/day after a pulmonary lobectomy. However, no significant differences were observed in postoperative complications, such as pleural fluid reaccumulation [Odds ratio (OR) = 1.73; 95% CI = 0.74-4.07; P = 0.21] and atelectasis (OR = 0.97; 95% CI = 0.52-1.81; P = 0.93). Thoracentesis rates after removing the CT also showed no significant difference (OR = 1.53; 95% CI 0.55-4.22; P = 0.41). Our results showed that a higher volume threshold, up to 300 ml/day, is effective in reducing hospitalization times and duration of drainage in patients who undergo a lobectomy. Moreover, the volume threshold of 300 ml/day does not increase the occurrence of postoperative atelectasis, pleural fluid reaccumulation and thoracentesis rates. However, this review is limited by the methodological quality of the included trials, and additional studies according to the recommendations of Cochrane Library are appreciated.

  4. Fronto-Parietal gray matter and white matter efficiency differentially predict intelligence in males and females.

    PubMed

    Ryman, Sephira G; Yeo, Ronald A; Witkiewitz, Katie; Vakhtin, Andrei A; van den Heuvel, Martijn; de Reus, Marcel; Flores, Ranee A; Wertz, Christopher R; Jung, Rex E

    2016-11-01

    While there are minimal sex differences in overall intelligence, males, on average, have larger total brain volume and corresponding regional brain volumes compared to females, measures that are consistently related to intelligence. Limited research has examined which other brain characteristics may differentially contribute to intelligence in females to facilitate equal performance on intelligence measures. Recent reports of sex differences in the neural characteristics of the brain further highlight the need to differentiate how the structural neural characteristics relate to intellectual ability in males and females. The current study utilized a graph network approach in conjunction with structural equation modeling to examine potential sex differences in the relationship between white matter efficiency, fronto-parietal gray matter volume, and general cognitive ability (GCA). Participants were healthy adults (n = 244) who completed a battery of cognitive testing and underwent structural neuroimaging. Results indicated that in males, a latent factor of fronto-parietal gray matter was significantly related to GCA when controlling for total gray matter volume. In females, white matter efficiency and total gray matter volume were significantly related to GCA, with no specificity of the fronto-parietal gray matter factor over and above total gray matter volume. This work highlights that different neural characteristics across males and females may contribute to performance on intelligence measures. Hum Brain Mapp 37:4006-4016, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  5. Sex dependence of brain size and shape in bipolar disorder: an exploratory study.

    PubMed

    Mackay, Clare E; Roddick, Elina; Barrick, Thomas R; Lloyd, Adrian J; Roberts, Neil; Crow, Tim J; Young, Allan H; Ferrier, I Nicol

    2010-05-01

    Anomalies of asymmetry and sex differences in brain structure have frequently been described in schizophrenic illnesses but have seldom been explored in bipolar disorder. We measured volumes of the left and right frontal, temporal, parietal, and occipital lobes and computed the magnitude of brain torque (i.e., rightward frontal and leftward occipital asymmetry) for 49 patients with bipolar disorder and 47 healthy controls and performed an exploratory analysis of sex differences in patients and controls. Patients had significantly greater cerebrospinal fluid volume than controls, but no difference in total brain volume. There were no main effects of diagnosis in gray matter lobe volume or brain torque, but when analyses were performed separately for male and female subjects, significant sex-by-diagnosis interactions were found in the volume of the left frontal, left temporal, right parietal, and right occipital lobes, such that male patients with bipolar disorder tend toward larger, more symmetric brains than male controls, whereas female patients tend toward smaller, more asymmetric brains than female controls. The lateralised nature of these interactions was such that the normal sex difference in volume was significantly accentuated, whilst the normal sex difference in asymmetry tended to be diminished in patients with bipolar disorder. We conclude that bipolar disorder in part reflects an interaction between brain growth and sex along the anterior-posterior axis of the human brain.

  6. Laboratory Control for Wastewater Facilities, Wastewater Technology: A Two-Year Post High School Instructional Program. Volume III, Parts A, B, C, D, E, F, G.

    ERIC Educational Resources Information Center

    Wagner, David; And Others

    This volume is one in a series which outlines performance objectives and instructional modules for a course of study which explains the relationship and function of the process units in a wastewater treatment plant. Examples of modules include measuring settleable matter, total solids, dissolved solids, suspended solids, and volatile solids. The…

  7. CrossTalk: The Journal of Defense Software Engineering. Volume 19, Number 6

    DTIC Science & Technology

    2006-06-01

    improvement methods. The total volume of projects studied now exceeds 12,000. Software Productivity Research, LLC Phone: (877) 570-5459 (973) 273-5829...While performing quality con- sulting, Olson has helped organizations measurably improve quality and productivity , save millions of dollars in costs of...This article draws parallels between the outrageous events on the Jerry Springer Show and problems faced by process improvement programs. by Paul

  8. Integrated Power/Attitude Control System (IPACS) study. Volume 1: Feasibility studies. [application of flywheels for power storage and generation

    NASA Technical Reports Server (NTRS)

    Notti, J. E.; Cormack, A., III; Schmill, W. C.

    1974-01-01

    An Integrated Power/Attitude Control System (IPACS) concept consisting of an array of spinning flywheels, with or without gimbals, capable of performing the dual function of power storage and generation, as well as attitude control has been investigated. This system provides attitude control through momentum storage, and replaces the storage batteries onboard the spacecraft. The results of the investigation are presented in two volumes. The trade-off studies performed to establish the feasibility, cost effectiveness, required level of development, and boundaries of application of IPACS to a wide variety of spacecraft are discussed. The conceptual designs for a free-flying research application module (RAM), and for a tracking and data relay satellite (TDRS) are presented. Results from dynamic analyses and simulations of the IPACS conceptual designs are included.

  9. Agreement and reliability of pelvic floor measurements during contraction using three-dimensional pelvic floor ultrasound and virtual reality.

