Effect of patient position on the lordosis and scoliosis of patients with degenerative lumbar scoliosis.

PubMed

Fei, Han; Li, Wei-Shi; Sun, Zhuo-Ran; Jiang, Shuai; Chen, Zhong-Qiang

2017-08-01

This study aimed to analyze the effect of patient positions on the lordosis and scoliosis of patients with degenerative lumbar scoliosis (DLS).Seventy-seven patients with DLS were retrospectively analyzed. We measured lordosis and Cobb's angle on preoperative upright x-rays and magnetic resonance imagings in supine position. The lordosis and scoliosis of surgical segments in intraoperative prone position were measured on intraoperative radiographs of 20 patients to compare with that in standing position. Paired t tests were performed to investigate the parameters of the sample.From standing to supine position the whole lordosis increased (29.2 ± 15.7 degree vs. 34.9 ± 11.2 degree), and the whole scoliosis decreased (24.3 ± 11.8 degree vs. 19.0 ± 10.5 degree); 53 of 77 (68.8%) cases had increased lordosis, and 67 of 77 (87%) cases had decreased scoliosis. The lordosis of surgical segments in standing position had no difference with that in intraoprerative prone position. But in changing from supine/standing position to intraoprerative prone position, the scoliosis of surgical segments decreased (14.7 ± 9.4 degree vs. 11.4 ± 7.0 degree; 19.0 ± 11.8 degree vs. 11.4 ± 7.0 degree, respectively), and 18 of 20 (90%) cases had decreased scoliosis in intraoperative prone position than that in standing position.Compared with standing position in DLS patients, supine position increased lordosis and reduced scoliosis, and intraoperative prone position reduced scoliosis significantly. When evaluating the severity of DLS and making preoperative surgical plans, lumbar lordosis in supine position should also be evaluated in addition to upright x-ray, and the effects of different positions should be taken into consideration to reduce deviation.

Boredom proneness: its relationship to positive and negative affect.

PubMed

Vodanovich, S J; Verner, K M; Gilbride, T V

1991-12-01

170 undergraduate students completed the Boredom Proneness Scale by Farmer and Sundberg and the Multiple Affect Adjective Checklist by Zuckerman and Lubin. Significant negative relationships were found between boredom proneness and negative affect scores (i.e., Depression, Hostility, Anxiety). Significant positive correlations also obtained between boredom proneness and positive affect (i.e., Positive Affect, Sensation Seeking). The correlations between boredom proneness "subscales" and positive and negative affect were congruent with those obtained using total boredom proneness scores. Implications for counseling are discussed.

Isometric elbow extensors strength in supine- and prone-lying positions.

PubMed

Abdelzaher, Ibrahim E; Ababneh, Anas F; Alzyoud, Jehad M

2013-01-01

The purpose of this study was to compare isometric strength of elbow extensors measured in supine- and prone-lying positions at elbow flexion angles of 45 and 90 degrees. Twenty-two male subjects under single-blind procedures participated in the study. Each subject participated in both supine-lying and prone-lying measuring protocols. Calibrated cable tensiometer was used to measure isometric strength of the right elbow extensors and a biofeedback electromyography was used to assure no substitution movements from shoulder girdle muscles. The mean values of isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees were 11.1  ±  4.2 kg and 13.1  ±  4.6 kg, while those measured from prone-lying position were 9.9  ±  3.6 kg and 12  ±  4.2 kg, respectively. There is statistical significant difference between the isometric strength of elbow extensors measured from supine-lying position at elbow flexion angles of 45 and 90 degrees compared to that measured from prone-lying position (p  <  0.05). The results suggest that in manual muscle testing starting position can affect the isometric strength of elbow extensors since supine-lying starting position is better than prone-lying starting position.

Probabilistic multi-person localisation and tracking in image sequences

NASA Astrophysics Data System (ADS)

Klinger, T.; Rottensteiner, F.; Heipke, C.

2017-05-01

The localisation and tracking of persons in image sequences in commonly guided by recursive filters. Especially in a multi-object tracking environment, where mutual occlusions are inherent, the predictive model is prone to drift away from the actual target position when not taking context into account. Further, if the image-based observations are imprecise, the trajectory is prone to be updated towards a wrong position. In this work we address both these problems by using a new predictive model on the basis of Gaussian Process Regression, and by using generic object detection, as well as instance-specific classification, for refined localisation. The predictive model takes into account the motion of every tracked pedestrian in the scene and the prediction is executed with respect to the velocities of neighbouring persons. In contrast to existing methods our approach uses a Dynamic Bayesian Network in which the state vector of a recursive Bayes filter, as well as the location of the tracked object in the image, are modelled as unknowns. This allows the detection to be corrected before it is incorporated into the recursive filter. Our method is evaluated on a publicly available benchmark dataset and outperforms related methods in terms of geometric precision and tracking accuracy.

TU-H-CAMPUS-JeP2-01: Inter-Observer Delineation Comparison of Visible Glandular Breast Tissue On Magnetic Resonance Imaging and Computed Tomography (prone and Supine)

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

Pogson, EM; University of Wollongong, Wollongong, NSW; Liverpool and Macarthur Cancer Therapy Centres, Liverpool, NSW

2016-06-15

Purpose: Breast cancers predominantly arise from Glandular Breast Tissue (GBT). If the GBT can be treated effectively post-operatively utilising radiotherapy this may be adequate volumetric coverage for adjuvant breast radiotherapy. Adequate imaging of the GBT is necessary and will be assessed between MRI and CT modalities. GBT visualisation is acknowledged to be qualitatively superior on Magnetic Resonance Image (MRI) compared to Computed Tomography (CT), the current radiotherapy imaging standard, however this has not been quantitatively assessed. For radiotherapy purposes it is important that any treatment volume can be consistently defined between observers. This study investigates the consistency of CT andmore » MRI GBT contours for potential radiotherapy planning. Methods: Ten experts (9 breast radiation oncologists and 1 radiologist) contoured the extent of the visible GBT for 33 patients on MRI and CT (both without contrast), which was performed according to a contouring guideline in supine and prone patient positions. The GBT volume was not a conventional whole breast radiotherapy planning volume, but rather the extent of GBT that was indicated from the CT or MR imaging. Volumes were compared utilizing the dice similarity coefficient (DSC), kappa statistic, and Hausdorff Distances (HDs) to ascertain the modality that was most consistently volumed. Results: The inter-observer concordance was of substantial agreement (kappa above 0.6) for the CT supine, CT prone, MRI supine and MRI prone datasets. The MRI GBT volumes were larger than the CT GBT volumes (p<0.001). Inter-observer conformity was higher for CT than MRI, although the magnitude of this difference was small (VOI<0.04). Conformity between modalities (CT and MRI) was in agreement for both prone and supine, DSC=0.75. Prone GBT volumes were larger than supine for both MRI and CT. Conclusion: MRI improves the extent of GBT delineation. The role of MRI guided, GBT-targeted radiotherapy requires investigation in a clinical trial. This work was supported by a grant number APP1033237 from Cancer Australia and the National Breast Cancer Foundation.« less

Poster - 34: Clinical Implementation of Prone Breast Treatment

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

Jiang, Runqing; Fleming, Katrina; Kobeleva, Sofya

2016-08-15

Purpose: Prone breast treatment is used to reduce acute and late toxicities for large or pendulous breast patients. This study developed and implemented the clinical workflow of prone breast radiotherapy treatment. Methods: Varian kVue Access360™ Prone Breast Couchtop was used as prone breast board. The treatment planning (TP)is performed in Eclipse TP system. TP comparisons between supine deep inspiration breathing hold (DIBH) and prone breast; prone forward field-in-field (FinF) planning and inverse IMRT planning were performed and discussed. For the daily setup, breast coverage was assessed in the room using light field and MV imaging was used at day 1more » and weekly. Results: The first ten patients are CT scanned and planned both supine and prone. The coverage was all excellent for supine DIBH plan and prone breast plan. The plan in the prone position demonstrated improvements in lung sparing comparing to the DIBH plan. Both forward FinF plan and inverse IMRT plan achieved acceptable coverage of the breast, and heart dose is comparable. Considering the daily setup variations and MLC leakage, forward FinF plan was recommended for routine clinical use. The procedure has been tested in phantom and patients were treated clinically. Conclusions: Prone breast irradiation has been advocated for women with large pendulous breasts in order to decrease acute and late toxicities. The workflow for prone breast radiation therapy has been developed and the technique is ready to treat patients.« less

The Effect of Body Posture on Brain Glymphatic Transport.

PubMed

Lee, Hedok; Xie, Lulu; Yu, Mei; Kang, Hongyi; Feng, Tian; Deane, Rashid; Logan, Jean; Nedergaard, Maiken; Benveniste, Helene

2015-08-05

The glymphatic pathway expedites clearance of waste, including soluble amyloid β (Aβ) from the brain. Transport through this pathway is controlled by the brain's arousal level because, during sleep or anesthesia, the brain's interstitial space volume expands (compared with wakefulness), resulting in faster waste removal. Humans, as well as animals, exhibit different body postures during sleep, which may also affect waste removal. Therefore, not only the level of consciousness, but also body posture, might affect CSF-interstitial fluid (ISF) exchange efficiency. We used dynamic-contrast-enhanced MRI and kinetic modeling to quantify CSF-ISF exchange rates in anesthetized rodents' brains in supine, prone, or lateral positions. To validate the MRI data and to assess specifically the influence of body posture on clearance of Aβ, we used fluorescence microscopy and radioactive tracers, respectively. The analysis showed that glymphatic transport was most efficient in the lateral position compared with the supine or prone positions. In the prone position, in which the rat's head was in the most upright position (mimicking posture during the awake state), transport was characterized by "retention" of the tracer, slower clearance, and more CSF efflux along larger caliber cervical vessels. The optical imaging and radiotracer studies confirmed that glymphatic transport and Aβ clearance were superior in the lateral and supine positions. We propose that the most popular sleep posture (lateral) has evolved to optimize waste removal during sleep and that posture must be considered in diagnostic imaging procedures developed in the future to assess CSF-ISF transport in humans. The rodent brain removes waste better during sleep or anesthesia compared with the awake state. Animals exhibit different body posture during the awake and sleep states, which might affect the brain's waste removal efficiency. We investigated the influence of body posture on brainwide transport of inert tracers of anesthetized rodents. The major finding of our study was that waste, including Aβ, removal was most efficient in the lateral position (compared with the prone position), which mimics the natural resting/sleeping position of rodents. Although our finding awaits testing in humans, we speculate that the lateral position during sleep has advantage with regard to the removal of waste products including Aβ, because clinical studies have shown that sleep drives Aβ clearance from the brain. Copyright © 2015 the authors 0270-6474/15/3511034-11$15.00/0.

The Effect of Body Posture on Brain Glymphatic Transport

PubMed Central

Lee, Hedok; Xie, Lulu; Yu, Mei; Kang, Hongyi; Feng, Tian; Deane, Rashid; Logan, Jean; Nedergaard, Maiken

2015-01-01

The glymphatic pathway expedites clearance of waste, including soluble amyloid β (Aβ) from the brain. Transport through this pathway is controlled by the brain's arousal level because, during sleep or anesthesia, the brain's interstitial space volume expands (compared with wakefulness), resulting in faster waste removal. Humans, as well as animals, exhibit different body postures during sleep, which may also affect waste removal. Therefore, not only the level of consciousness, but also body posture, might affect CSF–interstitial fluid (ISF) exchange efficiency. We used dynamic-contrast-enhanced MRI and kinetic modeling to quantify CSF-ISF exchange rates in anesthetized rodents' brains in supine, prone, or lateral positions. To validate the MRI data and to assess specifically the influence of body posture on clearance of Aβ, we used fluorescence microscopy and radioactive tracers, respectively. The analysis showed that glymphatic transport was most efficient in the lateral position compared with the supine or prone positions. In the prone position, in which the rat's head was in the most upright position (mimicking posture during the awake state), transport was characterized by “retention” of the tracer, slower clearance, and more CSF efflux along larger caliber cervical vessels. The optical imaging and radiotracer studies confirmed that glymphatic transport and Aβ clearance were superior in the lateral and supine positions. We propose that the most popular sleep posture (lateral) has evolved to optimize waste removal during sleep and that posture must be considered in diagnostic imaging procedures developed in the future to assess CSF-ISF transport in humans. SIGNIFICANCE STATEMENT The rodent brain removes waste better during sleep or anesthesia compared with the awake state. Animals exhibit different body posture during the awake and sleep states, which might affect the brain's waste removal efficiency. We investigated the influence of body posture on brainwide transport of inert tracers of anesthetized rodents. The major finding of our study was that waste, including Aβ, removal was most efficient in the lateral position (compared with the prone position), which mimics the natural resting/sleeping position of rodents. Although our finding awaits testing in humans, we speculate that the lateral position during sleep has advantage with regard to the removal of waste products including Aβ, because clinical studies have shown that sleep drives Aβ clearance from the brain. PMID:26245965

SU-E-T-307: Dosimetric Comparison of Prone Versus Supine Positioning for Adjuvant Breast Radiation Therapy

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

Pope, C; O’Connor, B; Hayes, L

Purpose: The prone treatment position has been used to reduce ipsilateral lung and heart dose in left breast radiation. We conducted a retrospective study to evaluate the difference in the dosimetry between prone and supine treatment positions. Methods: Eight left breast cancer patients were simulated in both the supine and prone positions as a pretreatment evaluation for the optimal treatment position. Treatment plans were created for all patients in both the supine and prone positions using a field in field three dimensional planning technique. Prescribed dose was 45 Gy delivered by two tangential photon fields. Irradiated volume (IV) was evaluatedmore » by V50, V100, and dose to lung and heart by V5, V10, V20, and the mean dose were evaluated. Results: All dosimetry metrics for both the supine and prone plans met our internal normal structure guidelines which are based on Quantec data. The average IVs (50% and 100%) were 2223cc and 1361cc prone, 2315cc and 1315cc supine. The average ipsilateral lung Mean dose (0.83Gy prone vs 5.8Gy supine), V5 (1.6% prone vs 20.9% supine), V10 (0.78% prone vs 15% supine) and V20 (0.36% prone vs 11% supine) were significantly lower in prone position. Heart Mean dose (1.4Gy prone vs 2.9Gy supine), V10 (1.4% prone vs 5.0% supine) and V20 (0.4% prone vs 3.5% supine) were found improved for all patients except one where the mean dose was the same and all other values were improved. Conclusion: The prone position offer preferable dosimetry for all patients planned in our study. These patients were chosen based on the physician’s belief that they would benefit from prone treatment either because they had large pendulous breasts or due to the amount of heart seen in the field on CT simulation.« less

Effect of prone positioning on cannula function and impaired oxygenation during extracorporeal circulation.

PubMed

Masuda, Yoshiki; Tatsumi, Hiroomi; Imaizumi, Hitoshi; Gotoh, Kyoko; Yoshida, Shinichiro; Chihara, Shinya; Takahashi, Kanako; Yamakage, Michiaki

2014-03-01

Prone ventilation is an effective method for improving oxygenation in patients with acute respiratory failure. However, in extracorporeal circulation, there is a risk of cannula-related complications when changing the position. In this study, we investigated cannula-related complications when changing position for prone ventilation and the effect of prone ventilation on impaired oxygenation in patients who underwent extracorporeal membrane oxygenation (ECMO). The study subjects were patients who underwent prone ventilation during ECMO in the period from 2004 to 2011. Indication for prone ventilation was the presence of dorsal infiltration shown by lung computed tomography. Factors investigated were cannula insertion site, dislodgement or obstruction of the cannula, malfunction of vascular access and unplanned dislodgement of the catheters when changing position. Mean arterial pressure, PaO2/FiO2, PEEP level, blood flow and rotation speed of the pump were also determined before and after position change. Five patients were selected as study subjects. The mean duration of prone positioning was 15.3 ± 0.5 h. Strict management during position changes prevented cannula-related complications in the patients who underwent extracorporeal circulation. There were no significant changes in mean arterial pressure, PEEP level, blood flow and rotation speed of the pump when changing position. Low PaO2/FiO2 prior to prone ventilation was significantly increased after supine to prone and then prone to supine position. Prone positioning to improve impaired oxygenation is a safe procedure and not a contraindication in patients receiving extracorporeal circulation.

Intracellular Protein Delivery for Treating Breast Cancer

DTIC Science & Technology

2013-06-01

accumulation of Dox in tumors. (A) Preparation of 64Cu-AmBaSar-labeled liposomes. (B) In vivo PET images of C57/ BL6 mice bearing B16 tumors at 1, 3, and 24 h...Knoxville, TN). The B16 -F10 tumor-bearing C57/ BL6 mice were imaged in the prone position in the microPET scanner. The mice were injected with

Prototype volumetric ultrasound tomography image guidance system for prone stereotactic partial breast irradiation: proof-of-concept

NASA Astrophysics Data System (ADS)

Chiu, Tsuicheng D.; Parsons, David; Zhang, Yue; Hrycushko, Brian; Zhao, Bo; Chopra, Rajiv; Kim, Nathan; Spangler, Ann; Rahimi, Asal; Timmerman, Robert; Jiang, Steve B.; Lu, Weiguo; Gu, Xuejun

2018-03-01

Accurate dose delivery in stereotactic partial breast irradiation (S-PBI) is challenging because of the target position uncertainty caused by breast deformation, the target volume changes caused by lumpectomy cavity shrinkage, and the target delineation uncertainty on simulation computed tomography (CT) images caused by poor soft tissue contrast. We have developed a volumetric ultrasound tomography (UST) image guidance system for prone position S-PBI. The system is composed of a novel 3D printed rotation water tank, a patient-specific resin breast immobilization cup, and a 1D array ultrasound transducer. Coronal 2D US images were acquired in 5° increments over a 360° range, and planes were acquired every 2 mm in elevation. A super-compounding technique was used to reconstruct the image volume. The image quality of UST was evaluated with a BB-1 breast phantom and BioZorb surgical marker, and the results revealed that UST offered better soft tissue contrast than CT and similar image quality to MR. In the evaluated plane, the size and location of five embedded objects were measured and compared to MR, which is considered as the ground truth. Objects’ diameters and the distances between objects in UST differ by approximately 1 to 2 mm from those in MR, which showed that UST offers the image quality required for S-PBI. In future work we will develop a robotic system that will be ultimately implemented in the clinic.

Prototype volumetric ultrasound tomography image guidance system for prone stereotactic partial breast irradiation: proof-of-concept.

PubMed

Chiu, Tsuicheng D; Parsons, David; Zhang, Yue; Hrycushko, Brian; Zhao, Bo; Chopra, Rajiv; Kim, Nathan; Spangler, Ann; Rahimi, Asal; Timmerman, Robert; Jiang, Steve B; Lu, Weiguo; Gu, Xuejun

2018-03-01

Accurate dose delivery in stereotactic partial breast irradiation (S-PBI) is challenging because of the target position uncertainty caused by breast deformation, the target volume changes caused by lumpectomy cavity shrinkage, and the target delineation uncertainty on simulation computed tomography (CT) images caused by poor soft tissue contrast. We have developed a volumetric ultrasound tomography (UST) image guidance system for prone position S-PBI. The system is composed of a novel 3D printed rotation water tank, a patient-specific resin breast immobilization cup, and a 1D array ultrasound transducer. Coronal 2D US images were acquired in 5° increments over a 360° range, and planes were acquired every 2 mm in elevation. A super-compounding technique was used to reconstruct the image volume. The image quality of UST was evaluated with a BB-1 breast phantom and BioZorb surgical marker, and the results revealed that UST offered better soft tissue contrast than CT and similar image quality to MR. In the evaluated plane, the size and location of five embedded objects were measured and compared to MR, which is considered as the ground truth. Objects' diameters and the distances between objects in UST differ by approximately 1 to 2 mm from those in MR, which showed that UST offers the image quality required for S-PBI. In future work we will develop a robotic system that will be ultimately implemented in the clinic.

SU-E-T-292: Dosimetric Advantage of Prone Breast Radiotherapy for Korean Left-Sided Breast Cancer Patients

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

Chung, Y; Shin, J; Yu, J

Purpose: To evaluate the dosimetric benefit of prone breast radiotherapy for Korean left-sided early-stage breast cancer patients who have relatively small breast Methods: From April to June, 2014, 10 left-sided breast cancer patients received the whole breast irradiation in prone position after partial mastectomy with sentinel lymph node biopsy or axillary lymph node dissection. All patients were pTmi-2N0-1mi. Each patient underwent two computed tomoradiography (CT) simulations in supine and prone positions. The whole breast, ipsilateral lung, heart, and left anterior descending coronary artery (LAD) were contoured on each simulation CT images, and then tangential-fields treatment plan in each position wasmore » designed for the whole breast irradiation with the total dose of 50 Gy in 2 Gy fractions. Dose-volume histograms of two setups were compared for target coverage and radiation dose to normal organs with Wilcoxon signed rank tests. Results: The median age of patients was 47 years (range, 37 to 53). The median chest size was 82.5 cm (range, 75 to 90) and bra cup size was A in 4, B in 4, and C in 2 patients. The radiation dose to the whole breast was similar when comparing mean dose (Dmean) and dose covering 95% of the breast volume, but maximum dose (Dmax) of breast was higher in supine (median 52.3 vs. 52.7 Gy, p=0.013). Prone position reduced significantly the radiation dose in ipsilateral lung, heart, and LAD by median 5.7, 1.1, and 6.9 Gy of Dmean (p=0.005, 0.007, and 0.005) and 28.2, 18.8, and 35.0 Gy of Dmax (p=0.005, 0.005, and 0.007), respectively. Conclusion: Prone breast radiotherapy could be beneficial for Korean breast cancer patients since it substantially spared normal organs while achieving adequate coverage of the breast tissue. Further prospective study is required to validate the potential benefit of prone breast radiotherapy.« less

SU-E-T-538: Does Abdominal Compression Through Prone Patient Position Reduce Respiratory Motion in Lung Cancer Radiotherapy?

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

Catron, T; Rosu, M; Weiss, E

2014-06-01

Purpose: This study assesses the effect of physiological abdominal compression from prone positioning by comparing respiratory-induced tumor movements in supine and prone positions. Methods: 19 lung cancer patients underwent repeated supine and prone free-breathing 4DCT scans. The effect of patient position on motion magnitude was investigated for tumors, lymph nodes (9 cases), and subgroups of central (11 cases), peripheral (8 cases) and small peripheral tumors (5 cases), by evaluating the population average excursions, absolute and relative to a carina-point. Results: Absolute motion analysis: In prone, motion increased by ~20% for tumors and ~25% for lymph nodes. Central tumors moved moremore » compared to peripheral tumors in both supine and prone (~22%, and ~4% respectively). Central tumors movement increased by ~12% in prone. For peripheral tumors the increase in prone position was ~25% (~40% and 29% changes on along RL and AP directions). Motion relative to carina-point analysis: Overall, tumor excursions relative to carina-point increased by ~17% in prone. Lymph node relative magnitudes were lower by ~4%. Likewise, the central tumors moved ~7% less in prone. The subgroup of peripheral tumors exhibited increased amplitudes by ~44%; the small peripheral tumors had even larger relative displacements in prone (~46%). Conclusion: Tumor and lymph node movement in the patient population from this study averaged to be higher in prone than in supine position. Results from carina analysis also suggest that peripheral tissues have more physiologic freedom of motility when placed in the prone position, regardless of size. From these observations we should continue to avoid prone positioning for all types of primary lung tumor, suggesting that patients should receive radiotherapy for primary lung cancer in supine position to minimize target tissue mobility during normal respiratory effort. Further investigation will include more patients with peripheral tumors to validate our observations.« less

An update on the prone position: Continuing Professional Development.

PubMed

Chui, Jason; Craen, Rosemary Ann

2016-06-01

The purpose of this Continuing Professional Development module is to provide information needed to prepare for and clinically manage a patient in the prone position. Prone positioning is required for surgical procedures that involve the posterior aspect of a patient. We searched MEDLINE(®) and EMBASE™ from January 2000 to January 2015 for literature related to the prone position and retrieved only original articles in English. We reviewed the advantages and disadvantages of various equipment used in prone positioning, the physiological changes associated with prone positioning, and the complications that can occur. We also reviewed strategies for the safe conduct and management of position-related complications. Increased age, elevated body mass index, the presence of comorbidities, and long duration of surgery appear to be the most important risk factors for complications associated with prone positioning. We recommend a structured team approach and careful selection of equipment tailored to the patient and surgery. The systematic use of checklists is recommended to guide operating room teams and to reduce prone position-related complications. Anesthesiologists should be prepared to manage major intraoperative emergencies (e.g., accidental extubation) and anticipate postoperative complications (e.g., airway edema and visual loss).

The 'modified prone position': a new approach for treating pre-vesical stones with extracorporeal shock wave lithotripsy.

PubMed

Köse, A C; Demirbas, M

2004-02-01

To investigate the utility of a new 'modified-prone' position for treating pre-vesical stones with extracorporeal shock wave lithotripsy (ESWL), usually considered an acceptable and effective treatment for such stones, but for which many different body positions have been used in an attempt to increase its efficacy. The study included 268 consecutive patients with a solitary pre-vesical stone who underwent ESWL either prone (69) or in the modified-prone position (199) between May 1999 and August 2001. Only those with one stone between the ureteric orifice and 1 cm proximal to the vesico-ureteric junction were included. In each case the stone diameter, days to stone clearance, number of shock waves applied per treatment, and number of sessions required to become stone-free were recorded. If the treatment failed this was also noted. Success rates in the prone and modified-prone groups were compared and analysed to assess which of the variables influenced success with ESWL. After ESWL, 95.5% of the 268 patients were stone-free; the rates in the prone and modified-prone groups were 89.9% and 97.5%, respectively (P = 0.015). The probability of success with ESWL therapy for pre-vesical calculi in modified-prone position was about five times (odds ratio 4.56, 95% confidence interval 1.2-17.7) greater than that expected with when prone. The modified-prone position was an independent factor most significantly influencing success with ESWL in these patients. The modified-prone position for ESWL is a new and very effective way to treat patients with pre-vesical stones.

Regional ventilation-perfusion distribution is more uniform in the prone position

NASA Technical Reports Server (NTRS)

Mure, M.; Domino, K. B.; Lindahl, S. G.; Hlastala, M. P.; Altemeier, W. A.; Glenny, R. W.

2000-01-01

The arterial blood PO(2) is increased in the prone position in animals and humans because of an improvement in ventilation (VA) and perfusion (Q) matching. However, the mechanism of improved VA/Q is unknown. This experiment measured regional VA/Q heterogeneity and the correlation between VA and Q in supine and prone positions in pigs. Eight ketamine-diazepam-anesthetized, mechanically ventilated pigs were studied in supine and prone positions in random order. Regional VA and Q were measured using fluorescent-labeled aerosols and radioactive-labeled microspheres, respectively. The lungs were dried at total lung capacity and cubed into 603-967 small ( approximately 1.7-cm(3)) pieces. In the prone position the homogeneity of the ventilation distribution increased (P = 0.030) and the correlation between VA and Q increased (correlation coefficient = 0.72 +/- 0.08 and 0.82 +/- 0.06 in supine and prone positions, respectively, P = 0.03). The homogeneity of the VA/Q distribution increased in the prone position (P = 0.028). We conclude that the improvement in VA/Q matching in the prone position is secondary to increased homogeneity of the VA distribution and increased correlation of regional VA and Q.

Prone breast forward intensity-modulated radiotherapy for Asian women with early left breast cancer: factors for cardiac sparing and clinical outcomes

PubMed Central

Chen, Jenny Ling-Yu; Cheng, Jason Chia-Hsien; Kuo, Sung-Hsin; Chan, Hsing-Min; Huang, Yu-Sen; Chen, Yu-Hsuan

2013-01-01

Since December 2009, after breast-conserving surgery for Stage 0–I cancer of the left breast, 21 women with relatively pendulous breasts underwent computed tomography prone and supine simulations. The adjuvant radiotherapy was 50 Gy in 25 fractions to the left breast alone. Four plans—conventional wedged tangents and forward intensity-modulated radiotherapy (fIMRT) in supine and prone positions—were generated. fIMRT generated better homogeneity in both positions. Prone position centralized the breast tissue by gravity and also shortened the breast width which led to better conformity in both planning techniques. Prone fIMRT significantly reduced doses to left lung, Level I and Level II axilla. The mean cardiac doses did not differ between positions. Among the four plans, prone fIMRT produced the best target dosimetry and normal organ sparing. In subgroup analysis, patients with absolute breast depth > 7 cm in the prone position or breast depth difference > 3 cm between positions had significant cardiac sparing with prone fIMRT. Sixteen patients with significant cardiac sparing in prone position were treated using prone fIMRT and the others using supine fIMRT. All patients received a supine electron tumor bed boost of 10 Gy in 5 fractions. No patients developed Grade 2 or worse acute or late toxicities. There was no difference in the number of segments or beams, monitor units, treatment time, or positioning reproducibility between prone and supine positions. At a median follow-up time of 26.8 months, no locoregional or distant recurrence or death was noted. PMID:23504450

Development of hyperspectral imaging technique for salmonella enteritidis and typhimurium on agar plates

USDA-ARS?s Scientific Manuscript database

Salmonella is a common cause of foodborne disease resulting from the consumption of contaminated food products. Although a direct plating method is widely used for presumptive positive screening of pathogenic Salmonella colonies on agar plates, it is labor-intensive, time-consuming and also prone to...

Association between sleep position and early motor development.

PubMed

Majnemer, Annette; Barr, Ronald G

2006-11-01

To compare motor performance in infants sleeping in prone versus supine positions. Healthy 4-month-olds (supine: n = 71, prone: n = 12) and 6-month olds (supine: n = 50, prone: n = 22) were evaluated with the Alberta Infant Motor Scale (AIMS) and Peabody Developmental Motor Scale (PDMS), and parents completed a positioning diary. Infants were reassessed at 15 months. At 4 months, motor scores were lower in the supine group and were less likely to achieve prone extension (P < .05). At 6 months, there were wide discrepancies on the AIMS (supine: 44.5 +/- 21.6, prone: 60.0 +/- 18.8, P = .005) and the gross motor PDMS (supine: 85.7 +/- 7.6, prone: 90.2 +/- 9.5, P = .03). Motor delays were documented in 22% of babies sleeping supine. Prone sleep-positioned infants were more likely to sit and roll. Daily exposure to awake prone positioning was predictive of motor performance in infants sleeping supine. At 15 months, sleep position continued to predict motor performance. Infants sleeping supine may exhibit early motor lags, associated with less time in prone while awake. This has implications for accurate interpretation of assessment of infants at risk and prevention of inappropriate referrals. Rate of infant motor development appears influenced by extrinsic factors such as positioning practices.

Dysmorphic concern is related to delusional proneness and negative affect in a community sample.

PubMed

Keating, Charlotte; Thomas, Neil; Stephens, Jessie; Castle, David J; Rossell, Susan L

2016-06-30

Body image concerns are common in the general population and in some mental illnesses reach pathological levels. We investigated whether dysmorphic concern with appearance (a preoccupation with minor or imagined defects in appearance) is explained by psychotic processes in a community sample. In a cross-sectional design, two hundred and twenty six participants completed an online survey battery including: The Dysmorphic Concern Questionnaire; the Peters Delusional inventory; the Aberrant Salience Inventory; and the Depression, Anxiety, Stress Scale. Participants were native English speakers residing in Australia. Dysmorphic concern was positively correlated with delusional proneness, aberrant salience and negative emotion. Regression established that negative emotion and delusional proneness predicted dysmorphic concern, whereas, aberrant salience did not. Although delusional proneness was related to body dysmorphia, there was no evidence that it was related to aberrant salience. Understanding the contribution of other psychosis processes, and other health related variables to the severity of dysmorphic concern will be a focus of future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Prone position in balloon kyphoplasty leads to no secondary vertebral compression fractures in osteoporotic spine – a MRI study

PubMed Central

Spalteholz, Matthias; Strasser, Evald; Hantel, Torsten; Gahr, Ralf Herbert

2014-01-01

Purpose: Vertebral compression fractures are the most common fractures in the elderly. Long lasting pain and deformity is responsible for consecutive impairment with markedly reduced life quality, increased morbidity and mortality. The beneficial effects of balloon kyphoplasty are verified in many studies. Subsequent fracture risk is not finally clarified, cement related risks and deformity related risks are discussed. There is less knowledge about the risk of bone marrow edema and new fractures during balloon kyphoplasty procedure. The goal of this study is to examine, if prone position during kyphoplasty is an independent risk factor for new fractures in the osteoporotic spine. Methods: Consecutive MRI study of 20 patients with fresh, non-traumatic thoracolumbar vertebral compression fractures and balloon kyphoplasty treatment. MRI Scans of the thoracolumbar spine were obtained after surgery, before patients have been mobilized. Specific MRI changes like new bone marrow edema, signal intensity changes in adjacent and remote segments and new fractures were assessed by specialized neuro-radiologist. Results: 20 MR images were examined within 48 hours after balloon kyphoplasty procedure. 85% did not show bone marrow edema extent changes after kyphoplasty. We found minor increase of bone marrow edema within the augmented vertebral body in 3 cases. We did not find any new bone marrow edema and no new fractures in adjacent and remote segments after balloon kyphoplasty treatment. Conclusion: Prone position leads to no new bone marrow edema and no new fractures in the osteoporotic spine. Accordingly, prone position has no risk for adjacent level fractures in osteoporotic spines. PMID:26504728

Treatment of ARDS With Prone Positioning.

PubMed

Scholten, Eric L; Beitler, Jeremy R; Prisk, G Kim; Malhotra, Atul

2017-01-01

Prone positioning was first proposed in the 1970s as a method to improve gas exchange in ARDS. Subsequent observations of dramatic improvement in oxygenation with simple patient rotation motivated the next several decades of research. This work elucidated the physiological mechanisms underlying changes in gas exchange and respiratory mechanics with prone ventilation. However, translating physiological improvements into a clinical benefit has proved challenging; several contemporary trials showed no major clinical benefits with prone positioning. By optimizing patient selection and treatment protocols, the recent Proning Severe ARDS Patients (PROSEVA) trial demonstrated a significant mortality benefit with prone ventilation. This trial, and subsequent meta-analyses, support the role of prone positioning as an effective therapy to reduce mortality in severe ARDS, particularly when applied early with other lung-protective strategies. This review discusses the physiological principles, clinical evidence, and practical application of prone ventilation in ARDS. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Comparison of supine and prone positions for percutaneous nephrolithotomy in treatment of staghorn stones.

PubMed

Gökce, Mehmet İlker; Ibiş, Arif; Sancı, Adem; Akıncı, Aykut; Bağcı, Uygar; Ağaoğlu, Eylül Asya; Süer, Evren; Gülpınar, Ömer

2017-12-01

Percutaneous nephrolithotomy (PNL) is the primary treatment modality for management of staghorn stones. PNL in supine position has important advantages over prone positon. However, studies comparing prone and supine positions for PNL in staghorn stone patients have conflicting results, and the aim of the current study was to compare prone and supine positions for PNL in staghorn stone cases. Data of patients underwent PNL for staghorn stones in supine or prone position by a single urologist were collected prospectively. The supine and prone position groups were compared for stone free rate (SFR) and complication rates. All patients were evaluated with NCCT for evaluation of SFR. Chi-square test was used to compare categorical variables and Student t test was applied for continuous variables of the treatment groups. The groups were similar for demographic and stone-related characteristics. Multi-caliceal and intercostal access was more common in prone position. Operation duration was significantly shorter and hemoglobin drop was significantly less in supine group. SFR was 64.1 and 60.4% in the supine and prone groups, respectively (p = 0.72). Complication rates were similar in the two groups but Clavien III complications were observed in two patients in the prone group. PNL in supine position is an effective treatment for management of staghorn stones. The need for multi-caliceal and intercostal puncture is less when combined with retrograde intrarenal surgery. PNL in supine position should be considered as primary treatment option in staghorn stone cases.

SU-G-BRC-13: Model Based Classification for Optimal Position Selection for Left-Sided Breast Radiotherapy: Free Breathing, DIBH, Or Prone

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

Lin, H; Liu, T; Xu, X

Purpose: There are clinical decision challenges to select optimal treatment positions for left-sided breast cancer patients—supine free breathing (FB), supine Deep Inspiration Breath Hold (DIBH) and prone free breathing (prone). Physicians often make the decision based on experiences and trials, which might not always result optimal OAR doses. We herein propose a mathematical model to predict the lowest OAR doses among these three positions, providing a quantitative tool for corresponding clinical decision. Methods: Patients were scanned in FB, DIBH, and prone positions under an IRB approved protocol. Tangential beam plans were generated for each position, and OAR doses were calculated.more » The position with least OAR doses is defined as the optimal position. The following features were extracted from each scan to build the model: heart, ipsilateral lung, breast volume, in-field heart, ipsilateral lung volume, distance between heart and target, laterality of heart, and dose to heart and ipsilateral lung. Principal Components Analysis (PCA) was applied to remove the co-linearity of the input data and also to lower the data dimensionality. Feature selection, another method to reduce dimensionality, was applied as a comparison. Support Vector Machine (SVM) was then used for classification. Thirtyseven patient data were acquired; up to now, five patient plans were available. K-fold cross validation was used to validate the accuracy of the classifier model with small training size. Results: The classification results and K-fold cross validation demonstrated the model is capable of predicting the optimal position for patients. The accuracy of K-fold cross validations has reached 80%. Compared to PCA, feature selection allows causal features of dose to be determined. This provides more clinical insights. Conclusion: The proposed classification system appeared to be feasible. We are generating plans for the rest of the 37 patient images, and more statistically significant results are to be presented.« less

Inter- and Intrafractional Positional Uncertainties in Pediatric Radiotherapy Patients With Brain and Head and Neck Tumors

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

Beltran, Chris, E-mail: chris.beltran@stjude.or; Krasin, Matthew J.; Merchant, Thomas E.

2011-03-15

Purpose: To estimate radiation therapy planning margins based on inter- and intrafractional uncertainty for pediatric brain and head and neck tumor patients at different imaging frequencies. Methods: Pediatric patients with brain (n = 83) and head and neck (n = 17) tumors (median age = 7.2 years) were enrolled on an internal review board-approved localization protocol and stratified according to treatment position and use of anesthesia. Megavoltage cone-beam CT (CBCT) was performed before each treatment and after every other treatment. The pretreatment offsets were used to calculate the interfractional setup uncertainty (SU), and posttreatment offsets were used to calculate themore » intrafractional residual uncertainty (RU). The SU and RU are the patient-related components of the setup margin (SM), which is part of the planning target volume (PTV). SU data was used to simulate four intervention strategies using different imaging frequencies and thresholds. Results: The SM based on all patients treated on this study was 2.1 mm (SU = 0.9 mm, RU = 1.9 mm) and varied according to treatment position (supine = 1.8 mm, prone = 2.6 mm) and use of anesthesia (with = 1.7 mm, without = 2.5 mm) because of differences in the RU. The average SU for a 2-mm threshold based on no imaging, once per week imaging, initial five images, and daily imaging was 3.6, 2.1, 2.2, and 0.9 mm, respectively. Conclusion: On the basis of this study, the SM component of the PTV may be reduced to 2 mm for daily CBCT compared with 3.5 mm for weekly CBCT. Considering patients who undergo daily pretreatment CBCT, the SM is larger for those treated in the prone position or smaller for those treated under anesthesia because of differences in the RU.« less

Automated image-based colon cleansing for laxative-free CT colonography computer-aided polyp detection

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

Linguraru, Marius George; Panjwani, Neil; Fletcher, Joel G.

2011-12-15

Purpose: To evaluate the performance of a computer-aided detection (CAD) system for detecting colonic polyps at noncathartic computed tomography colonography (CTC) in conjunction with an automated image-based colon cleansing algorithm. Methods: An automated colon cleansing algorithm was designed to detect and subtract tagged-stool, accounting for heterogeneity and poor tagging, to be used in conjunction with a colon CAD system. The method is locally adaptive and combines intensity, shape, and texture analysis with probabilistic optimization. CTC data from cathartic-free bowel preparation were acquired for testing and training the parameters. Patients underwent various colonic preparations with barium or Gastroview in divided dosesmore » over 48 h before scanning. No laxatives were administered and no dietary modifications were required. Cases were selected from a polyp-enriched cohort and included scans in which at least 90% of the solid stool was visually estimated to be tagged and each colonic segment was distended in either the prone or supine view. The CAD system was run comparatively with and without the stool subtraction algorithm. Results: The dataset comprised 38 CTC scans from prone and/or supine scans of 19 patients containing 44 polyps larger than 10 mm (22 unique polyps, if matched between prone and supine scans). The results are robust on fine details around folds, thin-stool linings on the colonic wall, near polyps and in large fluid/stool pools. The sensitivity of the CAD system is 70.5% per polyp at a rate of 5.75 false positives/scan without using the stool subtraction module. This detection improved significantly (p = 0.009) after automated colon cleansing on cathartic-free data to 86.4% true positive rate at 5.75 false positives/scan. Conclusions: An automated image-based colon cleansing algorithm designed to overcome the challenges of the noncathartic colon significantly improves the sensitivity of colon CAD by approximately 15%.« less

Registration of central paths and colonic polyps between supine and prone scans in computed tomography colonography: Pilot study

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

Li Ping; Napel, Sandy; Acar, Burak

2004-10-01

Computed tomography colonography (CTC) is a minimally invasive method that allows the evaluation of the colon wall from CT sections of the abdomen/pelvis. The primary goal of CTC is to detect colonic polyps, precursors to colorectal cancer. Because imperfect cleansing and distension can cause portions of the colon wall to be collapsed, covered with water, and/or covered with retained stool, patients are scanned in both prone and supine positions. We believe that both reading efficiency and computer aided detection (CAD) of CTC images can be improved by accurate registration of data from the supine and prone positions. We developed amore » two-stage approach that first registers the colonic central paths using a heuristic and automated algorithm and then matches polyps or polyp candidates (CAD hits) by a statistical approach. We evaluated the registration algorithm on 24 patient cases. After path registration, the mean misalignment distance between prone and supine identical anatomic landmarks was reduced from 47.08 to 12.66 mm, a 73% improvement. The polyp registration algorithm was specifically evaluated using eight patient cases for which radiologists identified polyps separately for both supine and prone data sets, and then manually registered corresponding pairs. The algorithm correctly matched 78% of these pairs without user input. The algorithm was also applied to the 30 highest-scoring CAD hits in the prone and supine scans and showed a success rate of 50% in automatically registering corresponding polyp pairs. Finally, we computed the average number of CAD hits that need to be manually compared in order to find the correct matches among the top 30 CAD hits. With polyp registration, the average number of comparisons was 1.78 per polyp, as opposed to 4.28 comparisons without polyp registration.« less

Prone positioning in the patient who has acute respiratory distress syndrome: the art and science.

PubMed

Vollman, Kathleen M

2004-09-01

Acute respiratory distress syndrome (ARDS) remains a significant contributor to the morbidity and mortality of patients in the ICU. A variety of treatments are used to support the lung of the patient who has ARDS and improve gas exchange during the acute injury phase. It seems, however, that the simple, safe, and noninvasive act of prone positioning of the critically ill patient who has ARDS may improve gas exchange while preventing potential complications of high positive end-expiratory pressure, volutrauma, and oxygen toxicity. This article provides the critical care nurse with the physiologic rationale for use of the prone position, indications and contraindications for use, safe strategies for prone positioning, and care techniques and monitoring methods of the patient who is in the prone position.

SHAME AND GUILT-PRONENESS AS MEDIATORS OF ASSOCIATIONS BETWEEN GENERAL CAUSALITY ORIENTATIONS AND DEPRESSIVE SYMPTOMS

PubMed Central

YOUNG, CHELSIE M.; NEIGHBORS, CLAYTON; DIBELLO, ANGELO M.; TRAYLOR, ZACHARY K.; TOMKINS, MARY

2017-01-01

The present study examined the roles of shame- and guilt-proneness as mediators of associations between general causality orientations and depressive symptoms. We expected autonomy would be associated with less depressive symptoms based on higher guilt-proneness and lower shame-proneness, whereas control would be associated with more depressive symptoms based on lower guilt-proneness and higher shame-proneness. Undergraduates (N = 354) completed assessments of general causality orientations, shame- and guilt-proneness, and depressive symptoms in exchange for extra credit. Results of mediation analyses were generally supportive of the framework indicating that shame- and guilt-proneness mediate associations between self-determination and depressive symptoms. Autonomy was indirectly associated with less depressive symptoms through positive associations with guilt-proneness, in spite of unexpected positive associations with shame-proneness. Control and impersonal orientation were indirectly associated with more depressive symptoms through positive associations with shame-proneness. Results extend previous research relating self-determination to mental health in providing preliminary support suggesting that individual differences in self-determination facilitate differential tendencies in experiencing guilt and shame. PMID:28344381

[Reduction of pressure sores during prone positioning of ventilated intensive care patients by the prone-head support system: a pilot study].

PubMed

Prebio, Michael; Katz-Papatheophilou, Elfriede; Heindl, Werner; Gelbmann, Herbert; Burghuber, Otto C

2005-02-01

Prone positioning in patients with adult respiratory distress syndrome is a well-known method to improve oxygenation. The aim of our study was to evaluate a new device for prone positioning, the prone-head support system (PHS system), with regard to reduction of cutaneous pressure sores. In a pilot study we randomized 8 patients with ARDS in two groups: 180 degrees standard prone positioning (group without mask) and prone positioning with the PHS system (group with mask). The PHS system consists of a facemask support, which is connected to an adapted air suspension bed. The patients of both groups were intermittently proned for several days. We evaluated the pressure sores on head and neck before turning the patients prone for the first time and after each period of prone positioning. We documented the quantity, the size, the type and the localization of the pressure sores. There was no significant difference in the mean duration of prone positioning (27.1+/-14.7 hours in the group with mask versus 24.5+/-18.7 h in the group without mask). In the group with mask there were 1.5+/-0.8 new pressure sores by each proning, whereas in the group without mask there were 2.37+/-1.6 new pressure sores, which was lower, but not significantly. The overall area of pressure sores (798 mm2 versus 3184 mm2, p=0.004), the area of pressure sores per patient (199.5+/-104.7 mm2 versus 796+/-478 mm2, p=0.03) and the increase of the area of pressure sores per proning (79.8+/-52.0 mm2 versus 398.0+/-214.3 mm2, p=0.004) were significantly lower in the group with mask in comparison to the group without mask. The lips were the most effected localization in both groups. The pressure sores in the group with mask were less severe and showed a homogenous distribution in comparison to the group without mask. Blisters dominated in the group with mask in comparison to erosions, necrosis and ulcers in the group without mask. The PHS system with its face mask is able to reduce the extent and the severity of pressure sores in patients ventilated in prone position. Controlled randomized studies with large study populations seem justified.

Beyond prone position in percutaneous nephrolithotomy: a comprehensive review.

PubMed

de la Rosette, Jean J M C H; Tsakiris, Peter; Ferrandino, Michael N; Elsakka, Ahmed M; Rioja, Jorge; Preminger, Glenn M

2008-12-01

Percutaneous nephrolithotomy (PNL) is traditionally performed with the patient in the prone position. To assess the efficacy and safety of the prone and supine positions, particularly in obese patients and in those with staghorn calculi. A Medline search was conducted for articles published during the last 10 yr related to PNL in the prone and supine positions. This search revealed 9 published studies for supine and 25 for prone PNL. None of the supine PNL studies reported visceral injuries, while transfusion rates were 0.0-9.4% and stone-free rates were 69.6-95.0%. One study of supine PNL evaluated a significant proportion of obese patients. Prone PNL studies in obese patients report transfusion rates of 3.2-8.8% and stone-free rates of 79.0-89.2%. In the only randomized study, excluding obese patients and staghorn calculi, operative time favors the supine position. A nonrandomized comparative study demonstrated similar complication rates with insignificant improvement in treatment success for supine PNL; however, when comparing series with similar proportions of staghorn calculi cases, there are slightly improved outcomes for prone PNL. Moreover, comparison of weighted means favors prone PNL. For obese patients and staghorn calculi, prone PNL appears to be associated with decreased operative times with similar bleeding rates and slightly better stone-free rates than supine PNL.

Clinical Meaning of Early Oxygenation Improvement in Severe Acute Respiratory Distress Syndrome under Prolonged Prone Positioning

PubMed Central

Lee, Kwangha; Kim, Mi-Young; Yoo, Jung-Wan; Hong, Sang-Bum; Lim, Chae-Man

2010-01-01

Background/Aims Ventilating patients with acute respiratory distress syndrome (ARDS) in the prone position has been shown to improve arterial oxygenation, but prolonged prone positioning frequently requires continuous deep sedation, which may be harmful to patients. We evaluated the meaning of early gas exchange in patients with severe ARDS under prolonged (≥ 12 hours) prone positioning. Methods We retrospectively studied 96 patients (mean age, 60.1 ± 15.6 years; 75% men) with severe ARDS (PaO2/FiO2 ≤ 150 mmHg) admitted to a medical intensive care unit (MICU). The terms "PaO2 response" and "PaCO2 response" represented responses that resulted in increases in the PaO2/FiO2 ratio of ≥ 20 mmHg and decreases in PaCO2 of ≥ 1 mmHg, respectively, 8 to 12 hours after first placement in the prone position. Results The mean duration of prone positioning was 78.5 ± 61.2 hours, and the 28-day mortality rate after MICU admission was 56.3%. No significant difference in clinical characteristics was observed between PaO2 and PaCO2 responders and non-responders. The PaO2 responders after prone positioning showed an improved 28-day outcome, compared with non-responders by Kaplan-Meier survival estimates (p < 0.05 by the log-rank test), but the PaCO2 responders did not. Conclusions Our results suggest that the early oxygenation improvement after prone positioning might be associated with an improved 28-day outcome and may be an indicator to maintain prolonged prone positioning in patients with severe ARDS. PMID:20195404

Profound Obstructive Hypotension From Prone Positioning Documented by Transesophageal Echocardiography in a Patient With Scoliosis: A Case Report.

PubMed

Abcejo, Arnoley S; Diaz Soto, Juan; Castoro, Courtney; Armour, Sarah; Long, Timothy R

2017-08-01

In a healthy 12-year-old female with scoliosis, prone positioning resulted in pressor-refractory cardiovascular collapse. Resumption of supine position immediately improved hemodynamics. Intraoperative transesophageal echocardiography (TEE) revealed a collapsed left atrium and biventricular failure. Repeat prone positioning resulted in a recurrence of hypotension. However, hemodynamic stabilization was restored and maintained by repositioning chest pads caudally. The patient successfully underwent a 6-hour scoliosis repair without perioperative morbidity. With this case, we aim to: (1) reintroduce awareness of this mechanical obstructive cause of reversible hypotension; (2) highlight the use of intraoperative TEE during prone hemodynamic collapse; and (3) suggest an alternative prone positioning technique if chest compression results in hemodynamic instability.

The effect of prone position on respiratory mechanics during spinal surgery.

PubMed

Manna, Essam M; Ibraheim, Osama A; Samarkandi, Abdulhamid H; Alotaibi, Wadha M; Elwatidy, Sherif M

2005-10-01

To study the effect of prone position on respiratory mechanics during spine surgery. Prospective study. Elective spine surgery at a university hospital. 12 ASA physical I & II with no coexisting cardiorespiratory disease undergoing cervical or lumbar laminectomy under general anesthesia in prone position. Ten min after induction of general anesthesia and endotracheal intubation, while patients were in supine position, the following measurements were taken using anesthesia delivery unit (Datex Ohmeda type A_Elec, Promma, Sweden): peak airway pressure (Ppeak), peak plataeu pressure (Pplat), peak mean pressure (Pmean) and dynamic lung compliance (DLC). The same measurements were recorded 10 min after placing patients into prone position. At the end of surgery and 5 min after turning the patients supine and before tracheal extubation, the same measurements were again recorded. The results expressed as means +/- sd. One way ANOVA was used for analysis of differences in the data before, during prone position and after turning patients supine at the end of the procedure. For all comparisons p < 0.05 was considered significant. During prone position there was significant reduction in DLC and significant increase in airway pressures. We conclude that turning the patients form supine to prone position during anesthesia for spine surgery caused significant decrease of DLC and significant increase of airway pressure.

Prone position for the prevention of lung infection.

PubMed

Beuret, P

2002-04-01

Pulmonary infection is frequent in brain injured patients. It has been identified as an independent predictor of unfavorable neurological outcome, calling for attempts of prevention. We recently evaluated intermittent prone positioning for the prevention of ventilator-associated pneumonia (VAP) in comatose brain injured patients, in a randomized study. 25 patients were included in the prone position (PP) group: they were positioned on prone four hours once daily until they could get up to sit in an armchair; 26 patients were included in the supine position (SP) group. The main characteristics of the patients from the two groups were similar at randomization. The primary end-point was the incidence of lung worsening, defined by an increase in the Lung Injury Score by at least one point since the time of randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) (p=0.003). The incidence of VAP was 38.4% in the SP group and 20% in the PP group (p=0.14). There was no serious complication attributable to prone positioning. In conclusion, the beneficial effect of prone positioning for prevention of lung infection in brain injured patients is not well established. However, in those patients, prone positioning is able to avoid the worsening of pulmonary function, especially in oxygenation.

Effects of Prone Position and Positive End-Expiratory Pressure on Noninvasive Estimators of ICP: A Pilot Study.

PubMed

Robba, Chiara; Bragazzi, Nicola Luigi; Bertuccio, Alessandro; Cardim, Danilo; Donnelly, Joseph; Sekhon, Mypinder; Lavinio, Andrea; Duane, Derek; Burnstein, Rowan; Matta, Basil; Bacigaluppi, Susanna; Lattuada, Marco; Czosnyka, Marek

2017-07-01

Prone positioning and positive end-expiratory pressure can improve pulmonary gas exchange and respiratory mechanics. However, they may be associated with the development of intracranial hypertension. Intracranial pressure (ICP) can be noninvasively estimated from the sonographic measurement of the optic nerve sheath diameter (ONSD) and from the transcranial Doppler analysis of the pulsatility (ICPPI) and the diastolic component (ICPFVd) of the velocity waveform. The effect of the prone positioning and positive end-expiratory pressure on ONSD, ICPFVd, and ICPPI was assessed in a prospective study of 30 patients undergoing spine surgery. One-way repeated measures analysis of variance, fixed-effect multivariate regression models, and receiver operating characteristic analyses were used to analyze numerical data. The mean values of ONSD, ICPFVd, and ICPPI significantly increased after change from supine to prone position. Receiver operating characteristic analyses demonstrated that, among the noninvasive methods, the mean ONSD measure had the greatest area under the curve signifying it is the most effective in distinguishing a hypothetical change in ICP between supine and prone positioning (0.86±0.034 [0.79 to 0.92]). A cutoff of 0.43 cm was found to be a best separator of ONSD value between supine and prone with a specificity of 75.0 and a sensitivity of 86.7. Noninvasive ICP estimation may be useful in patients at risk of developing intracranial hypertension who require prone positioning.

About Non-Line-Of-Sight Satellite Detection and Exclusion in a 3D Map-Aided Localization Algorithm

PubMed Central

Peyraud, Sébastien; Bétaille, David; Renault, Stéphane; Ortiz, Miguel; Mougel, Florian; Meizel, Dominique; Peyret, François

2013-01-01

Reliable GPS positioning in city environment is a key issue actually, signals are prone to multipath, with poor satellite geometry in many streets. Using a 3D urban model to forecast satellite visibility in urban contexts in order to improve GPS localization is the main topic of the present article. A virtual image processing that detects and eliminates possible faulty measurements is the core of this method. This image is generated using the position estimated a priori by the navigation process itself, under road constraints. This position is then updated by measurements to line-of-sight satellites only. This closed-loop real-time processing has shown very first promising full-scale test results. PMID:23344379

Hip rotation range of motion in sitting and prone positions in healthy Japanese adults

PubMed Central

Han, Heonsoo; Kubo, Akira; Kurosawa, Kazuo; Maruichi, Shizuka; Maruyama, Hitoshi

2015-01-01

[Purpose] The aim of this study was to elucidate the difference in hip external and internal rotation ranges of motion (ROM) between the prone and sitting positions. [Subjects] The subjects included 151 students. [Methods] Hip rotational ROM was measured with the subjects in the prone and sitting positions. Two-way repeated measures analysis of variance (ANOVA) was used to analyze ipsilateral hip rotation ROM in the prone and sitting positions in males and females. The total ipsilateral hip rotation ROM was calculated by adding the measured values for external and internal rotations. [Results] Ipsilateral hip rotation ROM revealed significant differences between two positions for both left and right internal and external rotations. Hip rotation ROM was significantly higher in the prone position than in the sitting position. Hip rotation ROM significantly differed between the men and women. Hip external rotation ROM was significantly higher in both positions in men; conversely, hip internal rotation ROM was significantly higher in both positions in women. [Conclusion] Hip rotation ROM significantly differed between the sexes and between the sitting and prone positions. Total ipsilateral hip rotation ROM, total angle of external rotation, and total angle of internal rotation of the left and right hips greatly varied, suggesting that hip joint rotational ROM is widely distributed. PMID:25729186

The effect of prone positioning in acute respiratory distress syndrome or acute lung injury: a meta-analysis. Areas of uncertainty and recommendations for research.

PubMed

Abroug, Fekri; Ouanes-Besbes, Lamia; Elatrous, Souheil; Brochard, Laurent

2008-06-01

To compare the effects of ventilation in prone and in supine position in patients with acute lung injury/acute respiratory distress syndrome (ALI/ARDS). Meta-analysis of randomised controlled trials. BioMedCentral, PubMed, CINAHL, and Embase (to November 2007), with additional information from authors. From selected randomised controlled trials comparing positioning in ALI/ARDS we extracted data concerning study design, disease severity, clinical outcomes, and adverse events. Five trials including 1,372 patients met the inclusion criteria for mortality analysis; one trial was added to assess the effects on acquisition of ventilator-associated pneumonia (VAP). The included trials were significantly underpowered and enrolled patients with varying severity. Prone positioning duration and mechanical ventilation strategy were not standardised across studies. Using a fixed-effects model, we did not find a significant effect of prone positioning (proning) on mortality (odds ratio 0.97, 95% confidence interval 0.77-1.22). The PaO(2)/FiO(2) ratio increased significantly more with proning (weighted means difference 25 mmHg, p < 0.00001). Proning was associated with a non-significant 23% reduction in the odds of VAP (p=0.09), and with no increase in major adverse airway complications: OR 1.01, 95% CI 0.71-1.43. Length of intensive care unit stay was marginally and not significantly increased by proning. Prone position is not associated with a significant reduction in mortality from ALI/ARDS despite a significant increase in PaO(2)/FiO(2), is safe, and tends to decrease VAP. Published studies exhibit substantial clinical heterogeneity, suggesting that an adequately sized study optimising the duration of proning and ventilation strategy is warranted to enable definitive conclusions to be drawn.

The gravitational distribution of ventilation-perfusion ratio is more uniform in prone than supine posture in the normal human lung

PubMed Central

Sá, Rui Carlos; Theilmann, Rebecca J.; Buxton, Richard B.; Prisk, G. Kim; Hopkins, Susan R.

2013-01-01

The gravitational gradient of intrapleural pressure is suggested to be less in prone posture than supine. Thus the gravitational distribution of ventilation is expected to be more uniform prone, potentially affecting regional ventilation-perfusion (V̇a/Q̇) ratio. Using a novel functional lung magnetic resonance imaging technique to measure regional V̇a/Q̇ ratio, the gravitational gradients in proton density, ventilation, perfusion, and V̇a/Q̇ ratio were measured in prone and supine posture. Data were acquired in seven healthy subjects in a single sagittal slice of the right lung at functional residual capacity. Regional specific ventilation images quantified using specific ventilation imaging and proton density images obtained using a fast gradient-echo sequence were registered and smoothed to calculate regional alveolar ventilation. Perfusion was measured using arterial spin labeling. Ventilation (ml·min−1·ml−1) images were combined on a voxel-by-voxel basis with smoothed perfusion (ml·min−1·ml−1) images to obtain regional V̇a/Q̇ ratio. Data were averaged for voxels within 1-cm gravitational planes, starting from the most gravitationally dependent lung. The slope of the relationship between alveolar ventilation and vertical height was less prone than supine (−0.17 ± 0.10 ml·min−1·ml−1·cm−1 supine, −0.040 ± 0.03 prone ml·min−1·ml−1·cm−1, P = 0.02) as was the slope of the perfusion-height relationship (−0.14 ± 0.05 ml·min−1·ml−1·cm−1 supine, −0.08 ± 0.09 prone ml·min−1·ml−1·cm−1, P = 0.02). There was a significant gravitational gradient in V̇a/Q̇ ratio in both postures (P < 0.05) that was less in prone (0.09 ± 0.08 cm−1 supine, 0.04 ± 0.03 cm−1 prone, P = 0.04). The gravitational gradients in ventilation, perfusion, and regional V̇a/Q̇ ratio were greater supine than prone, suggesting an interplay between thoracic cavity configuration, airway and vascular tree anatomy, and the effects of gravity on V̇a/Q̇ matching. PMID:23620488

Undermining optimistic denial reactions to domestic and campus emergency warning messages.

PubMed

Thompson, Suzanne C; Schlehofer, Michele M

2014-07-01

Individuals who prepare for public emergencies can mitigate the effects of an incident, but denial of personal susceptibility may reduce the likelihood of preparation. Some denial may be due to a positive self-image that is at odds with being "at risk". The potential for an enhanced warning message that included a positive image of a protector to circumvent this denial was tested in two studies. Optimistic denial threat orientation was measured. Then participants received either a traditional or a positive protector warning message about terrorism (Study 1; nationally representative sample of US adults; N = 587) or campus emergency preparation (Study 2; US college students; N = 179). As predicted, in the enhanced image condition optimistic denial was no longer related to stronger denial reactions and lower intentions to protect oneself. In addition, Study 2 tested explanatory mediators and found that negative perceptions of and low similarity to a protector partially explained the denial of those higher in optimistic denial and why their denial was dampened in the positive image condition. An enhanced message including a positive image of protector may be an effective way to encourage protection for those prone to optimistic denial. © 2014 The International Association of Applied Psychology.

SU-E-J-21: Setup Variability of Colorectal Cancer Patients Treated in the Prone Position and Dosimetric Comparison with the Supine Position

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

Kim, A; Foster, J; Chu, W

2015-06-15

Purpose: Many cancer centers treat colorectal patients in the prone position on a belly board to minimize dose to the small bowel. That may potentially Result in patient setup instability with corresponding impact on dose delivery accuracy for highly conformal techniques such as IMRT/VMAT. Two aims of this work are 1) to investigate setup accuracy of rectum patients treated in the prone position on a belly board using CBCT and 2) to evaluate dosimetric impact on bladder and small bowel of treating rectum patients in supine vs. prone position. Methods: For the setup accuracy study, 10 patients were selected. Weeklymore » CBCTs were acquired and matched to bone. The CBCT-determined shifts were recorded. For the dosimetric study, 7 prone-setup patients and 7 supine-setup patients were randomly selected from our clinical database. Various clinically relevant dose volume histogram values were recorded for the small bowel and bladder. Results: The CBCT-determined rotational shifts had a wide variation. For the dataset acquired at the time of this writing, the ranges of rotational setup errors for pitch, roll, and yaw were [−3.6° 4.7°], [−4.3° 3.2°], and [−1.4° 1.4°]. For the dosimetric study: the small bowel V(45Gy) and mean dose for the prone position was 5.6±12.1% and 18.4±6.2Gy (ranges indicate standard deviations); for the supine position the corresponding dose values were 12.9±15.8% and 24.7±8.8Gy. For the bladder, the V(30Gy) and mean dose for prone position were 68.7±12.7% and 38.4±3.3Gy; for supine position these dose values were 77.1±13.7% and 40.7±3.1Gy. Conclusion: There is evidence of significant rotational instability in the prone position. The OAR dosimetry study indicates that there are some patients that may still benefit from the prone position, though many patients can be safely treated supine.« less

Efficacy of prone position in acute respiratory distress syndrome patients: A pathophysiology-based review

PubMed Central

Koulouras, Vasilios; Papathanakos, Georgios; Papathanasiou, Athanasios; Nakos, Georgios

2016-01-01

Acute respiratory distress syndrome (ARDS) is a syndrome with heterogeneous underlying pathological processes. It represents a common clinical problem in intensive care unit patients and it is characterized by high mortality. The mainstay of treatment for ARDS is lung protective ventilation with low tidal volumes and positive end-expiratory pressure sufficient for alveolar recruitment. Prone positioning is a supplementary strategy available in managing patients with ARDS. It was first described 40 years ago and it proves to be in alignment with two major ARDS pathophysiological lung models; the “sponge lung” - and the “shape matching” -model. Current evidence strongly supports that prone positioning has beneficial effects on gas exchange, respiratory mechanics, lung protection and hemodynamics as it redistributes transpulmonary pressure, stress and strain throughout the lung and unloads the right ventricle. The factors that individually influence the time course of alveolar recruitment and the improvement in oxygenation during prone positioning have not been well characterized. Although patients’ response to prone positioning is quite variable and hard to predict, large randomized trials and recent meta-analyses show that prone position in conjunction with a lung-protective strategy, when performed early and in sufficient duration, may improve survival in patients with ARDS. This pathophysiology-based review and recent clinical evidence strongly support the use of prone positioning in the early management of severe ARDS systematically and not as a rescue maneuver or a last-ditch effort. PMID:27152255

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

An automated calibration method for non-see-through head mounted displays.

PubMed

Gilson, Stuart J; Fitzgibbon, Andrew W; Glennerster, Andrew

2011-08-15

Accurate calibration of a head mounted display (HMD) is essential both for research on the visual system and for realistic interaction with virtual objects. Yet, existing calibration methods are time consuming and depend on human judgements, making them error prone, and are often limited to optical see-through HMDs. Building on our existing approach to HMD calibration Gilson et al. (2008), we show here how it is possible to calibrate a non-see-through HMD. A camera is placed inside a HMD displaying an image of a regular grid, which is captured by the camera. The HMD is then removed and the camera, which remains fixed in position, is used to capture images of a tracked calibration object in multiple positions. The centroids of the markers on the calibration object are recovered and their locations re-expressed in relation to the HMD grid. This allows established camera calibration techniques to be used to recover estimates of the HMD display's intrinsic parameters (width, height, focal length) and extrinsic parameters (optic centre and orientation of the principal ray). We calibrated a HMD in this manner and report the magnitude of the errors between real image features and reprojected features. Our calibration method produces low reprojection errors without the need for error-prone human judgements. Copyright © 2011 Elsevier B.V. All rights reserved.

Whole-breast irradiation: a subgroup analysis of criteria to stratify for prone position treatment

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

Ramella, Sara, E-mail: s.ramella@unicampus.it; Trodella, Lucio; Ippolito, Edy

2012-07-01

To select among breast cancer patients and according to breast volume size those who may benefit from 3D conformal radiotherapy after conservative surgery applied with prone-position technique. Thirty-eight patients with early-stage breast cancer were grouped according to the target volume (TV) measured in the supine position: small ({<=}400 mL), medium (400-700 mL), and large ({>=}700 ml). An ad-hoc designed and built device was used for prone set-up to displace the contralateral breast away from the tangential field borders. All patients underwent treatment planning computed tomography in both the supine and prone positions. Dosimetric data to explore dose distribution and volumemore » of normal tissue irradiated were calculated for each patient in both positions. Homogeneity index, hot spot areas, the maximum dose, and the lung constraints were significantly reduced in the prone position (p < 0.05). The maximum heart distance and the V{sub 5Gy} did not vary consistently in the 2 positions (p = 0.06 and p = 0.7, respectively). The number of necessary monitor units was significantly higher in the supine position (312 vs. 232, p < 0.0001). The subgroups analysis pointed out the advantage in lung sparing in all TV groups (small, medium and large) for all the evaluated dosimetric constraints (central lung distance, maximum lung distance, and V{sub 5Gy}, p < 0.0001). In the small TV group, a dose reduction in nontarget areas of 22% in the prone position was detected (p = 0.056); in the medium and high TV groups, the difference was of about -10% (p = NS). The decrease in hot spot areas in nontarget tissues was 73%, 47%, and 80% for small, medium, and large TVs in the prone position, respectively. Although prone breast radiotherapy is normally proposed in patients with breasts of large dimensions, this study gives evidence of dosimetric benefit in all patient subgroups irrespective of breast volume size.« less

Prone positioning for head and neck reconstructive surgery.

PubMed

Mobley, Steven Ross; Miller, Brian Thomas; Astor, Frank C; Fine, Bradley; Halliday, N James

2007-11-01

Certain head and neck surgical cases require the patient to be positioned prone. Such positioning carries with it an attendant subset of risks and complications not otherwise encountered in more traditional supine positioning. Gaining awareness of these risks and complications, and developing proactive positioning strategies, will enable the surgical team to position the patient optimally for the procedure and provide for every consideration of patient safety. This article consists of a specific literature review of those issues directly related to the anatomical and physiological concerns arising from prone positioning. Particular attention is paid to the cardiopulmonary, renal, ophthalmologic, and neurological vulnerabilities unique to this position. Proper planning by the surgical team and utilization of the correct equipment are a necessity. A tailored approach to the needs of the individual patient and an intimate awareness of the potential pitfalls will contribute to better outcomes when using the prone position.

Effects of systematic prone positioning in hypoxemic acute respiratory failure: a randomized controlled trial.

PubMed

Guerin, Claude; Gaillard, Sandrine; Lemasson, Stephane; Ayzac, Louis; Girard, Raphaele; Beuret, Pascal; Palmier, Bruno; Le, Quoc Viet; Sirodot, Michel; Rosselli, Sylvaine; Cadiergue, Vincent; Sainty, Jean-Marie; Barbe, Philippe; Combourieu, Emmanuel; Debatty, Daniel; Rouffineau, Jean; Ezingeard, Eric; Millet, Olivier; Guelon, Dominique; Rodriguez, Luc; Martin, Olivier; Renault, Anne; Sibille, Jean-Paul; Kaidomar, Michel

2004-11-17

A recent trial showed that placing patients with acute lung injury in the prone position did not increase survival; however, whether those results hold true for patients with hypoxemic acute respiratory failure (ARF) is unclear. To determine whether prone positioning improves mortality in ARF patients. Prospective, unblinded, multicenter controlled trial of 791 ARF patients in 21 general intensive care units in France using concealed randomization conducted from December 14, 1998, through December 31, 2002. To be included, patients had to be at least 18 years, hemodynamically stable, receiving mechanical ventilation, and intubated and had to have a partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FIO2) ratio of 300 or less and no contraindications to lying prone. Patients were randomly assigned to prone position placement (n = 413), applied as early as possible for at least 8 hours per day on standard beds, or to supine position placement (n = 378). The primary end point was 28-day mortality; secondary end points were 90-day mortality, duration of mechanical ventilation, incidence of ventilator-associated pneumonia (VAP), and oxygenation. The 2 groups were comparable at randomization. The 28-day mortality rate was 32.4% for the prone group and 31.5% for the supine group (relative risk [RR], 0.97; 95% confidence interval [CI], 0.79-1.19; P = .77). Ninety-day mortality for the prone group was 43.3% vs 42.2% for the supine group (RR, 0.98; 95% CI, 0.84-1.13; P = .74). The mean (SD) duration of mechanical ventilation was 13.7 (7.8) days for the prone group vs 14.1 (8.6) days for the supine group (P = .93) and the VAP incidence was 1.66 vs 2.14 episodes per 100-patients days of intubation, respectively (P = .045). The PaO2/FIO2 ratio was significantly higher in the prone group during the 28-day follow-up. However, pressure sores, selective intubation, and endotracheal tube obstruction incidences were higher in the prone group. This trial demonstrated no beneficial outcomes and some safety concerns associated with prone positioning. For patients with hypoxemic ARF, prone position placement may lower the incidence of VAP.

Prone Positioning Improves Oxygenation in Adult Burn Patients with Severe Acute Respiratory Distress Syndrome

DTIC Science & Technology

2012-01-01

Prone positioning improves oxygenation in adult burn patients with severe acute respiratory distress syndrome Diane F. Hale, MD, Jeremy W. Cannon, MD...Kevin K. Chung, MD, San Antonio, Texas BACKGROUND: Prone positioning (PP) improves oxygenation and may provide a benefit in patients with acute... positioning improves oxygenation in adult burn patients with severe acute respiratory distress syndrome 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM

Factors among patients receiving prone positioning for the acute respiratory distress syndrome found useful for predicting mortality in the intensive care unit.

PubMed

Modrykamien, Ariel M; Daoud, Yahya

2018-01-01

Optimal mechanical ventilation management in patients with the acute respiratory distress syndrome (ARDS) involves the use of low tidal volumes and limited plateau pressure. Refractory hypoxemia may not respond to this strategy, requiring other interventions. The use of prone positioning in severe ARDS resulted in improvement in 28-day survival. To determine whether mechanical ventilation strategies or other parameters affected survival in patients undergoing prone positioning, a retrospective analysis was conducted of a consecutive series of patients with severe ARDS treated with prone positioning. Demographic and clinical information involving mechanical ventilation strategies, as well as other variables associated with prone positioning, was collected. The rate of in-hospital mortality was obtained, and previously described parameters were compared between survivors and nonsurvivors. Forty-three patients with severe ARDS were treated with prone positioning, and 27 (63%) died in the intensive care unit. Only three parameters were significant predictors of survival: APACHE II score ( P = 0.03), plateau pressure ( P = 0.02), and driving pressure ( P = 0.04). The ability of each of these parameters to predict mortality was assessed with receiver operating characteristic curves. The area under the curve values for APACHE II, plateau pressure, and driving pressure were 0.74, 0.69, and 0.67, respectively. In conclusion, in a group of patients with severe ARDS treated with prone positioning, only APACHE II, plateau pressure, and driving pressure were associated with mortality in the intensive care unit.

Health departments do it better: prenatal care site and prone infant sleep position.

PubMed

Lahr, Martin B; Rosenberg, Kenneth D; Lapidus, Jodi A

2005-06-01

Reduction of prone infant sleep position has been the main public health effort to reduce the incidence of Sudden Infant Death Syndrome (SIDS). Oregon Pregnancy Risk Assessment Monitoring System (PRAMS) surveys a stratified random sample of women after a live birth. In 1998-1999, 1867 women completed the survey (64.0% unweighted response; 73.5% weighted response). Overall, 9.2% of all women "usually" chose prone infant sleep position, while 24.2% chose side and 66.5% chose supine position. Women receiving care from private physicians or HMOs more often chose prone position (10.6%) than women receiving prenatal care from health department clinics (2.5%), hospital clinics (6.1%) or other sites (8.3%). Compared to health department prenatal clinic patients, private prenatal patients were more likely to choose prone infant sleep position, adjusted odds ratio = 4.78 (95% confidence interval [CI] 1.64-13.92). Health Department clinics have done a better job than private physicians in educating mothers about putting infants to sleep on their backs. Providers-especially private providers-should continue to stress the importance of supine sleep position for infants.

Effects on lung stress of position and different doses of perfluorocarbon in a model of ARDS.

PubMed

López-Aguilar, Josefina; Lucangelo, Umberto; Albaiceta, Guillermo M; Nahum, Avi; Murias, Gastón; Cañizares, Rosario; Oliva, Joan Carles; Romero, Pablo V; Blanch, Lluís

2015-05-01

We determined whether the combination of low dose partial liquid ventilation (PLV) with perfluorocarbons (PFC) and prone positioning improved lung function while inducing minimal stress. Eighteen pigs with acute lung injury were assigned to conventional mechanical ventilation (CMV) or PLV (5 or 10 ml/kg of PFC). Positive end-expiratory pressure (PEEP) trials in supine and prone positions were performed. Data were analyzed by a multivariate polynomial regression model. The interplay between PLV and position depended on the PEEP level. In supine PLV dampened the stress induced by increased PEEP during the trial. The PFC dose of 5 ml/kg was more effective than the dose 10 ml/kg. This effect was not observed in prone. Oxygenation was significantly higher in prone than in supine position mainly at lower levels of PEEP. In conclusion, MV settings should take both gas exchange and stress/strain into account. When protective CMV fails, rescue strategies combining prone positioning and PLV with optimal PEEP should improve gas exchange with minimal stress. Copyright © 2015 Elsevier B.V. All rights reserved.

Initial clinical experience with a quadrupole butterfly coil for spinal injection interventions in an open MRI system at 1.0 tesla.

PubMed

Jonczyk, Martin; Hamm, Bernd; Heinrich, Andreas; Thomas, Andreas; Rathke, Hendrik; Schnackenburg, Bernhard; Güttler, Felix; Teichgräber, Ulf K M; de Bucourt, Maximilian

2014-02-01

To report our initial clinical experience with a new magnetic resonance imaging (MRI) quadrupole coil that allows interventions in prone position. Fifteen patients (seven women, eight men; average age, 42.8 years) were treated in the same 1.0-Tesla Panorama High Field Open (HFO) MRI system (Panorama HFO) using a quadrupole butterfly coil (Bfly) and compared with 15 patients matched for sex, age, and MR intervention using the MultiPurposeL coil (MPL), performed in conventional lateral decubitus position (all, Philips Medical Systems, Best, The Netherlands). All interventions were performed with a near-real-time proton density turbo spin echo (PD TSE) sequence (time to repeat/time to echo/flip angle/acquisition time, 600 ms/10 ms/90°/3 s/image). Qualitative and quantitative image analyses were performed, including signal intensity, signal-to-noise and contrast-to-noise ratio (SNR, CNR), contrast, and full width at half maximum (FWHM) measurements. Contrast differed significantly between the needle and muscles (Bfly 0.27/MPL 0.17), as well as the needle and periradicular fat (0.13/0.24) during the intervention (both, p=0.029), as well as the CNR between muscles and the needle (10.61/5.23; p=0.010), although the FWHM values did not (2.4/2.2; p=0.754). The signal intensity of the needle in interventional imaging (1152.9/793.2; p=0.006) and the postinterventional SNR values of subcutaneous fat (15.3/28.6; p=0.007), muscles (6.6/11.8; p=0.011), and the CNR between these tissues (8.7/17.5; p=0.004) yielded significant differences. The new coil is a valid alternative for MR-guided interventions in an open MRI system at 1.0 tesla, especially if patients cannot (or prefer not to) be in a lateral decubitus position or if prone positioning yields better access to the target zone.

Biomechanical modelling for breast image registration

NASA Astrophysics Data System (ADS)

Lee, Angela; Rajagopal, Vijay; Chung, Jae-Hoon; Bier, Peter; Nielsen, Poul M. F.; Nash, Martyn P.

2008-03-01

Breast cancer is a leading cause of death in women. Tumours are usually detected by palpation or X-ray mammography followed by further imaging, such as magnetic resonance imaging (MRI) or ultrasound. The aim of this research is to develop a biophysically-based computational tool that will allow accurate collocation of features (such as suspicious lesions) across multiple imaging views and modalities in order to improve clinicians' diagnosis of breast cancer. We have developed a computational framework for generating individual-specific, 3D finite element models of the breast. MR images were obtained of the breast under gravity loading and neutrally buoyant conditions. Neutrally buoyant breast images, obtained whilst immersing the breast in water, were used to estimate the unloaded geometry of the breast (for present purposes, we have assumed that the densities of water and breast tissue are equal). These images were segmented to isolate the breast tissues, and a tricubic Hermite finite element mesh was fitted to the digitised data points in order to produce a customized breast model. The model was deformed, in accordance with finite deformation elasticity theory, to predict the gravity loaded state of the breast in the prone position. The unloaded breast images were embedded into the reference model and warped based on the predicted deformation. In order to analyse the accuracy of the model predictions, the cross-correlation image comparison metric was used to compare the warped, resampled images with the clinical images of the prone gravity loaded state. We believe that a biomechanical image registration tool of this kind will aid radiologists to provide more reliable diagnosis and localisation of breast cancer.

Prone positioning in hypoxemic respiratory failure: meta-analysis of randomized controlled trials.

PubMed

Kopterides, Petros; Siempos, Ilias I; Armaganidis, Apostolos

2009-03-01

Prone positioning is used to improve oxygenation in patients with hypoxemic respiratory failure (HRF). However, its role in clinical practice is not yet clearly defined. The aim of this meta-analysis was to assess the effect of prone positioning on relevant clinical outcomes, such as intensive care unit (ICU) and hospital mortality, days of mechanical ventilation, length of stay, incidence of ventilator-associated pneumonia (VAP) and pneumothorax, and associated complications. We used literature search of MEDLINE, Current Contents, and Cochrane Central Register of Controlled Trials. We focused only on randomized controlled trials reporting clinical outcomes in adult patients with HRF. Four trials met our inclusion criteria, including 662 patients randomized to prone ventilation and 609 patients to supine ventilation. The pooled odds ratio (OR) for the ICU mortality in the intention-to-treat analysis was 0.97 (95% confidence interval [CI], 0.77-1.22), for the comparison between prone and supine ventilated patients. Interestingly, the pooled OR for the ICU mortality in the selected group of the more severely ill patients favored prone positioning (OR, 0.34; 95% CI, 0.18-0.66). The duration of mechanical ventilation and the incidence of pneumothorax were not different between the 2 groups. The incidence of VAP was lower but not statistically significant in patients treated with prone positioning (OR, 0.81; 95% CI, 0.61-1.10). However, prone positioning was associated with a higher risk of pressure sores (OR, 1.49; 95% CI, 1.17-1.89) and a trend for more complications related to the endotracheal tube (OR, 1.30; 95% CI, 0.94-1.80). Despite the inherent limitations of the meta-analytic approach, it seems that prone positioning has no discernible effect on mortality in patients with HRF. It may decrease the incidence of VAP at the expense of more pressure sores and complications related to the endotracheal tube. However, a subgroup of the most severely ill patients may benefit most from this intervention.

SU-F-T-520: Dosimetric Comparison of Radiation Treatment Plans for Whole Breast Irradiation Between 3D Conformal in Prone and Supine Positions Vs. VMAT and IMRT in Supine Positions

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

Bejarano Buele, A; Parsai, E

Purpose: The target volume for Whole Breast Irradiation (WBI) is dictated by location of tumor mass, breast tissue distribution, and involvement of lymph nodes. Dose coverage and Organs at Risk (OARs) sparing can be difficult to achieve in patients with unfavorable thoracic geometries. For these cases, inverse-planned and 3D-conformal prone treatments can be alternatives to traditional supine 3D-conformal plans. A dosimetric comparison can determine which of these techniques achieve optimal target coverage while sparing OARs. Methods: This study included simulation datasets for 8 patients, 5 of whom were simulated in both supine and prone positions. Positioning devices included breast boardsmore » and Vaclok bags for the supine position, and prone breast boards for the prone position. WBI 3-D conformal plans were created for patients simulated in both positions. Additional VMAT and IMRT WBI plans were made for all patients in the supine position. Results: Prone and supine 3D conformal plans had comparable PTV coverage. Prone 3D conformal plans received a significant 50% decrease to V20, V10, V5 and V30% for the ipsilateral lung in contrast to the supine plans. The heart also experienced a 10% decrease in maximum dose in the prone position, and V20, V10, V5 and V2 had significantly lower values than the supine plan. Supine IMRT and VMAT breast plans obtained comparable PTV coverage. The heart experienced a 10% decrease in maximum dose with inverse modulated plans when compared to the supine 3D conformal plan, while V20, V10, V5 and V2 showed higher values with inverse modulated plans than with supine 3D conformal plans. Conclusion: Prone 3D-conformal, and supine inverse planned treatments were generally superior in sparing OARs to supine plans with comparable PTV coverage. IMRT and VMAT plans offer sparing of OARs from high dose regions with an increase of irradiated volume in the low dose regions.« less

Influence of prone positioning on premature newborn infant stress assessed by means of salivary cortisol measurement: pilot study.

PubMed

Cândia, Maria Fernanda; Osaku, Erica Fernanda; Leite, Marcela Aparecida; Toccolini, Beatriz; Costa, Nicolle Lamberti; Teixeira, Sandy Nogueira; Costa, Claudia Rejane Lima de Macedo; Piana, Pitágoras Augusto; Cristovam, Marcos Antonio da Silva; Osaku, Nelson Ossamu

2014-01-01

This study sought to assess the influence of prone positioning on the stress of newborn premature infants through the measurement of the salivary cortisol concentration and the evaluation of physiological and behavioral responses before and after changes in body positioning. Saliva samples were collected from newborn infants at two different times: the first (corresponding to the baseline) after a period of 40 minutes during which the infants were not subjected to any manipulation and were placed in the lateral or supine position, and the second 30 minutes after placement in the prone position. Variables including heart rate, respiratory rate, peripheral oxygen saturation, and the Brazelton sleep score were recorded before, during, and at the end of the period in the prone position. The sample comprised 16 newborn premature infants (56.3% male) with a gestational age between 26 and 36 weeks, postnatal age between 1 and 33 days, birth weight of 935 to 3,050g, and weight at the time of intervention of 870 to 2,890g. During the intervention, six participants breathed room air, while the remainder received oxygen therapy. The median salivary cortisol concentration was lower in the prone position compared to baseline (0.13 versus 0.20; p=0.003), as was the median Brazelton sleep score (p=0.02). The average respiratory rate was lower after the intervention (54.88±7.15 versus 60±7.59; p=0.0004). The remainder of the investigated variables did not exhibit significant variation. Prone positioning significantly reduced the salivary cortisol level, respiratory rate, and Brazelton sleep score, suggesting a correlation between prone positioning and reduction of stress in preterm infants.

Optimal reproducibility of gated sestamibi and thallium myocardial perfusion study left ventricular ejection fractions obtained on a solid-state CZT cardiac camera requires operator input.

PubMed

Cherk, Martin H; Ky, Jason; Yap, Kenneth S K; Campbell, Patrina; McGrath, Catherine; Bailey, Michael; Kalff, Victor

2012-08-01

To evaluate the reproducibility of serial re-acquisitions of gated Tl-201 and Tc-99m sestamibi left ventricular ejection fraction (LVEF) measurements obtained on a new generation solid-state cardiac camera system during myocardial perfusion imaging and the importance of manual operator optimization of left ventricular wall tracking. Resting blinded automated (auto) and manual operator optimized (opt) LVEF measurements were measured using ECT toolbox (ECT) and Cedars-Sinai QGS software in two separate cohorts of 55 Tc-99m sestamibi (MIBI) and 50 thallium (Tl-201) myocardial perfusion studies (MPS) acquired in both supine and prone positions on a cadmium zinc telluride (CZT) solid-state camera system. Resting supine and prone automated LVEF measurements were similarly obtained in a further separate cohort of 52 gated cardiac blood pool scans (GCBPS) for validation of methodology and comparison. Appropriate use of Bland-Altman, chi-squared and Levene's equality of variance tests was used to analyse the resultant data comparisons. For all radiotracer and software combinations, manual checking and optimization of valve planes (+/- centre radius with ECT software) resulted in significant improvement in MPS LVEF reproducibility that approached that of planar GCBPS. No difference was demonstrated between optimized MIBI/Tl-201 QGS and planar GCBPS LVEF reproducibility (P = .17 and P = .48, respectively). ECT required significantly more manual optimization compared to QGS software in both supine and prone positions independent of radiotracer used (P < .02). Reproducibility of gated sestamibi and Tl-201 LVEF measurements obtained during myocardial perfusion imaging with ECT toolbox or QGS software packages using a new generation solid-state cardiac camera with improved image quality approaches that of planar GCBPS however requires visual quality control and operator optimization of left ventricular wall tracking for best results. Using this superior cardiac technology, Tl-201 reproducibility also appears at least equivalent to sestamibi for measuring LVEF.

Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

PubMed

Macke, Jeremy J; Woo, Raymund; Varich, Laura

2016-06-01

This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS. Given the potential for serious complications, the need for improved accuracy of screw placement has spurred multiple innovations including robot-assisted guidance devices. No studies to date have evaluated this robot-assisted technique using CT exclusively within the AIS population. Fifty patients were included in the study. All operative procedures were performed at a single institution by a single pediatric orthopedic surgeon. We evaluated the grade of screw breach, the direction of screw breach, and the positioning of the patient for preoperative scan (supine versus prone). Of 662 screws evaluated, 48 screws (7.2 %) demonstrated a breach of greater than 2 mm. With preoperative prone position CT scanning, only 2.4 % of screws were found to have this degree of breach. Medial malposition was found in 3 % of screws, a rate which decreased to 0 % with preoperative prone position scanning. Based on our results, we conclude that the proper use of image-guided robot-assisted surgery can improve the accuracy and safety of thoracic pedicle screw placement in patients with adolescent idiopathic scoliosis. This is the first study to evaluate the accuracy of pedicle screw placement using CT assessment in robot-assisted surgical correction of patients with AIS. In our study, the robot-assisted screw misplacement rate was lower than similarly constructed studies evaluating conventional (non-robot-assisted) procedures. If patients are preoperatively scanned in the prone position, the misplacement rate is further decreased.

Positioning of patients with acute respiratory distress syndrome: combining prone and upright makes sense.

PubMed

Richard, Jean-Christophe M; Lefebvre, Jean-Claude

2011-01-01

Positional strategies have been proposed for mechanically ventilated patients with acute respiratory distress syndrome. Despite different physiological mechanisms involved, oxygenation improvement has been demonstrated with both prone and upright positions. In the previous issue of Critical Care, Robak and colleagues reported the first study evaluating the short-term effects of combining prone and upright positioning. The combined positioning enhanced the response rate in terms of oxygenation. Other benefits, such as a reduction in ventilator-associated pneumonia and better enteral feeding tolerance, can potentially be expected.

Ultrasonographic examination of plantar fasciitis: a comparison of patient positions during examination.