    PubMed

    Speksnijder, L; Rousian, M; Steegers, E A P; Van Der Spek, P J; Koning, A H J; Steensma, A B

    2012-07-01

    Virtual reality is a novel method of visualizing ultrasound data with the perception of depth and offers possibilities for measuring non-planar structures. The levator ani hiatus has both convex and concave aspects. The aim of this study was to compare levator ani hiatus volume measurements obtained with conventional three-dimensional (3D) ultrasound and with a virtual reality measurement technique and to establish their reliability and agreement. 100 symptomatic patients visiting a tertiary pelvic floor clinic with a normal intact levator ani muscle diagnosed on translabial ultrasound were selected. Datasets were analyzed using a rendered volume with a slice thickness of 1.5 cm at the level of minimal hiatal dimensions during contraction. The levator area (in cm(2)) was measured and multiplied by 1.5 to get the levator ani hiatus volume in conventional 3D ultrasound (in cm(3)). Levator ani hiatus volume measurements were then measured semi-automatically in virtual reality (cm(3) ) using a segmentation algorithm. An intra- and interobserver analysis of reliability and agreement was performed in 20 randomly chosen patients. The mean difference between levator ani hiatus volume measurements performed using conventional 3D ultrasound and virtual reality was 0.10 (95% CI, - 0.15 to 0.35) cm(3). The intraclass correlation coefficient (ICC) comparing conventional 3D ultrasound with virtual reality measurements was > 0.96. Intra- and interobserver ICCs for conventional 3D ultrasound measurements were > 0.94 and for virtual reality measurements were > 0.97, indicating good reliability for both. Levator ani hiatus volume measurements performed using virtual reality were reliable and the results were similar to those obtained with conventional 3D ultrasonography. Copyright © 2012 ISUOG. Published by John Wiley & Sons, Ltd.

  10. Weight versus volume in breast surgery: an observational study

    PubMed Central

    Parmar, Chetan; West, Malcolm; Pathak, Samir; Nelson, J; Martin, Lee

    2011-01-01

    Objectives The study hypothesis is to assess correlation of breast specimen weight versus volume. Design Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted. Setting Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection. Participants Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens. Main outcome measures Breast specimen weight correlation to breast specimen volume. Results The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant. Conclusions No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived. PMID:22140613

  11. Weight versus volume in breast surgery: an observational study.

    PubMed

    Parmar, Chetan; West, Malcolm; Pathak, Samir; Nelson, J; Martin, Lee

    2011-11-01

    The study hypothesis is to assess correlation of breast specimen weight versus volume. Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted. Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection. Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens. Breast specimen weight correlation to breast specimen volume. The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant. No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived.

  12. Evaluation of bioimpedance for the measurement of physiologic variables as related to hemodynamic studies in space flight

    NASA Technical Reports Server (NTRS)

    Taylor, Bruce C.

    1993-01-01

    Orthostatic intolerance, following space flight, has received substantial attention because of the possibility that it compromises astronaut safety and reduces the ability of astronauts to function at peak performance levels upon return to a one-g environment. Many pre- and post-flight studies are performed to evaluate changes in hemodynamic responses to orthostatic challenges after shuttle missions. The purpose of this present project is to validate bioimpedance as a means to acquire stroke volume and other hemodynamic information in these studies. In this study, ten male and ten female subjects were subjected to simultaneous measurements of thoracic bioimpedance and Doppler ultrasonic velocimetry under supine, 10 degree head down and 30 degree head up conditions. Paired measurements were made during six periods of five seconds breath holding, over a two minute period, for each of the three positions. Stroke volume was calculated by three bioimpedance techniques and ultrasonic Doppler.

  13. Evaluating the effect of emergency residency training on productivity in the emergency department.

    PubMed

    Henning, Daniel J; McGillicuddy, Daniel C; Sanchez, Leon D

    2013-09-01

    Resident productivity, defined as patients seen per unit time, is one measure that is used to assess the performance and educational progress of residents in the emergency department (ED). One published study suggested that emergency residency training (EM) does not improve productivity compared with that in other specialties, including internal medicine (IM). This study assesses how EM and IM trainees perform in the ED and illustrates how resident productivity changes through the academic year. A retrospective review of attending physicians and residents working 8-h shifts in the higher acuity zone of a large-volume, tertiary, academic health care center was performed for July 2009, October 2009, January 2010, and April 2010. The total number of patients seen primarily and admitted during each shift was recorded. ED volume was approximated by the number of patients seen by the attending physician, and acuity was approximated by admission rate. A mixed model regression assessed the impact of year and type of residency training (e.g., EM1, EM2, IM1, and IM2), ED volume, and acuity on resident productivity (number of patients per shift). The study was granted waiver of informed consent by our institutional review board. We reviewed 936 shifts. After adjusting for acuity and ED volume, the EM1 group had a significant increase in patients per shift over the year, from 6.11 in July to 10.3 in April (p < 0.001). No other group increased productivity significantly. The first EM training year leads to a significant change in productivity that separates EM from IM residents. This contradicts the previous assertion that non-EM residents have the same productivity as EM residents in the ED. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Effect of Maturation of the Magnitude of Mechanosensitive and Chemosensitive Reflexes in the Premature Human Esophagus

    PubMed Central

    Jadcherla, Sudarshan Rao; Hoffmann, Raymond G.; Shaker, Reza

    2014-01-01

    Objectives To investigate the effect of esophageal mechanosensitive and chemosensitive stimulation on the magnitude and recruitment of peristaltic reflexes and upper esophageal sphincter (UES)-contractile reflex in premature infants. Study design Esophageal manometry and provocation testing were performed in the same 18 neonates at 33 and 36 weeks postmenstrual age (PMA). Mechanoreceptor and chemoreceptor stimulation were performed using graded volumes of air, water, and apple juice (pH 3.7), respectively. The frequency and magnitude of the resulting esophago-deglutition response (EDR) or secondary peristalsis (SP), and esophago-UES-contractile reflex (EUCR) were quantified. Results Threshold volumes to evoke EDR, SP, or EUCR were similar. The recruitment and magnitude of SP and EUCR increased with volume increments of air and water in either study (P < .05). However, apple juice infusions resulted in increased recruitment of EDR in the 33 weeks group (P < .05), and SP in the 36 weeks group (P < .05). The magnitude of EUCR was also volume responsive (all media, P < .05), and significant differences between media were noted (P < .05). At maximal stimulation (1 mL, all media), sensory-motor characteristics of peristaltic and EUCR reflexes were different (P < .05) between media and groups. Conclusions Mechano- and chemosensitive stimuli evoke volume-dependent specific peristaltic and UES reflexes at 33 and 36 weeks PMA. The recruitment and magnitude of these reflexes are dependent on the physicochemical properties of the stimuli in healthy premature infants. PMID:16860132

  15. Influence of radiofrequency surgery on architecture of the palatine tonsils.

    PubMed

    Plzak, Jan; Macokova, Pavla; Zabrodsky, Michal; Kastner, Jan; Lastuvka, Petr; Astl, Jaromir

    2014-01-01

    Radiofrequency surgery is a widely used modern technique for submucosal volume reduction of the tonsils. So far there is very limited information on morphologic changes in the human tonsils after radiofrequency surgery. We performed histopathological study of tonsillectomy specimens after previous bipolar radiofrequency induced thermotherapy (RFITT). A total of 83 patients underwent bipolar RFITT for hypertrophy of palatine tonsils. Tonsil volume reduction was measured by 3D ultrasonography. Five patients subsequently underwent tonsillectomy. Profound histopathological examination was performed to determine the effect of RFITT on tonsillar architecture. All tonsillectomy specimens showed the intact epithelium, intact germinal centers, normal vascularization, and no evidence of increased fibrosis. No microscopic morphological changes in tonsillectomy specimens after bipolar RFITT were observed. RFITT is an effective submucosal volume reduction procedure for treatment of hypertrophic palatine tonsils with no destructive effect on microscopic tonsillar architecture and hence most probably no functional adverse effect.

  16. Scattering volume in the collective Thomson scattering measurement using high power gyrotron in the LHD

    NASA Astrophysics Data System (ADS)

    Kubo, S.; Nishiura, M.; Tanaka, K.; Moseev, D.; Ogasawara, S.; Shimozuma, T.; Yoshimura, Y.; Igami, H.; Takahashi, H.; Tsujimura, T. I.; Makino, R.

    2016-06-01

    High-power gyrotrons prepared for the electron cyclotron heating at 77 GHz has been used for a collective Thomson scattering (CTS) study in LHD. Due to the difficulty in removing fundamental and/or second harmonic resonance in the viewing line of sight, the subtraction of the background ECE from measured signal was performed by modulating the probe beam power from a gyrotron. The separation of the scattering component from the background has been performed successfully taking into account the response time difference between both high-energy and bulk components. The other separation was attempted by fast scanning the viewing beam across the probing beam. It is found that the intensity of the scattered spectrum corresponding to the bulk and high energy components were almost proportional to the calculated scattering volume in the relatively low density region, while appreciable background scattered component remains even in the off volume in some high density cases. The ray-trace code TRAVIS is used to estimate the change in the scattering volume due to probing and receiving beam deflection effect.

  17. Correlation of Electrolyte Volume and Electrochemical Performance in Lithium-Ion Pouch Cells with Graphite Anodes and NMC532 Cathodes

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

    An, Seong Jin; Li, Jianlin; Mohanty, Debasish

    2017-01-01

    The work herein reports on studies aimed at exploring the correlation between electrolyte volume and electrochemical performance of full cell, pouch-cells consisting of graphite/ Li 1.02Ni 0.50Mn 0.29Co 0.19O 2 (NMC-532) as the electrodes and 1.2 M LiPF6 in ethylene carbonate:ethylmethyl carbonate (EC:EMC) as the electrolyte. It is demonstrated that a minimum electrolyte volume factor of 1.9 times the total pore volume of cell components (cathode, anode, and separator) is needed for long-term cyclability and low impedance. Less electrolyte results in an increase of the measured ohmic resistances. Increased resistance ratios for charge transfer and passivation layers at cathode, relativemore » to initial values, were 1.5–2.0 after 100 cycles. At the cathode, the resistance from charge transfer was 2–3 times higher than for passivation layers. Differential voltage analysis showed that anodes were less delithiated after discharging as the cells were cycled.« less

  18. Correlation of Electrolyte Volume and Electrochemical Performance in Lithium-Ion Pouch Cells with Graphite Anodes and NMC532 Cathodes

    DOE PAGES

    An, Seong Jin; Li, Jianlin; Mohanty, Debasish; ...

    2017-04-07

    The work herein reports on studies aimed at exploring the correlation between electrolyte volume and electrochemical performance of full cell, pouch-cells consisting of graphite/ Li 1.02Ni 0.50Mn 0.29Co 0.19O 2 (NMC-532) as the electrodes and 1.2 M LiPF 6 in ethylene carbonate:ethylmethyl carbonate (EC:EMC) as the electrolyte. In addition, it is demonstrated that a minimum electrolyte volume factor of 1.9 times the total pore volume of cell components (cathode, anode, and separator) is needed for long-term cyclability and low impedance. Less electrolyte results in an increase of the measured Ohmic resistances. Increased resistance ratios for charge transfer and passivation layersmore » at cathode, relative to initial values, were 1.5 2.0 after 100 cycles. At the cathode, the resistance from charge transfer was 2-3 times higher than for passivation layers. Lastly, differential voltage analysis showed that anodes were less delithiated after discharging as the cells were cycled.« less

  19. Inlet Diameter and Flow Volume Effects on Separation and Energy Efficiency of Hydrocyclones

    NASA Astrophysics Data System (ADS)

    Erikli, Ş.; Olcay, A. B.