PubMed

Ahn, Jae Hoon; Lee, Choong Woo; Park, ChanJoo; Kim, Yoon-Chung

2016-01-01

Musculoskeletal ultrasound is a non-invasive and low-cost modality for real-time visualisation of the plantar fascia. Ultrasound examination for plantar fasciitis is generally performed with the patient in a prone position, although the rational for using a prone position has not been validated. The aim of the study was to investigate if ultrasound examination in a supine position, which is more comfortable than the prone position, is valid. We conducted a prospective study of 30 participants with plantar fasciitis, 8 men (27 %) and 22 women (73 %), with a mean age of 53.9 ± 12.6 (range, 32 to 77) years, and an equal distribution of left and right feet. The plantar heel was divided into three portions for ultrasound examination: medial, central and lateral. Two measurements of plantar fascia thickness were obtained for each portion, with participants in 2 positions (supine and prone) and for 2 ankle postures (neutral and 15° of plantarflexion). Mean measurements of plantar fascia thickness were compared between the two positions (Wilcoxon signed rank tests for non-normally distributed data and paired t-tests for normally distributed data). Participants were asked to report their preferred position for examination, supine or prone. The measured thickness was comparable for both supine and prone positions, for both ankle postures, neutral and 15° of plantarflexion (p > 0.05). A specific self-reported preferred position was not identified. Ultrasound examination of plantar fasciitis can be performed in the supine position without any significant difference in measurement compared to examination in the conventional prone position. The Catholic Medical Center Office of Human Research Protection Program (CMC-OHRP)/Institutional Review Board approved the current study (Approval No. KC12DISI0338), and all participants provided their written informed consent for participation and publication.

Optimal Patient Positioning (Prone Versus Supine) for VMAT in Gynecologic Cancer: A Dosimetric Study on the Effect of Different Margins

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

Heijkoop, Sabrina T., E-mail: s.heijkoop@erasmusmc.nl; Westerveld, Henrike; Bijker, Nina

Purpose/Objective: It is unknown whether the historically found dosimetric advantages of treating gynecologic cancer with the patient in a prone position with use of a small-bowel displacement device (belly-board) remain when volumetric arc therapy (VMAT) is used and whether these advantages depend on the necessary margin between clinical target volume (CTV) and planning target volume (PTV). The aim of this study is to determine the best patient position (prone or supine) in terms of sparing organs at risk (OAR) for various CTV-to-PTV margins and VMAT dose delivery. Methods and Materials: In an institutional review board—approved study, 26 patients with gynecologicmore » cancer scheduled for primary (9) or postoperative (17) radiation therapy were scanned in a prone position on a belly-board and in a supine position on the same day. The primary tumor CTV, nodal CTV, bladder, bowel, and rectum were delineated on both scans. The PTVs were created each with a different margin for the primary tumor and nodal CTV. The VMAT plans were generated with our in-house system for automated treatment planning. For all margin combinations, the supine and prone plans were compared with consideration of all OAR dose-volume parameters but with highest priority given to bowel cavity V{sub 45Gy} (cm{sup 3}). Results: For both groups, the prone position reduced the bowel cavity V{sub 45Gy}, in particular for nodal margins ≥10 mm (ΔV{sub 45Gy} = 23.9 ± 10.6 cm{sup 3}). However, for smaller margins, the advantage was much less pronounced (ΔV{sub 45Gy} = 6.5 ± 3.0 cm{sup 3}) and did not reach statistical significance. The rectum mean dose (D{sub mean}) was significantly lower (ΔD{sub mean} = 2.5 ± 0.3 Gy) in the prone position for both patient groups and for all margins, and the bladder D{sub mean} was significantly lower in the supine position (ΔD{sub mean} = 2.6 ± 0.4 Gy) only for the postoperative group. The advantage of the prone position was not present if it needed a larger margin than the supine position. Conclusion: For patients with gynecologic cancer, the historically found dosimetric advantages for the prone position remain for modern dose delivery techniques if large margins are needed. However, the advantage is lost for small margins and if the prone position needs a larger margin than the supine position.« less

Interactions between sleeping position and feeding on cardiorespiratory activity in preterm infants.

PubMed

Fifer, William P; Myers, Michael M; Sahni, Rakesh; Ohira-Kist, Kiyoko; Kashyap, Sudha; Stark, Raymond I; Schulze, Karl F

2005-11-01

Infants sleeping in the prone position are at greater risk for sudden infant death syndrome (SIDS). Sleep position-dependent changes in cardiorespiratory activity may contribute to this increased risk. Cardiorespiratory activity is also affected by feeding. Twenty prematurely-born infants were studied at 31-36 weeks postconceptional age while sleeping in the prone and supine positions. Heart rate, respiratory rate, and patterns of variability were recorded during interfeed intervals, and effects of position and time after feeding were analyzed by repeated measures analyses of variance. There were significant effects of both sleeping position and time after feeding. Heart rate is higher and heart period variability is lower in the prone position, and the effects of sleeping position on cardiac functioning are more pronounced during the middle of the intrafeed interval. In preterm infants, autonomic responses to nutrient processing modulate the cardiorespiratory effects of sleeping position. Prone sleeping risk may vary with time after feeding. Copyright 2005 Wiley Periodicals, Inc.

Automatic detection of the breast border and nipple position on digital mammograms using genetic algorithm for asymmetry approach to detection of microcalcifications.

PubMed

Karnan, M; Thangavel, K

2007-07-01

The presence of microcalcifications in breast tissue is one of the most incident signs considered by radiologist for an early diagnosis of breast cancer, which is one of the most common forms of cancer among women. In this paper, the Genetic Algorithm (GA) is proposed for automatic look at commonly prone area the breast border and nipple position to discover the suspicious regions on digital mammograms based on asymmetries between left and right breast image. The basic idea of the asymmetry approach is to scan left and right images are subtracted to extract the suspicious region. The proposed system consists of two steps: First, the mammogram images are enhanced using median filter, normalize the image, at the pectoral muscle region is excluding the border of the mammogram and comparing for both left and right images from the binary image. Further GA is applied to magnify the detected border. The figure of merit is calculated to evaluate whether the detected border is exact or not. And the nipple position is identified using GA. The some comparisons method is adopted for detection of suspected area. Second, using the border points and nipple position as the reference the mammogram images are aligned and subtracted to extract the suspicious region. The algorithms are tested on 114 abnormal digitized mammograms from Mammogram Image Analysis Society database.

Dimensional schizotypy and social cognition: an fMRI imaging study.

PubMed

Wang, Yi; Liu, Wen-Hua; Li, Zhi; Wei, Xin-Hua; Jiang, Xin-Qing; Neumann, David L; Shum, David H K; Cheung, Eric F C; Chan, Raymond C K

2015-01-01

Impairment in empathy has been demonstrated in patients with schizophrenia and individuals with psychosis proneness. In the present study, we examined the neural correlates underlying theory of mind (ToM) and empathy and the relationships between these two social cognitive abilities with schizotypy. Fifty-six first-year college students (31 males, 25 females) between 17 and 21 years of age (M = 19.3, SD = 0.9) from a medical university in China participated. All participants undertook a comic strips functional imaging task that specifically examined both empathy and ToM. In addition, they completed two self-report scales: the Chapman Psychosis Proneness scale and the Interpersonal Responsivity Index (IRI). Results showed that both empathy and ToM conditions of the task were associated with brain activity in the middle temporal gyrus, the temporo-parietal junction (TPJ), the precuneus and the posterior cingulate gyrus. In addition, we found positive correlations between negative schizotypy and brain activity in regions involved in social cognition, namely, the middle temporal gyrus, the TPJ, as well as the medial prefrontal gyrus. These findings highlight that different dimensions of schizotypy may show different associations with brain regions involved in social cognitive abilities. More importantly, the positive correlation between brain activity and anhedonia suggests the presence of compensatory mechanisms in high-risk populations.

Dimensional schizotypy and social cognition: an fMRI imaging study

PubMed Central

Wang, Yi; Liu, Wen-hua; Li, Zhi; Wei, Xin-hua; Jiang, Xin-qing; Neumann, David L.; Shum, David H. K.; Cheung, Eric F. C.; Chan, Raymond C. K.

2015-01-01

Impairment in empathy has been demonstrated in patients with schizophrenia and individuals with psychosis proneness. In the present study, we examined the neural correlates underlying theory of mind (ToM) and empathy and the relationships between these two social cognitive abilities with schizotypy. Fifty-six first-year college students (31 males, 25 females) between 17 and 21 years of age (M = 19.3, SD = 0.9) from a medical university in China participated. All participants undertook a comic strips functional imaging task that specifically examined both empathy and ToM. In addition, they completed two self-report scales: the Chapman Psychosis Proneness scale and the Interpersonal Responsivity Index (IRI). Results showed that both empathy and ToM conditions of the task were associated with brain activity in the middle temporal gyrus, the temporo-parietal junction (TPJ), the precuneus and the posterior cingulate gyrus. In addition, we found positive correlations between negative schizotypy and brain activity in regions involved in social cognition, namely, the middle temporal gyrus, the TPJ, as well as the medial prefrontal gyrus. These findings highlight that different dimensions of schizotypy may show different associations with brain regions involved in social cognitive abilities. More importantly, the positive correlation between brain activity and anhedonia suggests the presence of compensatory mechanisms in high-risk populations. PMID:26074796

SU-E-J-227: Breathing Pattern Consistency and Reproducibility: Comparative Analysis for Supine and Prone Body Positioning

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

Laugeman, E; Weiss, E; Chen, S

2014-06-01

Purpose: Evaluate and compare the cycle-to-cycle consistency of breathing patterns and their reproducibility over the course of treatment, for supine and prone positioning. Methods: Respiratory traces from 25 patients were recorded for sequential supine/prone 4DCT scans acquired prior to treatment, and during the course of the treatment (weekly or bi-weekly). For each breathing cycle, the average(AVE), end-of-exhale(EoE) and end-of-inhale( EoI) locations were identified using in-house developed software. In addition, the mean values and variations for the above quantities were computed for each breathing trace. F-tests were used to compare the cycle-to-cycle consistency of all pairs of sequential supine and pronemore » scans. Analysis of variances was also performed using population means for AVE, EoE and EoI to quantify differences between the reproducibility of prone and supine respiration traces over the treatment course. Results: Consistency: Cycle-to-cycle variations are less in prone than supine in the pre-treatment and during-treatment scans for AVE, EoE and EoI points, for the majority of patients (differences significant at p<0.05). The few cases where the respiratory pattern had more variability in prone appeared to be random events. Reproducibility: The reproducibility of breathing patterns (supine and prone) improved as treatment progressed, perhaps due to patients becoming more comfortable with the procedure. However, variability in supine position continued to remain significantly larger than in prone (p<0.05), as indicated by the variance analysis of population means for the pretreatment and subsequent during-treatment scans. Conclusions: Prone positioning stabilizes breathing patterns in most subjects investigated in this study. Importantly, a parallel analysis of the same group of patients revealed a tendency towards increasing motion amplitude of tumor targets in prone position regardless of their size or location; thus, the choice for body positioning during radiation therapy will have to consider the clinical relevance of the two opposing trends - breathing consistency and motion amplitude.« less

Estimation of regional lung expansion via 3D image registration

NASA Astrophysics Data System (ADS)

Pan, Yan; Kumar, Dinesh; Hoffman, Eric A.; Christensen, Gary E.; McLennan, Geoffrey; Song, Joo Hyun; Ross, Alan; Simon, Brett A.; Reinhardt, Joseph M.

2005-04-01

A method is described to estimate regional lung expansion and related biomechanical parameters using multiple CT images of the lungs, acquired at different inflation levels. In this study, the lungs of two sheep were imaged utilizing a multi-detector row CT at different lung inflations in the prone and supine positions. Using the lung surfaces and the airway branch points for guidance, a 3D inverse consistent image registration procedure was used to match different lung volumes at each orientation. The registration was validated using a set of implanted metal markers. After registration, the Jacobian of the deformation field was computed to express regional expansion or contraction. The regional lung expansion at different pressures and different orientations are compared.

Neck motion due to the halo-vest in prone and supine positions.

PubMed

Ivancic, Paul C; Telles, Connor J

2010-05-01

An in vitro biomechanical study of the effectiveness of halo-vest fixation. The objective was to evaluate motion of the injured cervical spine with normal halo-vest application and vest loose in the prone and supine positions. Snaking motion of the neck is defined as rotation in opposing directions throughout the cervical spine. Previous clinical studies have suggested snaking neck motion due to the halo-vest may lead to inadequate healing or nonunion. The halo-vest was applied to a Human Model of the Neck, which consisted of a cervical spine specimen mounted to the torso of an anthropometric test dummy and carrying a surrogate head. The model was transitioned from prone, to upright, to supine with the halo-vest applied normally and with the vest loose. Average peak spinal motions were computed in the prone and supine positions and contrasted with the physiologic rotation range, obtained from the intact flexibility test, and statistically compared (P < 0.05) between normal halo-vest application and vest loose. Snaking motion of the neck was observed in the prone and supine positions, consisting of extension at head/C1 and C1/2 and flexion at the inferior spinal levels. The intervertebral rotation peaks generally exceeded the physiologic range throughout the cervical spine due to the loose vest in the prone position. Significant increases in the extension peaks at head/C1 (16.9 degrees vs. 5.7 degrees) and flexion peaks at C4/5 (6.9 degrees vs. 3.6 degrees) and C7-T1 (5.2 degrees vs. 0.7 degrees) were observed in the prone position due to the loose vest, as compared to normal halo-vest application. Axial neck separation was consistently observed in the prone and supine positions. The present results, which document snaking motion of the cervical spine due to the halo-vest, indicate that an inadequately fitting or loose vest may significantly diminish its immobilization capacity leading to delayed healing or nonunion.

The effects of supine and prone positions on oxygenation in premature infants undergoing mechanical ventilation

PubMed Central

Abdeyazdan, Zahra; Nematollahi, Monirosadat; Ghazavi, Zohreh; Mohhamadizadeh, Majid

2010-01-01

BACKGROUND: Since the use of high concentrations of oxygen in infants may lead to chronic lung problems, using proper methods of care in infants under mechanical ventilation is one of the most important measures in NICU. This study aimed to investigate the effects of prone and supine positions on oxygenation (SPO2) in premature infants under mechanical ventilation and comparing infants’ oxygenation in the two positions. METHODS: In across over non randomized clinical trial study, 32 preterm infants under mechanical ventilation who had inclusion criteria were enrolled in simple convenient method. Firstly, they were placed in supine position for 120 minutes and further in prone position for 120 minutes .Their SPO2 were monitored by pulse oximeter continuously and was recorded every minute. Data analysis was done using Software SPSS15 by ANOVA test and post hoc test. RESULTS: The data showed that during 120 minutes of exposure of infants in each position there were no significant changes in SPO2. In addition, the SPO2 levels in the prone position were significantly higher than the SPO2 levels in the supine position from 15th minute to 120th minute (to the end). CONCLUSIONS: Neonatal positioning in prone position is a simple, non-invasive, and free of charge method that could lead to improve oxygenation in infants undergoing mechanical ventilation. PMID:22049286

Using the prone position for ventilated patients with respiratory failure: a review.

PubMed

Wright, Angie D; Flynn, Maria

2011-01-01

this review explored the evidence relating to prone positioning in ventilated patients diagnosed with respiratory failure, including acute lung injury (ALI) or adult respiratory distress syndrome (ARDS). mortality rates for ventilated patients with ALI or ARDS are high, and there is a growing body of evidence suggesting that the position these patients are nursed in may influence clinical outcomes. However, there are no guidelines to inform nursing practice in positioning these patients. Medline, Scopus, Cinahl and the Cochrane Library databases were searched for original research reports or systematic reviews of evidence between 2000 and 2009. Reference lists of retrieved papers were hand searched and included studies were analysed using the Critical Appraisal and Skills Programme framework. A narrative data synthesis considered the strengths and limitations of studies, and findings were collated and interpreted. Application of the search strategy identified a systematic review, currently underway, which has not yet reported and 14 relevant studies eligible for inclusion in this review. Analysis showed considerable variation in study design, but suggests that PaO(2) /FiO(2) ratio, incidence of VAP and mortality may be positively affected by prone positioning. evidence of the clinical benefits associated with prone positioning is inconclusive and provides little guidance for nursing practice. There is a need for further research into the clinical outcomes of prone positioning, and greater understanding of the practicalities of prone positioning critically ill patients is required. nurses have a central role to play in the continual assessment and management of this patient group, including the position they are nursed in, not only to ensure the best clinical outcomes but also to provide care and comfort to the patient and their family. It is therefore important that their nursing practice and interventions are informed by the best available evidence.

Prone position craniotomy in pregnancy without fetal heart rate monitoring.

PubMed

Jacob, Jean; Alexander, Ashish; Philip, Shoba; Thomas, Anoop

2016-09-01

A pregnant patient in second trimester scheduled for posterior fossa craniotomy in prone position is a challenge for the anesthesiologist. Things to consider are physiological changes during pregnancy, non-obstetric surgery in pregnant patients, neuroanesthetic principles, effects of prone positioning, and need for fetal heart rate (FHR) monitoring. We have described the anesthetic management of this case and discussed intra-operative FHR monitoring including controversies about its role, indications, and various options available as per fetal gestational age. In our case we attempted intermittent intra-operative FHR monitoring to optimize maternal positioning and fetal oxygenation even though the fetus was pre-viable. However the attempt was abandoned due to practical difficulties with prone positioning. Patient made good neurological recovery following the procedure and delivered a healthy term baby 4 months later. Decisions regarding fetal monitoring should be individualized based on viability of the fetus and feasibility of emergency cesarean delivery. Good communication between a multidisciplinary team involving neurosurgeon, anesthesiologist, obstetrician, and neonatologist is important for a successful outcome for mother and fetus. We conclude that prone position neurosurgery can safely be carried out in a pregnant patient with pre-viable fetus without FHR monitoring. Copyright © 2016 Elsevier Inc. All rights reserved.

ZD multipurpose neurosurgical image-guided localizing unit: experience in 103 consecutive cases of open stereotaxis

NASA Astrophysics Data System (ADS)

Zamorano, Lucia J.; Dujovny, Manuel

1991-05-01

A unit is presented that provides the neurosurgeon with CT, MRI, x-ray, DA, and DSA compatible headholder and multimodality image localization as well as freedom of choice for surgical approach on patient's intraoperative positioning. The unit consists of a carbon fiber ring-shaped headholder which allows free selection for location of three or four fixation pins, avoiding interference with the flap sites or craniotomy. The base ring is mounted intraoperatively on a special adapter that allows any patient positioning including supine, lateral, prone, 3/4 prone, sitting, etc. Surgical draping can be performed given a completely sterile field. An arc/quadrant localizing device can be mounted on any four alternative positions according to the neurosurgeon's preference. A PC compatible software gives the setting for any possible mounting. Intraoperative the localizing unit can be used in a 'fixed' permanent setting or as a 'non-fixed' system to provide intraoperative three-dimensional orientation. Different are adapted instruments which give the unit further capabilities, especially 'bayonet' type brain retractors (cylinders and speculum) that allows the neurosurgeon to keep the surgical corridor unobstructed from the arc. As an alternative, in the 'non-fixed' setting, self-retaining arms are fixed to the base ring and brain retractors and conventional microsurgical technique can be used without any mechanical obstruction. This article presents the unit details, methodology and the clinical experience in 103 consecutive cases of 'open stereotaxis' for resection or internal decompression of deep seated or near eloquent area lesions.

Positions for percutaneous nephrolithotomy: Thirty-five years of evolution

PubMed Central

Karaolides, Theocharis; Moraitis, Konstantinos; Bach, Christian; Masood, Junaid; Buchholz, Noor

2012-01-01

Objectives To present the chronological development of the different positions described for percutaneous nephrolithotomy (PCNL), in an attempt to identify the reasons for their development and to highlight their specific advantages and disadvantages. Methods Previous reports were identified by a non-systematic search of Medline and Scopus. Results The classic prone position for PCNL was first described in 1976. The technique was gradually standardised and PCNL with the patient prone became the generally accepted standard approach. In the next 35 years many other positions were described, with the patient placed prone, lateral or supine in various modifications. Modifications of the classic prone position in the early 1990s aimed to provide the option of a simultaneous retrograde approach during the procedure. As PCNL became more popular the lateral position was first described in 1994, to allow the application of PCNL to patients who were unable to tolerate being prone because of their body habitus. The supine position for percutaneous access was originally described even before 1990, but become more popular after 2007 when the Galdakao modification was reported. Several other modifications of the supine position have been described, with the latest being the flank-free modified supine position, which allows the best exposure of the flank among the supine positions. Each position has its specific advantages and disadvantages. Conclusion Urologists who perform PCNL should be familiar with the differences in the positions and be able to use the method appropriate to each case. PMID:26558042

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position.

PubMed

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation.

Comparison between conventional protective mechanical ventilation and high-frequency oscillatory ventilation associated with the prone position

PubMed Central

Fioretto, José Roberto; Klefens, Susiane Oliveira; Pires, Rafaelle Fernandes; Kurokawa, Cilmery Suemi; Carpi, Mario Ferreira; Bonatto, Rossano César; Moraes, Marcos Aurélio; Ronchi, Carlos Fernando

2017-01-01

Objective To compare the effects of high-frequency oscillatory ventilation and conventional protective mechanical ventilation associated with the prone position on oxygenation, histology and pulmonary oxidative damage in an experimental model of acute lung injury. Methods Forty-five rabbits with tracheostomy and vascular access were underwent mechanical ventilation. Acute lung injury was induced by tracheal infusion of warm saline. Three experimental groups were formed: healthy animals + conventional protective mechanical ventilation, supine position (Control Group; n = 15); animals with acute lung injury + conventional protective mechanical ventilation, prone position (CMVG; n = 15); and animals with acute lung injury + high-frequency oscillatory ventilation, prone position (HFOG; n = 15). Ten minutes after the beginning of the specific ventilation of each group, arterial gasometry was collected, with this timepoint being called time zero, after which the animal was placed in prone position and remained in this position for 4 hours. Oxidative stress was evaluated by the total antioxidant performance assay. Pulmonary tissue injury was determined by histopathological score. The level of significance was 5%. Results Both groups with acute lung injury showed worsening of oxygenation after induction of injury compared with the Control Group. After 4 hours, there was a significant improvement in oxygenation in the HFOG group compared with CMVG. Analysis of total antioxidant performance in plasma showed greater protection in HFOG. HFOG had a lower histopathological lesion score in lung tissue than CMVG. Conclusion High-frequency oscillatory ventilation, associated with prone position, improves oxygenation and attenuates oxidative damage and histopathological lung injury compared with conventional protective mechanical ventilation. PMID:29236845

Prone position as prevention of lung injury in comatose patients: a prospective, randomized, controlled study.

PubMed

Beuret, Pascal; Carton, Marie-Jose; Nourdine, Karim; Kaaki, Mahmoud; Tramoni, Gerard; Ducreux, Jean-Claude

2002-05-01

Comatose patients frequently exhibit pulmonary function worsening, especially in cases of pulmonary infection. It appears to have a deleterious effect on neurologic outcome. We therefore conducted a randomized trial to determine whether daily prone positioning would prevent lung worsening in these patients. Prospective, randomized, controlled study. Sixteen-bed intensive care unit. Fifty-one patients who required invasive mechanical ventilation because of coma with Glascow coma scores of 9 or less. In the prone position (PP) group: prone positioning for 4 h once daily until the patients could get up to sit in an armchair; in the supine position (SP) group: supine positioning. The primary end point was the incidence of lung worsening defined by an increase in the Lung Injury Score of at least 1 point since the time of randomization. The secondary end point was the incidence of ventilator-associated pneumonia (VAP). A total of 25 patients were randomly assigned to the PP group and 26 patients to the SP group. The characteristics of the patients from the two groups were similar at randomization. The incidence of lung worsening was lower in the PP group (12%) than in the SP group (50%) ( p=0.003). The incidence of VAP was 20% in the PP group and 38.4% in the SP group ( p=0.14). There was no serious complication attributable to prone positioning, however, there was a significant increase of intracranial pressure in the PP. In a selected population of comatose ventilated patients, daily prone positioning reduced the incidence of lung worsening.

A Technique to Allow Prone Positioning in the Spine Surgery Patient With Unstable Spine Fracture and Flail Segment Rib Fractures.

PubMed

Pennington, Matthew W; Roche, Anthony M; Bransford, Richard J; Zhang, Fangyi; Dagal, Armagan

2016-07-01

Two patients with unstable thoracic spine and flail segment rib fractures initially failed prone positioning on a Jackson spinal table used for posterior spinal instrumentation and fusion surgery. Both patients experienced rapid hemodynamic collapse. We developed a solution using the anterior portions of a thoracolumbosacral orthosis brace as chest supports to use during prone positioning, allowing both patients to undergo uncomplicated posterior spinal instrumentation and fusion surgeries with greater hemodynamic stability.

Effects of body position on thermal, cardiorespiratory and metabolic activity in low birth weight infants.

PubMed

Ammari, Amer; Schulze, Karl F; Ohira-Kist, Kiyoko; Kashyap, Sudha; Fifer, William P; Myers, Michael M; Sahni, Rakesh

2009-08-01

Low birth weight (LBW) infants sleeping prone are known to exhibit many physiological differences from those sleeping supine, including lower energy expenditure (heat production) and higher surface temperature. This apparent increase in heat storage suggests that heat loss may be inhibited in the prone position which, in turn, might influence cardiorespiratory activity. To determine the effects of body position (prone vs. supine) on absolute surface temperature profile (heat storage), central-peripheral (C-P) thermal gradients (vasomotor response), cardiorespiratory activity and metabolic gas exchange in growing LBW infants. Six-hour continuous recordings of absolute surface temperature profiles, cardiorespiratory activity and O2 and CO2 exchange, along with minute-to-minute assessment of behavioral sleep states were performed in 32 healthy growing LBW infants (birth weight 805-1590 g, gestational age 26-35 weeks and postconceptional age at study 33-38 weeks). Each infant was randomly assigned to the prone or supine position for the first 3 h of the study and then reversed for the second 3 h. Surface temperatures were recorded from 4 sites (forehead, flank, forearm and leg) and averaged each minute. Central (forehead and flank)-to-peripheral (forearm and leg) and forehead-to-environment (H-E) thermal gradients were calculated from the surface temperatures. Corresponding sleep states were aligned with minute averages obtained from the temperature and cardiorespiratory measurements. Data were then sorted for prone and supine positions during quiet (QS) and active sleep (AS) and compared using paired t-tests. In the prone position during both AS and QS, infants had higher forehead, flank, forearm and leg surface temperatures, narrower C-P gradients, higher heart rates and respiratory frequency, and lower heart rate and respiratory variability. Despite similar environmental temperatures, the H-E gradient was higher in the prone position. In the prone position infants demonstrated lower O2 consumption and CO2 production and a higher respiratory quotient. Despite thermoregulatory adjustments in cardiorespiratory function, infants sleeping prone have relatively higher body temperature. The cardiorespiratory responses to this modest increase in temperature indicate that thermal and metabolic control of cardiac and respiratory pumps seem to work in opposition. The consequences of any attendant changes in blood gas activity (e.g. hypocapnia and/or increased mixed venous oxygen concentration) due to this override of metabolic control remains speculative.

A prospective study to evaluate and compare laryngeal mask airway ProSeal and i-gel airway in the prone position.

PubMed

Taxak, Susheela; Gopinath, Ajith; Saini, Savita; Bansal, Teena; Ahlawat, Mangal Singh; Bala, Manju

2015-01-01

Prone position is commonly used to provide surgical access to a variety of surgeries. In view of the advantages of induction of anesthesia in the prone position, we conducted a randomized study to evaluate and compare ProSeal laryngeal mask airway (LMA) and i-gel in the prone position. Totally, 40 patients of either sex as per American Society of Anesthesiologists physical status I or II, between 16 and 60 years of age, scheduled to undergo surgery in prone position were included in the study. After the patients positioned themselves prone on the operating table, anesthesia was induced by the standard technique. LMA ProSeal was used as an airway conduit in group 1 while i-gel was used in group 2. At the end of surgery, the airway device was removed in the same position. Insertion of airway device was successful in first attempt in 16, and 17 cases in ProSeal laryngeal mask airway (PLMA) and i-gel groups, respectively. A second attempt was required to secure the airway in 4 and 3 patients in PLMA and i-gel groups, respectively. The mean insertion time was 21.8 ± 2.70 s for group 1 and 13.1 ± 2.24 s for group 2, the difference being statistically significant (P < 0.05). The mean seal pressure in group 1 was 36 ± 6.22 cm H2 O and in group 2 was 25.4 ± 3.21 cm H2 O. The difference was statistically significant (P < 0.05). 13 patients in group 1 had fiberoptic bronchoscopy (FOB) grade 1 while it was 6 for group 2. The remaining patients in both groups had FOB grade 2. Insertion of supraglottic airways and conduct of anesthesia with them is feasible in the prone position. The PLMA has a better seal while insertion is easier with i-gel.

Shame and guilt and their relationship to positive expectations and anger expressiveness.

PubMed

Lutwak, N; Panish, J B; Ferrari, J R; Razzino, B E

2001-01-01

College students (174 females, 91 males) completed measures of shame, guilt, expectations for future success, and styles of anger expression. Significant gender differences were found in proneness for both shame and guilt, with young women exhibiting a greater propensity for shame and guilt than young men. For both females and males, however, shame-proneness was positively related to expressions of inward anger. Among males and females, guilt-proness was negatively related to outward anger, but positively related to anger control. For females, guilt-proness was also negatively related to expectations for future success. Multiple regression analyses indicated that for male and female late adolescents, the best positive predictor of shame-proneness was inward anger. Gender differences emerged in predicting guilt-proneness; greater anger control, lower outward anger, and lower expectations for future success significantly predicted this variable among females.

Successful delivery of adjuvant external beam radiotherapy for ependymoma in a patient with Ondine's curse

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

Choi, Mehee; Thoma, Miranda; Tolekidis, George

Ondine's curse is a rare, potentially life-threatening disorder characterized by loss of automatic breathing during sleep and preserved voluntary breathing. It is seldom encountered in the radiotherapy clinic but can pose significant technical challenges and safety concerns in the delivery of a prescribed radiation course. We report a unique case of successful delivery of radiotherapy for ependymoma in a patient with Ondine's curse. A 53-year-old gentleman presented with vertigo when lying down. Brain magnetic resonance imaging revealed an enhancing mass in the floor of the fourth ventricle. He underwent maximal safe resection. Pathology revealed ependymoma. The patient was referred formore » radiotherapy. Computed tomography simulation was performed in supine position with 3-point thermoplastic mask immobilization. Sequential TomoTherapy plans were developed. At first scheduled treatment, shortly after mask placement, his arms went limp and he was unresponsive. Vitals showed oxygen saturation 83%, pulse 127, and blood pressure 172/97 mm Hg. He was diagnosed with Ondine's curse thought secondary to previous brainstem damage; the combination of lying flat and pressure from the mask was causing him to go into respiratory arrest. As supine positioning did not seem clinically advisable, he was simulated in prone position. A RapidArc plan and a back-up conformal plan were developed. Prescriptions were modified to meet conservative organs-at-risk constraints. Several strategies were used to minimize uncertainties in set-up reproducibility associated with prone positioning. He tolerated prone RapidArc treatments well. The report highlights the importance of applying practical patient safety and treatment planning/delivery strategies in the management of this challenging case.« less

Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: a systematic review and meta-analysis.

PubMed

Sud, Sachin; Friedrich, Jan O; Adhikari, Neill K J; Taccone, Paolo; Mancebo, Jordi; Polli, Federico; Latini, Roberto; Pesenti, Antonio; Curley, Martha A Q; Fernandez, Rafael; Chan, Ming-Cheng; Beuret, Pascal; Voggenreiter, Gregor; Sud, Maneesh; Tognoni, Gianni; Gattinoni, Luciano; Guérin, Claude

2014-07-08

Mechanical ventilation in the prone position is used to improve oxygenation and to mitigate the harmful effects of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). We sought to determine the effect of prone positioning on mortality among patients with ARDS receiving protective lung ventilation. We searched electronic databases and conference proceedings to identify relevant randomized controlled trials (RCTs) published through August 2013. We included RCTs that compared prone and supine positioning during mechanical ventilation in patients with ARDS. We assessed risk of bias and obtained data on all-cause mortality (determined at hospital discharge or, if unavailable, after longest follow-up period). We used random-effects models for the pooled analyses. We identified 11 RCTs (n=2341) that met our inclusion criteria. In the 6 trials (n=1016) that used a protective ventilation strategy with reduced tidal volumes, prone positioning significantly reduced mortality (risk ratio 0.74, 95% confidence interval 0.59-0.95; I2=29%) compared with supine positioning. The mortality benefit remained in several sensitivity analyses. The overall quality of evidence was high. The risk of bias was low in all of the trials except one, which was small. Statistical heterogeneity was low (I2<50%) for most of the clinical and physiologic outcomes. Our analysis of high-quality evidence showed that use of the prone position during mechanical ventilation improved survival among patients with ARDS who received protective lung ventilation. © 2014 Canadian Medical Association or its licensors.

Effect of prone positioning during mechanical ventilation on mortality among patients with acute respiratory distress syndrome: a systematic review and meta-analysis

PubMed Central

Sud, Sachin; Friedrich, Jan O.; Adhikari, Neill K. J.; Taccone, Paolo; Mancebo, Jordi; Polli, Federico; Latini, Roberto; Pesenti, Antonio; Curley, Martha A.Q.; Fernandez, Rafael; Chan, Ming-Cheng; Beuret, Pascal; Voggenreiter, Gregor; Sud, Maneesh; Tognoni, Gianni; Gattinoni, Luciano; Guérin, Claude

2014-01-01

Background: Mechanical ventilation in the prone position is used to improve oxygenation and to mitigate the harmful effects of mechanical ventilation in patients with acute respiratory distress syndrome (ARDS). We sought to determine the effect of prone positioning on mortality among patients with ARDS receiving protective lung ventilation. Methods: We searched electronic databases and conference proceedings to identify relevant randomized controlled trials (RCTs) published through August 2013. We included RCTs that compared prone and supine positioning during mechanical ventilation in patients with ARDS. We assessed risk of bias and obtained data on all-cause mortality (determined at hospital discharge or, if unavailable, after longest follow-up period). We used random-effects models for the pooled analyses. Results: We identified 11 RCTs (n = 2341) that met our inclusion criteria. In the 6 trials (n = 1016) that used a protective ventilation strategy with reduced tidal volumes, prone positioning significantly reduced mortality (risk ratio 0.74, 95% confidence interval 0.59–0.95; I2 = 29%) compared with supine positioning. The mortality benefit remained in several sensitivity analyses. The overall quality of evidence was high. The risk of bias was low in all of the trials except one, which was small. Statistical heterogeneity was low (I2 < 50%) for most of the clinical and physiologic outcomes. Interpretation: Our analysis of high-quality evidence showed that use of the prone position during mechanical ventilation improved survival among patients with ARDS who received protective lung ventilation. PMID:24863923

Individual Differences in Emotion Regulation, Childhood Trauma and Proneness to Shame and Guilt in Adolescence

PubMed Central

2016-01-01

Dispositional shame and guilt have been associated with psychopathology and an increasing number of studies have traced this relation back to adolescence. This developmental period is thought to be characterized by maturational changes in emotion regulation, which also play an important role in vulnerability to psychopathology, but little is known about the links between emotion regulation and dispositional shame and guilt. The current study investigated the relations between individual differences in the habitual use of a wide range of emotion regulation strategies and proneness to shame and guilt in a large sample of adolescents (N = 706), aged 13 to 17 years. History of childhood trauma was also assessed. Our results showed that emotion regulation independently explained about 20% of the variance of shame-proneness and guilt-proneness. Higher use of maladaptive (e.g., Self-Blaming, Catastrophizing) and lower use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were positively associated with shame-proneness. In contrast, lower use of maladaptive (e.g., Catastrophizing, Blaming Others) and higher use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were associated with guilt-proneness, independent of the influence of childhood trauma, which also explained a relatively minor portion of guilt-proneness. Although there were age differences (i.e., rumination was used more by older adolescents, and the influence of emotion regulation on depression and anxiety symptoms increased with age) and sex differences (i.e., girls reported higher use of Putting into Perspective and Other Blaming compared to boys) in emotion regulation, age and sex were not significantly associated with proneness to shame and guilt. The positive relations with maladaptive emotion regulation underscores the dysfunctional nature of shame-proneness. Future studies could use longitudinal measures to establish that emotion regulation drives dispositional shame and guilt, and also investigate whether emotion regulation optimization is able to normalize proneness to shame and guilt and reduce risk for psychopathology. PMID:27898709

Individual Differences in Emotion Regulation, Childhood Trauma and Proneness to Shame and Guilt in Adolescence.

PubMed

Szentágotai-Tătar, Aurora; Miu, Andrei C

2016-01-01

Dispositional shame and guilt have been associated with psychopathology and an increasing number of studies have traced this relation back to adolescence. This developmental period is thought to be characterized by maturational changes in emotion regulation, which also play an important role in vulnerability to psychopathology, but little is known about the links between emotion regulation and dispositional shame and guilt. The current study investigated the relations between individual differences in the habitual use of a wide range of emotion regulation strategies and proneness to shame and guilt in a large sample of adolescents (N = 706), aged 13 to 17 years. History of childhood trauma was also assessed. Our results showed that emotion regulation independently explained about 20% of the variance of shame-proneness and guilt-proneness. Higher use of maladaptive (e.g., Self-Blaming, Catastrophizing) and lower use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were positively associated with shame-proneness. In contrast, lower use of maladaptive (e.g., Catastrophizing, Blaming Others) and higher use of adaptive (e.g., Refocus on Planning, Positive Reappraisal) emotion regulation strategies were associated with guilt-proneness, independent of the influence of childhood trauma, which also explained a relatively minor portion of guilt-proneness. Although there were age differences (i.e., rumination was used more by older adolescents) and sex differences (i.e., girls reported higher use of Putting into Perspective and lower use of Other Blaming compared to boys) in emotion regulation, age and sex were not significantly associated with proneness to shame and guilt. The positive relations with maladaptive emotion regulation underscore the dysfunctional nature of shame-proneness. Future studies could use longitudinal measures to establish that emotion regulation drives dispositional shame and guilt, and also investigate whether emotion regulation optimization is able to normalize proneness to shame and guilt and reduce risk for psychopathology.

Generic method for automatic bladder segmentation on cone beam CT using a patient-specific bladder shape model

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

Schoot, A. J. A. J. van de, E-mail: a.j.schootvande@amc.uva.nl; Schooneveldt, G.; Wognum, S.

Purpose: The aim of this study is to develop and validate a generic method for automatic bladder segmentation on cone beam computed tomography (CBCT), independent of gender and treatment position (prone or supine), using only pretreatment imaging data. Methods: Data of 20 patients, treated for tumors in the pelvic region with the entire bladder visible on CT and CBCT, were divided into four equally sized groups based on gender and treatment position. The full and empty bladder contour, that can be acquired with pretreatment CT imaging, were used to generate a patient-specific bladder shape model. This model was used tomore » guide the segmentation process on CBCT. To obtain the bladder segmentation, the reference bladder contour was deformed iteratively by maximizing the cross-correlation between directional grey value gradients over the reference and CBCT bladder edge. To overcome incorrect segmentations caused by CBCT image artifacts, automatic adaptations were implemented. Moreover, locally incorrect segmentations could be adapted manually. After each adapted segmentation, the bladder shape model was expanded and new shape patterns were calculated for following segmentations. All available CBCTs were used to validate the segmentation algorithm. The bladder segmentations were validated by comparison with the manual delineations and the segmentation performance was quantified using the Dice similarity coefficient (DSC), surface distance error (SDE) and SD of contour-to-contour distances. Also, bladder volumes obtained by manual delineations and segmentations were compared using a Bland-Altman error analysis. Results: The mean DSC, mean SDE, and mean SD of contour-to-contour distances between segmentations and manual delineations were 0.87, 0.27 cm and 0.22 cm (female, prone), 0.85, 0.28 cm and 0.22 cm (female, supine), 0.89, 0.21 cm and 0.17 cm (male, supine) and 0.88, 0.23 cm and 0.17 cm (male, prone), respectively. Manual local adaptations improved the segmentation results significantly (p < 0.01) based on DSC (6.72%) and SD of contour-to-contour distances (0.08 cm) and decreased the 95% confidence intervals of the bladder volume differences. Moreover, expanding the shape model improved the segmentation results significantly (p < 0.01) based on DSC and SD of contour-to-contour distances. Conclusions: This patient-specific shape model based automatic bladder segmentation method on CBCT is accurate and generic. Our segmentation method only needs two pretreatment imaging data sets as prior knowledge, is independent of patient gender and patient treatment position and has the possibility to manually adapt the segmentation locally.« less

Body Position Influences Which Neural Structures Are Recruited by Lumbar Transcutaneous Spinal Cord Stimulation

PubMed Central

Danner, Simon M.; Krenn, Matthias; Hofstoetter, Ursula S.; Toth, Andrea; Mayr, Winfried; Minassian, Karen

2016-01-01

Transcutaneous stimulation of the human lumbosacral spinal cord is used to evoke spinal reflexes and to neuromodulate altered sensorimotor function following spinal cord injury. Both applications require the reliable stimulation of afferent posterior root fibers. Yet under certain circumstances, efferent anterior root fibers can be co-activated. We hypothesized that body position influences the preferential stimulation of sensory or motor fibers. Stimulus-triggered responses to transcutaneous spinal cord stimulation were recorded using surface-electromyography from quadriceps, hamstrings, tibialis anterior, and triceps surae muscles in 10 individuals with intact nervous systems in the supine, standing and prone positions. Single and paired (30-ms inter-stimulus intervals) biphasic stimulation pulses were applied through surface electrodes placed on the skin between the T11 and T12 inter-spinous processes referenced to electrodes on the abdomen. The paired stimulation was applied to evaluate the origin of the evoked electromyographic response; trans-synaptic responses would be suppressed whereas direct efferent responses would almost retain their amplitude. We found that responses to the second stimulus were decreased to 14%±5% of the amplitude of the response to the initial pulse in the supine position across muscles, to 30%±5% in the standing, and to only 80%±5% in the prone position. Response thresholds were lowest during standing and highest in the prone position and response amplitudes were largest in the supine and smallest in the prone position. The responses obtained in the supine and standing positions likely resulted from selective stimulation of sensory fibers while concomitant motor-fiber stimulation occurred in the prone position. We assume that changes of root-fiber paths within the generated electric field when in the prone position increase the stimulation thresholds of posterior above those of anterior root fibers. Thus, we recommend conducting spinal reflex or neuromodulation studies with subjects lying supine or in an upright position, as in standing or stepping. PMID:26797502

Skull registration for prone patient position using tracked ultrasound

NASA Astrophysics Data System (ADS)

Underwood, Grace; Ungi, Tamas; Baum, Zachary; Lasso, Andras; Kronreif, Gernot; Fichtinger, Gabor

2017-03-01

PURPOSE: Tracked navigation has become prevalent in neurosurgery. Problems with registration of a patient and a preoperative image arise when the patient is in a prone position. Surfaces accessible to optical tracking on the back of the head are unreliable for registration. We investigated the accuracy of surface-based registration using points accessible through tracked ultrasound. Using ultrasound allows access to bone surfaces that are not available through optical tracking. Tracked ultrasound could eliminate the need to work (i) under the table for registration and (ii) adjust the tracker between surgery and registration. In addition, tracked ultrasound could provide a non-invasive method in comparison to an alternative method of registration involving screw implantation. METHODS: A phantom study was performed to test the feasibility of tracked ultrasound for registration. An initial registration was performed to partially align the pre-operative computer tomography data and skull phantom. The initial registration was performed by an anatomical landmark registration. Surface points accessible by tracked ultrasound were collected and used to perform an Iterative Closest Point Algorithm. RESULTS: When the surface registration was compared to a ground truth landmark registration, the average TRE was found to be 1.6+/-0.1mm and the average distance of points off the skull surface was 0.6+/-0.1mm. CONCLUSION: The use of tracked ultrasound is feasible for registration of patients in prone position and eliminates the need to perform registration under the table. The translational component of error found was minimal. Therefore, the amount of TRE in registration is due to a rotational component of error.

The feasibility of manual parameter tuning for deformable breast MR image registration from a multi-objective optimization perspective.

PubMed

Pirpinia, Kleopatra; Bosman, Peter A N; Loo, Claudette E; Winter-Warnars, Gonneke; Janssen, Natasja N Y; Scholten, Astrid N; Sonke, Jan-Jakob; van Herk, Marcel; Alderliesten, Tanja

2017-06-23

Deformable image registration is typically formulated as an optimization problem involving a linearly weighted combination of terms that correspond to objectives of interest (e.g. similarity, deformation magnitude). The weights, along with multiple other parameters, need to be manually tuned for each application, a task currently addressed mainly via trial-and-error approaches. Such approaches can only be successful if there is a sensible interplay between parameters, objectives, and desired registration outcome. This, however, is not well established. To study this interplay, we use multi-objective optimization, where multiple solutions exist that represent the optimal trade-offs between the objectives, forming a so-called Pareto front. Here, we focus on weight tuning. To study the space a user has to navigate during manual weight tuning, we randomly sample multiple linear combinations. To understand how these combinations relate to desirability of registration outcome, we associate with each outcome a mean target registration error (TRE) based on expert-defined anatomical landmarks. Further, we employ a multi-objective evolutionary algorithm that optimizes the weight combinations, yielding a Pareto front of solutions, which can be directly navigated by the user. To study how the complexity of manual weight tuning changes depending on the registration problem, we consider an easy problem, prone-to-prone breast MR image registration, and a hard problem, prone-to-supine breast MR image registration. Lastly, we investigate how guidance information as an additional objective influences the prone-to-supine registration outcome. Results show that the interplay between weights, objectives, and registration outcome makes manual weight tuning feasible for the prone-to-prone problem, but very challenging for the harder prone-to-supine problem. Here, patient-specific, multi-objective weight optimization is needed, obtaining a mean TRE of 13.6 mm without guidance information reduced to 7.3 mm with guidance information, but also providing a Pareto front that exhibits an intuitively sensible interplay between weights, objectives, and registration outcome, allowing outcome selection.