    2015-08-01

    This study investigates hydrocyclone performance of an oil injected screw compressor. Especially, the oil separation efficiency of a screw compressor plays a significant role for air quality and non-stop working hour of compressors has become an important issue when the efficiency in energy is considered. In this study, two separation efficiency parameters were selected to be hydrocyclone inlet diameter and flow volume height between oil reservoir surface and top of the hydrocyclone. Nine different cases were studied in which cyclone inlet diameter and flow volume height between oil reservoir surface and top were investigated in regards to separation and energy performance aspects and the effect of the parameters on the general performance appears to be causing powerful influence. Flow inside the hydrocyclone geometry was modelled by Reynolds Stress Model (RSM) and hydro particles were tracked by Discrete Phase Model (DPM). Besides, particle break up was modelled by the Taylor Analogy Breakup (TAB) model. The reversed vortex generation was observed at different planes. The upper limit of the inlet diameter of the cyclone yields the centrifugal force on particles to decrease while the flow becomes slower; and the larger diameter implies slower flow. On the contrary, the lower limit is increment in speed causes breakup problems that the particle diameters become smaller; consequently, it is harder to separate them from gas.

  20. Development of an analytical method for crystalline content determination in amorphous solid dispersions produced by hot-melt extrusion using transmission Raman spectroscopy: A feasibility study.

    PubMed

    Netchacovitch, L; Dumont, E; Cailletaud, J; Thiry, J; De Bleye, C; Sacré, P-Y; Boiret, M; Evrard, B; Hubert, Ph; Ziemons, E

    2017-09-15

    The development of a quantitative method determining the crystalline percentage in an amorphous solid dispersion is of great interest in the pharmaceutical field. Indeed, the crystalline Active Pharmaceutical Ingredient transformation into its amorphous state is increasingly used as it enhances the solubility and bioavailability of Biopharmaceutical Classification System class II drugs. One way to produce amorphous solid dispersions is the Hot-Melt Extrusion (HME) process. This study reported the development and the comparison of the analytical performances of two techniques, based on backscattering and transmission Raman spectroscopy, determining the crystalline remaining content in amorphous solid dispersions produced by HME. Principal Component Analysis (PCA) and Partial Least Squares (PLS) regression were performed on preprocessed data and tended towards the same conclusions: for the backscattering Raman results, the use of the DuoScan™ mode improved the PCA and PLS results, due to a larger analyzed sampling volume. For the transmission Raman results, the determination of low crystalline percentages was possible and the best regression model was obtained using this technique. Indeed, the latter acquired spectra through the whole sample volume, in contrast with the previous surface analyses performed using the backscattering mode. This study consequently highlighted the importance of the analyzed sampling volume. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Optical designs for MWIR and four quadrant detectors by using beam steering methods in missile applications

    NASA Astrophysics Data System (ADS)

    Sakarya, Doǧan Uǧur

    2017-10-01

    Beam steering optical arrangement needs less volume envelope for same field of regard than other gimbal approaches. Both for imaging and four quadrant missile applications, volume is critical parameter limiting system performance. Therefore, a conceptual design of beam steering method has been focused on both imaging and four quadrant missiles. In this study; four different optical designs have been made by using both beam steering and regular method for mid-wave infra-red imaging and four quadrant systems. Optical designs performances have been illustrated in simulation results. By using manufactured Risley prisms, some experimental results are conducted to compare simulations results.

  2. Evaluation of Military Field-Water Quality. Volume 8. Performance of Mobile Water-Purification Unit (MWPU) and Pretreatment Components of the 600-GPH Reverse Osmosis Water Purification Unit (ROWPU), and Consideration of Reverse Osmosis (RO) Bypass, Potable-Water Disinfection, and Water-Quality Analysis Techniques

    DTIC Science & Technology

    1990-05-01

    Health Risks in Potential Theaters of Operation for U.S. Military Forces. The nine volumes of this study contain a comprehensive assessment of the chemical...module. The percentage of total free chlorine ( hypochlorous acid , HOCl) plus hypochlorlte ion (OClN), measured by the Model 453 membrane sensor, varies...between the performances of the 600-Sph Reverse Osmosis Water Purification Unit (ROWPU) operated in the bypass node and ’the Mobile Water Purification

  3. Comparing Laser Welding Technologies with Friction Stir Welding for Production of Aluminum Tailor-Welded Blanks

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

    Hovanski, Yuri; Carsley, John; Carlson, Blair

    2014-01-15

    A comparison of welding techniques was performed to determine the most effective method for producing aluminum tailor-welded blanks for high volume automotive applications. Aluminum sheet was joined with an emphasis on post weld formability, surface quality and weld speed. Comparative results from several laser based welding techniques along with friction stir welding are presented. The results of this study demonstrate a quantitative comparison of weld methodologies in preparing tailor-welded aluminum stampings for high volume production in the automotive industry. Evaluation of nearly a dozen welding variations ultimately led to down selecting a single process based on post-weld quality and performance.

  4. Automated Segmentation of Kidneys from MR Images in Patients with Autosomal Dominant Polycystic Kidney Disease

    PubMed Central

    Kim, Youngwoo; Ge, Yinghui; Tao, Cheng; Zhu, Jianbing; Chapman, Arlene B.; Torres, Vicente E.; Yu, Alan S.L.; Mrug, Michal; Bennett, William M.; Flessner, Michael F.; Landsittel, Doug P.

    2016-01-01

    Background and objectives Our study developed a fully automated method for segmentation and volumetric measurements of kidneys from magnetic resonance images in patients with autosomal dominant polycystic kidney disease and assessed the performance of the automated method with the reference manual segmentation method. Design, setting, participants, & measurements Study patients were selected from the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease. At the enrollment of the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease Study in 2000, patients with autosomal dominant polycystic kidney disease were between 15 and 46 years of age with relatively preserved GFRs. Our fully automated segmentation method was on the basis of a spatial prior probability map of the location of kidneys in abdominal magnetic resonance images and regional mapping with total variation regularization and propagated shape constraints that were formulated into a level set framework. T2–weighted magnetic resonance image sets of 120 kidneys were selected from 60 patients with autosomal dominant polycystic kidney disease and divided into the training and test datasets. The performance of the automated method in reference to the manual method was assessed by means of two metrics: Dice similarity coefficient and intraclass correlation coefficient of segmented kidney volume. The training and test sets were swapped for crossvalidation and reanalyzed. Results Successful segmentation of kidneys was performed with the automated method in all test patients. The segmented kidney volumes ranged from 177.2 to 2634 ml (mean, 885.4±569.7 ml). The mean Dice similarity coefficient ±SD between the automated and manual methods was 0.88±0.08. The mean correlation coefficient between the two segmentation methods for the segmented volume measurements was 0.97 (P<0.001 for each crossvalidation set). The results from the crossvalidation sets were highly comparable. Conclusions We have developed a fully automated method for segmentation of kidneys from abdominal magnetic resonance images in patients with autosomal dominant polycystic kidney disease with varying kidney volumes. The performance of the automated method was in good agreement with that of manual method. PMID:26797708

  5. Automated Segmentation of Kidneys from MR Images in Patients with Autosomal Dominant Polycystic Kidney Disease.

    PubMed

    Kim, Youngwoo; Ge, Yinghui; Tao, Cheng; Zhu, Jianbing; Chapman, Arlene B; Torres, Vicente E; Yu, Alan S L; Mrug, Michal; Bennett, William M; Flessner, Michael F; Landsittel, Doug P; Bae, Kyongtae T

    2016-04-07

    Our study developed a fully automated method for segmentation and volumetric measurements of kidneys from magnetic resonance images in patients with autosomal dominant polycystic kidney disease and assessed the performance of the automated method with the reference manual segmentation method. Study patients were selected from the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease. At the enrollment of the Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease Study in 2000, patients with autosomal dominant polycystic kidney disease were between 15 and 46 years of age with relatively preserved GFRs. Our fully automated segmentation method was on the basis of a spatial prior probability map of the location of kidneys in abdominal magnetic resonance images and regional mapping with total variation regularization and propagated shape constraints that were formulated into a level set framework. T2-weighted magnetic resonance image sets of 120 kidneys were selected from 60 patients with autosomal dominant polycystic kidney disease and divided into the training and test datasets. The performance of the automated method in reference to the manual method was assessed by means of two metrics: Dice similarity coefficient and intraclass correlation coefficient of segmented kidney volume. The training and test sets were swapped for crossvalidation and reanalyzed. Successful segmentation of kidneys was performed with the automated method in all test patients. The segmented kidney volumes ranged from 177.2 to 2634 ml (mean, 885.4±569.7 ml). The mean Dice similarity coefficient ±SD between the automated and manual methods was 0.88±0.08. The mean correlation coefficient between the two segmentation methods for the segmented volume measurements was 0.97 (P<0.001 for each crossvalidation set). The results from the crossvalidation sets were highly comparable. We have developed a fully automated method for segmentation of kidneys from abdominal magnetic resonance images in patients with autosomal dominant polycystic kidney disease with varying kidney volumes. The performance of the automated method was in good agreement with that of manual method. Copyright © 2016 by the American Society of Nephrology.

  6. The Effect of Clearance Distribution on the Performance of a Compression-ignition Engine with a Precombustion Chamber

    NASA Technical Reports Server (NTRS)

    Moore, C. S.; Collins, J. H. Jr

    1932-01-01

    The clearance distribution in a precombustion chamber cylinder head was varied so that for a constant compression ratio of 13.5 the spherical auxiliary chambers contained 20, 35, 50, and 70 per cent of the total clearance volume. Each chamber was connected to the cylinder by a single circular passage, flared at both ends, and of a cross-sectional area proportional to the chamber volume, thereby giving the same calculated air-flow velocity through each passage. Results of engine-performance tests are presented with variations of power, fuel consumption, explosion pressure, rate of pressure rise, ignition lag, heat loss to the cooling water, and motoring characteristics. For good performance the minimum auxiliary chamber volume, with the cylinder head design used, was 35 per cent of the total clearance volume; for larger volumes the performance improves but slightly. With the auxiliary chamber that contained 35 percent of the clearance volume there were obtained the lowest explosion pressures, medium rates of pressure rise, and slightly less than the maximum power. For all clearance distributions an increase in engine speed decreased the ignition lag in seconds and increased the rate of pressure rise.

  7. Correlation between CT-based measured renal volumes and nuclear-renography-based split renal function in living kidney donors. Clinical diagnostic utility and practice patterns.

    PubMed

    Diez, Alejandro; Powelson, John; Sundaram, Chandru P; Taber, Tim E; Mujtaba, Muhammad A; Yaqub, Muhammad S; Mishler, Dennis P; Goggins, William C; Sharfuddin, Asif A

    2014-06-01

    Living donor evaluation involves imaging to determine the choice of kidney for nephrectomy. Our aim was to study the diagnostic accuracy and correlation between CT-based volume measurements and split renal function (SRF) as measured by nuclear renography in potential living donors and its impact on kidney selection decision. We analyzed 190 CT-based volume measurements in healthy donors, of which 65 donors had a radionuclide study performed to determine SRF. There were no differences in demographics, anthropometric measurements, total volumes, eGFR, creatinine clearances between those who required a nuclear scan and those who did not. There was a significant correlation between CT-volume-measurement-based SRF and nuclear-scan-based SRF (Pearson coefficient r 0.59; p < 0.001). Furthermore, selective nuclear-based SRF allowed careful selection of donor nephrectomy, leaving the donor with the higher functioning kidney in most cases. There was also a significantly higher number of right-sided nephrectomies selected after nuclear-based SRF studies. CT-based volume measurements in living donor imaging have sufficient correlation with nuclear-based SRF. Selective use of nuclear-scan-based SRF allows careful selection for donor nephrectomy. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Long-Term Treatment with Paroxetine Increases Verbal Declarative Memory and Hippocampal Volume in Posttraumatic Stress Disorder