The feasibility of manual parameter tuning for deformable breast MR image registration from a multi-objective optimization perspective

NASA Astrophysics Data System (ADS)

Pirpinia, Kleopatra; Bosman, Peter A. N.; E Loo, Claudette; Winter-Warnars, Gonneke; Y Janssen, Natasja N.; Scholten, Astrid N.; Sonke, Jan-Jakob; van Herk, Marcel; Alderliesten, Tanja

2017-07-01

Deformable image registration is typically formulated as an optimization problem involving a linearly weighted combination of terms that correspond to objectives of interest (e.g. similarity, deformation magnitude). The weights, along with multiple other parameters, need to be manually tuned for each application, a task currently addressed mainly via trial-and-error approaches. Such approaches can only be successful if there is a sensible interplay between parameters, objectives, and desired registration outcome. This, however, is not well established. To study this interplay, we use multi-objective optimization, where multiple solutions exist that represent the optimal trade-offs between the objectives, forming a so-called Pareto front. Here, we focus on weight tuning. To study the space a user has to navigate during manual weight tuning, we randomly sample multiple linear combinations. To understand how these combinations relate to desirability of registration outcome, we associate with each outcome a mean target registration error (TRE) based on expert-defined anatomical landmarks. Further, we employ a multi-objective evolutionary algorithm that optimizes the weight combinations, yielding a Pareto front of solutions, which can be directly navigated by the user. To study how the complexity of manual weight tuning changes depending on the registration problem, we consider an easy problem, prone-to-prone breast MR image registration, and a hard problem, prone-to-supine breast MR image registration. Lastly, we investigate how guidance information as an additional objective influences the prone-to-supine registration outcome. Results show that the interplay between weights, objectives, and registration outcome makes manual weight tuning feasible for the prone-to-prone problem, but very challenging for the harder prone-to-supine problem. Here, patient-specific, multi-objective weight optimization is needed, obtaining a mean TRE of 13.6 mm without guidance information reduced to 7.3 mm with guidance information, but also providing a Pareto front that exhibits an intuitively sensible interplay between weights, objectives, and registration outcome, allowing outcome selection.

Prone versus supine position in mechanically ventilated children: a pilot study.

PubMed

Sawhney, Ashu; Kumar, Nirmal; Sreenivas, Vishnubhatla; Gupta, Sangeeta; Tyagi, Vineet; Puliyel, Jacob M

2005-05-01

It is known that mechanically ventilated patients in the prone position have improved oxygenation compared with those supine. We did a prospective, randomized, controlled trial to evaluate the effect of prone position during mechanical ventilation, on survival in critically ill children. Forty-two children needing mechanical ventilation for various illnesses were randomized to receive initial ventilation for four hours prone or supine by drawing lots. Initial severity of illness and blood gases in all children were noted. In a crossover design, after the initial four hours the children were turned over and ventilated in the alternate posture for an hour. Oxygenation parameters and mean airway pressures were noted at one hour, four hours, and five hours. Mortality, duration of ventilation, and the above parameters were compared in the two groups. Initial PRISM scores were similar in the two groups. Mortality in the prone group was less than in the supine group. The odds ratio of mortality was 0.20 (95% CI 0.05-0.75). Duration of ventilation was similar in the two groups. The oxygenation index was significantly lower in the prone group at one, four, and five hours after onset of ventilation. Prone position in the first few hours of ventilation significantly improves gas exchange and oxygenation, reduces the mean airway pressures required to ventilate children, and may cause significant improvement in survival. Our study protocol allowed ventilator settings to be changed as needed during ventilation.

Disgust proneness and associated neural substrates in obesity.

PubMed

Watkins, Tristan J; Di Iorio, Christina R; Olatunji, Bunmi O; Benningfield, Margaret M; Blackford, Jennifer U; Dietrich, Mary S; Bhatia, Monisha; Theiss, Justin D; Salomon, Ronald M; Niswender, Kevin; Cowan, Ronald L

2016-03-01

Defects in experiencing disgust may contribute to obesity by allowing for the overconsumption of food. However, the relationship of disgust proneness and its associated neural locus has yet to be explored in the context of obesity. Thirty-three participants (17 obese, 16 lean) completed the Disgust Propensity and Sensitivity Scale-Revised and a functional magnetic resonance imaging paradigm where images from 4 categories (food, contaminates, contaminated food or fixation) were randomly presented. Independent two-sample t-tests revealed significantly lower levels of Disgust Sensitivity for the obese group (mean score = 14.7) compared with the lean group (mean score = 17.6, P = 0.026). The obese group had less activation in the right insula than the lean group when viewing contaminated food images. Multiple regression with interaction analysis revealed one left insula region where the association of Disgust Sensitivity scores with activation differed by group when viewing contaminated food images. These interaction effects were driven by the negative correlation of Disgust Sensitivity scores with beta values extracted from the left insula in the obese group (r = -0.59) compared with a positive correlation in the lean group (r = 0.65). Given these body mass index-dependent differences in Disgust Sensitivity and neural responsiveness to disgusting food images, it is likely that altered Disgust Sensitivity may contribute to obesity. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

The Effects of Prone Position Ventilation on Experimental Mild Acute Lung Injury Induced by Intraperitoneal Lipopolysaccharide Injection in Rats.

PubMed

Bianchi, Aydra Mendes Almeida; Reboredo, Maycon Moura; Lucinda, Leda Marília Fonseca; Reis, Fernando Fonseca; Silva, Manfrinni Vinícius Alves; Rabelo, Maria Aparecida Esteves; Holanda, Marcelo Alcantara; Oliveira, Júlio César Abreu; Lorente, José Ángel; Pinheiro, Bruno do Valle

2016-04-01

The benefits of prone position ventilation are well demonstrated in the severe forms of acute respiratory distress syndrome, but not in the milder forms. We investigated the effects of prone position on arterial blood gases, lung inflammation, and histology in an experimental mild acute lung injury (ALI) model. ALI was induced in Wistar rats by intraperitoneal Escherichia coli lipopolysaccharide (LPS, 5 mg/kg). After 24 h, the animals with PaO2/FIO2 between 200 and 300 mmHg were randomized into 2 groups: prone position (n = 6) and supine position (n = 6). Both groups were compared with a control group (n = 5) that was ventilated in the supine position. All of the groups were ventilated for 1 h with volume-controlled ventilation mode (tidal volume = 6 ml/kg, respiratory rate = 80 breaths/min, positive end-expiratory pressure = 5 cmH2O, inspired oxygen fraction = 1) RESULTS: Significantly higher lung injury scores were observed in the LPS-supine group compared to the LPS-prone and control groups (0.32 ± 0.03; 0.17 ± 0.03 and 0.13 ± 0.04, respectively) (p < 0.001), mainly due to a higher neutrophil infiltration level in the interstitial space and more proteinaceous debris that filled the airspaces. Similar differences were observed when the gravity-dependent lung regions and non-dependent lung regions were analyzed separately (p < 0.05). The BAL neutrophil content was also higher in the LPS-supine group compared to the LPS-prone and control groups (p < 0.05). There were no significant differences in the wet/dry ratio and gas exchange levels. In this experimental extrapulmonary mild ALI model, prone position ventilation for 1 h, when compared with supine position ventilation, was associated with lower lung inflammation and injury.

Dosimetric and toxicity comparison between prone and supine position IMRT for endometrial cancer

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

Beriwal, Sushil; Jain, Sheena K.; Heron, Dwight E.

2007-02-01

Purpose: To determine the dosimetric and toxicity differences between prone and supine position intensity-modulate radiotherapy in endometrial cancer patients treated with adjuvant radiotherapy. Methods: Forty-seven consecutive endometrial cancer patients treated with adjuvant RT were analyzed. Of these, 21 were treated in prone position and 26 in the supine position. Dose-volume histograms for normal tissue structures and targets were compared between the two groups. Acute and chronic toxicity were also compared between the cohorts. Results: The percentage of volume receiving 10, 20, 30, 40, 45, and 50 Gy for small bowel was 89.5%, 69%, 33%, 12.2%, 5%, and 0% in themore » prone group and 87.5%, 62.7%, 26.4%, 8%, 4.3%, and 0% in the supine group, respectively. The difference was not statistically significant. The dose-volume histograms for bladder and rectum were also comparable, except for a slightly greater percentage of volume receiving 10 Gy (1.5%) and 20 Gy (5%) for the rectum in the prone group. Acute small bowel toxicities were Grade 1 in 7 patients and Grade 2 in 14 patients in the prone group vs. Grade 1 in 6 patients and Grade 2 in 19 patients in the supine group. Chronic toxicity was Grade 1 in 7 patients and Grade 3 in 1 patient in the prone group and Grade 1 in 5 patients in the supine group. Conclusion: These preliminary results suggest that no difference exists in the dose to the normal tissue and toxicity between prone and supine intensity-modulated radiotherapy for endometrial cancer. Longer follow-up and more outcome studies are needed to determine whether any differences exist between the two approaches.« less

Arousal from sleep pathways are affected by the prone sleeping position and preterm birth: preterm birth, prone sleeping and arousal from sleep.

PubMed

Richardson, Heidi L; Horne, Rosemary S C

2013-09-01

Preterm infants exhibit depressed arousability from sleep when compared with term infants. As the final cortical element of the arousal process may be the most critical for survival, we hypothesized that the increased vulnerability of preterm infants to the Sudden Infant Death Syndrome (SIDS) could be explained by depressed cortical arousal (CA) responses. We evaluated the effects of preterm birth on stimulus-induced arousal processes in both the prone and supine sleeping positions. 10 healthy preterm infants were studied with daytime polysomnography, in both supine and prone sleeping positions, at 36 weeks gestational age, 2-4 weeks, 2-3 months and 5-6 months post-term corrected age. Sub-cortical activations and cortical arousals (CA) were expressed as proportions of total arousal responses. Preterm data were compared with data from 13 healthy term infants studied at the same corrected ages. In preterm infants increased CAs were observed in the prone position at all ages studied. Compared to term infants, preterm infants had significantly fewer CAs in QS when prone at 2-3 months of age and more CAs when prone at 2-4 weeks in AS. There were no differences in either sleep state when infants slept supine. Prone sleeping promoted CA responses in healthy preterm infants throughout the first six months of post-term age. We have previously suggested that in term infants enhanced CA represents a critical protection against a potentially harmful situation; we speculate that for preterm-born infants the need for this protection is greater than in term infants. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

[Care plan for patients in prone decubitus. An experience from practice].

PubMed

Oliva Torras, E; Subirana Casacuberta, M; Sebastià, M P; Jover Sancho, C; Solà Solé, N

1995-01-01

Offering a specific integral attention to patients with SDRA in prone decubitus positions makes us establish a performance plan with the aim to know the problems derived from the change in position, the time staying in prone decubitus and to standardize a care plan. We review the clinic records of the patients admitted in our unit from March '93 to March '95 who were positioned in prone decubitus. Taking as a base the nursing care model of V. Henderson and the taxonomy of NANDA, we analyse the needs which have been altered, and determine the nursing diagnosis, complications and most frequent interdependent problems establishing the aim to accomplish, planning the performance and rationalization. Five patients were positioned in prone decubitus before planning the performance and four more afterwards. All the patients tolerated SNG diet keeping a correct bowel transit. One patient showed an ulcera at frontal level. There were neither comeal ulceras nor alterations in the oral mucossa. The vascular accesses remained permeable. DP caused facial and periorbital edema in all the patients. We did not observe any increase in the amount of bronchial secretions. The eight patients who tolerated the change in position stayed in prone decubitus for an average of 77 hours, with a range of 10 to 216 hours. Four patients were discharged from the hospital, two of whom showed movility alterations, independently of the time staying in prone decubitus. We state explicitly the nursing care, determine five nursing diagnosis, one problem and seven interdependent complications. Establishing the nursing care from the experience and review of the records has allowed us to be more specific and objective. Standardizing the specific care plans makes the nursing care easier when dealing with real problems as well as with the care of complications derived from this situation.

Comparison of exercises inducing maximum voluntary isometric contraction for the latissimus dorsi using surface electromyography.

PubMed

Park, Se-yeon; Yoo, Won-gyu

2013-10-01

The aim of this study was to compare muscular activation during five different normalization techniques that induced maximal isometric contraction of the latissimus dorsi. Sixteen healthy men participated in the study. Each participant performed three repetitions each of five types of isometric exertion: (1) conventional shoulder extension in the prone position, (2) caudal shoulder depression in the prone position, (3) body lifting with shoulder depression in the seated position, (4) trunk bending to the right in the lateral decubitus position, and (5) downward bar pulling in the seated position. In most participants, maximal activation of the latissimus dorsi was observed during conventional shoulder extension in the prone position; the percentage of maximal voluntary contraction was significantly greater for this exercise than for all other normalization techniques except downward bar pulling in the seated position. Although differences in electrode placement among various electromyographic studies represent a limitation, normalization techniques for the latissimus dorsi are recommended to minimize error in assessing maximal muscular activation of the latissimus dorsi through the combined use of shoulder extension in the prone position and downward pulling. Copyright © 2013 Elsevier Ltd. All rights reserved.

Impact of patient position on the incidence of ventilator-associated pneumonia: a meta-analysis of randomized controlled trials.

PubMed

Alexiou, Vangelis G; Ierodiakonou, Vrettos; Dimopoulos, George; Falagas, Matthew E

2009-12-01

The aim of this study is to summarize the effect of position (prone and semirecumbent 45 degrees ) of mechanically ventilated patients on the incidence of ventilator-associated pneumonia (VAP) and other outcomes. A systematic search for randomized control trials (RCTs) was done. We estimated pooled odds ratios (ORs) and 95% confidence intervals (CIs) using fixed effects model or random effects model, where appropriate. For continuous variables, we calculated the estimation of weighted mean differences. We analyzed data extracted from 3 RCTs studying the semirecumbent 45 degrees and 4 RCTs studying the prone position with a total of 337 and 1018 patients, respectively. The odds of developing clinically diagnosed VAP were significantly lower among patients in the semirecumbent 45 degrees position compared to patients in the supine position (OR = 0.47; 95% CI, 0.27-0.82; 337 patients). The comparison of prone vs supine position group showed a moderate trend toward better outcomes regarding the incidence of clinically diagnosed VAP among patients in the prone position (OR = 0.80; 95% CI, 0.60-1.08; 1018 patients). The subanalysis regarding the incidence of microbiologically documented VAP, the length of intensive care unit stay, and the duration of mechanical ventilation showed that patients in the semirecumbent 45 degrees position have a moderate trend toward better clinical outcomes. This meta-analysis provides additional evidence that the usual practice of back-rest elevation of 15 degrees to 30 degrees is not sufficient to prevent VAP in mechanically ventilated patients. Patients positioned semirecumbently 45 degrees have significantly lower incidence of clinically diagnosed VAP compared to patients positioned supinely. On the other hand, the incidence of clinically diagnosed VAP among patients positioned pronely does not differ significantly from the incidence of clinically diagnosed VAP among patients positioned supinely.

[Effects of recruitment maneuver in prone position on hemodynamics in patients with severe pulmonary infection].

PubMed

Fan, Yuan-hua; Liu, Yuan-fei; Zhu, Hua-yong; Zhang, Min

2012-02-01

To evaluate effects of recruitment maneuver in prone position on hemodynamics in patients with severe pulmonary infection, based on the protective pulmonary ventilation strategy. Ninety-seven cases with severe pulmonary infection admitted to intensive care unit (ICU) of Ganzhou City People's Hospital undergoing mechanical ventilation were involved. Volume controlled ventilation mode with small tidal volume (8 ml/kg) and positive end-expiratory pressure (PEEP) of 6 cm H(2)O [1 cm H(2)O = 0.098 kPa] was conducted. Each patient underwent recruitment maneuver in supine position and then in prone position [PEEP 20 cm H(2)O+pressure control (PC) 20 cm H(2)O]. Heart rate (HR), mean arterial pressure (MAP), pulse oxygen saturation [SpO(2)] and blood gas analysis data were recorded before and after recruitment maneuver in either position. A double-lumen venous catheter was inserted into internal jugular vein or subclavian vein, and a pulse index contour cardiac output (PiCCO) catheter was introduced into femoral artery. Cardiac index (CI), stroke volume index (SVI), systemic vascular resistance index (SVRI), intra-thoracic blood volume index (ITBVI), extra vascular lung water index (EVLWI), global end-diastolic volume index (GEDVI), global ejection fraction (GEF), stroke volume variation (SVV) and central vein pressure (CVP) were monitored. (1) Compared with data before recruitment maneuver, there were no significant differences in HR and MAP after supine position and prone position recruitment maneuver, but significant differences in SpO(2) were found between before and after recruitment maneuver when patients' position was changed (supine position: 0.954 ± 0.032 vs. 0.917 ± 0.025, P < 0.05; prone position: 0.982 ± 0.028 vs. 0.936 ± 0.039, P < 0.05). SpO(2) was higher in prone position recruitment maneuver (P < 0.05). (2) Compared with data before recruitment maneuver, CI [L×min(-1)×m(-2)], SVI (ml/m(2)), GEDVI (ml/m(2)) and GEF were decreased significantly during recruitment maneuver (supine position: CI 3.2 ± 0.4 vs. 3.8 ± 0.6, SVI 32.4 ± 5.6 vs. 38.8 ± 6.5, GEDVI 689 ± 44 vs. 766 ± 32, GEF 0.267 ± 0.039 vs. 0.305 ± 0.056; prone position: CI 3.1 ± 0.5 vs. 3.6 ± 0.4, SVI 31.2 ± 5.8 vs. 37.3 ± 5.0, GEDVI 678 ± 41 vs. 758 ± 36, GEF 0.268 ± 0.040 vs. 0.288 ± 0.053, all P < 0.05), and CVP [cm H(2)O] and SVV were significantly increased [supine position: CVP 10.7 ± 1.5 vs. 8.2 ± 2.5, SVV (11.2 ± 3.3)% vs. (8.3 ± 4.7)%; prone position: CVP 10.3 ± 1.8 vs. 8.1 ± 2.5, SVV (12.7 ± 3.4)% vs. (9.1 ± 3.6)%, all P < 0.05], but they returned to the level of that before recruitment maneuver soon after termination of recruitment maneuver. There were no significant differences in SVRI, ITBVI and EVLWI between before and after recruitment maneuver in both positions. There were also no significant differences in above parameters between two positions. Based on the lung protective ventilation strategy of small tidal volume with PEEP, oxygenation was improved and SpO(2) was increased significantly when prone position ventilation combined with lung recruitment method was used in severe pulmonary infection patients. The effect of recruitment maneuver during prone position on hemodynamics was slight, except a temporary decrease of SVI and GEF just during recruitment maneuver.

Contact high: Mania proneness and positive perception of emotional touches.

PubMed

Piff, Paul K; Purcell, Amanda; Gruber, June; Hertenstein, Matthew J; Keltner, Dacher

2012-01-01

How do extreme degrees of positive emotion-such as those characteristic of mania-influence emotion perception? The present study investigated how mania proneness, assessed using the Hypomanic Personality Scale, influences the perception of emotion via touch. Using a validated dyadic interaction paradigm for communicating emotion through touch (Hertenstein, Keltner, App, Bulleit, & Jaskolka, 2006), participants (N=53) received eight different touches to their forearm from a stranger and then identified the emotion via forced-choice methodology. Mania proneness predicted increased overall accuracy in touch perception, particularly for positive emotion touches, as well as the over-attribution of positive and under-attribution of negative emotions across all touches. These findings highlight the effects of positive emotion extremes on the perception of emotion in social interactions.

Endoluminal surface registration for CT colonography using haustral fold matching☆

PubMed Central

Hampshire, Thomas; Roth, Holger R.; Helbren, Emma; Plumb, Andrew; Boone, Darren; Slabaugh, Greg; Halligan, Steve; Hawkes, David J.

2013-01-01

Computed Tomographic (CT) colonography is a technique used for the detection of bowel cancer or potentially precancerous polyps. The procedure is performed routinely with the patient both prone and supine to differentiate fixed colonic pathology from mobile faecal residue. Matching corresponding locations is difficult and time consuming for radiologists due to colonic deformations that occur during patient repositioning. We propose a novel method to establish correspondence between the two acquisitions automatically. The problem is first simplified by detecting haustral folds using a graph cut method applied to a curvature-based metric applied to a surface mesh generated from segmentation of the colonic lumen. A virtual camera is used to create a set of images that provide a metric for matching pairs of folds between the prone and supine acquisitions. Image patches are generated at the fold positions using depth map renderings of the endoluminal surface and optimised by performing a virtual camera registration over a restricted set of degrees of freedom. The intensity difference between image pairs, along with additional neighbourhood information to enforce geometric constraints over a 2D parameterisation of the 3D space, are used as unary and pair-wise costs respectively, and included in a Markov Random Field (MRF) model to estimate the maximum a posteriori fold labelling assignment. The method achieved fold matching accuracy of 96.0% and 96.1% in patient cases with and without local colonic collapse. Moreover, it improved upon an existing surface-based registration algorithm by providing an initialisation. The set of landmark correspondences is used to non-rigidly transform a 2D source image derived from a conformal mapping process on the 3D endoluminal surface mesh. This achieves full surface correspondence between prone and supine views and can be further refined with an intensity based registration showing a statistically significant improvement (p < 0.001), and decreasing mean error from 11.9 mm to 6.0 mm measured at 1743 reference points from 17 CTC datasets. PMID:23845949

Supine or prone position for mini-PNL procedure: does it matter.

PubMed

Tokatlı, Zafer; Gokce, Mehmet Ilker; Süer, Evren; Sağlam, Remzi

2015-06-01

In this study it is aimed to compare the success and complication rates of mini-PNL procedure in supine and prone positions. In this retrospective study data of 180 patients treated with MPNL either in supine (n = 54) or prone (n = 126) positions between May 2009 and August 2014 was investigated. Success was defined as no visible stones >2 mm. Perioperative complications were classified using the modified Clavien system. Groups were compared with Chi square test or Student t test and for statistical significance p value of 0.05 was accepted. Mean age of the population was 42.5 ± 8.2 years and mean stone size was 23.9 ± 4.1 mm. The two groups were similar with regard to demographic characteristics and stone related characteristics except the ASA status. Success rates of the supine and prone groups were 85.1 and 87.3%, respectively (p = 0.701). No statistically significant differences in terms of complications were observed. Mean operative time was the only parameter different between the two groups (55 vs 82 min, p = 0.001). Supine position for PNL seems to be promising and the complication and success rates are shown to be similar to the prone position with MPNL technique. The only significant benefit of this technique is shorter operative time.

Complications associated with prone positioning in elective spinal surgery.

PubMed

DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

2015-04-18

Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity.

Complications associated with prone positioning in elective spinal surgery

PubMed Central

DePasse, J Mason; Palumbo, Mark A; Haque, Maahir; Eberson, Craig P; Daniels, Alan H

2015-01-01

Complications associated with prone surgical positioning during elective spine surgery have the potential to cause serious patient morbidity. Although many of these complications remain uncommon, the range of possible morbidities is wide and includes multiple organ systems. Perioperative visual loss (POVL) is a well described, but uncommon complication that may occur due to ischemia to the optic nerve, retina, or cerebral cortex. Closed-angle glaucoma and amaurosis have been reported as additional etiologies for vision loss following spinal surgery. Peripheral nerve injuries, such as those caused by prolonged traction to the brachial plexus, are more commonly encountered postoperative events. Myocutaneous complications including pressure ulcers and compartment syndrome may also occur after prone positioning, albeit rarely. Other uncommon positioning complications such as tongue swelling resulting in airway compromise, femoral artery ischemia, and avascular necrosis of the femoral head have also been reported. Many of these are well-understood and largely avoidable through thoughtful attention to detail. Other complications, such as POVL, remain incompletely understood and thus more difficult to predict or prevent. Here, the current literature on the complications of prone positioning for spine surgery is reviewed to increase awareness of the spectrum of potential complications and to inform spine surgeons of strategies to minimize the risk of prone patient morbidity. PMID:25893178

Prone positioning ventilation for treatment of acute lung injury and acute respiratory distress syndrome.

PubMed

Lan, Mei-juan; He, Xiao-di

2009-08-01

Patients who are diagnosed with acute lung injury/acute respiratory distress syndrome (ALI/ARDS) usually have ventilation-perfusion mismatch, severe decrease in lung capacity, and gas exchange abnormalities. Health care workers have implemented various strategies in an attempt to compensate for these pathological alterations. By rotating patients with ALI/ARDS between the supine and prone position, it is possible to achieve a significant improvement in PaO2/FiO2, decrease shunting and therefore improve oxygenation without use of expensive, invasive and experimental procedures. Prone positioning is a safe and effective way to improve ventilation when conventional strategies fail to initiate a patient response. Because a specific cure for ARDS is not available, the goal is to support the patients with therapies that cause the least amount of injury while the lungs have an opportunity to heal. Based on current data, a trial of prone positioning ventilation should be offered to the patients who have ALI/ARDS in the early course of the disease. Published studies exhibit substantial heterogeneity in clinical results, suggesting that an adequately sized study optimizing the duration of proning ventilation strategy is warranted to enable definitive conclusions to be drawn.

Comparison of knee flexion isokinetic deficits between seated and prone positions after ACL reconstruction with hamstrings graft: Implications for rehabilitation and return to sports decisions.

PubMed

Koutras, Georgios; Bernard, Manfred; Terzidis, Ioannis P; Papadopoulos, Pericles; Georgoulis, Anastasios; Pappas, Evangelos

2016-07-01

Hamstrings grafts are commonly used in ACL reconstruction, however, the effect of graft harvesting on knee flexion strength has not been longitudinally evaluated in functional positions. We hypothesized that greater deficits in knee flexion strength exist in the prone compared to the seated position and these deficits remain as rehabilitation progresses. Case series. Forty-two consecutive patients who underwent ACL reconstruction with a hamstrings graft were followed prospectively for 9 months. Isokinetic knee flexion strength at a slow and a fast speed were collected at 3, 4, 6, and 9 months in two different positions: conventional (seated) and functional (0° of hip flexion). Peak torque knee flexion deficits were higher in the prone position compared to the seated position by an average of 6.5% at 60°/s and 9.1% at 180°/s (p<0.001). Measuring knee flexion strength in prone demonstrates higher deficits than in the conventional seated position. Most athletes would not be cleared to return to sports even at 9 months after surgery with this method. Copyright © 2015 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

Anatomically correct visualization of the human upper airway using a high-speed long range optical coherence tomography system with an integrated positioning sensor

NASA Astrophysics Data System (ADS)

Jing, Joseph C.; Chou, Lidek; Su, Erica; Wong, Brian J. F.; Chen, Zhongping

2016-12-01

The upper airway is a complex tissue structure that is prone to collapse. Current methods for studying airway obstruction are inadequate in safety, cost, or availability, such as CT or MRI, or only provide localized qualitative information such as flexible endoscopy. Long range optical coherence tomography (OCT) has been used to visualize the human airway in vivo, however the limited imaging range has prevented full delineation of the various shapes and sizes of the lumen. We present a new long range OCT system that integrates high speed imaging with a real-time position tracker to allow for the acquisition of an accurate 3D anatomical structure in vivo. The new system can achieve an imaging range of 30 mm at a frame rate of 200 Hz. The system is capable of generating a rapid and complete visualization and quantification of the airway, which can then be used in computational simulations to determine obstruction sites.

Ventilator-associated pneumonia in ARDS patients: the impact of prone positioning. A secondary analysis of the PROSEVA trial.

PubMed

Ayzac, L; Girard, R; Baboi, L; Beuret, P; Rabilloud, M; Richard, J C; Guérin, C

2016-05-01

The goal of this study was to assess the impact of prone positioning on the incidence of ventilator-associated pneumonia (VAP) and the role of VAP in mortality in a recent multicenter trial performed on patients with severe ARDS. An ancillary study of a prospective multicenter randomized controlled trial on early prone positioning in patients with severe ARDS. In suspected cases of VAP the diagnosis was based on positive quantitative cultures of bronchoalveolar lavage fluid or tracheal aspirate at the 10(4) and 10(7) CFU/ml thresholds, respectively. The VAP cases were then subject to central, independent adjudication. The cumulative probabilities of VAP were estimated in each position group using the Aalen-Johansen estimator and compared using Gray's test. A univariate and a multivariate Cox model was performed to assess the impact of VAP, used as a time-dependent covariate for mortality hazard during the ICU stay. In the supine and prone position groups, the incidence rate for VAP was 1.18 (0.86-1.60) and 1.54 (1.15-2.02) per 100 days of invasive mechanical ventilation (p = 0.10), respectively. The cumulative probability of VAP at 90 days was estimated at 46.5 % (27-66) in the prone group and at 33.5 % (23-44) in the supine group. The difference between the two cumulative probability curves was not statistically significant (p = 0.11). In the univariate Cox model, VAP was associated with an increase in the mortality rate during the ICU stay [HR 1.65 (1.05-2.61), p = 0.03]. HR increased to 2.2 (1.39-3.52) (p < 0.001) after adjustment for position group, age, SOFA score, McCabe score, and immunodeficiency. In severe ARDS patients prone positioning did not reduce the incidence of VAP and VAP was associated with higher mortality.

Foldover-free shape deformation for biomedicine.

PubMed

Yu, Hongchuan; Zhang, Jian J; Lee, Tong-Yee

2014-04-01

Shape deformation as a fundamental geometric operation underpins a wide range of applications, from geometric modelling, medical imaging to biomechanics. In medical imaging, for example, to quantify the difference between two corresponding images, 2D or 3D, one needs to find the deformation between both images. However, such deformations, particularly deforming complex volume datasets, are prone to the problem of foldover, i.e. during deformation, the required property of one-to-one mapping no longer holds for some points. Despite numerous research efforts, the construction of a mathematically robust foldover-free solution subject to positional constraints remains open. In this paper, we address this challenge by developing a radial basis function-based deformation method. In particular we formulate an effective iterative mechanism which ensures the foldover-free property is satisfied all the time. The experimental results suggest that the resulting deformations meet the internal positional constraints. In addition to radial basis functions, this iterative mechanism can also be incorporated into other deformation approaches, e.g. B-spline based FFDs, to develop different deformable approaches for various applications. Crown Copyright © 2013. Published by Elsevier Inc. All rights reserved.

Non-invasive ventilation in prone position for refractory hypoxemia after bilateral lung transplantation.

PubMed

Feltracco, Paolo; Serra, Eugenio; Barbieri, Stefania; Persona, Paolo; Rea, Federico; Loy, Monica; Ori, Carlo

2009-01-01

Temporary graft dysfunction with gas exchange abnormalities is a common finding during the postoperative course of a lung transplant and is often determined by the post-reimplantation syndrome. Supportive measures including oxygen by mask, inotropes, diuretics, and pulmonary vasodilators are usually effective in non-severe post-reimplantation syndromes. However, in less-responsive clinical pictures, tracheal intubation with positive pressure ventilation, or non-invasive positive pressure ventilation (NIV), is necessary. We report on the clinical course of two patients suffering from refractory hypoxemia due to post-reimplantation syndrome treated with NIV in the prone and Trendelenburg positions. NIV was well tolerated and led to resolution of atelectactic areas and dishomogeneous lung infiltrates. Repeated turning from supine to prone under non invasive ventilation determined a stable improvement of gas exchange and prevented a more invasive approach. Even though NIV in the prone position has not yet entered into clinical practice, it could be an interesting option to achieve a better match between ventilation and perfusion. This technique, which we successfully applied in lung transplantation, can be easily extended to other lung diseases with non-recruitable dorso-basal areas.

Preventing Facial Pressure Ulcers in Acute Respiratory Distress Syndrome (ARDS).

PubMed

Kim, Ruth S; Mullins, Kimberly

2016-01-01

In patients with acute lung injury and/or severe acute respiratory distress syndrome (ARDS), prone positioning is a therapeutic intervention to improve oxygenation. Positioning a patient in a prone position increases the risk of medical device-related pressure ulcers in the facial area. This article summarizes experience with 4 patients with ARDS. Two did not receive pressure ulcer preventive measures and subsequently developed multiple necrotic facial pressure ulcers related to prone positioning for treatment of ARDS. The other 2 patients were managed on a thin silicone foam dressing; neither of these patients developed facial pressure ulcers during pronation therapy. The use of thin soft silicone foam dressings may prevent the development of facial deep tissue injuries in patients receiving prolonged pronation therapy.

Robust 3D-2D image registration: application to spine interventions and vertebral labeling in the presence of anatomical deformation

NASA Astrophysics Data System (ADS)

Otake, Yoshito; Wang, Adam S.; Webster Stayman, J.; Uneri, Ali; Kleinszig, Gerhard; Vogt, Sebastian; Khanna, A. Jay; Gokaslan, Ziya L.; Siewerdsen, Jeffrey H.

2013-12-01

We present a framework for robustly estimating registration between a 3D volume image and a 2D projection image and evaluate its precision and robustness in spine interventions for vertebral localization in the presence of anatomical deformation. The framework employs a normalized gradient information similarity metric and multi-start covariance matrix adaptation evolution strategy optimization with local-restarts, which provided improved robustness against deformation and content mismatch. The parallelized implementation allowed orders-of-magnitude acceleration in computation time and improved the robustness of registration via multi-start global optimization. Experiments involved a cadaver specimen and two CT datasets (supine and prone) and 36 C-arm fluoroscopy images acquired with the specimen in four positions (supine, prone, supine with lordosis, prone with kyphosis), three regions (thoracic, abdominal, and lumbar), and three levels of geometric magnification (1.7, 2.0, 2.4). Registration accuracy was evaluated in terms of projection distance error (PDE) between the estimated and true target points in the projection image, including 14 400 random trials (200 trials on the 72 registration scenarios) with initialization error up to ±200 mm and ±10°. The resulting median PDE was better than 0.1 mm in all cases, depending somewhat on the resolution of input CT and fluoroscopy images. The cadaver experiments illustrated the tradeoff between robustness and computation time, yielding a success rate of 99.993% in vertebral labeling (with ‘success’ defined as PDE <5 mm) using 1,718 664 ± 96 582 function evaluations computed in 54.0 ± 3.5 s on a mid-range GPU (nVidia, GeForce GTX690). Parameters yielding a faster search (e.g., fewer multi-starts) reduced robustness under conditions of large deformation and poor initialization (99.535% success for the same data registered in 13.1 s), but given good initialization (e.g., ±5 mm, assuming a robust initial run) the same registration could be solved with 99.993% success in 6.3 s. The ability to register CT to fluoroscopy in a manner robust to patient deformation could be valuable in applications such as radiation therapy, interventional radiology, and an assistant to target localization (e.g., vertebral labeling) in image-guided spine surgery.

Conformational analysis of misfolded protein aggregation by FRET and live-cell imaging techniques.

PubMed

Kitamura, Akira; Nagata, Kazuhiro; Kinjo, Masataka

2015-03-16

Cellular homeostasis is maintained by several types of protein machinery, including molecular chaperones and proteolysis systems. Dysregulation of the proteome disrupts homeostasis in cells, tissues, and the organism as a whole, and has been hypothesized to cause neurodegenerative disorders, including amyotrophic lateral sclerosis (ALS) and Huntington's disease (HD). A hallmark of neurodegenerative disorders is formation of ubiquitin-positive inclusion bodies in neurons, suggesting that the aggregation process of misfolded proteins changes during disease progression. Hence, high-throughput determination of soluble oligomers during the aggregation process, as well as the conformation of sequestered proteins in inclusion bodies, is essential for elucidation of physiological regulation mechanism and drug discovery in this field. To elucidate the interaction, accumulation, and conformation of aggregation-prone proteins, in situ spectroscopic imaging techniques, such as Förster/fluorescence resonance energy transfer (FRET), fluorescence correlation spectroscopy (FCS), and bimolecular fluorescence complementation (BiFC) have been employed. Here, we summarize recent reports in which these techniques were applied to the analysis of aggregation-prone proteins (in particular their dimerization, interactions, and conformational changes), and describe several fluorescent indicators used for real-time observation of physiological states related to proteostasis.

Motor development and sleep, play, and feeding positions in very-low-birthweight infants with and without white matter disease.

PubMed

Fetters, Linda; Huang, Hsiang-Han

2007-11-01

We investigated the association of infants' sleep and awake positioning with motor milestone acquisition as measured by the Alberta Infant Motor Scale (AIMS). Participants were 30 very-low-birthweight (VLBW) infants with preterm white matter disease (PTWMD; 21 males, nine females; mean birthweight [BW] 1,129 g [SD 338]; mean gestational age [GA] 28 wks [SD 2.44]); 21 VLBW infants without preterm WMD (PT; 13 males, eight females; mean BW 1,107 g [SD 370]; mean GA 28.05 wks [SD 2.21]); and 17 term infants (Term; seven males, 10 females; mean BW 3,565 g [SD 382]; mean GA 40 wks [SD 1.31]). Testing occurred at 1, 5, and 9 months of age (corrected for prematurity). Preferred positions during sleeping, playing, and feeding were obtained through parent interview. These positions and group were the independent variables. Prone sleeping was significantly and positively associated with motor development at all ages (1 mo: p=0.005; 5 mo: p=0.011; 9 mo: p=0.040). At 5 months, prone sleeping and playing were significantly and positively associated with AIMS scores (prone sleeping, p=0.016; prone playing, p=0.047). However, group was negatively associated with preterm white matter disease, with the PTWMD group having significantly lower AIMS scores than the Term group (p=0.029). At 9 months, sitting playing and group membership were significantly associated with AIMS scores (sitting playing, p=0.005; group, p=0.012). Prone positioning should be encouraged for awake time, particularly for infants with preterm white matter disease.

Mapping intended spinal site of care from the upright to prone position: an interexaminer reliability study.

PubMed

Cooperstein, Robert; Young, Morgan

2014-01-01

Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the interexaminer reliability of a novel method for mapping upright spinal sites to the prone position. Experiment 1 was a thought experiment exploring the consequences of depending on the erroneous landmark association of the inferior scapular tip with the T7 spinous process upright and T6 spinous process prone (relatively recent studies suggest these levels are T8 and T9, respectively). This allowed deduction of targeting and charting errors. In experiment 2, 10 examiners (2 experienced, 8 novice) used an index finger to maintain contact with a mid-thoracic spinous process as each of 2 participants slowly moved from the upright to the prone position. Interexaminer reliability was assessed by computing Intraclass Correlation Coefficient, standard error of the mean, root mean squared error, and the absolute value of the mean difference for each examiner from the 10 examiner mean for each of the 2 participants. The thought experiment suggesting that using the (inaccurate) scapular tip landmark rule would result in a 3 level targeting and charting error when radiological findings are mapped to the prone position. Physical upright exam procedures like motion palpation would result in a 2 level targeting error for intervention, and a 3 level error for charting. The reliability experiment showed examiners accurately maintained contact with the same thoracic spinous process as the participant went from upright to prone, ICC (2,1) = 0.83. As manual therapists, the authors have emphasized how targeting errors may impact upon manual care of the spine. Practitioners in other fields that need to accurately locate spinal levels, such as acupuncture and anesthesiology, would also be expected to draw important conclusions from these findings.

Mapping intended spinal site of care from the upright to prone position: an interexaminer reliability study

PubMed Central

2014-01-01

Background Upright examination procedures like radiology, thermography, manual muscle testing, and spinal motion palpation may lead to spinal interventions with the patient prone. The reliability and accuracy of mapping upright examination findings to the prone position is unknown. This study had 2 primary goals: (1) investigate how erroneous spine-scapular landmark associations may lead to errors in treating and charting spine levels; and (2) study the interexaminer reliability of a novel method for mapping upright spinal sites to the prone position. Methods Experiment 1 was a thought experiment exploring the consequences of depending on the erroneous landmark association of the inferior scapular tip with the T7 spinous process upright and T6 spinous process prone (relatively recent studies suggest these levels are T8 and T9, respectively). This allowed deduction of targeting and charting errors. In experiment 2, 10 examiners (2 experienced, 8 novice) used an index finger to maintain contact with a mid-thoracic spinous process as each of 2 participants slowly moved from the upright to the prone position. Interexaminer reliability was assessed by computing Intraclass Correlation Coefficient, standard error of the mean, root mean squared error, and the absolute value of the mean difference for each examiner from the 10 examiner mean for each of the 2 participants. Results The thought experiment suggesting that using the (inaccurate) scapular tip landmark rule would result in a 3 level targeting and charting error when radiological findings are mapped to the prone position. Physical upright exam procedures like motion palpation would result in a 2 level targeting error for intervention, and a 3 level error for charting. The reliability experiment showed examiners accurately maintained contact with the same thoracic spinous process as the participant went from upright to prone, ICC (2,1) = 0.83. Conclusions As manual therapists, the authors have emphasized how targeting errors may impact upon manual care of the spine. Practitioners in other fields that need to accurately locate spinal levels, such as acupuncture and anesthesiology, would also be expected to draw important conclusions from these findings. PMID:24904747

CT protocols in interstitial lung diseases--a survey among members of the European Society of Thoracic Imaging and a review of the literature.

PubMed

Prosch, Helmut; Schaefer-Prokop, Cornelia M; Eisenhuber, Edith; Kienzl, Daniela; Herold, Christian J

2013-06-01

The aim of this study was to survey the current CT protocols used by members of the European Society of Thoracic Imaging (ESTI) to evaluate patients with interstitial lung diseases (ILD). A questionnaire was e-mailed to 173 ESTI members. The survey focussed on CT acquisition and reconstruction techniques. In particular, questions referred to the use of discontinuous HRCT or volume CT protocols, the acquisition of additional acquisitions in expiration or in the prone position, and methods of radiation dose reduction and on reconstruction algorithms. The overall response rate was 37 %. Eighty-five percent of the respondents used either volume CT alone or in combination with discontinuous HRCT. Forty-five percent of the respondents adapt their CT protocols to the patient's weight and/or age. Expiratory CT or CT in the prone position was performed by 58 % and 59 % of the respondents, respectively. The number of reconstructed series ranged from two to eight. Our survey showed that radiologists with a special interest and experience in chest radiology use a variety of CT protocols for the evaluation of ILD. There is a clear preference for volumetric scans and a strong tendency to use the 3D information. • Experienced thoracic radiologists use various CT protocols for evaluating interstitial lung diseases. • Most workers prefer volumetric CT acquisitions, making use of the 3D information • More attention to reducing the radiation dose appears to be needed.

A new orthosis reduces pain and mechanical forces in prone position in women with augmented or natural breast tissue: a pilot study.

PubMed

Armstrong, Simon; Ried, Karin; Sali, Avni; McLaughlin, Patrick

2013-07-01

Breast augmentation, post-mastectomy patients as well as some women with natural breast tissue, and lactating, women often experience discomfort in prone activities. Our study, for the first time, examines pain levels, mechanical force and peak pressure in natural, reconstructed and augmented breast tissues with and without a new orthosis designed for reduction of displacement, compression and loading forces through the breast tissue during prone activities. Twelve females with natural, lactating or augmented breast tissue, and cup-sizes C-F volunteered for the study. Pain perception was measured using an 11-point visual-analogue-scale without and with different sizes/textures of the orthosis. Magnetic-Resonance-Imaging captured segmental transverse and para-sagittal mid-breast views, and provided linear measurements of breast tissue displacement and deformation. Capacitance-pliance® sensorstrips were used to measure force and pressure between the breast tissue and the surface of a standard treatment table. Measurements were taken whilst the participants were load bearing in prone positions with and without the orthosis. The new orthosis significantly reduced pain and mechanical forces in participants with natural or augmented breast tissue with cup-sizes C-F. Larger orthotic sizes were correlated with greater reduction in pain and mechanical forces, with all participants reporting no pain with the largest size orthotic. A size-3 orthotic decreased load on the breast tissue by 82% and reduced peak pressure by 42%. The same orthotic decreased medio-lateral spread of breast tissue and implant whilst increasing height. The new orthosis significantly reduced pain and mechanical forces in all women with natural or augmented tissues. Results are of clinical significance, as reduced mechanical forces are associated with greater comfort and reduced pressure and displacement which may lower the probability of breast implant complication. In clinical settings the orthosis is recommended for all augmentation patients when undergoing prone treatment by therapists and clinicians for improved comfort and safety. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Probing the regional distribution of pulmonary gas exchange through single-breath gas- and dissolved-phase 129Xe MR imaging.