    PubMed Central

    Vermetten, Eric; Vythilingam, Meena; Southwick, Steven M.; Charney, Dennis S.; Bremner, J. Douglas

    2011-01-01

    Background Animal studies have shown that stress is associated with damage to the hippocampus, inhibition of neurogenesis, and deficits in hippocampal-based memory dysfunction. Studies in patients with posttraumatic stress disorder (PTSD) found deficits in hippocampal-based declarative verbal memory and smaller hippocampal volume, as measured with magnetic resonance imaging (MRI). Recent preclinical evidence has shown that selective serotonin reuptake inhibitors promote neurogenesis and reverse the effects of stress on hippocampal atrophy. This study assessed the effects of long-term treatment with paroxetine on hippocampal volume and declarative memory performance in PTSD. Methods Declarative memory was assessed with the Wechsler Memory Scale–Revised and Selective Reminding Test before and after 9–12 months of treatment with paroxetine in PTSD. Hippocampal volume was measured with MRI. Of the 28 patients who started the protocol, 23 completed the full course of treatment and neuropsychological testing. Twenty patients were able to complete MRI imaging. Results Patients with PTSD showed a significant improvement in PTSD symptoms with treatment. Treatment resulted in significant improvements in verbal declarative memory and a 4.6% increase in mean hippocampal volume. Conclusions These findings suggest that long-term treatment with paroxetine is associated with improvement of verbal declarative memory deficits and an increase in hippocampal volume in PTSD. PMID:14512209

  9. Chronic Use of Aspirin and Total White Matter Lesion Volume: Results from the Women's Health Initiative Memory Study of Magnetic Resonance Imaging Study.

    PubMed

    Holcombe, Andrea; Ammann, Eric; Espeland, Mark A; Kelley, Brendan J; Manson, JoAnn E; Wallace, Robert; Robinson, Jennifer

    2017-10-01

    To investigate the relationship between aspirin and subclinical cerebrovascular heath, we evaluated the effect of chronic aspirin use on white matter lesions (WML) volume among women. Chronic aspirin use was assessed in 1365 women who participated in the Women's Health Initiative Memory Study of Magnetic Resonance Imaging. Differences in WML volumes between aspirin users and nonusers were assessed with linear mixed models. A number of secondary analyses were performed, including lobe-specific analyses, subgroup analyses based on participants' overall risk of cerebrovascular disease, and a dose-response relationship analysis. The mean age of the women at magnetic resonance imaging examination was 77.6 years. Sixty-one percent of participants were chronic aspirin users. After adjusting for demographic variables and comorbidities, chronic aspirin use was nonsignificantly associated with 4.8% (95% CI: -6.8%, 17.9%) larger WML volumes. These null findings were confirmed in secondary and sensitivity analyses, including an active comparator evaluation where aspirin users were compared to users of nonaspirin nonsteroidal anti-inflammatory drugs or acetaminophen. There was a nonsignificant difference in WML volumes between aspirin users and nonusers. Further, our results suggest that chronic aspirin use may not have a clinically significant effect on WML volumes in women. Published by Elsevier Inc.

  10. Active Learning Improves Student Performance in a Respiratory Physiology Lab

    ERIC Educational Resources Information Center

    Wolf, Alex M.; Liachovitzky, Carlos; Abdullahi, Abass S.

    2015-01-01

    This study assessed the effectiveness of the introduction of active learning exercises into the anatomy and physiology curriculum in a community college setting. Specifically, the incorporation of a spirometry-based respiratory physiology lab resulted in improved student performance in two concepts (respiratory volumes and the hallmarks of…

  11. FIELD EVALUATION OF LOW-EMISSION COAL BURNER TECHNOLOGY ON UTILITY BOILERS. VOLUME I. DISTRIBUTED MIXING BURNER EVALUATION

    EPA Science Inventory

    The report gives results of a study in which NOx emissions and general combustion performance characteristics of four burners were evaluated under experimental furnace conditions. Of primary interest was the performance of a low NOx Distributed Mixing Burner (DMB), which was test...

  12. Highway concrete pavement technology development and testing : volume III, field evaluation of Strategic Highway Research Program (SHRP) C-205 test sites (high-performance concrete).

    DOT National Transportation Integrated Search

    2006-05-01

    This research study, sponsored by the Federal Highway Administration, summarizes the field performance of eight high-early-strength (HES) : concrete patches between 1994 and 1998. The patches were constructed under the Strategic Highway Research Prog...

  13. Conservation Reasoning Ability and Performance on BSCS Blue Version Examinations

    ERIC Educational Resources Information Center

    Lawson, Anton E.; Nordland, Floyd H.

    1977-01-01

    Twenty-three high school biology students using the Biological Sciences Curriculum Study (BSCS) Blue Textbook were administered a weight conservation and two volume conservation tasks. A majority performed below formal-operational level, indicating that these students would be likely to encounter difficuluty with BSCS Blue Version materials. (MLH)

  14. Integration of Intention and Outcome for Moral Judgment in Frontotemporal Dementia: Brain Structural Signatures.

    PubMed

    Baez, Sandra; Kanske, Philipp; Matallana, Diana; Montañes, Patricia; Reyes, Pablo; Slachevsky, Andrea; Matus, Cristian; Vigliecca, Nora Silvana; Torralva, Teresa; Manes, Facundo; Ibanez, Agustin