PubMed

Kaushik, S Sivaram; Freeman, Matthew S; Cleveland, Zackary I; Davies, John; Stiles, Jane; Virgincar, Rohan S; Robertson, Scott H; He, Mu; Kelly, Kevin T; Foster, W Michael; McAdams, H Page; Driehuys, Bastiaan

2013-09-01

Although some central aspects of pulmonary function (ventilation and perfusion) are known to be heterogeneous, the distribution of diffusive gas exchange remains poorly characterized. A solution is offered by hyperpolarized 129Xe magnetic resonance (MR) imaging, because this gas can be separately detected in the lung's air spaces and dissolved in its tissues. Early dissolved-phase 129Xe images exhibited intensity gradients that favored the dependent lung. To quantitatively corroborate this finding, we developed an interleaved, three-dimensional radial sequence to image the gaseous and dissolved 129Xe distributions in the same breath. These images were normalized and divided to calculate "129Xe gas-transfer" maps. We hypothesized that, for healthy volunteers, 129Xe gas-transfer maps would retain the previously observed posture-dependent gradients. This was tested in nine subjects: when the subjects were supine, 129Xe gas transfer exhibited a posterior-anterior gradient of -2.00 ± 0.74%/cm; when the subjects were prone, the gradient reversed to 1.94 ± 1.14%/cm (P < 0.001). The 129Xe gas-transfer maps also exhibited significant heterogeneity, as measured by the coefficient of variation, that correlated with subject total lung capacity (r = 0.77, P = 0.015). Gas-transfer intensity varied nonmonotonically with slice position and increased in slices proximal to the main pulmonary arteries. Despite substantial heterogeneity, the mean gas transfer for all subjects was 1.00 ± 0.01 while supine and 1.01 ± 0.01 while prone (P = 0.25), indicating good "matching" between gas- and dissolved-phase distributions. This study demonstrates that single-breath gas- and dissolved-phase 129Xe MR imaging yields 129Xe gas-transfer maps that are sensitive to altered gas exchange caused by differences in lung inflation and posture.

Poster - 33: Dosimetry Comparison of Prone Breast Forward and Inverse Treatment planning considering daily setup variations

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

Jiang, Runqing; Zhan, Lixin; Osei, Ernest

2016-08-15

Introduction: The purpose of this study is to investigate the effects of daily setup variations on prone breast forward field-in-field (FinF) and inverse IMRT treatment planning. Methods: Rando Phantom (Left breast) and Pixy phantom (Right breast) were built and CT scanned in prone position. The treatment planning (TP) is performed in Eclipse TP system. Forward FinF plan and inverse IMRT plan were created to satisfy the CTV coverage and OARs criteria. The daily setup variations were assumed to be 5 mm at left-right, superior-inferior, and anterior-posterior directions. The DVHs of CTV coverage and OARs were compared for both forward FinFmore » plan and inverse IMRT plans due to 5mm setup variation. Results and Discussions: DVHs of CTV coverage had fewer variations for 5m setup variation for forward FinF and inverse IMRT plan for both phantoms. However, for the setup variations in the left-right direction, the DVH of CTV coverage of IMRT plan showed the worst variation due to lateral setup variation for both phantoms. For anterior-posterior variation, the CTV could not get full coverage when the breast chest wall is shallow; however, with the guidance of MV imaging, breast chest wall will be checked during the MV imaging setup. So the setup variations have more effects on inverse IMRT plan, compared to forward FinF plan, especially in the left-right direction. Conclusions: The Forward FinF plan was recommended clinically considering daily setup variation.« less

Spatial Distortion in MRI-Guided Stereotactic Procedures: Evaluation in 1.5-, 3- and 7-Tesla MRI Scanners.

PubMed

Neumann, Jan-Oliver; Giese, Henrik; Biller, Armin; Nagel, Armin M; Kiening, Karl

2015-01-01

Magnetic resonance imaging (MRI) is replacing computed tomography (CT) as the main imaging modality for stereotactic transformations. MRI is prone to spatial distortion artifacts, which can lead to inaccuracy in stereotactic procedures. Modern MRI systems provide distortion correction algorithms that may ameliorate this problem. This study investigates the different options of distortion correction using standard 1.5-, 3- and 7-tesla MRI scanners. A phantom was mounted on a stereotactic frame. One CT scan and three MRI scans were performed. At all three field strengths, two 3-dimensional sequences, volumetric interpolated breath-hold examination (VIBE) and magnetization-prepared rapid acquisition with gradient echo, were acquired, and automatic distortion correction was performed. Global stereotactic transformation of all 13 datasets was performed and two stereotactic planning workflows (MRI only vs. CT/MR image fusion) were subsequently analysed. Distortion correction on the 1.5- and 3-tesla scanners caused a considerable reduction in positional error. The effect was more pronounced when using the VIBE sequences. By using co-registration (CT/MR image fusion), even a lower positional error could be obtained. In ultra-high-field (7 T) MR imaging, distortion correction introduced even higher errors. However, the accuracy of non-corrected 7-tesla sequences was comparable to CT/MR image fusion 3-tesla imaging. MRI distortion correction algorithms can reduce positional errors by up to 60%. For stereotactic applications of utmost precision, we recommend a co-registration to an additional CT dataset. © 2015 S. Karger AG, Basel.

The effects of prone position ventilation in patients with acute respiratory distress syndrome. A systematic review and metaanalysis.

PubMed

Mora-Arteaga, J A; Bernal-Ramírez, O J; Rodríguez, S J

2015-01-01

Prone position ventilation has been shown to improve oxygenation and ventilatory mechanics in patients with acute respiratory distress syndrome. We evaluated whether prone ventilation reduces the risk of mortality in adult patients with acute respiratory distress syndrome versus supine ventilation. A metaanalysis of randomized controlled trials comparing patients in supine versus prone position was performed. A search was conducted of the Pubmed, Embase, Cochrane Library, and LILACS databases. Mortality, hospital length of stay, days of mechanical ventilation and adverse effects were evaluated. Seven randomized controlled trials (2,119 patients) were included in the analysis. The prone position showed a nonsignificant tendency to reduce mortality (OR: 0.76; 95%CI: 0.54 to 1.06; P=.11, I(2) 63%). When stratified by subgroups, a significant decrease was seen in the risk of mortality in patients ventilated with low tidal volume (OR: 0.58; 95%CI: 0.38 to 0.87; P=.009, I(2) 33%), prolonged pronation (OR: 0.6; 95%CI: 0.43 to 0.83; p=.002, I(2) 27%), start within the first 48hours of disease evolution (OR 0.49; 95%CI 0.35 to 0.68; P=.0001, I(2) 0%) and severe hypoxemia (OR: 0.51: 95%CI: 0.36 to 1.25; P=.0001, I(2) 0%). Adverse effects associated with pronation were the development of pressure ulcers and endotracheal tube obstruction. Prone position ventilation is a safe strategy and reduces mortality in patients with severely impaired oxygenation. It should be started early, for prolonged periods, and should be associated to a protective ventilation strategy. Copyright © 2014 Elsevier España, S.L.U. and SEMICYUC. All rights reserved.

Influence of body position on the displacement of nasal prongs in preterm newborns receiving continuous positive airway pressure

PubMed Central

Brunherotti, Marisa Afonso Andrade; Martinez, Francisco Eulógio

2015-01-01

Abstract Objective: To evaluate the influence of body position on the displacement of nasal prongs in preterm infants. Methods: This prospective, randomized, crossover study enrolled infants born at a mean gestational age of 29.7±2 weeks, birth weight of 1353±280g and 2.9±2.2 days of life, submitted to continuous positive airway pressure by nasal prongs. The main outcome was the number of times that the nasal prongs were displaced following infant positioning in the following body positions: prone, right lateral, left lateral, and supine, according to a pre-established random order. Moreover, cardiorespiratory variables (respiratory rate, heart rate, and oxygen saturation) were evaluated for each body position. Data for each position were collected every 10 min, over a period of 60 min. An occurrence was defined when the nasal prongs were displaced from the nostrils after 3 min in the desired position, requiring intervention of the examiner. Results: Among the 16 studied infants, the occurrence of nasal prong displacement was only observed in the prone position (9 infants - 56.2%) and in the left lateral position (2 infants - 12.5%). The number of times that the prongs were displaced was 11 in the prone position (7 within the first 10min) and 2 in the left lateral position (1 within the first 10min). No clinically significant changes were observed in the cardiorespiratory variables. Conclusions: Maintenance of the nasal prongs to provide adequate noninvasive respiratory support was harder in the prone position. PMID:26116326

Pulmonary blood flow distribution in sheep: effects of anesthesia, mechanical ventilation, and change in posture

NASA Technical Reports Server (NTRS)

Walther, S. M.; Domino, K. B.; Glenny, R. W.; Hlastala, M. P.

1997-01-01

BACKGROUND: Recent studies providing high-resolution images of pulmonary perfusion have questioned the classical zone model of pulmonary perfusion. Hence the present work was undertaken to provide detailed maps of regional pulmonary perfusion to examine the influence of anesthesia, mechanical ventilation, and posture. METHODS: Pulmonary perfusion was analyzed with intravenous fluorescent microspheres (15 microm) in six sheep studied in four conditions: prone and awake, prone with pentobarbital-anesthesia and breathing spontaneously, prone with anesthesia and mechanical ventilation, and supine with anesthesia and mechanical ventilation. Lungs were air dried at total lung capacity and sectioned into approximately 1,100 pieces (about 2 cm3) per animal. The pieces were weighed and assigned spatial coordinates. Fluorescence was read on a spectrophotometer, and signals were corrected for piece weight and normalized to mean flow. Pulmonary blood flow heterogeneity was assessed using the coefficient of variation of flow data. RESULTS: Pentobarbital anesthesia and mechanical ventilation did not influence perfusion heterogeneity, but heterogeneity increased when the animals were in the supine posture (P < 0.01). Gravitational flow gradients were absent in the prone position but present in the supine (P < 0.001 compared with zero). Pulmonary perfusion was distributed with a hilar-to-peripheral gradient in animals breathing spontaneously (P < 0.05). CONCLUSIONS: The influence of pentobarbital anesthesia and mechanical ventilation on pulmonary perfusion heterogeneity is small compared with the effect of changes in posture. Analysis of flow gradients indicate that gravity plays a small role in determining pulmonary blood flow distribution.

The performance of a wire mesh collimator SPECT camera for different breast volumes in prone position

NASA Astrophysics Data System (ADS)

Roslan, R. E.; Saad, W. H. Mohd; Saripan, M. I.; Hashim, S.; Choong, W.-S.

2010-07-01

The multihole collimator is the most commonly used collimator in conventional SPECT cameras for general purpose imaging. However, there are some limitations with this collimator, which includes the lack of sensitivity as a trade-off for obtaining better spatial resolution. This paper looks at the performance of a wire mesh collimator that was introduced recently in order to improve the ability of SPECT cameras in mapping breast cancer cells, utilizing the Technetium-99 m 140 keV radiotracer. In this work, various volumes of breast are modelled and simulated using Monte Carlo N-Particle (MCNP5) code, derived based on the real cup sizes and volumes in prone position. The size of tumour is 1 cm in diameter with tumour to background ratios (TBRs) ranging between TBR from 1:1 to TBR 20:1, and located 2 cm inside breast skin. The results show that wire mesh collimator 1 (WM-1) has the highest sensitivity and signal to noise ratio (SNR) in comparison with wire mesh collimator 2 (WM-2) and the multihole collimator (MHC). This indicates the potential of using a wire mesh collimator for early mapping of breast cancer cells.

Description of a Simple Method of Stoma Protection During Prone Positioning.

PubMed

Mackert, Gina A; Reid, Christopher M; Dobke, Marek K; Tenenhaus, Mayer

2016-06-01

Surgeries conducted with the patient in the prone position are frequent and can be lengthy. Abdominal stomas and su- prapubic catheters require protection for the complete duration of the procedure to avoid complications such as stomal ischemia, bleeding, or mucocutaneous separation. Standard protection strategies such as pillows and wedges can eas- ily fail. In the course of managing several patients who had sustained ostomy complications following surgery in a prone position, a simple method of stoma protection was devised. Instead of discarding the foam headrest typically used dur- ing induction by anesthesia staff, this device is placed with its central recess over the stoma and secured to the patient's abdominal wall with gentle tape just before turning the patient into a prone position. This method, used in more than 80 patients, has been found to effectively relieve pressure, and no complications have been observed. The foam shape also enables unobstructed drainage of fluids, facilitating collection and preventing leakage and contamination of the surgical field. Because the device is widely used by anesthesia, it is readily available and does not add any extra cost.

Stereo-vision-based cooperative-vehicle positioning using OCC and neural networks

NASA Astrophysics Data System (ADS)

Ifthekhar, Md. Shareef; Saha, Nirzhar; Jang, Yeong Min

2015-10-01

Vehicle positioning has been subjected to extensive research regarding driving safety measures and assistance as well as autonomous navigation. The most common positioning technique used in automotive positioning is the global positioning system (GPS). However, GPS is not reliably accurate because of signal blockage caused by high-rise buildings. In addition, GPS is error prone when a vehicle is inside a tunnel. Moreover, GPS and other radio-frequency-based approaches cannot provide orientation information or the position of neighboring vehicles. In this study, we propose a cooperative-vehicle positioning (CVP) technique by using the newly developed optical camera communications (OCC). The OCC technique utilizes image sensors and cameras to receive and decode light-modulated information from light-emitting diodes (LEDs). A vehicle equipped with an OCC transceiver can receive positioning and other information such as speed, lane change, driver's condition, etc., through optical wireless links of neighboring vehicles. Thus, the target vehicle position that is too far away to establish an OCC link can be determined by a computer-vision-based technique combined with the cooperation of neighboring vehicles. In addition, we have devised a back-propagation (BP) neural-network learning method for positioning and range estimation for CVP. The proposed neural-network-based technique can estimate target vehicle position from only two image points of target vehicles using stereo vision. For this, we use rear LEDs on target vehicles as image points. We show from simulation results that our neural-network-based method achieves better accuracy than that of the computer-vision method.

Propofol pharmacokinetics in a dwarfism patient.

PubMed

Tsubokawa, T; Yamamoto, K; Komuro, A; Ishizuka, S; Kobayashi, T

2003-04-01

Pharmacokinetic information is important to control anesthetic depth. However, there are few available pharmacokinetic data of propofol in dwarfism patients. We anesthetized a dwarfism patient who underwent spinal decompression, and investigated the pharmacokinetics of propofol. The patient was a 40-year-old man suffering from muscle weakness and numbness in the arms. The operation consisted of two stages; anterior approach in the supine position and posterior approach in the prone position. We also obtained arterial blood for pharmacokinetic analysis. Distribution volume at steady-state and clearance in the supine position was 180 and 0.92 l min- 1, respectively, and in the prone position 127 and 0.74 l min- 1, respectively, in spite of a continuous infusion of dopamine. The data in the supine position were well predicted by Gepts' parameters (used in Diprifusor Zeneca Ltd, Cheshire, UK), which means the target-controlled infusion (TCI) technique can be available in the supine position, while attention is necessary to avoid overdosing when a patient is placed in the prone position.

Relationships between self-reported ankle function and modulation of Hoffmann reflex in patients with chronic ankle instability.

PubMed

Kim, Kyung-Min; Hart, Joseph M; Saliba, Susan A; Hertel, Jay

2016-01-01

To examine relationships between self-reported ankle function and Hoffmann (H) reflex modulation during changes in body positions in patients with chronic ankle instability (CAI). Observational. Laboratory. Thirty-one young adults with CAI (19 males, 12 females) participated. There were two subscales of Foot and Ankle Ability Measure (FAAM) to quantify self-reported ankle function during activities of daily living (ADL) and sports activities. Maximum H-reflexes (H-max) and motor waves (M-max) from soleus and fibularis longus were recorded while participants lied prone and stood in bipedal and unipedal stances. For each muscle, percent change scores in Hmax:Mmax ratios were calculated between each pair of positions: prone-to-bipedal, bipedal-to-unipedal, and prone-to-unipedal, and used as a measure of H-reflex modulation. Pearson correlation coefficients were calculated between FAAM and H-reflex modulation measures. There were significant correlations between: (1) FAAM-ADL and soleus prone-to-unipedal modulation (r = 0.384, p = 0.04), (2) FAAM-Sport and soleus prone-to-unipedal modulation (r = 0.505, p = 0.005), (3) FAAM-Sport and fibular bipedal-to-unipedal modulation (r = 0.377, p = 0.05), and (4) FAAM-Sport and fibular prone-to-unipedal modulation (r = 0.396, p = 0.04). CAI patients presented moderate, positive relationships between self-reported ankle function and H-reflex modulation during changes in body positions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Spinal Stiffness in Prone and Upright Postures During 0-1.8 g Induced by Parabolic Flight.

PubMed

Swanenburg, Jaap; Meier, Michael L; Langenfeld, Anke; Schweinhardt, Petra; Humphreys, B Kim

2018-06-01

The purpose of this study was to analyze posterior-to-anterior spinal stiffness in Earth, hyper-, and microgravity conditions during both prone and upright postures. During parabolic flight, the spinal stiffness of the L3 vertebra of a healthy 37-yr-old man was measured in normal Earth gravity (1.0 g), hypergravity (1.8 g), and microgravity (0.0 g) conditions induced in the prone and upright positions. Differences in spinal stiffness were significant across all three gravity conditions in the prone and upright positions. Most effect sizes were large; however, in the upright posture, the effect size between Earth gravity and microgravity was medium. Significant differences in spinal stiffness between the prone and upright positions were found during Earth gravity and hypergravity conditions. No difference was found between the two postures during microgravity conditions. Based on repeated measurements of a single individual, our results showed detectable changes in posterior-to-anterior spinal stiffness. Spinal stiffness increased during microgravity and decreased during hypergravity conditions. In microgravity conditions, posture did not impact spinal stiffness. More data on spinal stiffness in variable gravitational conditions is needed to confirm these results.Swanenburg J, Meier ML, Langenfeld A, Schweinhardt P, Humphreys BK. Spinal stiffness in prone and upright postures during 0-1.8 g induced by parabolic flight. Aerosp Med Hum Perform. 2018; 89(6):563-567.

Mitogen-activated protein kinase phosphatase-1 modulates regional effects of injurious mechanical ventilation in rodent lungs.

PubMed

Park, Moo Suk; He, Qianbin; Edwards, Michael G; Sergew, Amen; Riches, David W H; Albert, Richard K; Douglas, Ivor S

2012-07-01

Mechanical ventilation induces heterogeneous lung injury by mitogen-activated protein kinase (MAPK) and nuclear factor-κB. Mechanisms regulating regional injury and protective effects of prone positioning are unclear. To determine the key regulators of the lung regional protective effects of prone positioning in rodent lungs exposed to injurious ventilation. Adult rats were ventilated with high (18 ml/kg, positive end-expiratory pressure [PEEP] 0) or low Vt (6 ml/kg; PEEP 3 cm H(2)O; 3 h) in supine or prone position. Dorsal-caudal lung mRNA was analyzed by microarray and MAPK phosphatases (MKP)-1 quantitative polymerase chain reaction. MKP-1(-/-) or wild-type mice were ventilated with very high (24 ml/kg; PEEP 0) or low Vt (6-7 ml/kg; PEEP 3 cm H(2)O). The MKP-1 regulator PG490-88 (MRx-108; 0.75 mg/kg) or phosphate-buffered saline was administered preventilation. Injury was assessed by lung mechanics, bronchioalveolar lavage cell counts, protein content, and lung injury scoring. Immunoblotting for MKP-1, and IκBα and cytokine ELISAs were performed on lung lysates. Prone positioning was protective against injurious ventilation in rats. Expression profiling demonstrated MKP-1 20-fold higher in rats ventilated prone rather than supine and regional reduction in p38 and c-jun N-terminal kinase activation. MKP-1(-/-) mice experienced amplified injury. PG490-88 improved static lung compliance and injury scores, reduced bronchioalveolar lavage cell counts and cytokine levels, and induced MKP-1 and IκBα. Injurious ventilation induces MAPK in an MKP-1-dependent fashion. Prone positioning is protective and induces MKP-1. PG490-88 induced MKP-1 and was protective against high Vt in a nuclear factor-κB-dependent manner. MKP-1 is a potential target for modulating regional effects of injurious ventilation.

Role of belly board device in the age of intensity modulated radiotherapy for pelvic irradiation

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

Estabrook, Neil C.; Bartlett, Gregory K.; Compton, Julia J.

Small bowel dose often represents a limiting factor for radiation treatment of pelvic malignancies. To reduce small bowel toxicity, a belly board device (BBD) with a prone position is often recommended. Intensity modulated radiotherapy (IMRT) could reduce dose to small bowel based on the desired dose-volume constraints. We investigated the efficacy of BBD in conjunction with IMRT. A total of 11 consecutive patients with the diagnosis of rectal cancer, who were candidates for definitive therapy, were selected. Patients were immobilized with BBD in prone position for simulation and treatment. Supine position computed tomography (CT) data were either acquired at themore » same time or during a diagnostic scan, and if existed was used. Target volumes (TV) as well as organs at risk (OAR) were delineated in both studies. Three-dimensional conformal treatment (3DCRT) and IMRT plans were made for both scans. Thus for each patient, 4 plans were generated. Statistical analysis was conducted for maximum, minimum, and mean dose to each structure. When comparing the normalized mean Gross TV dose for the different plans, there was no statistical difference found between the planning types. There was a significant difference in small bowel sparing when using prone position on BBD comparing 3DCRT and IMRT plans, favoring IMRT with a 29.6% reduction in dose (p = 0.007). There was also a statistically significant difference in small bowel sparing when comparing supine position IMRT to prone-BBD IMRT favoring prone-BBD IMRT with a reduction of 30.3% (p = 0.002). For rectal cancer when small bowel could be a limiting factor, prone position using BBD along with IMRT provides the best sparing. We conclude that whenever a dose escalation in rectal cancer is desired where small bowel could be limiting factor, IMRT in conjunction with BBD should be selected.« less

Evaluation of supraspinatus strengthening exercises based on fiber bundle architectural changes.

PubMed

Sachdeva, R; Farthing, J P; Kim, S Y

2017-07-01

Supraspinatus strengthening is an integral part of rehabilitation programs. However, there is disparity regarding the best exercise. Thus, we investigated the effects of supraspinatus strengthening exercises on muscle fiber bundle architecture using real-time ultrasound. Participants were randomized into full-can (FC; n = 12), empty-can (EC; n = 11,) and prone horizontal abduction (PHA; n = 11) groups and performed three sessions/week for 8 weeks. Each session involved four sets of exercise for weeks 1-4 and six sets for weeks 5-8 with eight repetitions/set. Images of supraspinatus were captured in 0° (relaxed) and 60° (contracted) glenohumeral abduction. Fiber bundle length (FBL), pennation angle, and muscle thickness were measured at beginning, mid, and end of training. Maximum isometric abduction strength was measured in full-can, empty-can, and prone horizontal abduction positions using a hand-held dynamometer. FBL decreased after 4 weeks in FC [relaxed: Δ = -0.54 cm, P = 0.001, d = 0.92; contracted: Δ = -0.27 cm, P = 0.008, d = 0.27] and EC [relaxed: Δ = -0.59 cm, P = 0.008, d = 0.86; contracted: Δ = -0.36 cm, P = 0.013, d = 0.59], but not in PHA [relaxed: Δ = -0.11, P = 0.121, d = 0.31; contracted: Δ = -0.06 cm, P = 0.486, d = 0.13]. Strength increased significantly from week 4-8 only in PHA (Δ = +0.96 kg, P = 0.004, d = 0.47) when tested in prone horizontal abduction position. Maintenance of FBL with increased strength indicates prone horizontal abduction may be a better exercise to strengthen supraspinatus. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Evaluation of fatigue-prone details using a low-cost thermoelastic stress analysis system.

DOT National Transportation Integrated Search

2016-11-01

This study was designed to develop a novel approach for in situ evaluation of stress fields in the vicinity of fatigue-prone details on highway bridges using a low-cost microbolometer thermal imager. : The method was adapted into a field-deployable i...

Procrastination and suicide proneness: A moderated-mediation model for cognitive schemas and gender.

PubMed

Klibert, Jeffrey; LeLeux-LaBarge, Kayla; Tarantino, Nicholas; Yancey, Thresa; Lamis, Dorian A

2016-07-01

This study examined the direct and indirect paths between procrastination and suicide proneness while considering gender differences. Participants included 547 undergraduates from a southeastern university. Procrastination was positively related to suicide proneness for both genders, although this relation was stronger for women. Moderated-mediation analyses with bootstrapping highlighted insufficient self-control schemas as a mediator in the relation between procrastination and suicide proneness. However, indirect pathways did not vary by gender. Results represent an extension of the Procrastination-Health Model by highlighting the contribution of cognitive factors in explaining the relation between procrastination and suicide proneness.

Prone position in patients with acute respiratory distress syndrome

PubMed Central

Setten, Mariano; Plotnikow, Gustavo Adrián; Accoce, Matías

2016-01-01

Acute respiratory distress syndrome occupies a great deal of attention in intensive care units. Despite ample knowledge of the physiopathology of this syndrome, the focus in intensive care units consists mostly of life-supporting treatment and avoidance of the side effects of invasive treatments. Although great advances in mechanical ventilation have occurred in the past 20 years, with a significant impact on mortality, the incidence continues to be high. Patients with acute respiratory distress syndrome, especially the most severe cases, often present with refractory hypoxemia due to shunt, which can require additional treatments beyond mechanical ventilation, among which is mechanical ventilation in the prone position. This method, first recommended to improve oxygenation in 1974, can be easily implemented in any intensive care unit with trained personnel. Prone position has extremely robust bibliographic support. Various randomized clinical studies have demonstrated the effect of prone decubitus on the oxygenation of patients with acute respiratory distress syndrome measured in terms of the PaO2/FiO2 ratio, including its effects on increasing patient survival. The members of the Respiratory Therapists Committee of the Sociedad Argentina de Terapia Intensiva performed a narrative review with the objective of discovering the available evidence related to the implementation of prone position, changes produced in the respiratory system due to the application of this maneuver, and its impact on mortality. Finally, guidelines are suggested for decision-making. PMID:27925054

Critical Differences between the Type-A Prone and Type-A Personalitites.

ERIC Educational Resources Information Center

Cassel, Russell N.; Cassel, Susie L.

1984-01-01

Type-A Prone and Type-A personalities were assessed on the basis of the Cassel Type-A Personality Assessment Profile. Statistical data analysis indicated differences in positive lifestyle, blood pressure, and self-control and no differences in negative lifestyle, pulse rate, or peripheral temperature. Type-A Prone and Type-A norm profiles were…

Tension Pneumothorax During Surgery for Thoracic Spine Stabilization in Prone Position: A Case Report and Review of Literature.

PubMed

Rankin, Demicha; Mathew, Paul S; Kurnutala, Lakshmi N; Soghomonyan, Suren; Bergese, Sergio D

2014-01-01

The intraoperative progression of a simple or occult pneumothorax into a tension pneumothorax can be a devastating clinical scenario. Routine use of prophylactic thoracostomy prior to anesthesia and initiation of controlled ventilation in patients with simple or occult pneumothorax remains controversial. We report the case of a 75-year-old trauma patient with an insignificant pneumothorax on the right who developed an intraoperative tension pneumothorax on the left side while undergoing thoracic spine stabilization surgery in the prone position. Management of an intraoperative tension pneumothorax requires prompt recognition and treatment; however, the prone position presents an additional challenge of readily accessing the standard anatomic sites for pleural puncture and air drainage.

Effect of intrafractional prostate motion on simultaneous boost intensity-modulated radiotherapy to the prostate: A simulation study based on intrafractional motion in the prone position

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

Ikeda, Itaru; Mizowaki, Takashi, E-mail: mizo@kuhp.kyoto-u.ac.jp; Ono, Tomohiro

2015-01-01

Although the prostate displacement of patients in the prone position is affected by respiration-induced motion, the effect of intrafractional prostate motion in the prone position during “simultaneous integrated boost intensity-modulated radiotherapy” (SIB-IMRT) is unclear. The purpose of this study was to evaluate the dosimetric effects of intrafractional motion on SIB-IMRT to a dominant intraprostatic lesion (IPL) using measured motion data of patients in a prone position, fixed with a thermoplastic shell. We obtained 2 orthogonal x-ray fluoroscopic images at the same moment every 0.2 seconds for 30 seconds before and after treatment, once weekly, from 7 patients with localized prostatemore » cancer with detectable prostatic calcification. Prostate displacements in the left-right (LR), anteroposterior (AP), and superoinferior (SI) directions were calculated using the prostatic calcification as a fiducial marker. We defined the displacement between pretreatment and posttreatment as baseline drift (BD). An SIB-IMRT plan was generated in which each IPL + 3 mm received a dose of 94.5 Gy, whereas the remainder of the prostate + 7 mm received a dose of 75.6 Gy in 9 fields. A simulated plan of dose blurring was generated by the convolution of isocenter-shifted plans using measured motion data in 30 seconds and motion in 30 seconds + distance between pretreatment and posttreatment position (BD) for each of the 7 patients. The motion in 30 seconds mainly reflected respiration-induced motion. The mean displacements of BD were 1.4 mm (− 3.1 to 8.2 mm), − 2.2 mm (− 9.1 to 1.5 mm), and − 0.3 mm (− 5.0 to 1.8 mm) in the AP, SI, and LR directions, respectively. The differences in the target coverage with V{sub 90%} of the IPL and V{sub 100%} of the prostate between the simulated plan and original plan were − 3.9% to − 0.3% and − 0.6% to 1.1% for respiration-induced motion and 3.1% to − 67.8% and 3.6% to − 13.3% for BD with respiration-induced motion, respectively. The large motion of BD resulted in an inadequate coverage by the prescribed dose of the SIB-IMRT to the IPL. A 7-mm margin is recommended when real-time tracking techniques are not applied. The effect of respiration-induced motion was small, so long as a 3-mm margin was added.« less

Automated and unsupervised detection of malarial parasites in microscopic images.

PubMed

Purwar, Yashasvi; Shah, Sirish L; Clarke, Gwen; Almugairi, Areej; Muehlenbachs, Atis

2011-12-13

Malaria is a serious infectious disease. According to the World Health Organization, it is responsible for nearly one million deaths each year. There are various techniques to diagnose malaria of which manual microscopy is considered to be the gold standard. However due to the number of steps required in manual assessment, this diagnostic method is time consuming (leading to late diagnosis) and prone to human error (leading to erroneous diagnosis), even in experienced hands. The focus of this study is to develop a robust, unsupervised and sensitive malaria screening technique with low material cost and one that has an advantage over other techniques in that it minimizes human reliance and is, therefore, more consistent in applying diagnostic criteria. A method based on digital image processing of Giemsa-stained thin smear image is developed to facilitate the diagnostic process. The diagnosis procedure is divided into two parts; enumeration and identification. The image-based method presented here is designed to automate the process of enumeration and identification; with the main advantage being its ability to carry out the diagnosis in an unsupervised manner and yet have high sensitivity and thus reducing cases of false negatives. The image based method is tested over more than 500 images from two independent laboratories. The aim is to distinguish between positive and negative cases of malaria using thin smear blood slide images. Due to the unsupervised nature of method it requires minimal human intervention thus speeding up the whole process of diagnosis. Overall sensitivity to capture cases of malaria is 100% and specificity ranges from 50-88% for all species of malaria parasites. Image based screening method will speed up the whole process of diagnosis and is more advantageous over laboratory procedures that are prone to errors and where pathological expertise is minimal. Further this method provides a consistent and robust way of generating the parasite clearance curves.

Adolescence and Body Image.

ERIC Educational Resources Information Center

Weinshenker, Naomi

2002-01-01

Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…

Haustral fold registration in CT colonography and its application to registration of virtual stretched view of the colon

NASA Astrophysics Data System (ADS)

Fukano, Eiichiro; Oda, Masahiro; Kitasaka, Takayuki; Suenaga, Yasuhito; Takayama, Tetsuji; Takabatake, Hirotsugu; Mori, Masaki; Natori, Hiroshi; Nawano, Shigeru; Mori, Kensaku

2010-03-01

This paper proposes a method for making correspondence between the supine and the prone positions of the colon in CT volumes. In CT colonography, two CT volumes in the supine and the prone positions are often taken to observe the whole colonic wall by comparing them. However, the colonic wall is soft and changes its shape when a patient changes positions. Therefore, physicians need to take the positional relations into account when comparing the two CT volumes. Calculation of the positional relations between the two positions of the colon can reduce load of physicians. A large number of haustral folds exists in the colon and the order doesn't change even when a patient change positions. Therefore, haustral folds are suitable for registering the supine and the prone positions of the colon. We also find sharply bending points of the centerline of the colon as landmarks for brief registration. The precise registration is then performed by finding positional correspondence of the haustral folds in the supine and the prone positions. In correspondence search, we first find the correspondence among long haustral folds, followed by small haustral folds. As the result of experiment using six pairs of 3D abdominal CT volumes, 65.1% of the correspondence of large haustral folds were correct, 25.6% were incorrect, and 9.3% could not be judged. On the other hand, 13.3% of the correspondence of small haustral folds were correct, 42.9% were incorrect, and 32.7% could not be judged.

[Relationships between Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in clinic couples].

PubMed

Kong, Seong Sook

2010-06-01

The purpose of the study was to investigate the relationships between the Myers-Briggs Type Indicator (MBTI) psychological type and marital satisfaction, divorce proneness, positive affect, and conflict regulation in couple visiting a clinic. Couples (n=62) who visited "M" couple clinic participated in the study. Data were collected from March to June 2009 using the Marital Satisfaction Scale, Marital Status Inventory, Positive Affect Inventory, and Conflict Regulation Inventory. The couples showed no significant differences in marital satisfaction, positive affect, and conflict regulation according to similarities between spouses in MBTI types. However, they showed significant differences in divorce proneness of husband according to a similarity in the Sensing/Intuition indicator. They also showed significant differences in divorce proneness, positive affect, and conflict regulation between the couples for ISTJ (Introversion, Sensing, Thinking, Judging) or ESTJ (Extraversion, Sensing, Thinking, Judging) types compared to other couples. When nurses counsel couples, they should understand that differences in psychological type between spouses affects their marital relationship. In addition, nurses should educate couples on the characteristics of each type according to the couple's types and help them to understand each other, especially for couples where one spouse is the ISTJ/ESTJ type. These interventions will improve marital satisfaction and prevent the divorce in these couples.

The effect of bridge exercise method on the strength of rectus abdominis muscle and the muscle activity of paraspinal muscles while doing treadmill walking with high heels.

PubMed

Kang, Taewook; Lee, Jaeseok; Seo, Junghoon; Han, Dongwook

2017-04-01

[Purpose] The purpose of this research is to investigate the effect of the method of bridge exercise on the change of rectus abdominis muscle and the muscle activity of paraspinal muscles while doing treadmill walking with high heels. [Subjects and Methods] The subjects of this research are healthy female students consisting of 10 persons performing bridge exercises in a supine group, 10 persons performing bridge exercises in a prone group, and 10 persons in a control group while in S university in Busan. Bridge exercise in supine position is performed in hook lying position. Bridge exercise in prone position is plank exercise in prostrate position. To measure the strength of rectus abdominis muscle, maintaining times of the posture was used. To measure the muscle activity of paraspinal muscles, EMG (4D-MT & EMD-11, Relive, Korea) was used. [Results] The strength of rectus abdominis muscle of both bridge exercises in the supine group and bridge exercises in the prone group increases significantly after exercise. The muscle activity of paraspinal muscle such as thoracic parts and lumbar parts in bridge exercises in the prone group decreases statistically while walking on a treadmill with high heels. Muscle activity of thoracic parts paraspinal muscle and bridge exercises in the supine group decreased significantly. [Conclusion] According to this study, we noticed that bridge exercise in a prone position is desirable for women who prefer wearing high heels as a back pain prevention exercise method.

Effects of Early Motor Intervention in the Prone Position of Full-Term Infants through the First Year of Life.

ERIC Educational Resources Information Center

Douret, L.

1993-01-01

Full-term infants who had slept in the prone position since birth were followed to detect early postural abnormalities and differentiate potential peripheral abnormality from abnormalities of a central origin. Results showed that disappearance of initial signs of abnormality appeared to be muscular, and symptoms disappeared faster when a motor…

Exploring shame, guilt, and risky substance use among sexual minority men and women

PubMed Central

Hequembourg, Amy L.; Dearing, Ronda L.

2013-01-01

This study examined the interrelationships among shame-proneness, guilt-proneness, internalized heterosexism, and problematic substance use among 389 gay, lesbian, and bisexual men and women. Problematic alcohol and drug use were positively related to shame-proneness and negatively related to guilt-proneness. Bisexuals reported riskier substance use behaviors, lower levels of guilt-proneness, and higher levels of internalized heterosexism than gay men and lesbians. Furthermore, study findings indicated that shame and internalized heterosexism are related. Additional investigations of these associations would supplement current understanding of sexual minority stress and would advance the development of substance-related intervention and prevention efforts targeting sexual minorities. PMID:23469820

Prone positioning reduces severe pushing behavior: three case studies.

PubMed

Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Takahashi, Hidetoshi; Makita, Shigeru

2016-09-01

[Purpose] Pushing behavior is classically described as a disorder of body orientation in the coronal plane. Most interventions for pushing behavior have focused on correcting the deviation in vertical perception. However, pushing behavior seems to involve erroneous movements associated with excessive motor output by the non-paretic limbs and trunk. The present study aimed to inhibit muscular hyper-activity by placing the non-paretic limbs and trunk in the prone position. [Subjects and Methods] The subjects of the present study were 3 acute stroke patients with severe pushing behavior. The study consisted of the following 3 phases: baseline, intervention, and follow-up. In addition to conventional therapy, patients received relaxation therapy in the prone position for 10 minutes a day over 2 days. The severity of pushing behavior was assessed using the scale for contraversive pushing, and truncal balance was evaluated using the trunk control test. These assessments were performed before and after the baseline phase, and after the intervention and follow-up phases. [Results] At the baseline phase, both scores were poor. Both scores improved after the intervention and follow-up phases, and all the patients could sit independently. [Conclusion] Relaxation therapy in the prone position might ameliorate pushing behavior and impaired truncal balance.

You Don’t See What I See: Individual Differences in the Perception of Meaning from Visual Stimuli

PubMed Central

Partos, Timea R.; Cropper, Simon J.; Rawlings, David

2016-01-01

Everyone has their own unique version of the visual world and there has been growing interest in understanding the way that personality shapes one’s perception. Here, we investigated meaningful visual experiences in relation to the personality dimension of schizotypy. In a novel approach to this issue, a non-clinical sample of subjects (total n = 197) were presented with calibrated images of scenes, cartoons and faces of varying visibility embedded in noise; the spatial properties of the images were constructed to mimic the natural statistics of the environment. In two experiments, subjects were required to indicate what they saw in a large number of unique images, both with and without actual meaningful structure. The first experiment employed an open-ended response paradigm and used a variety of different images in noise; the second experiment only presented a series of faces embedded in noise, and required a forced-choice response from the subjects. The results in all conditions indicated that a high positive schizotypy score was associated with an increased tendency to perceive complex meaning in images comprised purely of random visual noise. Individuals high in positive schizotypy seemed to be employing a looser criterion (response bias) to determine what constituted a ‘meaningful’ image, while also being significantly less sensitive at the task than those low in positive schizotypy. Our results suggest that differences in perceptual performance for individuals high in positive schizotypy are not related to increased suggestibility or susceptibility to instruction, as had previously been suggested. Instead, the observed reductions in sensitivity along with increased response bias toward seeing something that is not there, indirectly implicated subtle neurophysiological differences associated with the personality dimension of schizotypy, that are theoretically pertinent to the continuum of schizophrenia and hallucination-proneness. PMID:26954696

Effects of Shame and Guilt on Error Reporting Among Obstetric Clinicians.

PubMed

Zabari, Mara Lynne; Southern, Nancy L

2018-04-17

To understand how the experiences of shame and guilt, coupled with organizational factors, affect error reporting by obstetric clinicians. Descriptive cross-sectional. A sample of 84 obstetric clinicians from three maternity units in Washington State. In this quantitative inquiry, a variant of the Test of Self-Conscious Affect was used to measure proneness to guilt and shame. In addition, we developed questions to assess attitudes regarding concerns about damaging one's reputation if an error was reported and the choice to keep an error to oneself. Both assessments were analyzed separately and then correlated to identify relationships between constructs. Interviews were used to identify organizational factors that affect error reporting. As a group, mean scores indicated that obstetric clinicians would not choose to keep errors to themselves. However, bivariate correlations showed that proneness to shame was positively correlated to concerns about one's reputation if an error was reported, and proneness to guilt was negatively correlated with keeping errors to oneself. Interview data analysis showed that Past Experience with Responses to Errors, Management and Leadership Styles, Professional Hierarchy, and Relationships With Colleagues were influential factors in error reporting. Although obstetric clinicians want to report errors, their decisions to report are influenced by their proneness to guilt and shame and perceptions of the degree to which organizational factors facilitate or create barriers to restore their self-images. Findings underscore the influence of the organizational context on clinicians' decisions to report errors. Copyright © 2018 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

Patient positioning and ventilator-associated pneumonia.

PubMed

Hess, Dean R

2005-07-01

Rotational beds, prone position, and semi-recumbent position have been proposed as procedures to prevent ventilator-associated pneumonia (VAP). Rotational therapy uses a special bed designed to turn continuously, or nearly continuously, the patient from side to side; specific designs include kinetic therapy and continuous lateral rotation therapy. A meta-analysis of studies evaluating the effect of rotational bed therapy shows a decrease in the risk of pneumonia but no effect on mortality. Two studies reported a lower risk of VAP in patients placed in a prone position, with no effect on mortality. Studies using radiolabeled enteral feeding solutions in mechanically ventilated patients have reported that aspiration of gastric contents occurs to a greater degree when patients are in the supine position, compared with the semirecumbent position. One study reported a lower rate of VAP in patients randomized to semi-recumbent compared to supine position. Although each of the techniques discussed in this paper has been shown to reduce the risk of VAP, none has been shown to affect mortality. The available evidence suggests that semi-recumbent position should be used routinely, rotational therapy should be considered in selected patients, and prone position should not be used as a technique to reduce the risk of VAP.

Hand-held dynamometer testing of the internal and external rotator musculature based on selected positions to establish normative data and unilateral ratios.

PubMed

Riemann, Bryan L; Davies, George J; Ludwig, Lauren; Gardenhour, Helen

2010-12-01

Objective documentation is needed of shoulder internal and external rotator strength using hand-held dynamometry in selected positions commonly used in a clinic. We compared strength measures and unilateral ratios between gender, limbs (dominant, nondominant), and 3 testing positions. We hypothesized that men would be stronger than women, the dominant shoulder would be stronger than the nondominant shoulder, and the seated neutral (0° adduction) and seated 30° abduction, 30° scaption, 30° diagonal (30°-30°-30°) positions would be stronger than the prone at 90°-90° position. Three positions (prone at 90°, seated at neutral, and seated at 30°-30°-30°) were evaluated in 181 individuals using hand-held dynamometry. Three separate 3-factor (limb by position by gender) analyses of variance were conducted on internal rotation, external rotation, and unilateral ratios. Although the dominant limb was significantly stronger (P < .001) than the nondominant for internal rotation, there was no difference for external rotation. The external rotators demonstrated significantly greater strength in the prone at 90° position compared with the seated at neutral (P = .001) and seated at 30°-30°-30° (P = .002) positions. The internal rotators demonstrated significantly greater (P = .036) strength in the neutral position than in the prone at 90° position for the women. The unilateral ratio of external rotators/internal rotators ranged from 86% to 99%. For the women, the prone at 90° ratio was significantly greater than seated at neutral (P = .001) and seated at 30°-30°-30° (P = .001) positions. Moderate strength relationships (r = 0.506 to 0.572) were revealed between body mass and all strength measures. The results of this study provide evidence to interpret normative data, bilateral comparisons and unilateral ratios of the internal/external rotators in the 3 selected positions. Because there are no differences between the seated at neutral and 30°-30°-30° positions and the advantages it offers, we recommend the 30°-30°-30° position for testing and the initiation of rehabilitation. Copyright © 2010 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Mosby, Inc. All rights reserved.

Seeing floaters - a case report and literature review of intraventricular migration of silicone oil tamponade material for retinal detachment.

PubMed

Potts, Matthew B; Wu, Alex C; Rusinak, David J; Kesavabhotla, Kartik; Jahromi, Babak S

2018-04-17

Intraocular injection of silicone oil is commonly performed during vitrectomy to tamponade the retina in place for treatment of retinal detachment. Although rare, this intravitreal silicone can migrate through the optic nerve and chiasm and enter the cerebral ventricles. Here we present a case report of a patient presenting with headache and intraventricular hyperdensities on computed tomography imaging raising concern for intraventricular hemorrhage. The intraventricular hyperdensities, however, were in a non-dependent location and moved to a new non-dependent location when a repeat imaging was performed with the patient in a prone position. We provide a literature review of this phenomenon and discuss the relevant CT and MRI findings. Intraocular silicone can rarely migrate into the cerebral ventricular system. Careful review of the clinical history and imaging findings can help distinguish this from other, more dangerous intracranial pathologies. Copyright © 2018. Published by Elsevier Inc.