    2016-01-01

    Moral judgment has been proposed to rely on a distributed brain network. This function is impaired in behavioral variant frontotemporal dementia (bvFTD), a condition involving damage to some regions of this network. However, no studies have investigated moral judgment in bvFTD via structural neuroimaging. We compared the performance of 21 bvFTD patients and 19 controls on a moral judgment task involving scenarios that discriminate between the contributions of intentions and outcomes. Voxel-based morphometry was used to assess (a) the atrophy pattern in bvFTD patients, (b) associations between gray matter (GM) volume and moral judgments, and (c) structural differences between bvFTD subgroups (patients with relatively preserved moral judgment and patients with severer moral judgment impairments). Patients judged attempted harm as more permissible and accidental harm as less permissible than controls. The groups' performance on accidental harm was associated with GM volume in the precuneus. In controls, it was al- so associated with the ventromedial prefrontal cortex (VMPFC). Also, both groups' performance on attempted harm was associated with GM volume in the temporoparietal junction. Patients exhibiting worse performance displayed smaller GM volumes in the precuneus and temporal pole. Results suggest that moral judgment abnormalities in bvFTD are associated with impaired integration of intentions and outcomes, which depends on an extended brain network. In bvFTD, moral judgment seems to critically depend on areas beyond the VMPFC. © 2016 S. Karger AG, Basel.

  15. Accuracy of cancellous bone volume fraction measured by micro-CT scanning.

    PubMed

    Ding, M; Odgaard, A; Hvid, I

    1999-03-01

    Volume fraction, the single most important parameter in describing trabecular microstructure, can easily be calculated from three-dimensional reconstructions of micro-CT images. This study sought to quantify the accuracy of this measurement. One hundred and sixty human cancellous bone specimens which covered a large range of volume fraction (9.8-39.8%) were produced. The specimens were micro-CT scanned, and the volume fraction based on Archimedes' principle was determined as a reference. After scanning, all micro-CT data were segmented using individual thresholds determined by the scanner supplied algorithm (method I). A significant deviation of volume fraction from method I was found: both the y-intercept and the slope of the regression line were significantly different from those of the Archimedes-based volume fraction (p < 0.001). New individual thresholds were determined based on a calibration of volume fraction to the Archimedes-based volume fractions (method II). The mean thresholds of the two methods were applied to segment 20 randomly selected specimens. The results showed that volume fraction using the mean threshold of method I was underestimated by 4% (p = 0.001), whereas the mean threshold of method II yielded accurate values. The precision of the measurement was excellent. Our data show that care must be taken when applying thresholds in generating 3-D data, and that a fixed threshold may be used to obtain reliable volume fraction data. This fixed threshold may be determined from the Archimedes-based volume fraction of a subgroup of specimens. The threshold may vary between different materials, and so it should be determined whenever a study series is performed.

  16. Reference data on muscle volumes of healthy human pelvis and lower extremity muscles: an in vivo magnetic resonance imaging feasibility study.

    PubMed

    Lube, Juliane; Cotofana, Sebastian; Bechmann, Ingo; Milani, Thomas L; Özkurtul, Orkun; Sakai, Tatsuo; Steinke, Hanno; Hammer, Niels

    2016-01-01

    Muscle volumes are of crucial interest when attempting to analyze individual physical performance and disease- or age-related alterations in muscle morphology. However, very little reference data are available in the literature on pelvis and lower extremity muscle volumes originating from healthy and young individuals. Furthermore, it is of interest if representative muscle volumes, covering large anatomical regions, can be obtained using magnetic resonance imaging (MRI) in a setting similar to the clinical routine. Our objective was therefore to provide encompassing, bilateral, 3-T MRI-based datasets on muscle volumes of the pelvis and the lower limb muscles. T1-weighted 3-T MRI records were obtained bilaterally from six young and healthy participants. Three-dimensional volumes were compiled from 28 muscles and muscle groups of each participant before the muscle volumes were computed. Muscle volumes were obtained from 28 muscles and muscle groups of the pelvis and lower extremity. Volumes were larger in male than in female participants. Volumes of the dominant and non-dominant sides were similar in both genders. The obtained results were in line with volumetric data obtained from smaller anatomical areas, thus extending the available datasets. This study provides an encompassing and feasible approach to obtain data on the muscle volumes of pelvic and limb muscles of healthy, young, and physically active individuals. The respective data form a basis to determine effects of therapeutic approaches, progression of diseases, or technical applications like automated segmentation algorithms applied to different populations.

  17. Total target volume is a better predictor of whole brain dose from gamma stereotactic radiosurgery than the number, shape, or location of the lesions

    PubMed Central

    Narayanasamy, Ganesh; Smith, Adam; Van Meter, Emily; McGarry, Ronald; Molloy, Janelle A.

    2013-01-01

    Purpose: To assess the hypothesis that the volume of whole brain that receives a certain dose level is primarily dependent on the treated volume rather than on the number, shape, or location of the lesions. This would help a physician validate the suitability of GammaKnife® based stereotactic radiosurgery (GKSR) prior to treatment. Methods: Simulation studies were performed to establish the hypothesis for both oblong and spherical shaped lesions of various numbers and sizes. Forty patients who underwent GKSR [mean age of 54 years (range 7–80), mean number of lesions of 2.5 (range 1–6), and mean lesion volume of 4.4 cm3 (range 0.02–22.2 cm3)] were also studied retrospectively. Following recommendations of QUANTEC, the volume of brain irradiated by the 12 Gy (VB12) isodose line was measured and a power-law based relation is proposed here for estimating VB12 from the known tumor volume and the prescription dose. Results: In the simulation study on oblong, spherical, and multiple lesions, the volume of brain irradiated by 50%, 10%, and 1% of maximum dose was found to have linear, linear, and exponentially increasing dependence on the volume of the treated region, respectively. In the retrospective study on 40 GKSR patients, a similar relationship was found to predict the brain dose with a Spearman correlation coefficient >0.9. In both the studies, the volume of brain irradiated by a certain dose level does not have a statistically significant relationship (p ≥ 0.05) with the number, shape, or position of the lesions. The measured VB12 agrees with calculation to within 1.7%. Conclusions: The results from the simulation and the retrospective clinical studies indicate that the volume of whole brain that receives a certain percentage of the maximum dose is primarily dependent on the treated volume and less on the number, shape, and location of the lesions. PMID:24007147