Why is there an increased risk for sudden infant death in prone sleeping? Fear paralysis and atrial stretch reflexes implicated?

PubMed

Kaada, B

1994-05-01

A number of recent reports have indicated a higher risk of sudden infant death syndrome (SIDS) in the prone sleeping position, compared with the supine position. However, the biological mechanisms for this increased risk have not been established. For this report, two biological explanations are proposed, each of which may be influenced by altered sleeping position in such a way that they may create conditions for increased triggering of SIDS.

Vocational interests and career indecision among psychosis-prone college students.

PubMed

Poreh, A M; Schullen, C

1998-10-01

This study investigated the relationship between scores on scales that purport to measure psychosis-proneness and scores on vocational interests, identity, and differentiation scales in a sample of 233 college students who completed the Perceptual Aberration and Magical Ideation scales, the Strong Campbell Interest Inventory, and the Career Decision Scale. The present findings are consistent with prior work indicating a sex-related association of scores on measures of psychosis-proneness and vocational interests. A positive correlation between scores on vocational indecision and measures of psychosis-proneness was also found, suggesting that both men and women who score high on psychosis-proneness find it difficult to formulate long-term career goals. Finally, there was no significant correlation between scores on measures of psychosis-proneness and Holland's Vocational Differentiation Index. Present results are discussed in light of previously reported sex differences among psychosis-prone adults and diagnosed schizophrenics. The implications of the findings for vocational counselors are also addressed.

Muscle magnetic resonance imaging sensitivity does not decrease in chronic, mild, or proximal lower limb neuropathies.

PubMed

Deroide, Nicolas; Bousson, Valérie; Daguet, Edouard; Dumurgier, Julien; Tin, Sophie Ng Wing; Hannouche, Didier; Richette, Pascal; Beaudreuil, Johann; Lioté, Frédéric; Lévy, Bernard; Vicaut, Eric; Laredo, Jean Denis; Kubis, Nathalie

2012-05-01

Muscle magnetic resonance imaging (MRI) is an innovative tool for exploring focal neuropathies. However, its usefulness in mild, proximal, or chronic lesions, when electromyography (EMG), the current "gold standard" sensitivity is inadequate, has yet to be studied. Clinical, MRI, and EMG examinations were performed in 113 muscles of 17 consecutive patients with clinically diagnosed lower limb focal neuropathies. The sensitivity and specificity of MRI and EMG were evaluated in relation to disease duration, severity, and anatomical location. Muscle MRI was highly sensitive for the detection of denervated muscle, and, unlike EMG, its sensitivity did not decrease regardless of the anatomical location, duration, or severity of the neuropathy. Five MRI false positives were noted, including three in the thigh muscles. Muscle MRI is an alternative tool to EMG in proximal, mild, or chronic clinical diagnoses of lower limb focal neuropathies. However, it also seems prone to false-positive results, particularly in proximal muscles. Copyright © 2012 Wiley Periodicals, Inc.

Effect of Body Position on Energy Expenditure of Preterm Infants as Determined by Simultaneous Direct and Indirect Calorimetry.

PubMed

Bell, Edward F; Johnson, Karen J; Dove, Edwin L

2017-04-01

Background  Indirect calorimetry is the standard method for estimating energy expenditure in clinical research. Few studies have evaluated indirect calorimetry in infants by comparing it with simultaneous direct calorimetry. Our purpose was (1) to compare the energy expenditure of preterm infants determined by these two methods, direct calorimetry and indirect calorimetry; and (2) to examine the effect of body position, supine or prone, on energy expenditure. Study Design  We measured energy expenditure by simultaneous direct (heat loss by gradient-layer calorimeter corrected for heat storage) and indirect calorimetry (whole-body oxygen consumption and carbon dioxide production) in 15 growing preterm infants during two consecutive interfeeding intervals, once in the supine position and once in the prone position. Results  The mean energy expenditure for all measurements in both positions did not differ significantly by the method used: 2.82 (standard deviation [SD] 0.42) kcal/kg/h by direct calorimetry and 2.78 (SD 0.48) kcal/kg/h by indirect calorimetry. The energy expenditure was significantly lower, by 10%, in the prone than in the supine position, whether examined by direct calorimetry (2.67 vs. 2.97 kcal/kg/h, p  < 0.001) or indirect calorimetry (2.64 vs. 2.92 kcal/kg/h, p  = 0.017). Conclusion  Direct calorimetry and indirect calorimetry gave similar estimates of energy expenditure. Energy expenditure was 10% lower in the prone position than in the supine position. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Charged-particle emission tomography

PubMed Central

Ding, Yijun; Caucci, Luca; Barrett, Harrison H.

2018-01-01

Purpose Conventional charged-particle imaging techniques —such as autoradiography —provide only two-dimensional (2D) black ex vivo images of thin tissue slices. In order to get volumetric information, images of multiple thin slices are stacked. This process is time consuming and prone to distortions, as registration of 2D images is required. We propose a direct three-dimensional (3D) autoradiography technique, which we call charged-particle emission tomography (CPET). This 3D imaging technique enables imaging of thick tissue sections, thus increasing laboratory throughput and eliminating distortions due to registration. CPET also has the potential to enable in vivo charged-particle imaging with a window chamber or an endoscope. Methods Our approach to charged-particle emission tomography uses particle-processing detectors (PPDs) to estimate attributes of each detected particle. The attributes we estimate include location, direction of propagation, and/or the energy deposited in the detector. Estimated attributes are then fed into a reconstruction algorithm to reconstruct the 3D distribution of charged-particle-emitting radionuclides. Several setups to realize PPDs are designed. Reconstruction algorithms for CPET are developed. Results Reconstruction results from simulated data showed that a PPD enables CPET if the PPD measures more attributes than just the position from each detected particle. Experiments showed that a two-foil charged-particle detector is able to measure the position and direction of incident alpha particles. Conclusions We proposed a new volumetric imaging technique for charged-particle-emitting radionuclides, which we have called charged-particle emission tomography (CPET). We also proposed a new class of charged-particle detectors, which we have called particle-processing detectors (PPDs). When a PPD is used to measure the direction and/or energy attributes along with the position attributes, CPET is feasible. PMID:28370094

Charged-particle emission tomography.

PubMed

Ding, Yijun; Caucci, Luca; Barrett, Harrison H

2017-06-01

Conventional charged-particle imaging techniques - such as autoradiography - provide only two-dimensional (2D) black ex vivo images of thin tissue slices. In order to get volumetric information, images of multiple thin slices are stacked. This process is time consuming and prone to distortions, as registration of 2D images is required. We propose a direct three-dimensional (3D) autoradiography technique, which we call charged-particle emission tomography (CPET). This 3D imaging technique enables imaging of thick tissue sections, thus increasing laboratory throughput and eliminating distortions due to registration. CPET also has the potential to enable in vivo charged-particle imaging with a window chamber or an endoscope. Our approach to charged-particle emission tomography uses particle-processing detectors (PPDs) to estimate attributes of each detected particle. The attributes we estimate include location, direction of propagation, and/or the energy deposited in the detector. Estimated attributes are then fed into a reconstruction algorithm to reconstruct the 3D distribution of charged-particle-emitting radionuclides. Several setups to realize PPDs are designed. Reconstruction algorithms for CPET are developed. Reconstruction results from simulated data showed that a PPD enables CPET if the PPD measures more attributes than just the position from each detected particle. Experiments showed that a two-foil charged-particle detector is able to measure the position and direction of incident alpha particles. We proposed a new volumetric imaging technique for charged-particle-emitting radionuclides, which we have called charged-particle emission tomography (CPET). We also proposed a new class of charged-particle detectors, which we have called particle-processing detectors (PPDs). When a PPD is used to measure the direction and/or energy attributes along with the position attributes, CPET is feasible. © 2017 The Authors. Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.

A review of images of sleeping infants in UK magazines and on the internet.

PubMed

Epstein, Joyce; Jolly, Clare; Mullan, Louisa

2011-09-01

This paper reports on findings of a survey of women's magazines and the internet looking at the extent to which images of babies reinforce or undermine safe infant care advice to reduce the risk of cot death. All images of babies printed in all issues of nine magazines over an eight-month period during 2009 to 2010 were reviewed. The review also included the first 20 pages of a Google search of UK sleeping babies conducted on one day in 2011. In total, 559 images were reviewed. A substantial proportion of images depicted unsafe situations, in particular side and prone sleeping and sleeping indoors with the head covered by a hat or other covering. There was a dearth of images of babies sleeping in the feet-to-foot position or with a dummy, both of which are included in FSID/Department of Health guidelines on reducing the risk of cot death. The findings are discussed in the context of health visitors' and other community practitioners' work and current government cuts in resources, and suggestions are made to respond to the situation.

Attitudes Toward Divorce, Commitment, and Divorce Proneness in First Marriages and Remarriages

PubMed Central

Whitton, Sarah W.; Stanley, Scott M.; Markman, Howard J.; Johnson, Christine A.

2012-01-01

A random multistate sample of married individuals (N = 1,931) was used to explore whether more positive attitudes toward divorce and weaker commitment to marriage may contribute to the greater instability of remarriages than first marriages. Remarried adults, whether or not they brought children from a previous union into the remarriage, reported marital quality (happiness and conflict) equal to those in first marriages. They also reported more positive attitudes toward divorce, which were associated with higher divorce proneness (i.e., thinking about and taking actions toward divorce). Marriage type interacted with marital quality to predict divorce proneness, such that the association between low marital quality and divorce proneness was stronger for remarried individuals than for those in first marriages. This suggests that remarried adults may be more likely than adults in first marriages to take steps toward divorce when experiencing marital distress, possibly reflecting a weaker commitment to marriage. PMID:23630405

Efficacy of endoscopic combined intrarenal surgery in the prone split-leg position for staghorn calculi.

PubMed

Hamamoto, Shuzo; Yasui, Takahiro; Okada, Atsushi; Koiwa, Satoshi; Taguchi, Kazumi; Itoh, Yasunori; Kawai, Noriyasu; Hashimoto, Yoshihiro; Tozawa, Keiichi; Kohri, Kenjiro

2015-01-01

Abstract Purpose: To evaluate the efficacy of endoscopic combined intrarenal surgery (ECIRS) using retrograde flexible ureteroscopy and miniature percutaneous nephrolithotomy (PNL) for the treatment of patients with staghorn calculi in the prone split-leg position. We retrospectively reviewed the records of 42 patients with staghorn calculi (45.8±3.2 mm) who underwent ECIRS using retrograde flexible ureteroscopy and miniature PNL in the prone split-leg position for the treatment of staghorn calculi in our center between December 2010 and August 2013. A flexible ureteroscope with a laser fiber was inserted through a ureteral access sheath, and lithoclast lithotripsy was performed through a mini-percutaneous tract. Both procedures were performed simultaneously by two urologists. Surgical parameters, including surgical time, stone-free (SF) rates, modified Clavien complication grades, and risk factors for residual stones, were analyzed. Fifteen patients (35.7%) had complete staghorn calculi. Among the 42 staghorn calculi treated, 23 had 0 to 5 stone branches, 14 had 6 to 10 stone branches, and 5 had ≥11 stone branches. All procedures were performed successfully using a single lithotripsy tract with the patient in the prone split-leg position. The mean surgical time was 143.2±9.2 minutes. The initial SF rate was 71.4%, and the final SF rate was 83.3% after further treatment. One patient required a blood transfusion (2.4%), but no patient experienced a ≥3 Clavien grade complication. Risk factors for residual stones were stone size, stone surface area, complete staghorn calculi, and the number of stone branches. ECIRS for staghorn calculi in the prone split-leg position is a safe, efficient, and versatile method for the effective management of staghorn calculi without the creation of multiple percutaneous tracts.

Preterm Infants Who Are Prone to Distress: Differential Effects of Parenting on 36-month Behavioral and Cognitive Outcomes

PubMed Central

Poehlmann, Julie; Hane, Amanda; Burnson, Cynthia; Maleck, Sarah; Hamburger, Elizabeth; Shah, Prachi E.

2012-01-01

Background The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive. Methods Participants included 109 preterm infants (gestation < 37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit (NICU); infant temperament and parenting interactions at 9 months postterm; and child behavior and cognitive skills at 36 months postterm. Hierarchical regression analyses tested study hypotheses. Results Temperamentally prone-to-distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (β= -.20, p<0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (β= .25, p< .01) and intrusive behaviors (β= .23, p< .05) at 9 months predicted 36-month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (β= -.19, p< .05). Conclusions Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions. PMID:22582942

Nasopharyngeal polymicrobial colonization during health, viral upper respiratory infection and upper respiratory bacterial infection.

PubMed

Xu, Qingfu; Wischmeyer, Jareth; Gonzalez, Eduardo; Pichichero, Michael E

2017-07-01

We sought to understand how polymicrobial colonization varies during health, viral upper respiratory infection (URI) and acute upper respiratory bacterial infection to understand differences in infection-prone vs. non-prone patients. Nasopharyngeal (NP) samples were collected from 74 acute otitis media (AOM) infection-prone and 754 non-prone children during 2094 healthy visits, 673 viral URI visits and 631 AOM visits. Three otopathogens Streptococcus pneumoniae (Spn), Nontypeable Haemophilus influenzae (NTHi), and Moraxella catarrhalis (Mcat) were identified by culture. NP colonization rates of multiple otopathogens during health were significantly lower than during viral URI, and during URI they were lower than at onset of upper respiratory bacterial infection in both AOM infection-prone and non-prone children. AOM infection-prone children had higher polymicrobial colonization rates than non-prone children during health, viral URI and AOM. Polymicrobial colonization rates of AOM infection-prone children during health were equivalent to that of non-prone children during viral URI, and during viral URI were equivalent to that of non-prone during AOM infection. Spn colonization was positively associated with NTHi and Mcat colonization during health, but negatively during AOM infection. The infection-prone patients more frequently have multiple potential bacterial pathogens in the NP than the non-prone patients. Polymicrobial interaction in the NP differs during health and at onset of infection. Copyright © 2017 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Innovations in percutaneous nephrolithotomy.

PubMed

Tailly, Thomas; Denstedt, John

2016-12-01

Technical innovations in all aspects of percutaneous nephrolithotomy have changed the field considerably. The current review is aimed at reporting on the most recent advancements in the field of percutaneous nephrolithotomy. Improvements in CT imaging and the possibility of 3D rendering have dethroned the intravenous pyelogram as gold standard for pre-operative imaging. Where gaining access in the lower pole in prone position with telescopic metal dilators, placing a 30F tract used to be standard, the plethora of alternatives provides the trained surgeon with a large armamentarium to tackle any obstacle. Novel lithotripters appear more efficient than their predecessors and with tubeless PCNL gaining some momentum, ambulatory PCNL is slowly but surely becoming feasible rather than fictional. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

SU-E-J-231: Comparison of Delineation Variability of Soft Tissue Volume and Position in Head-And-Neck Between Two T1-Weighted Pulse Sequences Using An MR-Simulator with Immobilization

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

Wong, O; Lo, G; Yuan, J

Purpose: There is growing interests in applying MR-simulator(MR-sim) in radiotherapy but MR images subject to hardware, patient and pulse sequence dependent geometric distortion that may potentially influence target definition. This study aimed to evaluate the influence on head-and-neck tissue delineation, in terms of positional and volumetric variability, of two T1-weighted(T1w) MR sequences on a 1.5T MR-sim Methods: Four healthy volunteers were scanned (4 scans for each on different days) using both spin-echo (3DCUBE, TR/TE=500/14ms, TA=183s) and gradient-echo sequences (3DFSPGR, TE/TR=7/4ms, TA=173s) with identical coverage, voxel-size(0.8×0.8×1.0mm3), receiver-bandwidth(62.5kHz/pix) and geometric correction on a 1.5T MR-sim immobilized with personalized thermoplastic cast and head-rest.more » Under this setting, similar T1w contrast and signal-to-noise ratio were obtained, and factors other than sequence that might bias image distortion and tissue delineation were minimized. VOIs of parotid gland(PGR, PGL), pituitary gland(PIT) and eyeballs(EyeL, EyeR) were carefully drawn, and inter-scan coefficient-of-variation(CV) of VOI centroid position and volume were calculated for each subject. Mean and standard deviation(SD) of the CVs for four subjects were compared between sequences using Wilcoxon ranksum test. Results: The mean positional(<4%) and volumetric(<7%) CVs varied between tissues, majorly dependent on tissue inherent properties like volume, location, mobility and deformability. Smaller mean volumetric CV was found in 3DCUBE, probably due to its less proneness to tissue susceptibility, but only PGL showed significant difference(P<0.05). Positional CVs had no significant differences for all VOIs(P>0.05) between sequences, suggesting volumetric variation might be more sensitive to sequence-dependent delineation difference. Conclusion: Although 3DCUBE is considered less prone to tissue susceptibility-induced artifact and distortion, our preliminary data showed that both sequences had insignificant differences on positional and volumetric CV in most head-and-neck tissues except for PGL. This study is majorly limited in its small sample size. Influences of image contrasts(T1w v.s. T2w) and inter-observer difference have to be further investigated.« less

Interactions among peripheral perfusion, cardiac activity, oxygen saturation, thermal profile and body position in growing low birth weight infants

PubMed Central

Sahni, R; Schulze, KF; Ohira-Kist, K; Kashyap, S; Myers, MM; Fifer, WP

2015-01-01

Aims To investigate the correlation between the ‘perfusion index’ (PI) and other commonly used estimates of cutaneous blood flow [heart rate (HR), surface temperatures (ST) and central-to-peripheral thermal gradients (C-P grad)] and to use this new non-invasive tool to compare differences between prone and supine sleep position in low birth weight (LBW) infants. Methods Six-hour continuous recordings of pulse oximetry, cardiac activity and absolute ST from three sites (flank, forearm and leg), along with minute-to-minute assessment of behavioural states were performed in 31 LBW infants. Infants were randomly assigned to the prone or supine position for the first 3 h and then reversed for the second 3 h. PI data were correlated with HR and C-P grad, and compared across sleep positions during quiet sleep (QS) and active sleep (AS). Results Perfusion index correlated significantly with HR (r2 = 0.40) and flank-to-forearm thermal gradient (r2 = 0.28). In the prone position during QS, infants exhibited higher PI (3.7 ± 0.9 vs. 3.1 ± 0.7), HR (158.4 ± 8.9 vs. 154.1 ± 8.8 bpm), SpO2 (95.8 ± 2.6 vs. 95.2 ± 2.6%), flank (36.7 ± 0.4 vs. 36.5 ± 0.4°C), forearm (36.1 ± 0.6 vs. 35.5 ± 0.4°C) and leg (35.4 ± 0.7 vs. 34.7 ± 0.7°C) temperatures and narrower flank-to-forearm (0.6 ± 0.4 vs. 0.9 ± 0.3°C) and flank-to-leg (1.3 ± 0.6 vs. 1.8 ± 0.7°C) gradients, compared to those of the supine position. Similar differences were observed during AS. Conclusion Perfusion index is a good non-invasive estimate of tissue perfusion. Prone sleeping position is associated with a higher PI, possibly reflecting thermoregulatory adjustments in cardiovascular control. The effects of these position-related changes may have important implications for the increased risk for sudden infant death syndrome in prone position. PMID:19785632

Prone positioning reduces severe pushing behavior: three case studies

PubMed Central

Fujino, Yuji; Amimoto, Kazu; Sugimoto, Satoshi; Fukata, Kazuhiro; Inoue, Masahide; Takahashi, Hidetoshi; Makita, Shigeru

2016-01-01

[Purpose] Pushing behavior is classically described as a disorder of body orientation in the coronal plane. Most interventions for pushing behavior have focused on correcting the deviation in vertical perception. However, pushing behavior seems to involve erroneous movements associated with excessive motor output by the non-paretic limbs and trunk. The present study aimed to inhibit muscular hyper-activity by placing the non-paretic limbs and trunk in the prone position. [Subjects and Methods] The subjects of the present study were 3 acute stroke patients with severe pushing behavior. The study consisted of the following 3 phases: baseline, intervention, and follow-up. In addition to conventional therapy, patients received relaxation therapy in the prone position for 10 minutes a day over 2 days. The severity of pushing behavior was assessed using the scale for contraversive pushing, and truncal balance was evaluated using the trunk control test. These assessments were performed before and after the baseline phase, and after the intervention and follow-up phases. [Results] At the baseline phase, both scores were poor. Both scores improved after the intervention and follow-up phases, and all the patients could sit independently. [Conclusion] Relaxation therapy in the prone position might ameliorate pushing behavior and impaired truncal balance. PMID:27799722

On the importance of distinguishing shame from guilt: Relations to problematic alcohol and drug use

PubMed Central

Dearing, Ronda L.; Stuewig, Jeffrey; Tangney, June Price

2011-01-01

Previous research has demonstrated that shame-proneness (the tendency to feel bad about the self) relates to a variety of life problems, whereas guilt-proneness (the tendency to feel bad about a specific behavior) is more likely to be adaptive. The current analyses sought to clarify the relations of shame-proneness and guilt-proneness to substance use problems in three samples with differing levels of alcohol and drug problem severity: college undergraduates (Study 1 N =235, Study 2 N =249) and jail inmates (Study 3 N =332). Across samples, shame-proneness was generally positively correlated with substance use problems, whereas guilt-proneness was inversely related (or unrelated) to substance use problems. Results suggest that shame and guilt should be considered separately in the prevention and treatment of substance misuse. PMID:16022935

Reward and Affective Regulation in Depression-Prone Smokers

PubMed Central

Audrain-McGovern, Janet; Wileyto, E. Paul; Ashare, Rebecca; Cuevas, Jocelyn; Strasser, Andrew A.

2014-01-01

Background There is a disproportionately high smoking prevalence among individuals who are prone to depression. While depression has been conceptualized as a disorder of dysregulated positive affect and disrupted reward processing, little research has been conducted to determine the role of smoking in these processes among depression-prone smokers. Methods Depression-prone smokers (DP+; n = 34) and smokers not depression-prone (DP-; n=49) underwent two laboratory sessions, once while smoking abstinent and once while smoking ad-libitum, to assess the relative reinforcing value of smoking and reward sensitivity. Using experience sampling methods, participants completed self-report measures of subjective reward, positive affect, and negative affect across three days while smoking as usual and three days while smoking abstinent. Results DP+ were two times more likely to work for cigarette puffs versus money in a progressive ratio, choice task (OR 2.05; CI 95% 1.04 to 4.06, p=0.039) compared to DP-. Reward sensitivity as measured by the signal detection task did not yield any significant findings. Mixed models regressions revealed a 3-way interaction (depression group, smoking phase, and time) for subjective reward, negative affect and positive affect. For all three of these outcomes, the slopes for DP- and DP+ differed significantly from each other (p's < 0.05), and the effect of smoking (vs. abstinence) over time was greater for DP+ than DP- smokers (p's <0.05). Conclusions These findings indicate that the effects of smoking on reward and positive affect regulation are specific to DP+ smokers and highlight novel targets for smoking cessation treatment in this population. PMID:24947541

Reward and affective regulation in depression-prone smokers.

PubMed

Audrain-McGovern, Janet; Wileyto, E Paul; Ashare, Rebecca; Cuevas, Jocelyn; Strasser, Andrew A

2014-11-01

There is a disproportionately high smoking prevalence among individuals who are prone to depression. While depression has been conceptualized as a disorder of dysregulated positive affect and disrupted reward processing, little research has been conducted to determine the role of smoking in these processes among depression-prone smokers. Depression-prone smokers (DP+; n = 34) and smokers not depression-prone (DP-; n = 49) underwent two laboratory sessions, one while smoking abstinent and one while smoking ad libitum, to assess the relative reinforcing value of smoking and reward sensitivity. Using experience sampling methods, participants completed self-report measures of subjective reward, positive affect, and negative affect across 3 days while smoking as usual and 3 days while smoking abstinent. DP+ were two times more likely to work for cigarette puffs versus money in a progressive ratio, choice task (odds ratio 2.05; 95% confidence interval 1.04 to 4.06, p = .039) compared with DP-. Reward sensitivity as measured by the signal detection task did not yield any significant findings. Mixed models regressions revealed a three-way interaction (depression group, smoking phase, and time) for subjective reward, negative affect, and positive affect. For all three of these outcomes, the slopes for DP- and DP+ differed significantly from each other (ps < .05) and the effect of smoking (versus abstinence) over time was greater for DP+ than DP- smokers (ps < .05). These findings indicate that the effects of smoking on reward and positive affect regulation are specific to DP+ smokers and highlight novel targets for smoking cessation treatment in this population. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Diagnostic value of 99mTc-bombesin scintigraphy for differentiation of malignant from benign breast lesions.

PubMed

Shariati, Farzaneh; Aryana, Kamran; Fattahi, Asiehsadat; Forghani, Mohammad N; Azarian, Azita; Zakavi, Seyed R; Sadeghi, Ramin; Ayati, Narjes; Sadri, Keyvan

2014-06-01

In this study, we evaluated the diagnostic accuracy of (99m)Tc-bombesin scintigraphy for differentiation of benign from malignant palpable breast lesions. (99m)Tc-Bombesin is a tracer with high affinity for gastrin-releasing peptide receptor, which is overexpressed on a variety of human tumors including breast carcinoma. We examined 33 consecutive women who were referred to our center with suspicious palpable breast lesions but had no definitive diagnosis in other imaging procedures. A volume of 370-444 MBq of (99m)Tc-bombesin was injected and dynamic 1-min images were taken for 20 min immediately after injection in anterior view. Thereafter, two static images in anterior and prone-lateral views were taken for 5 min. Finally, single-photon emission computed tomography images were taken for each patient. Definitive diagnosis was based on biopsy and histopathological evaluation. The scan findings were positive in 19 patients and negative in 11 on visual assessment of the planar and single-photon emission computed tomography images. Pathologic examination confirmed breast carcinoma in 12 patients with positive scans and benign pathology for 18 patients. The overall sensitivity, specificity, negative and positive predictive values, and accuracy of this radiotracer for diagnosis of breast cancer were 100, 66.1, 100, 63, and 76%, respectively. Semiquantitative analysis improved the specificity of the visual assessment from 66 to 84%. Our study showed that (99m)Tc-bombesin scintigraphy has a high sensitivity and negative predictive value for detecting malignant breast lesions, but the specificity and positive predictive value of this radiotracer for differentiation of malignant breast abnormalities from benign ones are relatively low.

Assessment Position Affects Problem-Solving Behaviors in a Child With Motor Impairments.

PubMed

OʼGrady, Michael G; Dusing, Stacey C

2016-01-01

The purpose of this report was to examine problem-solving behaviors of a child with significant motor impairments in positions she could maintain independently, in supine and prone positions, as well as a position that required support, sitting. The child was a 22-month-old girl who could not sit independently and had limited independent mobility. Her problem-solving behaviors were assessed using the Early Problem Solving Indicator, while she was placed in supine or prone position, and again in manually supported sitting position. In manually supported sitting position, the subject demonstrated a higher frequency of problem-solving behaviors and her most developmentally advanced problem-solving behavior. Because a child's position may affect cognitive test results, position should be documented at the time of testing.

ACR Appropriateness Criteria®  Resectable Rectal Cancer

PubMed Central

2012-01-01

The management of resectable rectal cancer continues to be guided by clinical trials and advances in technique. Although surgical advances including total mesorectal excision continue to decrease rates of local recurrence, the management of locally advanced disease (T3-T4 or N+) benefits from a multimodality approach including neoadjuvant concomitant chemotherapy and radiation. Circumferential resection margin, which can be determined preoperatively via MRI, is prognostic. Toxicity associated with radiation therapy is decreased by placing the patient in the prone position on a belly board, however for patients who cannot tolerate prone positioning, IMRT decreases the volume of normal tissue irradiated. The use of IMRT requires knowledge of the patterns of spreads and anatomy. Clinical trials demonstrate high variability in target delineation without specific guidance demonstrating the need for peer review and the use of a consensus atlas. Concomitant with radiation, fluorouracil based chemotherapy remains the standard, and although toxicity is decreased with continuous infusion fluorouracil, oral capecitabine is non-inferior to the continuous infusion regimen. Additional chemotherapeutic agents, including oxaliplatin, continue to be investigated, however currently should only be utilized on clinical trials as increased toxicity and no definitive benefit has been demonstrated in clinical trials. The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every two years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment. PMID:23006527

Finite Element Analysis of Film Stack Architecture for Complementary Metal-Oxide-Semiconductor Image Sensors.

PubMed

Wu, Kuo-Tsai; Hwang, Sheng-Jye; Lee, Huei-Huang

2017-05-02

Image sensors are the core components of computer, communication, and consumer electronic products. Complementary metal oxide semiconductor (CMOS) image sensors have become the mainstay of image-sensing developments, but are prone to leakage current. In this study, we simulate the CMOS image sensor (CIS) film stacking process by finite element analysis. To elucidate the relationship between the leakage current and stack architecture, we compare the simulated and measured leakage currents in the elements. Based on the analysis results, we further improve the performance by optimizing the architecture of the film stacks or changing the thin-film material. The material parameters are then corrected to improve the accuracy of the simulation results. The simulated and experimental results confirm a positive correlation between measured leakage current and stress. This trend is attributed to the structural defects induced by high stress, which generate leakage. Using this relationship, we can change the structure of the thin-film stack to reduce the leakage current and thereby improve the component life and reliability of the CIS components.

Finite Element Analysis of Film Stack Architecture for Complementary Metal-Oxide–Semiconductor Image Sensors

PubMed Central

Wu, Kuo-Tsai; Hwang, Sheng-Jye; Lee, Huei-Huang

2017-01-01

Image sensors are the core components of computer, communication, and consumer electronic products. Complementary metal oxide semiconductor (CMOS) image sensors have become the mainstay of image-sensing developments, but are prone to leakage current. In this study, we simulate the CMOS image sensor (CIS) film stacking process by finite element analysis. To elucidate the relationship between the leakage current and stack architecture, we compare the simulated and measured leakage currents in the elements. Based on the analysis results, we further improve the performance by optimizing the architecture of the film stacks or changing the thin-film material. The material parameters are then corrected to improve the accuracy of the simulation results. The simulated and experimental results confirm a positive correlation between measured leakage current and stress. This trend is attributed to the structural defects induced by high stress, which generate leakage. Using this relationship, we can change the structure of the thin-film stack to reduce the leakage current and thereby improve the component life and reliability of the CIS components. PMID:28468324

Perioperative management of two patients with left ventricular assist devices presenting for noncardiac surgery in the prone position.

PubMed

Chacon, M Megan; Hattrup, Emily A; Shillcutt, Sasha K

2014-03-15

Ventricular assist devices (VADs) provide mechanical circulatory support for patients with advanced heart failure. Patients with VADs are presenting for noncardiac surgery with increasing frequency. Understanding anesthetic management of patients with VADs is timely and necessary for perioperative physicians. We present 2 patients supported by left VADs who required intraoperative prone positioning, and how transesophageal echocardiography and VAD variables can be used to guide management.

[Lymphadenectomy performed along the left recurrent laryngeal nerve after anterior detachment of the esophagus via thoracoscopic esophagectomy in the prone position under artificial pneumothorax].

PubMed

Yamamoto, Shinichi; Ohshima, Hisami; Katsumori, Takashi; Hamaguchi, Hiromitsu; Tsukamoto, Yukika; Iwanaga, Tomohiro

2014-11-01

Thoracoscopic esophagectomy was performed in the prone position under artificial pneumothorax and did not affect the surgical area during lung ventilation; tracheal mobility was also improved. Lymphadenectomy around the left recurrent laryngeal nerve was performed by separating the left main bronchus and trachea between the esophagus and pericardium before detaching the dorsal side of the esophagus.

A Comparison of Target Detection and Rifle Marksmanship During Live and Simulator Firing with and without Caffeine Consumption

DTIC Science & Technology

2003-01-01

effort to quantify the effect of physiological and psychological stressors and/or ergogenic aids on marksmanship. The Weaponeer training simulator has...the supported prone position. Over the duration of a session, subjects complained of physical and psychological fatigue. Muscle, back and shoulder...likely that postural and psychological fatigue were contributing factors. As the supported prone position facilitates the greatest firing accuracy due

Lumbar Lordosis of Spinal Stenosis Patients during Intraoperative Prone Positioning

PubMed Central

Lee, Su-Keon; Song, Kyung-Sub; Park, Byung-Moon; Lim, Sang-Youn; Jang, Geun; Lee, Beom-Seok; Moon, Seong-Hwan; Lee, Hwan-Mo

2016-01-01

Background To evaluate the effect of spondylolisthesis on lumbar lordosis on the OSI (Jackson; Orthopaedic Systems Inc.) frame. Restoration of lumbar lordosis is important for maintaining sagittal balance. Physiologic lumbar lordosis has to be gained by intraoperative prone positioning with a hip extension and posterior instrumentation technique. There are some debates about changing lumbar lordosis on the OSI frame after an intraoperative prone position. We evaluated the effect of spondylolisthesis on lumbar lordosis after an intraoperative prone position. Methods Sixty-seven patients, who underwent spinal fusion at the Department of Orthopaedic Surgery of Gwangmyeong Sungae Hospital between May 2007 and February 2012, were included in this study. The study compared lumbar lordosis on preoperative upright, intraoperative prone and postoperative upright lateral X-rays between the simple stenosis (SS) group and spondylolisthesis group. The average age of patients was 67.86 years old. The average preoperative lordosis was 43.5° (± 14.9°), average intraoperative lordosis was 48.8° (± 13.2°), average postoperative lordosis was 46.5° (± 16.1°) and the average change on the frame was 5.3° (± 10.6°). Results Among all patients, 24 patients were diagnosed with simple spinal stenosis, 43 patients with spondylolisthesis (29 degenerative spondylolisthesis and 14 isthmic spondylolisthesis). Between the SS group and spondylolisthesis group, preoperative lordosis, intraoperative lordosis and postoperative lordosis were significantly larger in the spondylolisthesis group. The ratio of patients with increased lordosis on the OSI frame compared to preoperative lordosis was significantly higher in the spondylolisthesis group. The risk of increased lordosis on frame was significantly higher in the spondylolisthesis group (odds ratio, 3.325; 95% confidence interval, 1.101 to 10.039; p = 0.033). Conclusions Intraoperative lumbar lordosis on the OSI frame with a prone position was larger in the SS patients than the spondylolisthesis patients, which also produced a larger postoperative lordosis angle after posterior spinal fusion surgery. An increase in lumbar lordosis on the OSI frame should be considered during posterior spinal fusion surgery, especially in spondylolisthesis patients. PMID:26929801

Effect of posture on oxygenation and respiratory muscle strength in convalescent infants

PubMed Central

Dimitriou, G; Greenough, A; Pink, L; McGhee, A; Hickey, A; Rafferty, G

2002-01-01

Objective: To determine if differences in respiratory muscle strength could explain any posture related effects on oxygenation in convalescent neonates. Methods: Infants were examined in three postures: supine, supine with head up tilt of 45°, and prone. A subsequent study was performed to determine the influence of head position in the supine posture. In each posture/head position, oxygen saturation (SaO2) was determined and respiratory muscle strength assessed by measurement of the maximum inspiratory pressure (PIMAX). Patients: Twenty infants, median gestational age 34.5 weeks (range 25–43), and 10 infants, median gestational age 33 weeks (range 30–36), were entered into the first and second study respectively. Results: Oxygenation was higher in the prone and supine with 45° head up tilt postures than in the supine posture (p<0.001), whereas PIMAX was higher in the supine and supine with head up tilt of 45° postures than in the prone posture (p<0.001). Head position did not influence the effect of posture on PIMAX or oxygenation. Conclusion: Superior oxygenation in the prone posture in convalescent infants was not explained by greater respiratory muscle strength, as this was superior in the supine posture. PMID:11978742

Cervical spine motion in manual versus Jackson table turning methods in a cadaveric global instability model.

PubMed

DiPaola, Matthew J; DiPaola, Christian P; Conrad, Bryan P; Horodyski, MaryBeth; Del Rossi, Gianluca; Sawers, Andrew; Bloch, David; Rechtine, Glenn R

2008-06-01

A study of spine biomechanics in a cadaver model. To quantify motion in multiple axes created by transfer methods from stretcher to operating table in the prone position in a cervical global instability model. Patients with an unstable cervical spine remain at high risk for further secondary injury until their spine is adequately surgically stabilized. Previous studies have revealed that collars have significant, but limited benefit in preventing cervical motion when manually transferring patients. The literature proposes multiple methods of patient transfer, although no one method has been universally adopted. To date, no study has effectively evaluated the relationship between spine motion and various patient transfer methods to an operating room table for prone positioning. A global instability was surgically created at C5-6 in 4 fresh cadavers with no history of spine pathology. All cadavers were tested both with and without a rigid cervical collar in the intact and unstable state. Three headrest permutations were evaluated Mayfield (SM USA Inc), Prone View (Dupaco, Oceanside, CA), and Foam Pillow (OSI, Union City, CA). A trained group of medical staff performed each of 2 transfer methods: the "manual" and the "Jackson table" transfer. The manual technique entailed performing a standard rotation of the supine patient on a stretcher to the prone position on the operating room table with in-line manual cervical stabilization. The "Jackson" technique involved sliding the supine patient to the Jackson table (OSI, Union City, CA) with manual in-line cervical stabilization, securing them to the table, then initiating the table's lock and turn mechanism and rotating them into a prone position. An electromagnetic tracking device captured angular motion between the C5 and C6 vertebral segments. Repeated measures statistical analysis was performed to evaluate the following conditions: collar use (2 levels), headrest (3 levels), and turning technique (2 levels). For all measures, there was significantly more cervical spine motion during manual prone positioning compared with using the Jackson table. The use of a collar provided a slight reduction in motion in all the planes of movement; however, this was only significantly different from the no collar condition in axial rotation. Differences in gross motion between the headrest type were observed in lateral bending (Foam Pillow

Inability of infants to push up in the prone position and subsequent development.

PubMed

Senju, Ayako; Shimono, Masayuki; Tsuji, Mayumi; Suga, Reiko; Shibata, Eiji; Fujino, Yoshihisa; Kawamoto, Toshihiro; Kusuhara, Koichi

2018-06-14

During routine health screenings, pediatricians may note that some infants cannot maintain the prone position with an extended arm support at 6 months. However, little is known regarding the development of full-term infants with this developmental deviation. We investigated the developmental course of infants exhibiting this characteristic. We included 2020 full-term infants from a regional center for the Japan Environment and Children's Study. Their development was measured using the Ages and Stages Questionnaire, Third Edition, at 0.5, 1, 1.5, 2, 2.5, and 3 years. The children were grouped according to their ability to stay prone on extended arms at 6 months, and their development was compared. The questionnaire revealed that 1625 infants could stay prone on extended arms and 179 could not. We excluded 212 infants who could stay prone on extended arms only sometimes, and four did not respond. In the Gross Motor domain, significant difference in questionnaire scores was observed between the "could" and "could-not" groups at 6 months (Hedges' g 1.83) and persisted until 3 years (Hedges' g 0.33). Significant differences were also observed in the Communication, Fine Motor, Problem Solving, and Personal-Social domains at 6 months (Hedges' g 0.20-0.58) and persisted until 1, 2, 2, and 1.5 years, respectively (Hedges' g 0.21-0.25). Infants who cannot maintain the prone position on extended arms lag behind those who can, although the effect sizes become relatively small after 1.5 years of age. Early interventions may be considered if delays are problematic or persistent. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Combined effects of body position and sleep status on the cardiorespiratory stability of near-term infants.

PubMed

Oishi, Yoshihisa; Ohta, Hidenobu; Hirose, Takako; Nakaya, Sachiko; Tsuchiya, Keiji; Nakagawa, Machiko; Kusakawa, Isao; Sato, Toshihiro; Obonai, Toshimasa; Nishida, Hiroshi; Yoda, Hitoshi

2018-06-11

The purpose of this study was to determine the effects of body position (prone, supine and lateral) together with sleep status (wake and sleep) on the cardiorespiratory stability of near-term infants. A total of 53 infants (gestational age at birth 33.2 ± 3.5 weeks; birth weight 1,682 ± 521 g; gestational age at recording 38.6 ± 2.1 weeks; weight at recording: 2,273 ± 393 g) were monitored for 24 hours for clinically significant apnea (>15 seconds), bradycardia (<100 bpm), and oxygen desaturation (SpO 2  < 90%) in alternating body positions (prone, supine and lateral) by cardiorespiratory monitors and 3-orthogonal-axis accelerometers. Sleep status of the infants was also continuously monitored by actigraphs. No apnea was observed. During wake, severe bradycardia was most frequently observed in the lateral position while, during sleep, severe bradycardia was most frequently observed in the supine position. Desaturation was most frequently observed in the supine and lateral positions during both wake and sleep. Our study suggests that the cardiorespiratory stability of infants is significantly compromised by both body position and sleep status. During both wake and sleep, prone position induces the most stable cardiorespiratory functions of near-term infants.

Digital Subtraction Angiography (DSA) Techniques For The Evaluation Of Breast Lesions

NASA Astrophysics Data System (ADS)

Flynn, Michael J.; Ackerman, Laurens; Wilderman, Scott; Block, Roger; Watt, Christine; Burke, Matt; Shetty, P. C.

1984-08-01

Digital subtraction angiography of the breast may permit the differentiation of benign and malignant breast lesions. We have developed specific techniques for performing DSAB. The patient is examined in an oblique prone position with the involved breast in an immobilization device of our own design. The immobilization device adapts to our angiographic patient table and provides a water bolus with slight compression. The central ray of the x-ray beam is positioned for a lateral view of the breast, similar to the lateral view obtained in a mammogram. Iodinated contrast is injected from a catheter position in the superior vena cava. A kilovoltage of 50 kVp is employed which produces a near optimal signal to noise ratio for iodine contrast. The iodine signal to noise ratio characteristics of breast DSA have been modeled using a computer program which estimates the x-ray spectrum, filtration effects(tube, tissue, iodine, and grid), and image intensifier energy absorption. The energy absorbed in the input phosphor of the image intensifier is determined using a Monte Carlo radiation transport technique. Images are acquired in a 512 x 512 x 10 matrix with a 9" image intensifier using a geometric magnification of approximately 2. Typically, 10 mAs per exposure is required. A maximum of 40 exposures are made in three phases totalling 5 minutes. The average absorbed dose to the breast for a single exposure is 48 millirads (6 cm thickness) as determined by a Monte Carlo radiation transport computation of energy absorbed in breast tissue.

Neurodevelopmental correlates of proneness to guilt and shame in adolescence and early adulthood.

PubMed

Whittle, Sarah; Liu, Kirra; Bastin, Coralie; Harrison, Ben J; Davey, Christopher G

2016-06-01

Investigating how brain development during adolescence and early adulthood underlies guilt- and shame-proneness may be important for understanding risk processes for mental disorders. The aim of this study was to investigate the neurodevelopmental correlates of interpersonal guilt- and shame-proneness in healthy adolescents and young adults using structural magnetic resonance imaging (sMRI). Sixty participants (age range: 15-25) completed sMRI and self-report measures of interpersonal guilt- and shame-proneness. Independent of interpersonal guilt, higher levels of shame-proneness were associated with thinner posterior cingulate cortex (PCC) thickness and smaller amygdala volume. Higher levels of shame-proneness were also associated with attenuated age-related reductions in thickness of lateral orbitofrontal cortex (lOFC). Our findings highlight the complexities in understanding brain-behavior relationships during the adolescent/young adult period. Results were consistent with growing evidence that accelerated cortical thinning during adolescence may be associated with superior socioemotional functioning. Further research is required to understand the implications of these findings for mental disorders characterized by higher levels of guilt and shame. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Lung ventilation strategies for acute respiratory distress syndrome: a systematic review and network meta-analysis

PubMed Central

Wang, Changsong; Wang, Xiaoyang; Chi, Chunjie; Guo, Libo; Guo, Lei; Zhao, Nana; Wang, Weiwei; Pi, Xin; Sun, Bo; Lian, Ailing; Shi, Jinghui; Li, Enyou

2016-01-01

To identify the best lung ventilation strategy for acute respiratory distress syndrome (ARDS), we performed a network meta-analysis. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, CINAHL, and the Web of Science were searched, and 36 eligible articles were included. Compared with higher tidal volumes with FiO2-guided lower positive end-expiratory pressure [PEEP], the hazard ratios (HRs) for mortality were 0.624 (95% confidence interval (CI) 0.419–0.98) for lower tidal volumes with FiO2-guided lower PEEP and prone positioning and 0.572 (0.34–0.968) for pressure-controlled ventilation with FiO2-guided lower PEEP. Lower tidal volumes with FiO2-guided higher PEEP and prone positioning had the greatest potential to reduce mortality, and the possibility of receiving the first ranking was 61.6%. Permissive hypercapnia, recruitment maneuver, and low airway pressures were most likely to be the worst in terms of all-cause mortality. Compared with higher tidal volumes with FiO2-guided lower PEEP, pressure-controlled ventilation with FiO2-guided lower PEEP and lower tidal volumes with FiO2-guided lower PEEP and prone positioning ventilation are associated with lower mortality in ARDS patients. Lower tidal volumes with FiO2-guided higher PEEP and prone positioning ventilation and lower tidal volumes with pressure-volume (P–V) static curve-guided individual PEEP are potential optimal strategies for ARDS patients. PMID:26955891

Venous air embolism in consecutive balloon kyphoplasties visualised on CT imaging.

PubMed

Tins, Bernhard J; Cassar-Pullicino, Victor N; Lalam, Radhesh; Haddaway, Mike

2012-09-01

We noted a large amount of intravenous gas during balloon kyphoplasty on CT imaging. Formal assessment to understand the extent, possible causes and implications was undertaken. Ten consecutive cases of balloon kyphoplasty were performed under general anaesthesia in the prone position, on a single vertebral level using a two-step technique under combined fluoroscopic and CT guidance. CT of the affected vertebra was performed before, after, and intermittently during the procedure. In 2 cases delayed CT was carried out in the supine position. Gas was seen on CT imaging, but not on conventional fluoroscopy. The gas is most likely to be air introduced during the procedure and was seen in the epidural and paravertebral venous plexus, posterior intercostal veins, renal veins, IVC and azygos vein. The average measured volume of gas seen on the post-procedure CT imaging was 1.07 mL, range 0.16-3.97 mL. There was no correlation of the measured amount of gas to the procedure duration or location, the use of a curette or the injected cement volume. Delayed CT in the supine position no longer showed air in the local venous system. Balloon kyphoplasty is associated with the fluoroscopically invisible introduction of air into the vertebral and paravertebral veins and deep systemic veins and is likely to be much more extensive than identified on CT imaging. There is potential for serious air embolism in kyphoplasty and if there is a sudden deterioration in patient condition during the procedure the possibility of this complication needs to be considered.

Infant Positioning, Baby Gear Use, and Cranial Asymmetry.

PubMed

Zachry, Anne H; Nolan, Vikki G; Hand, Sarah B; Klemm, Susan A

2017-12-01

Objectives This study aimed to identify predictors of cranial asymmetry. We hypothesize that among infants diagnosed with cranial asymmetry in the sampled region, there is an association between exposure to more time in baby gear and less awake time in prone and side-lying than in infants who do not present with this condition. Methods The study employed a cross sectional survey of caregivers of typically developing infants and infants diagnosed with cranial asymmetry. Results A mutivariable model reveals that caregivers of children who are diagnosed with cranial asymmetry report their children spending significantly less time in prone play than those children without a diagnosis of cranial asymmetry. Side-lying and time spent in baby gear did not attain statistical significance. Conclusions for Practice Occupational therapists, physical therapists, pediatricians, nurses and other health care professionals must provide parents with early education about the importance of varying positions and prone play in infancy and address fears and concerns that may serve as barriers to providing prone playtime.

Self-conscious emotions and criminal offending.

PubMed

Tibbetts, Stephen G

2003-08-01

This study examined the relation of personality traits--shame-proneness, guilt-proneness, and pride--on offending behavior. Using survey data from a sample of 224 college students, the construct and criterion-related validity of scales of the Shame Proneness Scale, the Test of Self-conscious Affect, and the Personality Feelings Questionnaire-2 were assessed. Regression analyses showed that self-conscious emotions are important in the etiology of criminal offending. Specifically, rated pride was positively correlated with self-reported criminal activity, whereas ratings of guilt were negatively associated with offending. The relation of shame with criminality varied depending on the type of measure used to indicate proneness to shame.

When feeling bad leads to feeling good: guilt-proneness and affective organizational commitment.

PubMed

Flynn, Francis J; Schaumberg, Rebecca L

2012-01-01

The authors posit that higher levels of guilt-proneness are associated with higher levels of affective organizational commitment. To explain this counterintuitive link, the authors suggest that a dispositional tendency to feel guilt motivates individuals to exert greater effort on their work-related tasks that, in turn, strengthens their affinity for the organization. The authors tested this idea using a laboratory study and field data from 2 samples of working adults. Individuals who are more guilt-prone reported higher levels of organizational attachment compared with less guilt-prone individuals. Furthermore, mediation analyses indicate that the link between guilt-proneness and affective commitment is driven by greater task effort. The authors discuss the implications of these findings for understanding the affective drivers of commitment in organizations.

Prone position improves lung mechanical behavior and enhances gas exchange efficiency in mechanically ventilated chronic obstructive pulmonary disease patients.

PubMed

Mentzelopoulos, Spyros D; Zakynthinos, Spyros G; Roussos, Charris; Tzoufi, Maria J; Michalopoulos, Argyris S

2003-06-01

Pronation might favorably affect respiratory system (rs) mechanics and function in volume-controlled, mode-ventilated chronic obstructive pulmonary disease (COPD) patients. We studied 10 COPD patients, initially positioned supine (baseline supine [supine(BAS)]) and then randomly and consecutively changed to protocol supine (supine(PROT)), semirecumbent, and prone positions. Rs mechanics and inspiratory work (W(I)) were assessed at baseline (0.6 L) (all postures) and sigh (1.2 L) (supine(BAS) excluded) tidal volume (V(T)) with rapid airway occlusion during constant-flow inflation. Hemodynamics and gas exchange were assessed in all postures. There were no complications. Prone positioning resulted in (a) increased dynamic-static chest wall (cw) elastance (at both V(Ts)) and improved oxygenation versus supine(BAS), supine(PROT), and semirecumbent, (b) decreased additional lung (L) resistance-elastance versus supine(PROT) and semirecumbent at sigh V(T), (c) decreased L-static elastance (at both V(Ts)) and improved CO(2) elimination versus supine(BAS) and supine(PROT), and (d) improved oxygenation versus all other postures. Semirecumbent positioning increased mainly additional cw-resistance versus supine(BAS) and supine(PROT) at baseline. V(T) W(I)-sub-component changes were consistent with changes in rs, cw, and L mechanical properties. Total rs-W(I) and hemodynamics were unaffected by posture change. After pronation, five patients were repositioned supine (supine(POSTPRO)). In supine(POSTPRO), static rs-L elastance were lower, and oxygenation was still improved versus supine(BAS). Pronation of mechanically ventilated COPD patients exhibits applicability and effectiveness and improves oxygenation and sigh-L mechanics versus semirecumbent ("gold standard") positioning. By assessing respiratory mechanics, inspiratory work, hemodynamics, and gas exchange, we showed that prone positioning of mechanically ventilated chronic obstructed pulmonary disease patients improves oxygenation and lung mechanics during sigh versus semirecumbent positioning. Furthermore, certain pronation-related benefits versus preprone-supine positioning (reduced lung elastance and improved oxygenation) are maintained in the postprone supine position.

[Cardiorespiratory effects of the body position in premature newborns submitted to the increase of the gastric volume].

PubMed

Pádua, Gisley de; Martinez, Edson Zangiacomi; Brunherotti, Marisa Afonso de Andrade

2009-01-01

The increase of the gastric volume observed in the gavage feeding is likely to cause consequences to the premature newborn, modifying the respiratory indicators. To investigate the alterations in the cardiorespiratory system of premature newborns submitted to an increase of the gastric volume by gavage feeding, according to four different body positioning methods. The study is a randomized crossover trial using a sample of 16 newborns with gestational age from 31 to 34 weeks and birth weight less or equal to 2.500 g. The newborns were included in the study if they had from 7 to 10 days of life, feeding by orogastric tube, total volume of 150 mL/kg/day and absence of supplemental oxygen-therapy. A different positioning method was used at each gavage (all raised to 30 degrees), or say, right lateral, left lateral, prone and supine positions. The following response variables were considered: respiratory and cardiac frequencies, saturation of oxygen, drawing of intercostals, beating of nasal wing and grunting. These measures were collected in intervals of 2 minutes during 5 minutes after the gavage feeding, during whole period of the gavage feeding, and during 5 minutes before the gavage feeding. The mean gestational age was 32 weeks (standard deviation 1.3) and the mean weight of the newborns was 1.722 g (standard deviation 276.3). The newborns presented higher values of the mean respiratory frequency in supine and left lateral body positions. In the right lateral and prone positions, the newborns presented lower mean cardiac frequency. The mean oxygen saturation had the lowest values in the left lateral and supine positions. The right lateral and prone positions presented low frequencies of intercostals drawing, beating of nasal wing and grunting. Our results indicate that right lateral and prone positions have influence on the cardiorespiratory effect, where left lateral and supine are the positions who presented higher negative effect in the newborns submitted to the increase of the gastric volume.

Group-wise feature-based registration of CT and ultrasound images of spine

NASA Astrophysics Data System (ADS)

Rasoulian, Abtin; Mousavi, Parvin; Hedjazi Moghari, Mehdi; Foroughi, Pezhman; Abolmaesumi, Purang

2010-02-01

Registration of pre-operative CT and freehand intra-operative ultrasound of lumbar spine could aid surgeons in the spinal needle injection which is a common procedure for pain management. Patients are always in a supine position during the CT scan, and in the prone or sitting position during the intervention. This leads to a difference in the spinal curvature between the two imaging modalities, which means a single rigid registration cannot be used for all of the lumbar vertebrae. In this work, a method for group-wise registration of pre-operative CT and intra-operative freehand 2-D ultrasound images of the lumbar spine is presented. The approach utilizes a pointbased registration technique based on the unscented Kalman filter, taking as input segmented vertebrae surfaces in both CT and ultrasound data. Ultrasound images are automatically segmented using a dynamic programming approach, while the CT images are semi-automatically segmented using thresholding. Since the curvature of the spine is different between the pre-operative and the intra-operative data, the registration approach is designed to simultaneously align individual groups of points segmented from each vertebra in the two imaging modalities. A biomechanical model is used to constrain the vertebrae transformation parameters during the registration and to ensure convergence. The mean target registration error achieved for individual vertebrae on five spine phantoms generated from CT data of patients, is 2.47 mm with standard deviation of 1.14 mm.

Breath-by-breath analysis of expiratory gas concentration in chickens.

PubMed

Itabisashi, T

1981-01-01

Expiratory oxygen and carbon-dioxide concentration were analysed breath by breath in order to examine their wave forms in adult awake hens restrained in various postural positions, including supine, prone and sitting positions. Expired gas was collected at the nostril in almost all the hens. In the sitting position free from vocalization, feeding, drinking, panting, and restlessness, hens showed various forms of stable pattern of oxygen-gas curves. These forms were classified into three types, or the ascending, flat and descending types, with respect to the plateau inclination. The waves of carbon-dioxide were not always a mirror image of those of oxygen. The rate of occurrence of each type varied with the hen's postural position. The wave form was altered with the experimental body-rotation of the hen. When placed between the deflections of stable pattern, the episodes of wave deformation resembling that seen at the time of uneven pulmonary ventilation in mammals could frequently be observed in any hen's posture examined. Cardiogenic oscillation appeared on the plateau of expired-gas curves.

AAPM/RSNA physics tutorial for residents: physics of flat-panel fluoroscopy systems: Survey of modern fluoroscopy imaging: flat-panel detectors versus image intensifiers and more.

PubMed

Nickoloff, Edward Lee

2011-01-01

This article reviews the design and operation of both flat-panel detector (FPD) and image intensifier fluoroscopy systems. The different components of each imaging chain and their functions are explained and compared. FPD systems have multiple advantages such as a smaller size, extended dynamic range, no spatial distortion, and greater stability. However, FPD systems typically have the same spatial resolution for all fields of view (FOVs) and are prone to ghosting. Image intensifier systems have better spatial resolution with the use of smaller FOVs (magnification modes) and tend to be less expensive. However, the spatial resolution of image intensifier systems is limited by the television system to which they are coupled. Moreover, image intensifier systems are degraded by glare, vignetting, spatial distortions, and defocusing effects. FPD systems do not have these problems. Some recent innovations to fluoroscopy systems include automated filtration, pulsed fluoroscopy, automatic positioning, dose-area product meters, and improved automatic dose rate control programs. Operator-selectable features may affect both the patient radiation dose and image quality; these selectable features include dose level setting, the FOV employed, fluoroscopic pulse rates, geometric factors, display software settings, and methods to reduce the imaging time. © RSNA, 2011.

Preterm infants who are prone to distress: differential effects of parenting on 36-month behavioral and cognitive outcomes.

PubMed

Poehlmann, Julie; Hane, Amanda; Burnson, Cynthia; Maleck, Sarah; Hamburger, Elizabeth; Shah, Prachi E

2012-10-01

The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized that temperamentally prone to distress preterm infants would exhibit more optimal cognition and fewer behavior problems when early parenting was positive; and less optimal cognition and more behavior problems when early parenting was less positive. Participants included 109 preterm infants (gestation <37 weeks) and their mothers. We assessed neonatal risk and basal vagal tone in the neonatal intensive care unit; infant temperament and parenting interactions at 9 months post-term; and child behavior and cognitive skills at 36 months post-term. Hierarchical regression analyses tested study hypotheses. Temperamentally prone-to-distress infants exhibited more externalizing problems if they experienced more critical parenting at 9 months (β = -.20, p < 0.05) but fewer externalizing problems with more positive parenting. Similarly, variations in maternal positive affect (β = .25, p < .01) and intrusive behaviors (β = .23, p < .05) at 9 months predicted 36-month cognition at high but not at low levels of infant temperamental distress. Higher basal vagal tone predicted fewer externalizing problems (β = -.19, p < .05). Early parenting behaviors relate to later behavior and development in preterm infants who are temperamentally prone to distress, and neonatal basal vagal tone predicts subsequent externalizing behaviors. These findings suggest that both biological reactivity and quality of caregiving are important predictors for later outcomes in preterm infants and may be considered as foci for developmental surveillance and interventions. © 2012 The Authors. Journal of Child Psychology and Psychiatry © 2012 Association for Child and Adolescent Mental Health.

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

Lin, H; Gao, Y; Liu, T

Purpose: To develop quantitative clinical guidelines between supine Deep Inspiratory Breath Hold (DIBH) and prone free breathing treatments for breast patients, we applied 3D deformable phantoms to perform Monte Carlo simulation to predict corresponding Dose to the Organs at Risk (OARs). Methods: The RPI-adult female phantom (two selected cup sizes: A and D) was used to represent the female patient, and it was simulated using the MCNP6 Monte Carlo code. Doses to OARs were investigated for supine DIBH and prone treatments, considering two breast sizes. The fluence maps of the 6-MV opposed tangential fields were exported. In the Monte Carlomore » simulation, the fluence maps allow each simulated photon particle to be weighed in the final dose calculation. The relative error of all dose calculations was kept below 5% by simulating 3*10{sup 7} photons for each projection. Results: In terms of dosimetric accuracy, the RPI Adult Female phantom with cup size D in DIBH positioning matched with a DIBH treatment plan of the patient. Based on the simulation results, for cup size D phantom, prone positioning reduced the cardiac dose and the dose to other OARs, while cup size A phantom benefits more from DIBH positioning. Comparing simulation results for cup size A and D phantom, dose to OARs was generally higher for the large breast size due to increased scattering arising from a larger portion of the body in the primary beam. The lower dose that was registered for the heart in the large breast phantom in prone positioning was due to the increase of the distance between the heart and the primary beam when the breast was pendulous. Conclusion: Our 3D deformable phantom appears an excellent tool to predict dose to the OARs for the supine DIBH and prone positions, which might help quantitative clinical decisions. Further investigation will be conducted. National Institutes of Health R01EB015478.« less

The patient position for PNL: does it matter?

PubMed

Cracco, Cecilia Maria; Scoffone, Cesare Marco; Poggio, Massimiliano; Scarpa, Roberto Mario

2010-03-01

Currently, PNL is the treatment of choice for large and/or otherwise complex urolithiasis. PNL was initially performed with the patient in a supine-oblique position, but later on the prone position became the conventional one for habit and handiness. The prone position provides a larger area for percutaneous renal access, a wider space for instrument manipulation, and a claimed lower risk of splanchnic injury. Nonetheless, it implies important anaesthesiological risks, including circulatory, haemodynamic, and ventilatory difficulties; need of several nurses to be present for intraoperative changes of the decubitus in case of simultaneous retrograde instrumentation of the ureter, implying evident risks related to pressure points; an increased radiological hazard to the urologist's hands; patient discomfort. To overcome these drawbacks, various safe and effective changes in patient positioning for PNL have been proposed over the years, including the reverse lithotomy position, the prone split-leg position, the lateral decubitus, the supine position, and the Galdakao-modified supine Valdivia (GMSV) position. Among these, the GMSV position is safe and effective, and seems profitable and ergonomic. It allows optimal cardiopulmonary control during general anaesthesia; an easy puncture of the kidney; a reduced risk of colonic injury; simultaneous antero-retrograde approach to the renal cavities (PNL and retrograde ureteroscopy = ECIRS, Endoscopic Combined IntraRenal Surgery), with no need of intraoperative repositioning of the anaesthetized patient, less need for nurses in the operating room, less occupational risk due to shifting of heavy loads, less risk of pressure injuries related to inaccurate repositioning, and reduced duration of the procedure; facilitated spontaneous evacuation of stone fragments; a comfortable sitting position and a restrained X-ray exposure of the hands for the urologist. But, first of all, GMSV position fully supports a new comprehensive attitude of the urologist towards a variety of upper urinary tract pathologies, facing them with a rich armamentarium of rigid and flexible endoscopes and a versatile antero-retrograde approach. Prone position may still be useful in case of important vertebral malformations, specifically hindering the supine position, or for simultaneous bilateral PNL, without having to move the patient intraoperatively, so is still present in the complementary techniques of a skilled endourologist.

Alcohol-Related Problems and Risk of Suicide among College Students: The Mediating Roles of Belongingness and Burdensomeness

ERIC Educational Resources Information Center

Lamis, Dorian A.; Malone, Patrick S.

2011-01-01

The relationship among alcohol-related problems, perceived burdensomeness, thwarted belongingness, and suicide proneness in undergraduate college students (N = 996) was examined. As hypothesized, alcohol-related problems, perceived burdensomeness, and thwarted belongingness were all significantly and positively correlated with suicide proneness.…

Self-reflection and positive schizotypy in the adolescent brain.

PubMed

Debbané, Martin; Vrtička, Pascal; Lazouret, Marine; Badoud, Deborah; Sander, David; Eliez, Stephan

2014-01-01

Clinical and phenomenological accounts of schizophrenia suggest that impairments in self-reflective processes significantly contribute to psychopathological expression. Recent imaging studies observe atypical cerebral activation patterns during self-reflection, especially around the cortical midline structures, both in psychosis-prone adults and individuals with schizophrenia. Given that self-reflection processes consolidate during adolescence, and that early transient expression of psychosis (positive schizotypy) also arises during this period, the present study sought to examine whether atypical cerebral activation during self-reflection task could be associated with early schizotypic expression during adolescence. Forty-two neurotypical adolescent participants (19 females) aged from 12 to 19 (15.92±1.9) underwent a self-reflection task using functional neuroimaging (fMRI), where they had to evaluate trait adjectives (1 to 4 ratings) about themselves or their same sex best friend. The Schizotypal Personality Questionnaire (SPQ) was employed to assess positive schizotypic expression. Results showed that positive schizotypy in adolescents significantly correlated with cortical midline activation patterns in the dorsomedial prefrontal cortex (dmPFC) and the posterior cingulate cortex (PCC), as well as the dorsolateral PFC and the lingual gyrus. The results are consistent with previous imaging literature on self-reflection and schizophrenia. They further highlight that the relationship between self-reflection processes and positive schizotypy operates at the trait level of expression and can be observed as early as adolescence. Copyright © 2013 Elsevier B.V. All rights reserved.

Fat-suppressed MR images of both hands obtained using CHESS can be improved by rice pads.

PubMed

Moriya, Susumu; Miki, Yukio; Kamishima, Tamotsu; Kanagaki, Mitsunori; Yokobayashi, Tsuneo; Ishikawa, Mitsunori

2012-09-01

When chemical shift selective (CHESS) imaging is used with magnetic resonance imaging (MRI) for simultaneous imaging of both hands for the evaluation of rheumatoid arthritis, the fat suppression effect is poor. We investigated whether these fat-suppressed images using CHESS could be improved with the use of rice pads. T1-weighted images were obtained with CHESS and the same imaging parameters were used with and without rice pads on the coronal plane of both hands in 10 healthy volunteers. Patients were placed in a prone position with both hands extended overhead. The fat-suppression effect was classified into four categories and scored for both sets of images, and visual assessments were made by one radiologist and one radiologic technologist. The evaluation score was 1.1 for the images made without rice pads, and 3.2 for the images made with rice pads. The fat suppression effect was thus significantly better in the images made using rice pads (P<0.0001). Lingering fat signals disappeared almost completely in images of both hands using CHESS with rice pads, and it was confirmed that the images were improved and had good fat suppression. More accurate evaluation of inflammatory sites that occur in rheumatoid arthritis may thus be possible, promising better diagnostic accuracy. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

MRI quantification of pancreas motion as a function of patient setup for particle therapy —a preliminary study

PubMed Central

Riboldi, Marco; Gianoli, Chiara; Chirvase, Cezarina I.; Villa, Gaetano; Paganelli, Chiara; Summers, Paul E.; Tagaste, Barbara; Pella, Andrea; Fossati, Piero; Ciocca, Mario; Baroni, Guido; Valvo, Francesca; Orecchia, Roberto

2016-01-01

Particle therapy (PT) has shown positive therapeutic results in local control of locally advanced pancreatic lesions. PT effectiveness is highly influenced by target localization accuracy both in space, since the pancreas is located in proximity to radiosensitive vital organs, and in time as it is subject to substantial breathing‐related motion. The purpose of this preliminary study was to quantify pancreas range of motion under typical PT treatment conditions. Three common immobilization devices (vacuum cushion, thermoplastic mask, and compressor belt) were evaluated on five male patients in prone and supine positions. Retrospective four‐dimensional magnetic resonance imaging data were reconstructed for each condition and the pancreas was manually segmented on each of six breathing phases. A k‐means algorithm was then applied on the manually segmented map in order to obtain clusters representative of the three pancreas segments: head, body, and tail. Centers of mass (COM) for the pancreas and its segments were computed, as well as their displacements with respect to a reference breathing phase (beginning exhalation). The median three‐dimensional COM displacements were in the range of 3 mm. Latero–lateral and superior–inferior directions had a higher range of motion than the anterior–posterior direction. Motion analysis of the pancreas segments showed slightly lower COM displacements for the head cluster compared to the tail cluster, especially in prone position. Statistically significant differences were found within patients among the investigated setups. Hence a patient‐specific approach, rather than a general strategy, is suggested to define the optimal treatment setup in the frame of a millimeter positioning accuracy. PACS number(s): 87.55.‐x, 87.57.nm, 87.61 PMID:27685119

SIDS-CDF Hypothesis Revisited: Cause vs. Contributing Factors.

PubMed

Siren, Pontus M A

2016-01-01

The sudden infant death syndrome (SIDS)-critical diaphragm failure (CDF) hypothesis was first published by Siren and Siren in 2011 (1). Since its publication, the hypothesis has continued to generate interest and several colleagues have contributed perspectives and insights to it (2-5). The basic premise of the hypothesis is that the diaphragm is a vital organ that must continuously generate adequate force to maintain ventilation, and that CDF is a terminal event and the cause of death in SIDS. I have argued in two follow-up articles that all SIDS factors either increase the workload of the respiratory muscles, the diaphragm being the primary muscle affected, or reduce its force generating capacity (6, 7). The SIDS-CDF hypothesis posits that SIDS has many contributing factors but only one cause, namely, the failure of the vital respiratory pump. There are several known SIDS factors, such as the prone sleeping position, non-lethal infections, deep sleep, gestational prematurity, low birth weight, cigarette smoke, male gender, and altitude, but of these, some such as the prone sleeping position more significantly both impact diaphragm function and correlate with SIDS. However, SIDS cases are multifactorial and as such can be caused by different combinations of factors. An infection combined with a prone sleeping position and elevated room temperature could lead to SIDS, whereas in other circumstances, low birth weight, cigarette smoke, prone sleeping position, and altitude could result in CDF and SIDS. The SIDS-CDF hypothesis also posits that SIDS does not have a congenital or genetic origin, and that efforts to identify significant genetic anomalies in SIDS victims are unlikely to be successful (8-11).

[Relationship between the prone position and achieving head control at 3 months].

PubMed

Pérez-Machado, J L; Rodríguez-Fuentes, G

2013-10-01

Owing to the significant increase of mild motor delays and the strong intolerance of infants to be placed on prone position observed in the Physiotherapy Unit of the Maternal and Children's University Hospital of the Canaries (HUMIC), a study was conducted to determine whether positioning infants in the prone position while awake affected the achievement and quality of head control at three months. A prospective comparative practice-based study of a representative sample of 67 healthy infants born in the HUMIC, and divided into an experimental group (n = 35) and control group (n = 32). The Alberta Infant Motor Scale (AIMS) and a parent questionnaire were used as measurement tools. The intervention consisted of regular home visits to the experimental group (from the first to the third month). The two groups were evaluated in their homes at the end of 3 months. The differences in mean raw score of the AIMS at 3 months were, 16.26 in the experimental group and 10.38 in control group (P<.001). The percentile mean was 94 in the experimental group, and less than 50 (42) in the control group. All of the experimental group babies achieved the head control, with only 8 in the control group (25%). The significant findings suggest a direct relationship between the time spent in the prone position when the baby is awake and the achievement of head control at three months. Copyright © 2012 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Automatic pose correction for image-guided nonhuman primate brain surgery planning

NASA Astrophysics Data System (ADS)

Ghafurian, Soheil; Chen, Antong; Hines, Catherine; Dogdas, Belma; Bone, Ashleigh; Lodge, Kenneth; O'Malley, Stacey; Winkelmann, Christopher T.; Bagchi, Ansuman; Lubbers, Laura S.; Uslaner, Jason M.; Johnson, Colena; Renger, John; Zariwala, Hatim A.

2016-03-01

Intracranial delivery of recombinant DNA and neurochemical analysis in nonhuman primate (NHP) requires precise targeting of various brain structures via imaging derived coordinates in stereotactic surgeries. To attain targeting precision, the surgical planning needs to be done on preoperative three dimensional (3D) CT and/or MR images, in which the animals head is fixed in a pose identical to the pose during the stereotactic surgery. The matching of the image to the pose in the stereotactic frame can be done manually by detecting key anatomical landmarks on the 3D MR and CT images such as ear canal and ear bar zero position. This is not only time intensive but also prone to error due to the varying initial poses in the images which affects both the landmark detection and rotation estimation. We have introduced a fast, reproducible, and semi-automatic method to detect the stereotactic coordinate system in the image and correct the pose. The method begins with a rigid registration of the subject images to an atlas and proceeds to detect the anatomical landmarks through a sequence of optimization, deformable and multimodal registration algorithms. The results showed similar precision (maximum difference of 1.71 in average in-plane rotation) to a manual pose correction.

Self-compassion: a potential resource for young women athletes.

PubMed

Mosewich, Amber D; Kowalski, Kent C; Sabiston, Catherine M; Sedgwick, Whitney A; Tracy, Jessica L

2011-02-01

Self-compassion has demonstrated many psychological benefits (Neff, 2009). In an effort to explore self-compassion as a potential resource for young women athletes, we explored relations among self-compassion, proneness to self-conscious emotions (i.e., shame, guilt-free shame, guilt, shame-free guilt, authentic pride, and hubristic pride), and potentially unhealthy self-evaluative thoughts and behaviors (i.e., social physique anxiety, obligatory exercise, objectified body consciousness, fear of failure, and fear of negative evaluation). Young women athletes (N = 151; Mage = 15.1 years) participated in this study. Self-compassion was negatively related to shame proneness, guilt-free shame proneness, social physique anxiety, objectified body consciousness, fear of failure, and fear of negative evaluation. In support of theoretical propositions, self-compassion explained variance beyond self-esteem on shame proneness, guilt-free shame proneness, shame-free guilt proneness, objectified body consciousness, fear of failure, and fear of negative evaluation. Results suggest that, in addition to self-esteem promotion, self-compassion development may be beneficial in cultivating positive sport experiences for young women.

Ultrasound Guidance for Renal Tract Access and Dilation Reduces Radiation Exposure during Percutaneous Nephrolithotomy

PubMed Central

2016-01-01

Purposes. To present our series of 38 prone percutaneous nephrolithotomy procedures performed with renal access and tract dilation purely under ultrasound guidance and describe the benefits and challenges accompanying this approach. Methods. Thirty-eight consecutive patients presenting for percutaneous nephrolithotomy for renal stone removal were included in this prospective cohort study. Ultrasonographic imaging in the prone position was used to obtain percutaneous renal access and guide tract dilation. Fluoroscopic screening was used only for nephrostomy tube placement. Preoperative, intraoperative, and postoperative procedural and patient data were collected for analysis. Results. Mean age of patients was 52.7 ± 17.2 years. Forty-five percent of patients were male with mean BMI of 26.1 ± 7.3 and mean stone size of 27.2 ± 17.6 millimeters. Renal puncture was performed successfully with ultrasonographic guidance in all cases with mean puncture time of 135.4 ± 132.5 seconds. Mean dilation time was 11.5 ± 3.8 min and mean stone fragmentation time was 37.5 ± 29.0 min. Mean total operative time was 129.3 ± 41.1. No patients experienced any significant immediate postoperative complication. All patients were rendered stone-free and no additional secondary procedures were required. Conclusions. Ultrasound guidance for renal access and tract dilation in prone percutaneous nephrolithotomy is a feasible and effective technique. It can be performed safely with significantly reduced fluoroscopic radiation exposure to the patient, surgeon, and intraoperative personnel. PMID:27042176

Effect of core muscle thickness and static or dynamic balance on prone bridge exercise with sling by shoulder joint angle in healthy adults.

PubMed

Park, Mi Hwa; Yu, Jae Ho; Hong, Ji Heon; Kim, Jin Seop; Jung, Sang Woo; Lee, Dong Yeop

2016-03-01

[Purpose] To date, core muscle activity detected using ultrasonography during prone bridge exercises has not been reported. Here we investigated the effects of core muscle thickness and balance on sling exercise efficacy by shoulder joint angle in healthy individuals. [Subjects and Methods] Forty-three healthy university students were enrolled in this study. Ultrasonography thickness of external oblique, internal oblique, and transversus abdominis during sling workouts was investigated. Muscle thickness was measured on ultrasonography imaging before and after the experiment. Dynamic balance was tested using a functional reaching test. Static balance was tested using a Tetrax Interactive Balance System. [Results] Different muscle thicknesses were observed during the prone bridge exercise with the shoulder flexed at 60°, 90° or 120°. Shoulder flexion at 60° and 90° in the prone bridge exercise with a sling generated the greatest thickness of most transversus abdominis muscles. Shoulder flexion at 120° in the prone bridge exercise with a sling generated the greatest thickness of most external oblique muscles. [Conclusion] The results suggest that the prone bridge exercise with shoulder joint angle is an effective method of increasing global and local muscle strength.

Ventilation distribution in rats: Part 2 – A comparison of electrical impedance tomography and hyperpolarised helium magnetic resonance imaging

PubMed Central

2012-01-01

Background Hyperpolarised helium MRI (He3 MRI) is a new technique that enables imaging of the air distribution within the lungs. This allows accurate determination of the ventilation distribution in vivo. The technique has the disadvantages of requiring an expensive helium isotope, complex apparatus and moving the patient to a compatible MRI scanner. Electrical impedance tomography (EIT) a non-invasive bedside technique that allows constant monitoring of lung impedance, which is dependent on changes in air space capacity in the lung. We have used He3MRI measurements of ventilation distribution as the gold standard for assessment of EIT. Methods Seven rats were ventilated in supine, prone, left and right lateral position with 70% helium/30% oxygen for EIT measurements and pure helium for He3 MRI. The same ventilator and settings were used for both measurements. Image dimensions, geometric centre and global in homogeneity index were calculated. Results EIT images were smaller and of lower resolution and contained less anatomical detail than those from He3 MRI. However, both methods could measure positional induced changes in lung ventilation, as assessed by the geometric centre. The global in homogeneity index were comparable between the techniques. Conclusion EIT is a suitable technique for monitoring ventilation distribution and inhomgeneity as assessed by comparison with He3 MRI. PMID:22966835

Image to physical space registration of supine breast MRI for image guided breast surgery

NASA Astrophysics Data System (ADS)

Conley, Rebekah H.; Meszoely, Ingrid M.; Pheiffer, Thomas S.; Weis, Jared A.; Yankeelov, Thomas E.; Miga, Michael I.

2014-03-01

Breast conservation therapy (BCT) is a desirable option for many women diagnosed with early stage breast cancer and involves a lumpectomy followed by radiotherapy. However, approximately 50% of eligible women will elect for mastectomy over BCT despite equal survival benefit (provided margins of excised tissue are cancer free) due to uncertainty in outcome with regards to complete excision of cancerous cells, risk of local recurrence, and cosmesis. Determining surgical margins intraoperatively is difficult and achieving negative margins is not as robust as it needs to be, resulting in high re-operation rates and often mastectomy. Magnetic resonance images (MRI) can provide detailed information about tumor margin extents, however diagnostic images are acquired in a fundamentally different patient presentation than that used in surgery. Therefore, the high quality diagnostic MRIs taken in the prone position with pendant breast are not optimal for use in surgical planning/guidance due to the drastic shape change between preoperative images and the common supine surgical position. This work proposes to investigate the value of supine MRI in an effort to localize tumors intraoperatively using image-guidance. Mock intraoperative setups (realistic patient positioning in non-sterile environment) and preoperative imaging data were collected from a patient scheduled for a lumpectomy. The mock intraoperative data included a tracked laser range scan of the patient's breast surface, tracked center points of MR visible fiducials on the patient's breast, and tracked B-mode ultrasound and strain images. The preoperative data included a supine MRI with visible fiducial markers. Fiducial markers localized in the MRI were rigidly registered to their mock intraoperative counterparts using an optically tracked stylus. The root mean square (RMS) fiducial registration error using the tracked markers was 3.4mm. Following registration, the average closest point distance between the MR generated surface nodes and the LRS point cloud was 1.76±0.502 mm.

Back to sleep or not: the effect of the supine position on pediatric OSA: Sleeping position in children with OSA.

PubMed

Walter, Lisa M; Dassanayake, Daranagama U N; Weichard, Aidan J; Davey, Margot J; Nixon, Gillian M; Horne, Rosemary S C

2017-09-01

In both adults and children, obstructive sleep apnea (OSA) has significant adverse cardiovascular consequences. In adults, sleeping position has a marked effect on the severity of OSA; however, the limited number of studies conducted in children have reported conflicting findings. We aimed to evaluate the effect of sleeping position on OSA severity and the cardiovascular consequences in preschool-aged children. This was a retrospective analysis of children (3-5 years of age) diagnosed with OSA (n = 75) and nonsnoring controls (n = 25). Sleeping position was classified as supine, semi-supine, left lateral, right lateral, prone, and semi-prone by using video recordings during one night of attended polysomnography. OSA severity and cardiovascular parameters were compared between the positions. All children spent significantly more sleep time in the supine position than in any other position. The obstructive apnea-hypopnea index was higher in the supine position than in the other sleeping positions during NREM (p < 0.05), higher in the moderate/severe OSA group when sleeping in the supine position than when sleeping in the left and right lateral positions (p < 0.05 for both) and prone position (p = 0.007) during REM. Sympathovagal balance was decreased in children with OSA in the supine and lateral positions (p < 0.05). This study identified that preschool-aged children, whether nonsnoring controls or children with OSA, predominately sleep in the supine position, and OSA was more severe in the supine position. We suggest that to avoid the supine sleep position, positional therapy has the potential to ameliorate OSA severity, and the known cardiovascular consequences. Copyright © 2017 Elsevier B.V. All rights reserved.

An examination of a modified Yo-Yo test to measure intermittent running performance in rugby players.

PubMed

Dobbin, Nick; Moss, Samantha Louise; Highton, Jamie; Twist, Craig

2018-06-17

This study examined how starting each shuttle in the prone position altered the internal, external and perceptual responses to the Yo-Yo Intermittent Recovery Test Level 1 (Yo-Yo IR1). Using a randomized crossover design, 17 male rugby players completed the Yo-Yo IR1 and prone Yo-Yo IR1 on two separate occasions. External loads (via microtechnology), [Formula: see text], heart rate (HR) and rating of perceived exertion (RPE) were measured at 160, 280 and 440 m (sub-maximal) and when the test was terminated (peak). The pre-to-post change in blood lactate concentration (Δ[La] b ) was determined for both tests. All data were analysed using effect sizes (ES) and magnitude-based inferences. Between-trial differences (ES ± 90% CL) indicated that total distance was most likely lower (-1.87 ± 0.19), whereas other measures of peak external load were likely to very likely higher during the prone Yo-Yo IR1 (0.62-1.80). Sub-maximal RPE was likely to most likely higher (0.40-0.96) and peak RPE very likely higher (0.63 ± 0.41) in the prone Yo-Yo IR1. The change in [La] b was likely higher after the prone Yo-Yo IR1. Mean HR was possibly lower at 440 m (-0.25 ± 0.29) as was peak HR (-0.26 ± 0.25) in the prone Yo-Yo IR1. [Formula: see text], [Formula: see text] and [Formula: see text] were likely to very likely higher at 280 and 440 m (ES = 0.36-1.22), while peak values were possibly to likely higher (ES = 0.23-0.37) in the prone Yo-Yo IR1. Adopting a prone position during the Yo-Yo IR1 increases the internal, external and perceptual responses, placing greater emphasis on metabolically demanding actions typical of rugby.

Automating cell detection and classification in human brain fluorescent microscopy images using dictionary learning and sparse coding.

PubMed

Alegro, Maryana; Theofilas, Panagiotis; Nguy, Austin; Castruita, Patricia A; Seeley, William; Heinsen, Helmut; Ushizima, Daniela M; Grinberg, Lea T

2017-04-15

Immunofluorescence (IF) plays a major role in quantifying protein expression in situ and understanding cell function. It is widely applied in assessing disease mechanisms and in drug discovery research. Automation of IF analysis can transform studies using experimental cell models. However, IF analysis of postmortem human tissue relies mostly on manual interaction, often subjected to low-throughput and prone to error, leading to low inter and intra-observer reproducibility. Human postmortem brain samples challenges neuroscientists because of the high level of autofluorescence caused by accumulation of lipofuscin pigment during aging, hindering systematic analyses. We propose a method for automating cell counting and classification in IF microscopy of human postmortem brains. Our algorithm speeds up the quantification task while improving reproducibility. Dictionary learning and sparse coding allow for constructing improved cell representations using IF images. These models are input for detection and segmentation methods. Classification occurs by means of color distances between cells and a learned set. Our method successfully detected and classified cells in 49 human brain images. We evaluated our results regarding true positive, false positive, false negative, precision, recall, false positive rate and F1 score metrics. We also measured user-experience and time saved compared to manual countings. We compared our results to four open-access IF-based cell-counting tools available in the literature. Our method showed improved accuracy for all data samples. The proposed method satisfactorily detects and classifies cells from human postmortem brain IF images, with potential to be generalized for applications in other counting tasks. Copyright © 2017 Elsevier B.V. All rights reserved.

Influence of gravity for optimal head positions in the treatment of head injury patients.

PubMed

Li, Xiaogai; von Holst, Hans; Kleiven, Svein

2011-10-01

Brain edema is a major neurological complication of traumatic brain injury (TBI), commonly including a pathologically increased intracranial pressure (ICP) associated with poor outcome. In this study, gravitational force is suggested to have a significant impact on the pressure of the edema zone in the brain tissue and the objective of the study was to investigate the significance of head position on edema at the posterior part of the brain using a finite element (FE) model. A detailed FE model including the meninges, brain tissue and a fully connected cerebrospinal fluid (CSF) system was used in this study. Brain tissue was modelled as a poroelastic material consisting of an elastic solid skeleton composed of neurons and neuroglia, permeated by interstitial fluid. The effect of head positions (supine and prone position) due to gravity was investigated for a localized brain edema at the posterior part of the brain. The water content increment at the edema zone remained nearly identical for both positions. However, the interstitial fluid pressure (IFP) inside the edema zone decreased around 15% by having the head in a prone position compared with a supine position. The decrease of IFP inside the edema zone by changing patient position from supine to prone has the potential to alleviate the damage to central nervous system nerves. These observations indicate that considering the patient's head position during intensive care and at rehabilitation might be of importance to the treatment of edematous regions in TBI patients.

Boredom proneness--the development and correlates of a new scale.

PubMed

Farmer, R; Sundberg, N D

1986-01-01

This article reports the development, validation, and correlates of a self-report measure of boredom proneness. The 28-item Boredom Proneness (BP) Scale demonstrates satisfactory levels of internal consistency (coefficient alpha = .79) and test-retest reliability (r = .83) over a 1-week interval. Evidence of validity for the BP is supported by correlations with other boredom measures and from a set of studies evaluating interest and attention in the classroom. Other hypothesized relationships with boredom were tested, with significant positive associations found with depression, hopelessness, perceived effort, loneliness, and amotivational orientation. Additional findings indicate boredom proneness to be negatively related to life satisfaction and autonomy orientation. The relationship of boredom to other affective states is discussed, and directions for future research are outlined.

Crisis Management of Accidental Extubation in a Prone-Positioned Patient with Klippel-Feil Syndrome.

PubMed

Spond, Matthew; Burns, Tyler; Rosenbaum, Thea; Lienhart, Kristen

2016-06-15

We present the case of an accidental extubation in a prone-positioned patient with a challenging airway because of Klippel-Feil syndrome and previous cervical spine fusions. The surgical procedure was well underway when this occurred, which added substantially to the difficulties produced by this event. We herein highlight the corrective steps we took in our case. We also recommend the need for a comprehensive preoperative briefing with all operating room personnel together with an action plan for how to prevent this particular scenario.

SU-E-T-378: Limits and Possibilities of a Simplistic Approach to Whole Breast Radiation Therapy Planning

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

Hipp, E; Osa, E; No, H

2014-06-01

Purpose: Challenges for radiation therapy in developing countries include unreliable infrastructure and high patient load. We propose a system to treat whole breast in the prone position without computed tomography and/or planning software. Methods: Six parameters are measured using calipers and levels with the patient prone in the treatment position. (1) The largest separation; (2) the angle that separation makes with the horizontal; (3) the separation 2 cm posterior to the nipple; (4) the vertical distance between these two separations; (5) the sup/inf length and (6) angle of the desired posterior field edge. The data in (5) (6) and (2)more » provide field length, collimator and gantry angles. Isocenter is set to the midpoint of (1), anterior jaw setting is 20cm (half-beam setup), and the dose is prescribed to a point 1.5 cm anterior to isocenter. MUs and wedge angles are calculated using an MU calculator and by requiring 100% dose at that point and 100-105% at the midpoint of (3). Measurements on 30 CT scans were taken to obtain the data 1-6. To test the resulting MU/wedge combinations, they were entered into Eclipse (Varian) and dose distributions were calculated. The MU/wedge combinations were recorded and tabulated. Results: Performing a dose volume histogram analysis, the contoured breast V95 was 90.5%, and the average V90 was 94.1%. The maximum dose never exceeded 114.5%, (average 108%). The lung V20 was <5% for 96.7%, and the heart V5 was <10% for 93.3% of our sample. Conclusion: A method to provide prone whole breast treatment without CT-planning was developed. The method provides reasonable coverage and normal tissue sparing. This approach is not recommended if imaging and planning capabilities are available; it was designed to specifically avoid the need for CT planning and should be reserved to clinics that need to avoid that step.« less

InSAR imaging of volcanic deformation over cloud-prone areas - Aleutian islands

USGS Publications Warehouse

Lu, Zhong

2007-01-01

Interferometric synthetic aperture radar (INSAR) is capable of measuring ground-surface deformation with centimeter-tosubcentimeter precision and spatial resolution of tens-of meters over a relatively large region. With its global coverage and all-weather imaging capability, INSAR is an important technique for measuring ground-surface deformation of volcanoes over cloud-prone and rainy regions such as the Aleutian Islands, where only less than 5 percent of optical imagery is usable due to inclement weather conditions. The spatial distribution of surface deformation data, derived from INSAR images, enables the construction of detailed mechanical models to enhance the study of magmatic processes. This paper reviews the basics of INSAR for volcanic deformation mapping and the INSAR studies of ten Aleutian volcanoes associated with both eruptive and noneruptive activity. These studies demonstrate that all-weather INSAR imaging can improve our understanding of how the Aleutian volcanoes work and enhance our capability to predict future eruptions and associated hazards.

Evaluation of a cone beam computed tomography geometry for image guided small animal irradiation.

PubMed

Yang, Yidong; Armour, Michael; Wang, Ken Kang-Hsin; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

2015-07-07

The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal ('tubular' geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal ('pancake' geometry). The small animal radiation research platform developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Not withstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e. pancake and tubular geometry, respectively.