  18. Learning of serial digits leads to frontal activation in functional MR imaging.

    PubMed

    Karakaş, Hakki Muammer; Karakaş, Sirel

    2006-03-01

    Clinical studies have shown that performance on the serial digit learning test (SDLT) is dependent upon the mesial temporal lobes, which are responsible for learning and its consolidation. However, an effective SDLT performance is also dependent upon sequencing, temporal ordering, and the utilization of mnemonic strategies. All of these processes are among the functions of the frontal lobes; in spite of this, the relationship between SDLT performance and the frontal lobes has not been demonstrated with previously used mapping techniques. The aim of this study was to investigate the areas of the brain that are activated by SDLT performance. Ten healthy, right handed volunteers (mean age, 20.1 years; SD: 3.3) who had 12 years of education were studied with a 1.0 T MR imaging scanner. BOLD (blood oxygen level dependent) contrast and a modified SDLT were used. Activated loci were automatically mapped using a proportional grid. In learning, the most consistent activation was observed in B-a-7 of the right (80%) and the left hemispheres (50%). In recall, the most consistent activation was observed in B-a-7 of the right hemisphere (60%). Activations were observed in 2.5+/-0.97 Talairach volumes in learning, whereas they encompassed 1.7+/-0.95 volumes in recall. The difference between both phases (learning and recall) regarding total activated volume was significant (p < 0.05). The prefrontal activation during SDLT performance was not related to learning or to recall, but to a function that is common to both of these cognitive processes. A candidate for this common factor may be the executive functions, which also include serial position processing and temporal ordering.

  19. European cardiovascular nurses' and allied professionals' knowledge and practical skills regarding cardiopulmonary resuscitation.

    PubMed

    Pettersen, Trond R; Mårtensson, Jan; Axelsson, Åsa; Jørgensen, Marianne; Strömberg, Anna; Thompson, David R; Norekvål, Tone M

    2018-04-01

    Cardiopulmonary resuscitation (CPR) remains a cornerstone in the treatment of cardiac arrest, and is directly linked to survival rates. Nurses are often first responders and need to be skilled in the performance of cardiopulmonary resuscitation. As cardiopulmonary resuscitation skills deteriorate rapidly, the purpose of this study was to investigate whether there was an association between participants' cardiopulmonary resuscitation training and their practical cardiopulmonary resuscitation test results. This comparative study was conducted at the 2014 EuroHeartCare meeting in Stavanger ( n=133) and the 2008 Spring Meeting on Cardiovascular Nursing in Malmö ( n=85). Participants performed cardiopulmonary resuscitation for three consecutive minutes CPR training manikins from Laerdal Medical®. Data were collected with a questionnaire on demographics and participants' level of cardiopulmonary resuscitation training. Most participants were female (78%) nurses (91%) from Nordic countries (77%), whose main role was in nursing practice (63%), and 71% had more than 11 years' experience ( n=218). Participants who conducted cardiopulmonary resuscitation training once a year or more ( n=154) performed better regarding ventilation volume than those who trained less (859 ml vs. 1111 ml, p=0.002). Those who had cardiopulmonary resuscitation training offered at their workplace ( n=161) also performed better regarding ventilation volume (889 ml vs. 1081 ml, p=0.003) and compression rate per minute (100 vs. 91, p=0.04) than those who had not. Our study indicates a positive association between participants' performance on the practical cardiopulmonary resuscitation test and the frequency of cardiopulmonary resuscitation training and whether cardiopulmonary resuscitation training was offered in the workplace. Large ventilation volumes were the most common error at both measuring points.

  20. Muscle atrophy, voluntary activation disturbances, and low serum concentrations of IGF-1 and IGFBP-3 are associated with weakness in people with chronic stroke.

    PubMed

    Silva-Couto, Marcela de Abreu; Prado-Medeiros, Christiane Lanatovitz; Oliveira, Ana Beatriz; Alcântara, Carolina Carmona; Guimarães, Araci Teixeira; Salvini, Tania de Fatima; Mattioli, Rosana; de Russo, Thiago Luiz

    2014-07-01

    The muscle weakness that is exhibited poststroke is due to a multifactorial etiology involving the central nervous system and skeletal muscle changes. Insulinlike growth factor 1 (IGF-1) and IGF binding protein 3 (IGFBP-3) have been described as biomarkers of neuromuscular performance in many conditions. However, no information about these biomarkers is available for people with chronic hemiparesis. The purpose of this study was to investigate possible factors involved in muscle weakness, such as IGF-1 and IGFBP-3 serum concentrations, muscle volume, and neuromuscular performance of the knee flexors and extensors, in people with chronic hemiparesis poststroke. This was a cross-sectional study. A cross-sectional study was performed on 14 individuals poststroke who were paired with healthy controls. Mobility, function, balance, and quality of life were recorded as outcome measures. Knee flexor and extensor muscle volumes and neuromuscular performance were measured using nuclear magnetic resonance imaging, dynamometry, and electromyography. The serum concentrations of IGF-1 and IGFBP-3 were quantified by enzyme-linked immunosorbent assay (ELISA). The hemiparetic group had low serum concentrations of IGF-1 (25%) and IGFBP-3 (40%); reduced muscle volume in the vastus medialis (32%), vastus intermedius (29%), biceps femoris (16%), and semitendinosus and semimembranosus (12%) muscles; reduced peak torque, power, and work of the knee flexors and extensors; and altered agonist and antagonist muscle activation compared with controls. Low serum concentrations of IGF-1 and IGFBP-3, deficits in neuromuscular performance, selective muscle atrophy, and decreased agonist muscle activation were found in the group with chronic hemiparesis poststroke. Both hemorrhagic and ischemic stroke were considered, and the data reflect a chronic poststroke population with good function. © 2014 American Physical Therapy Association.

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