Evaluation of a Cone Beam Computed Tomography Geometry for Image Guided Small Animal Irradiation

PubMed Central

Yang, Yidong; Armour, Michael; Wang, Ken Kang-Hsin; Gandhi, Nishant; Iordachita, Iulian; Siewerdsen, Jeffrey; Wong, John

2015-01-01

The conventional imaging geometry for small animal cone beam computed tomography (CBCT) is that a detector panel rotates around the head-to-tail axis of an imaged animal (“tubular” geometry). Another unusual but possible imaging geometry is that the detector panel rotates around the anterior-to-posterior axis of the animal (“pancake” geometry). The small animal radiation research platform (SARRP) developed at Johns Hopkins University employs the pancake geometry where a prone-positioned animal is rotated horizontally between an x-ray source and detector panel. This study is to assess the CBCT image quality in the pancake geometry and investigate potential methods for improvement. We compared CBCT images acquired in the pancake geometry with those acquired in the tubular geometry when the phantom/animal was placed upright simulating the conventional CBCT geometry. Results showed signal-to-noise and contrast-to-noise ratios in the pancake geometry were reduced in comparison to the tubular geometry at the same dose level. But the overall spatial resolution within the transverse plane of the imaged cylinder/animal was better in the pancake geometry. A modest exposure increase to two folds in the pancake geometry can improve image quality to a level close to the tubular geometry. Image quality can also be improved by inclining the animal, which reduces streak artifacts caused by bony structures. The major factor resulting in the inferior image quality in the pancake geometry is the elevated beam attenuation along the long axis of the phantom/animal and consequently increased scatter-to-primary ratio in that orientation. Notwithstanding, the image quality in the pancake-geometry CBCT is adequate to support image guided animal positioning, while providing unique advantages of non-coplanar and multiple mice irradiation. This study also provides useful knowledge about the image quality in the two very different imaging geometries, i.e., pancake and tubular geometry, respectively. PMID:26083659

Preterm Infants Who Are Prone to Distress: Differential Effects of Parenting on 36-Month Behavioral and Cognitive Outcomes

ERIC Educational Resources Information Center

Poehlmann, Julie; Hane, Amanda; Burnson, Cynthia; Maleck, Sarah; Hamburger, Elizabeth; Shah, Prachi E.

2012-01-01

Background: The differential susceptibility (DS) model suggests that temperamentally prone-to-distress infants may exhibit adverse outcomes in negative environments but optimal outcomes in positive environments. This study explored temperament, parenting, and 36-month cognition and behavior in preterm infants using the DS model. We hypothesized…

Use of thermal inertia determined by HCMM to predict nocturnal cold prone areas in Florida

NASA Technical Reports Server (NTRS)

Allen, L. H., Jr. (Principal Investigator)

1983-01-01

Pairs of HCMM day-night thermal infrared (IR) data were selected during the 1978-79 winter to examine patterns of surface temperature and thermal inertia (TI) of peninsular Florida. The GOES and NOAA-6 thermal IR, as well as National Climatic Center temperatures and rainfall, were also used. The HCMM apparent thermal inertia (ATI) images closely corresponded to the general soil map of Florida, based on soil drainage classes. Areas with low ATI overlay well-drained soils, such as deep sands and drained organic soils, whereas with high ATI overlay areas with wetlands and bodies of water. The HCMM ATI images also corresponded well with GOES-detected winter nocturnal cold-prone areas. Use of HCMM data with Carlson's energy balance model showed both high moisture availability (MA) and high thermal inertia (TI) of wetland-type surfaces and low MA and low TI of upland, well-drained soils. Since soil areas with low TI develop higher temperatures during the day, then antecedent patterns of highest maximum daytime surface temperature can also be used to predict nocturnal cold-prone areas in Florida.

Pattern classification of brain activation during emotional processing in subclinical depression: psychosis proneness as potential confounding factor.

PubMed

Modinos, Gemma; Mechelli, Andrea; Pettersson-Yeo, William; Allen, Paul; McGuire, Philip; Aleman, Andre

2013-01-01

We used Support Vector Machine (SVM) to perform multivariate pattern classification based on brain activation during emotional processing in healthy participants with subclinical depressive symptoms. Six-hundred undergraduate students completed the Beck Depression Inventory II (BDI-II). Two groups were subsequently formed: (i) subclinical (mild) mood disturbance (n = 17) and (ii) no mood disturbance (n = 17). Participants also completed a self-report questionnaire on subclinical psychotic symptoms, the Community Assessment of Psychic Experiences Questionnaire (CAPE) positive subscale. The functional magnetic resonance imaging (fMRI) paradigm entailed passive viewing of negative emotional and neutral scenes. The pattern of brain activity during emotional processing allowed correct group classification with an overall accuracy of 77% (p = 0.002), within a network of regions including the amygdala, insula, anterior cingulate cortex and medial prefrontal cortex. However, further analysis suggested that the classification accuracy could also be explained by subclinical psychotic symptom scores (correlation with SVM weights r = 0.459, p = 0.006). Psychosis proneness may thus be a confounding factor for neuroimaging studies in subclinical depression.

Effects of posture on blood flow diversion by hypoxic pulmonary vasoconstriction in dogs

NASA Technical Reports Server (NTRS)

Walther, S. M.; Domino, K. B.; Hlastala, M. P.

1998-01-01

We used differential excretion of sulphur hexafluoride from the left and right lung to measure blood flow diversion by hypoxic pulmonary vasoconstriction (HPV) in the prone and supine positions in dogs (n = 9). Gas exchange was assessed using the multiple inert gas elimination technique. Blood flow diversion from the hypoxic (3% oxygen) left lung was mean 70.7 (SD 11.2)% in the supine compared with 57.0 (12.1)% in the prone position (P < 0.02). The supine position was associated with increased perfusion to low VA/Q regions (P < 0.05). The increased flow diversion with hypoxia in the supine position was associated with more ventilation to high VA/Q regions (P < 0.05). We conclude that flow diversion by hypoxic pulmonary vasoconstriction is greater in the supine position. This effect could contribute to the variable response in gas exchange with positioning in patients with ARDS.

Shame aversion and maladaptive eating-related attitudes and behaviors.

PubMed

Manjrekar, Eishita; Schoenleber, Michelle; Mu, Wenting

2013-12-01

Consistent with affect regulation models of eating-related psychopathology, prior research indicates that trait-like shame and state self-conscious emotion are associated with maladaptive eating-related attitudes/behaviors. The present investigation extended past research on shame and maladaptive eating-related attitudes/behaviors by examining the role of shame aversion - the perception of shame as an especially unwanted and painful emotion - in these attitudes/behaviors over and above shame-proneness, general distress, and experiential avoidance. In 488 female undergraduates, shame aversion was positively associated with dieting, self-perceptions of body shape, awareness of food content, and food preoccupation even after taking into account other possible explanatory variables. Additionally, shame aversion moderated shame-proneness' associations with dieting, awareness of food content, and food preoccupation, such that shame-proneness was positively associated with these attitudes/behaviors only when shame aversion was high. Future directions for research and clinical implications of the present findings are discussed. © 2013.

Postoperative Posterior Ischemic Optic Neuropathy After Left Far-Lateral Craniectomy for Resection of Craniocervical Meningioma.

PubMed

Eli, Ilyas M; Kim, Robert B; Kilburg, Craig; Pecha, Travis J; Couldwell, William T; Menacho, Sarah T

2018-06-01

Postoperative posterior ischemic optic neuropathy (PION) is a rare cause of postoperative vision loss, most often seen when surgical patients are placed in the prone position for a prolonged period of time. We report a case of bilateral PION after far-lateral craniectomy in the lateral position. A 36-year-old man presented with a history of right extremity numbness, weakness, and muscle atrophy, and a craniocervical meningioma was diagnosed. Surgery in the lateral position lasted 9 hours, 52 minutes; the patient had 2 L of blood loss. On postoperative day 1, the patient had bilateral vision loss, which prompted further work-up. Diffusion-weighted imaging of the orbits demonstrated restricted diffusion within the bilateral optic nerves. The clinical presentation of painless vision loss after surgery with these imaging findings led to a diagnosis of PION. At the time of discharge, he had not recovered any visual function. This case suggests that PION can occur in the lateral position where there is no direct pressure on the orbits. PION is often not discussed as a potential complication during the preoperative consent process. This case suggests it may be prudent to discuss PION in similar neurosurgical cases. Intraoperative blood transfusion should be considered in prolonged surgeries in the lateral position, where slow blood loss over a long period could be a contributing factor to development of PION. Copyright © 2018 Elsevier Inc. All rights reserved.

Thought-action fusion and schizotypy in undergraduate students.

PubMed

Muris, Peter; Merckelbach, Harald

2003-06-01

To examine the relationship between thought-action fusion (TAF) and schizotypy. In two separate samples of undergraduate students (Ns = 77 and 64), correlations were computed between a measure of TAF and indices of schizotypy and fantasy proneness. Positive correlations were found between TAF and various aspects of schizotypy (i.e. perceptual aberration, magical ideation, schizotypal personality characteristics, disposition to hallucinate). However, correlations between TAF and schizotypy no longer attained significance when controlling for fantasy proneness. At least in the non-clinical population, the connection between TAF and schizotypy seems to be a by-product of fantasy-prone individuals' tendency to report unusual experiences.

Depressive symptoms, depression proneness, and outcome expectancies for cigarette smoking.

PubMed

Friedman-Wheeler, Dara G; Ahrens, Anthony H; Haaga, David A F; McIntosh, Elizabeth; Thorndike, Frances P

2007-08-01

The high rates of cigarette smoking among depressed persons may be partially explained by increased positive expectancies for cigarette smoking among this population. In view of theoretical and empirical work on depressed people's negative views of the future, though, it would be expected that depressed smokers would hold particularly negative expectancies about the effects of cigarette smoking. The two current studies examined the relations between depression and smoking outcome expectancies in (a) a general population of adult regular smokers and (b) adult smokers seeking to quit smoking. Depressive symptoms and depression proneness both showed significant positive correlations with positive expectancies for cigarette smoking. Several positive correlations with negative expectancies also emerged. Thus, experiencing depressive symptoms may serve to amplify both favorable and unfavorable expectancies about the effects of smoking.

Motor development of infants with positional plagiocephaly.

PubMed

Kennedy, Eileen; Majnemer, Annette; Farmer, Jean-Pierre; Barr, Ronald G; Platt, Robert W

2009-01-01

Concurrent with recommendations to place infants to sleep in supine, there has been a dramatic increase in the number of infants with positional plagiocephaly (PP). Recent evidence suggests that infants who have decreased exposure to prone position may have a higher incidence of PP and may be at risk for a delay in the acquisition of certain motor skills. The purpose of this study was to compare motor development between infants with PP and matched peers without PP. We also examined differences in infant positioning practices when asleep and awake between the two groups. Twenty-seven infants with PP, 3 to 8 months of age, were matched by age, gender, and race to infants without PP. Motor performance was evaluated using the Alberta Infant Motor Scale (AIMS) and the Peabody Developmental Motor Scales (PDMS). Parents completed a diary that recorded infant positioning over a 3-day period. Mean AIMS percentile score for infants with PP was 31.1 +/- 21.6 as compared with 42.7 +/- 20.2 in infants without PP (p = .06). Better performance on the AIMS was positively correlated with the amount of time in prone position when awake, for both groups of children (PP r = .52, no PP r = .44, p < .05). Therapists should be aware of a risk of a motor delay when evaluating infants with PP. It is also important for parents to be informed about the importance of supervised prone playtime to enhance the development of early motor skills.

Selective recruitment of the lower fibers of the trapezius muscle.

PubMed

Arlotta, Melissa; Lovasco, Gina; McLean, Linda

2011-06-01

We aimed to determine the effectiveness of five isometric exercises at maximally activating the lower trapezius muscle in healthy subjects. Surface electromyography data were recorded from the upper, middle, and lower fibers of the trapezius muscle bilaterally while 18 healthy subjects performed five different exercises: Latissimus Pull-down, Prone Row, Prone V-Raise, Posterior Fly and Modified Prone Cobra. The peak activation was determined from the rectified and smoothed data to determine which exercise generated the highest amount of lower trapezius activity, and to determine which exercise best resulted in activation of the lower fibers of trapezius while minimizing activation of the upper and middle fibers of trapezius. Males and females demonstrated different patterns of lower trapezius recruitment and therefore the data were analyzed separately for each sex. For the males, the Prone Row exercise (2.84 ± 1.67 mV), the Posterior Fly (2.23 ± 1.00 mV) and the Modified Prone Cobra (2.26 ± 1.19 mV) exercises generated the highest EMG activity in the lower trapezius muscle. For the females, the Modified Prone Cobra (2.40 ± 1.32 mV) and the Prone Row (2.37 ± 1.14 mV) exercises generated higher activation than the Latissimus Pull Down (1.04 ± 0.56 mV), the Posterior Fly (1.62 ± 1.044 mV) and the Prone V-Raise (1.32 ± 1.07 mV). In both sexes, the Modified Prone Cobra, the Prone Row and the Latissimus Pull Down outperformed the other exercises in terms of maximizing lower trapezius activation while minimizing activation of the upper and middle fibers of trapezius. The Modified Prone Cobra showed lower relative activation of the upper trapezius muscle than did the Prone Row exercise. The Modified Prone Cobra and Prone Row exercises are the most effective exercises for targeted strengthening of the lower trapezius muscle in both sexes. The Modified Prone Cobra is somewhat better than the Prone Row due to the low activation of the upper trapezius muscle during this exercise. The Modified Prone Cobra exercise should therefore be considered as a manual muscle test position and as a strengthening exercise for the lower trapezius muscle fibers. Copyright © 2010 Elsevier Ltd. All rights reserved.

Crying in Middle Childhood: A Report on Gender Differences.

PubMed

Jellesma, Francine C; Vingerhoets, Ad J J M

2012-10-01

The aims of this study were (1) to confirm gender differences in crying in middle childhood and (2) to identify factors that may explain why girls cry more than boys in a Dutch sample (North Holland and Utrecht). We examined 186 children's (age: 9-13 years) self-reports on crying, catharsis, seeking support for feelings, and internalizing feelings. Girls reported a greater crying frequency and crying proneness, and more emotional and physical catharsis after crying. In addition, they more frequently sought support for feelings and more often experienced sadness and somatic complaints than boys. Seeking help for negative feelings and the experience of sadness and somatic complaints were positively associated with crying frequency and crying proneness. Emotional catharsis was positively linked to crying proneness. Support was found for the potential mediating role of sadness and somatic complaints with respect to the gender difference in crying frequency and for the potential mediating role of emotional catharsis and somatic complaints for crying proneness. This study demonstrates that gender differences in crying frequency already exist in middle childhood and the findings suggest a linkage between these gender differences in crying and psychosocial factors.

Dynamic contrast-enhanced breast MRI at 7 Tesla utilizing a single-loop coil: a feasibility trial.

PubMed

Umutlu, Lale; Maderwald, Stefan; Kraff, Oliver; Theysohn, Jens M; Kuemmel, Sherko; Hauth, Elke A; Forsting, Michael; Antoch, Gerald; Ladd, Mark E; Quick, Harald H; Lauenstein, Thomas C

2010-08-01

The aim of this study was to assess the feasibility of dynamic contrast-enhanced ultra-high-field breast imaging at 7 Tesla. A total of 15 subjects, including 5 patients with histologically proven breast cancer, were examined on a 7 Tesla whole-body magnetic resonance imaging system using a unilateral linearly polarized single-loop coil. Subjects were placed in prone position on a biopsy support system, with the coil placed directly below the region of interest. The examination protocol included the following sequences: 1) T2-weighted turbo spin echo sequence; 2) six dynamic T1-weighted spoiled gradient-echo sequences; and 3) subtraction imaging. Contrast-enhanced T1-weighted imaging at 7 Tesla could be obtained at high spatial resolution with short acquisition times, providing good image accuracy and a conclusively good delineation of small anatomical and pathological structures. T2-weighted imaging could be obtained with high spatial resolution at adequate acquisition times. Because of coil limitations, four high-field magnetic resonance examinations showed decreased diagnostic value. This first scientific approach of dynamic contrast-enhanced breast magnetic resonance imaging at 7 Tesla demonstrates the complexity of ultra-high-field breast magnetic resonance imaging and countenances the implementation of further advanced bilateral coil concepts to circumvent current limitations from the coil and ultra-high-field magnetic strength. 2010 AUR. Published by Elsevier Inc. All rights reserved.

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

Dewyngaert, K; Jozsef, G; Formenti, S

Purpose: To report on the clinical validation of the Varian Pivotal™ Treatment Solution for Prone Breast Care: a platform for prone breast radiation therapy. Methods: Patients treated using Breast Conserving Radiation Therapy may benefit from treatment in the prone position with the breast tissue falling freely away from the body. This geometry allows the breast tissue to be treated while avoiding the lung and heart tissue. Eighteen patients simulated and treated using the Varian Medical Systems Pivotal™ Treatment Solution for Prone Breast Care were monitored over the course of treatment for positioning integrity and reproducibility. As this carbon-fiber platform actuallymore » replaces a portion of the couch top, indexing is inherent to its design. Patients were positioned on the couch and aligned using fiducial markers and lateral SSD to the breast fiducial point. The daily couch coordinates then serves as indicators for positioning variability with this system. Results: The variations in couch vertical, longitudinal and lateral positions were centered on a mean value of zero with standard deviations of 0.44cm, 0.75cm and 0.79cm respectively. Other factors explored were variations in distance of mid-sternum to table edge and patient rotation into the opening. The median rotation of the chest wall was found to be 11.5 degrees at CT-Simulation with a median distance of 2.5cm from midsternum to support opening. Patient rotation was not associated with either breast size or distance from edge of platform. Conclusion: The Pivotal™ Treatment solution consists of a couch top that replaces the standard top and as such is open from beneath without obstruction. This is a distinction from all other solutions which rely on a platform positioned above and indexed to the treatment couch. We found the reproducibility to be consistent with our historical measures while offering benefits of an integrated solution as stated above. supported by Professional Services Agreeement with Varian Medical Systems.« less

Ivor Lewis esophagectomy with manual esogastric anastomosis by thoracoscopy in prone position and laparoscopy.

PubMed

Cadière, G B; Dapri, G; Himpens, J; Fodderie, L; Rajan, A

2010-06-01

Only a few authors have reported the technique of Ivor Lewis esophagectomy by minimally invasive means, and anastomosis was usually performed by a circular stapler. We report an Ivor Lewis esophagogastrectomy with manual esogastric anastomosis performed by thoracoscopy in the prone position. An adenocarcinoma of the distal esophagus without lymph nodes invasion was diagnosed in a 51-year-old man. General anesthesia and double-lumen endotracheal tube intubation were used. First the patient was placed in the supine position, and five abdominal trocars were placed. Celiac lymphadenectomy was performed with section of the left gastric vessels. A wide Kocher maneuver and pyloroplasty were performed. A wide gastric tube was performed and advanced through the hiatus into the right chest. Subsequently the patient was placed in the prone position. Three trocars (two 5-mm and one 11-mm) were placed on the posterior axillary line in the fifth, seventh, and ninth right intercostal space. The intrathoracic esophagus was dissected. Mediastinal lymphadenectomy with en bloc resection of the left inferior mediastinal pleura was performed. The azygos vein was sectioned, and the esophagus was transected by scissors 1-cm cranial to the azygos vein. A completely thoracoscopic manual double-layer anastomosis was performed by using running sutures with PDS 2/0 externally and Maxon 4/0 internally. Finally the patient was replaced in the supine position to retrieve the specimen through a suprapubic incision, and the gastric tube was fixed to the hiatus. Thoracoscopy lasted 157' (anastomosis 40'), laparoscopy 160', and second laparoscopy 20'. Blood loss was estimated at 170 ml. The gastrograffin swallow on postoperative day 4 showed absence of stenosis and leak. The patient was discharged on postoperative day 6. Thoracoscopy in the prone position allows the surgeon to perform a thoracoscopic esogastric anastomosis completely handsewn without selective lung desufflation, and using only three trocars.

Sagittal Thoracic and Lumbar Spine Profiles in Upright Standing and Lying Prone Positions Among Healthy Subjects: Influence of Various Biometric Features.

PubMed

Salem, Walid; Coomans, Ysaline; Brismée, Jean-Michel; Klein, Paul; Sobczak, Stéphane; Dugailly, Pierre-Michel

2015-08-01

A prospective study was performed on the assessment of both thoracic and lumbar spine sagittal profiles (from C7 to S1). To propose a new noninvasive method for measuring the spine curvatures in standing and lying prone positions and to analyze their relationship with various biometric characteristics. Modifications of spine curvatures (i.e. lordosis or kyphosis) are of importance in the development of spinal disorders. Studies have emphasized the development of new devices to measure the spine sagittal profiles using a noninvasive and low-cost method. To date, it has not been applied for analyzing both lumbar and thoracic alterations for various positioning. Seventy-five healthy subjects (mean 22.6 ± 4.3 yr) were recruited to participate in this study. Thoracic and lumbar sagittal profiles were assessed in standing and lying prone positions using a 3D digitizer. In addition, several biometric data were collected including maximal trunk isometric strength for flexion and extension movement. Statistical analysis consisted in data comparisons of spine profiles and a multivariate analysis including biometric features, to classify individuals considering low within- and high between-variability. Kyphosis and lordosis angles decreased significantly from standing to lying prone position by an average of 13.4° and 16.6°, respectively. Multivariate analysis showed a sample clustering of 3 homogenous subgroups. The first group displayed larger lordosis and flexibility, and had low data values for height, weight, and strength. The second group had lower values than the overall trend of the whole sample, whereas the third group had larger score values for the torques, height, weight, waist, body mass index, and kyphosis angle but a reduced flexibility. The present results demonstrate a significant effect of the positioning on both thoracic and lumbar spine sagittal profiles and highlight the use of cluster analysis to categorize subgroups after biometric characteristics including curvature measurement. N/A.

Prone Whole-Breast Irradiation Using Three-Dimensional Conformal Radiotherapy in Women Undergoing Breast Conservation for Early Disease Yields High Rates of Excellent to Good Cosmetic Outcomes in Patients With Large and/or Pendulous Breasts

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

Bergom, Carmen; Kelly, Tracy; Morrow, Natalya

2012-07-01

Purpose: To report our institution's experience using prone positioning for three-dimensional conformal radiotherapy (3D-CRT) to deliver post-lumpectomy whole breast irradiation (WBI) in a cohort of women with large and/or pendulous breasts, to determine the rate of acute and late toxicities and, more specifically, cosmetic outcomes. We hypothesized that using 3D-CRT for WBI in the prone position would reduce or eliminate patient and breast size as negative prognostic indicators for toxicities associated with WBI. Methods and Materials: From 1998 to 2006, 110 cases were treated with prone WBI using 3D-CRT. The lumpectomy, breast target volumes, heart, and lung were contoured onmore » all computed tomography scans. A dose of 45-50 Gy was prescribed to the breast volume using standard fractionation schemes. The planning goals were {>=}95% of prescription to 95% of the breast volume, and 100% of boost dose to 95% of lumpectomy planning target volume. Toxicities and cosmesis were prospectively scored using the Common Terminology Criteria for Adverse Effects Version 3.0 and the Harvard Scale. The median follow-up was 40 months. Results: The median body mass index (BMI) was 33.6 kg/m{sup 2}, and median breast volume was 1396 cm{sup 3}. The worst toxicity encountered during radiation was Grade 3 dermatitis in 5% of our patient population. Moist desquamation occurred in 16% of patients, with only 2% of patients with moist desquamation outside the inframammary/axillary folds. Eleven percent of patients had Grade {>=}2 late toxicities, including Grade 3 induration/fibrosis in 2%. Excellent to good cosmesis was achieved in 89%. Higher BMI was associated with moist desquamation and breast pain, but BMI and breast volume did not impact fibrosis or excellent to good cosmesis. Conclusion: In patients with higher BMI and/or large-pendulous breasts, delivering prone WBI using 3D-CRT results in favorable toxicity profiles and high excellent to good cosmesis rates. Higher BMI was associated with moist desquamation, but prone positioning removed BMI and breast size as factors for poorer cosmetic outcomes. This series adds to the growing literature demonstrating that prone WBI may be advantageous in select patients.« less

Facilitation of Hoffmann reflexes of ankle muscles in prone but not standing positions by focal ankle-joint cooling.

PubMed

Kim, Kyung-Min; Ingersoll, Christopher D; Hertel, Jay

2015-05-01

Focal ankle-joint cooling (FAJC) has been shown to increase Hoffmann (H) reflex amplitudes of select leg muscles while subjects lie prone, but it is unknown whether the neurophysiological cooling effects persist in standing. To assess the effects of FAJC on H-reflexes of the soleus and fibularis longus during 3 body positions (prone, bipedal, and unipedal stances) in individuals with and without chronic ankle instability (CAI). Crossover. Laboratory. 15 young adults with CAI (9 male, 6 female) and 15 healthy controls. All subjects received both FAJC and sham treatments on separate days in a randomized order. FAJC was accomplished by applying a 1.5-L plastic bag filled with crushed ice to the ankle for 20 min. Sham treatment involved room-temperature candy corn. Maximum amplitudes of H-reflexes and motor (M) waves were recorded while subjects lay prone and then stood in quiet bipedal and unipedal stances before and immediately after each treatment. Primary outcome measures were H(max):M(max) ratios for the soleus and fibularis longus. Three-factor (group × treatment condition × time) repeated-measures ANOVAs and Fisher LSD tests were performed for statistical analyses. Significant interactions of treatment condition by time for prone H(max):M(max) ratios were found in the soleus (P = .001) and fibularis longus (P = .003). In both muscles, prone H(max):M(max) ratios moderately increased after FAJC but not after sham treatment. The CAI and healthy groups responded similarly to FAJC. In contrast, there were no significant interactions or main effects in the bipedal and unipedal stances in either muscle (P > .05). FAJC moderately increased H-reflex amplitudes of the soleus and fibularis longus while subjects were prone but not during bipedal or unipedal standing. These results were not different between groups with and without CAI.

Musculoskeletal disorders, personality traits, psychological distress, and accident proneness of Chinese coal miners.

PubMed

Deng, Mingming; Wu, Feng; Wang, Jun; Sun, Linyan

2017-01-01

Human factors comprise one of the important reasons leading to the casualty accidents in coal mines. The aim of this study was to analyze the relationships among musculoskeletal disorders (MSDs), personality traits, psychological distress, and accident proneness of coal miners. There were 1500 Chinese coal miners surveyed in this study. Among these miners, 992 valid samples were obtained. The study surveyed the MSDs, personality traits, psychological distress, and accident proneness of coal miners with MSDs Likert scale, Eysenck personality questionnaire, Symptom Checklist-90 (SCL-90) scale, and accident proneness questionnaire, respectively. The highest MSDs level was found in the waist. The increasing working age of the miners was connected with increased MSDs and psychological distress. Significant differences in MSDs and psychological distress of miners from different types of work were observed. Coal miners with higher MSDs had higher accident proneness. Coal miners with higher neuroticism dimension of Eysenck personality and more serious psychological distress had higher accident proneness. Phobic anxiety, paranoid ideation and psychoticism dimension of psychological distress were the three most important indicators that had significant positive relationships with accident proneness. The MSDs, neuroticism dimension, and psychological distress of the coal mine workers are important to work safety and require serious attention. Some implications concerning coal mine safety management in China were provided.

Two Faces of Shame: Understanding Shame and Guilt in the Prediction of Jail Inmates’ Recidivism

PubMed Central

Tangney, June P.; Stuewig, Jeffrey; Martinez, Andres G.

2014-01-01

Psychological research using mostly cross-sectional methods calls into question the presumed function of shame as inhibitor of immoral or illegal behavior. In a longitudinal study of 476 jail inmates, we assessed shame-proneness, guilt-proneness, and externalization of blame shortly upon incarceration. Participants (n = 332) were interviewed one year following release into the community and official arrest records were accessed (n = 446). Guilt-proneness negatively, and directly, predicted re-offense in the first year post-release; shame-proneness did not. Further mediational modeling showed that shame-proneness positively predicted recidivism via its robust link to externalization of blame. There remained a direct effect of shame on recidivism, however, such that shame – unimpeded by defensive externalization of blame – inhibited recidivism. Items assessing a motivation to hide were primarily responsible for this pattern. Overall, results suggest that the pain of shame may have two faces – one with destructive and the other with constructive potential. PMID:24395738

Distress after a single violent crime: how shame-proneness and event-related shame work together as risk factors for post-victimization symptoms.

PubMed

Semb, Olof; Strömsten, Lotta M J; Sundbom, Elisabet; Fransson, Per; Henningsson, Mikael

2011-08-01

To increase understanding of post-victimization symptom development, the present study investigated the role of shame- and guilt-proneness and event-related shame and guilt as potential risk factors. 35 individuals (M age = 31.7 yr.; 48.5% women), recently victimized by a single event of severe violent crime, were assessed regarding shame- and guilt-proneness, event-related shame and guilt, and post-victimization symptoms. The mediating role of event-related shame was investigated with structural equation modeling (SEM), using bootstrapping. The guilt measures were unrelated to each other and to post-victimization symptoms. The shame measures were highly intercorrelated and were both positively correlated to more severe post-victimization symptom levels. Event-related shame as mediator between shame-proneness and post-victimization symptoms was demonstrated by prevalent significant indirect effects. Both shame measures are potent risk factors for distress after victimization, whereby part of the effect of shame-proneness on post-victimization symptoms is explained by event-related shame.

Normal values and standardization of parameters in nuclear cardiology: Japanese Society of Nuclear Medicine working group database.

PubMed

Nakajima, Kenichi; Matsumoto, Naoya; Kasai, Tokuo; Matsuo, Shinro; Kiso, Keisuke; Okuda, Koichi

2016-04-01

As a 2-year project of the Japanese Society of Nuclear Medicine working group activity, normal myocardial imaging databases were accumulated and summarized. Stress-rest with gated and non-gated image sets were accumulated for myocardial perfusion imaging and could be used for perfusion defect scoring and normal left ventricular (LV) function analysis. For single-photon emission computed tomography (SPECT) with multi-focal collimator design, databases of supine and prone positions and computed tomography (CT)-based attenuation correction were created. The CT-based correction provided similar perfusion patterns between genders. In phase analysis of gated myocardial perfusion SPECT, a new approach for analyzing dyssynchrony, normal ranges of parameters for phase bandwidth, standard deviation and entropy were determined in four software programs. Although the results were not interchangeable, dependency on gender, ejection fraction and volumes were common characteristics of these parameters. Standardization of (123)I-MIBG sympathetic imaging was performed regarding heart-to-mediastinum ratio (HMR) using a calibration phantom method. The HMRs from any collimator types could be converted to the value with medium-energy comparable collimators. Appropriate quantification based on common normal databases and standard technology could play a pivotal role for clinical practice and researches.

Automating Cell Detection and Classification in Human Brain Fluorescent Microscopy Images Using Dictionary Learning and Sparse Coding

PubMed Central

Alegro, Maryana; Theofilas, Panagiotis; Nguy, Austin; Castruita, Patricia A.; Seeley, William; Heinsen, Helmut; Ushizima, Daniela M.

2017-01-01

Background Immunofluorescence (IF) plays a major role in quantifying protein expression in situ and understanding cell function. It is widely applied in assessing disease mechanisms and in drug discovery research. Automation of IF analysis can transform studies using experimental cell models. However, IF analysis of postmortem human tissue relies mostly on manual interaction, often subjected to low-throughput and prone to error, leading to low inter and intra-observer reproducibility. Human postmortem brain samples challenges neuroscientists because of the high level of autofluorescence caused by accumulation of lipofuscin pigment during aging, hindering systematic analyses. We propose a method for automating cell counting and classification in IF microscopy of human postmortem brains. Our algorithm speeds up the quantification task while improving reproducibility. New method Dictionary learning and sparse coding allow for constructing improved cell representations using IF images. These models are input for detection and segmentation methods. Classification occurs by means of color distances between cells and a learned set. Results Our method successfully detected and classified cells in 49 human brain images. We evaluated our results regarding true positive, false positive, false negative, precision, recall, false positive rate and F1 score metrics. We also measured user-experience and time saved compared to manual countings. Comparison with existing methods We compared our results to four open-access IF-based cell-counting tools available in the literature. Our method showed improved accuracy for all data samples. Conclusion The proposed method satisfactorily detects and classifies cells from human postmortem brain IF images, with potential to be generalized for applications in other counting tasks. PMID:28267565

Structure-Preserving Smoothing of Biomedical Images

NASA Astrophysics Data System (ADS)

Gil, Debora; Hernàndez-Sabaté, Aura; Burnat, Mireia; Jansen, Steven; Martínez-Villalta, Jordi

Smoothing of biomedical images should preserve gray-level transitions between adjacent tissues, while restoring contours consistent with anatomical structures. Anisotropic diffusion operators are based on image appearance discontinuities (either local or contextual) and might fail at weak inter-tissue transitions. Meanwhile, the output of block-wise and morphological operations is prone to present a block structure due to the shape and size of the considered pixel neighborhood.

An algorithm for longitudinal registration of PET/CT images acquired during neoadjuvant chemotherapy in breast cancer: preliminary results.

PubMed

Li, Xia; Abramson, Richard G; Arlinghaus, Lori R; Chakravarthy, Anuradha Bapsi; Abramson, Vandana; Mayer, Ingrid; Farley, Jaime; Delbeke, Dominique; Yankeelov, Thomas E

2012-11-16

By providing estimates of tumor glucose metabolism, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can potentially characterize the response of breast tumors to treatment. To assess therapy response, serial measurements of FDG-PET parameters (derived from static and/or dynamic images) can be obtained at different time points during the course of treatment. However, most studies track the changes in average parameter values obtained from the whole tumor, thereby discarding all spatial information manifested in tumor heterogeneity. Here, we propose a method whereby serially acquired FDG-PET breast data sets can be spatially co-registered to enable the spatial comparison of parameter maps at the voxel level. The goal is to optimally register normal tissues while simultaneously preventing tumor distortion. In order to accomplish this, we constructed a PET support device to enable PET/CT imaging of the breasts of ten patients in the prone position and applied a mutual information-based rigid body registration followed by a non-rigid registration. The non-rigid registration algorithm extended the adaptive bases algorithm (ABA) by incorporating a tumor volume-preserving constraint, which computed the Jacobian determinant over the tumor regions as outlined on the PET/CT images, into the cost function. We tested this approach on ten breast cancer patients undergoing neoadjuvant chemotherapy. By both qualitative and quantitative evaluation, our constrained algorithm yielded significantly less tumor distortion than the unconstrained algorithm: considering the tumor volume determined from standard uptake value maps, the post-registration median tumor volume changes, and the 25th and 75th quantiles were 3.42% (0%, 13.39%) and 16.93% (9.21%, 49.93%) for the constrained and unconstrained algorithms, respectively (p = 0.002), while the bending energy (a measure of the smoothness of the deformation) was 0.0015 (0.0005, 0.012) and 0.017 (0.005, 0.044), respectively (p = 0.005). The results indicate that the constrained ABA algorithm can accurately align prone breast FDG-PET images acquired at different time points while keeping the tumor from being substantially compressed or distorted. NCT00474604.

Effects of ipsilateral anterior thigh soft tissue stretching on passive unilateral straight-leg raise.

PubMed

Clark, S; Christiansen, A; Hellman, D F; Hugunin, J W; Hurst, K M

1999-01-01

Randomized 3-group pretest-posttest with blind assessment of outcome. The purpose of this study was to examine the effect of sagittal plane hold-relax exercise applied to the ipsilateral anterior thigh, and prone positioning on passive unilateral straight-leg raise measurements. Straight-leg raising has been viewed as a measurement for hamstring muscle length, but literature suggests that other structures may affect this measurement. Sixty subjects (45 men, 15 women) qualified for inclusion into the study based on a straight-leg raise measurement of < or = 65 degrees. Subjects were randomly assigned to one of three groups: control, static stretch, or sagittal plane hold-relax exercise. Pretest and posttest straight-leg raise measurements of the right lower extremity were performed for each subject. A 1-way ANOVA of the change scores showed a significant difference between groups. A Tukey post hoc analysis of the change scores showed that both treatment groups' means differed significantly from the control group and from each other, with the sagittal plane hold-relax group exhibiting the largest change (mean of 7.8 degrees +/- 2.8 degrees). The results of this study show that sagittal plane hold-relax exercise and passive prone results of this study show that sagittal plane hold-relax and passive prone positioning can significantly increase straight-leg raise range of motion, however the sagittal plane hold-relax stretching of the anterior thigh is more effective than passive prone positioning.

Automated PET-only quantification of amyloid deposition with adaptive template and empirically pre-defined ROI

NASA Astrophysics Data System (ADS)

Akamatsu, G.; Ikari, Y.; Ohnishi, A.; Nishida, H.; Aita, K.; Sasaki, M.; Yamamoto, Y.; Sasaki, M.; Senda, M.

2016-08-01

Amyloid PET is useful for early and/or differential diagnosis of Alzheimer’s disease (AD). Quantification of amyloid deposition using PET has been employed to improve diagnosis and to monitor AD therapy, particularly in research. Although MRI is often used for segmentation of gray matter and for spatial normalization into standard Montreal Neurological Institute (MNI) space where region-of-interest (ROI) template is defined, 3D MRI is not always available in clinical practice. The purpose of this study was to examine the feasibility of PET-only amyloid quantification with an adaptive template and a pre-defined standard ROI template that has been empirically generated from typical cases. A total of 68 subjects who underwent brain 11C-PiB PET were examined. The 11C-PiB images were non-linearly spatially normalized to the standard MNI T1 atlas using the same transformation parameters of MRI-based normalization. The automatic-anatomical-labeling-ROI (AAL-ROI) template was applied to the PET images. All voxel values were normalized by the mean value of cerebellar cortex to generate the SUVR-scaled images. Eleven typical positive images and eight typical negative images were normalized and averaged, respectively, and were used as the positive and negative template. Positive and negative masks which consist of voxels with SUVR  ⩾1.7 were extracted from both templates. Empirical PiB-prone ROI (EPP-ROI) was generated by subtracting the negative mask from the positive mask. The 11C-PiB image of each subject was non-rigidly normalized to the positive and negative template, respectively, and the one with higher cross-correlation was adopted. The EPP-ROI was then inversely transformed to individual PET images. We evaluated differences of SUVR between standard MRI-based method and PET-only method. We additionally evaluated whether the PET-only method would correctly categorize 11C-PiB scans as positive or negative. Significant correlation was observed between the SUVRs obtained with AAL-ROI and those with EPP-ROI when MRI-based normalization was used, the latter providing higher SUVR. When EPP-ROI was used, MRI-based method and PET-only method provided almost identical SUVR. All 11C-PiB scans were correctly categorized into positive and negative using a cutoff value of 1.7 as compared to visual interpretation. The 11C-PiB SUVR were 2.30  ±  0.24 and 1.25  ±  0.11 for the positive and negative images. PET-only amyloid quantification method with adaptive templates and EPP-ROI can provide accurate, robust and simple amyloid quantification without MRI.

Oxygen venous embolism after the use of hydrogen peroxide during lumbar discectomy.

PubMed

Despond, O; Fiset, P

1997-04-01

The knee-prone position is commonly used for patients undergoing spinal surgery. Venous air embolism in such a position may be produced by the negative venous pressure gradient between the ambient air and the venous plexuses of the spinous process. When hydrogen peroxide is used to cleanse the wound, oxygen is produced. We report a case of suspected oxygen venous embolism during lumbar discectomy in the knee-prone position after use of H2O2. Immediately after irrigation of a discectomy wound with H2O2, a dramatic decrease of the PETCO2, blood pressure and oxygen saturation coincident with ST segment elevation occurred suggesting a coronary gas embolism. Symptomatic treatment was initiated immediately and the patient recovered without any sequelae. Although hydrogen peroxide has an innocuous reputation, cases of accidental ingestion or massive gas embolism after wound irrigation leading to death have been reported. A review of the literature suggests that many of the clinical and physiopathological features of air and oxygen emboli are similar. For both, measures of prevention and treatment of complications are similar. We argue that the use of hydrogen peroxide should be avoided during procedures where the position of the patient (sitting, knee-prone) increases the risk of gas embolism and that hydrogen peroxide is a potentially dangerous solution.

[ARDS and severe brain injury. Therapeutic strategies in conflict].

PubMed

Bein, T; Kuhr, L P; Metz, C; Woertgen, C; Philipp, A; Taeger, K

2002-07-01

The development of adult respiratory distress syndrome (ARDS) complicates the treatment of patients with severe head injury, since special therapeutic strategies for both conditions might lead to a "conflict of interest". We report on the intensive care treatment of a young man who suffered severe brain injury (Glasgow Coma Scale = 3) due to a traffic accident and simultaneously developed ARDS from the aspiration of gastric content. We performed extensive monitoring of cerebral hemodynamics and metabolism (intracranial pressure measurement, jugular bulb oxymetry, estimation of arterial-jugular bulb lactate concentration difference) to prevent cerebral hypoxia and to control cerebral hyperemia. The application of a "lung protective strategy" with "permissive hypercapnia" led to a conflict, since the development of cranial hyperemia combined with cranial hypertension a few days after trauma, warranted the concept of controlled, temporary hyperventilation. Therefore, we applied a pumpless extracorporeal lung assist to improve carbon dioxide elimination. Furthermore, we started the ventilation in the prone position, since arterial oxygenation continued to deteriorate, although there is a lack of data describing the effect of a prone position on acute cerebral injury. Positioning the patient prone, we observed a prompt increase in intracranial pressure, which resulted in pharmacological intervention (mannitol). Treating the patient by intermittent prone position, by continuous extracorporeal lung assist and aerosolized prostacyclin administration in the following period, lung function improved and ARDS was treated successfully. After withdrawing the analgo-sedation the patient's vigilance rose continuously. The patient was transferred to a rehabilitation ward 33 days after admission to the intensive care unit. The combination of ARDS and severe brain injury needs special treatment, which includes extensive monitoring techniques to find a solution for therapeutic conflicts.

Random Sample Consensus: A Paradigm for Model Fitting with Applications to Image Analysis and Automated Cartography

DTIC Science & Technology

1980-03-01

interpreting/smoothing data containing a significant percentage of gross errors, and thus is ideally suited for applications in automated image ... analysis where interpretation is based on the data provided by error-prone feature detectors. A major portion of the paper describes the application of

Depression proneness and reactions to a depressive stimulus.

PubMed

Wernicke, Rachel A; Pearlman, Michelle Y; Thorndike, Frances P; Haaga, David A F

2006-01-01

In the context of a project examining depression vulnerability and cigarette smoking, the authors tested whether depression-vulnerable people differed from less vulnerable people in their reactions to a depressive stimulus. Regular smokers with a history of depression but not currently depressed (n = 63) and never-depressed smokers (n = 64) listened to audiotapes of confederates reading depressive and nondepressive scripts and reported their reactions. Neither a history of depression nor self-reported depression proneness predicted reactions to depression. However, depression proneness was positively correlated with beliefs about depression contagion. Likewise, stronger depression-related contagion beliefs and lower levels of empathic responding predicted behavioral rejection of the depressive stimulus.

Systematic feasibility analysis of a quantitative elasticity estimation for breast anatomy using supine/prone patient postures.

PubMed

Hasse, Katelyn; Neylon, John; Sheng, Ke; Santhanam, Anand P

2016-03-01

Breast elastography is a critical tool for improving the targeted radiotherapy treatment of breast tumors. Current breast radiotherapy imaging protocols only involve prone and supine CT scans. There is a lack of knowledge on the quantitative accuracy with which breast elasticity can be systematically measured using only prone and supine CT datasets. The purpose of this paper is to describe a quantitative elasticity estimation technique for breast anatomy using only these supine/prone patient postures. Using biomechanical, high-resolution breast geometry obtained from CT scans, a systematic assessment was performed in order to determine the feasibility of this methodology for clinically relevant elasticity distributions. A model-guided inverse analysis approach is presented in this paper. A graphics processing unit (GPU)-based linear elastic biomechanical model was employed as a forward model for the inverse analysis with the breast geometry in a prone position. The elasticity estimation was performed using a gradient-based iterative optimization scheme and a fast-simulated annealing (FSA) algorithm. Numerical studies were conducted to systematically analyze the feasibility of elasticity estimation. For simulating gravity-induced breast deformation, the breast geometry was anchored at its base, resembling the chest-wall/breast tissue interface. Ground-truth elasticity distributions were assigned to the model, representing tumor presence within breast tissue. Model geometry resolution was varied to estimate its influence on convergence of the system. A priori information was approximated and utilized to record the effect on time and accuracy of convergence. The role of the FSA process was also recorded. A novel error metric that combined elasticity and displacement error was used to quantify the systematic feasibility study. For the authors' purposes, convergence was set to be obtained when each voxel of tissue was within 1 mm of ground-truth deformation. The authors' analyses showed that a ∼97% model convergence was systematically observed with no-a priori information. Varying the model geometry resolution showed no significant accuracy improvements. The GPU-based forward model enabled the inverse analysis to be completed within 10-70 min. Using a priori information about the underlying anatomy, the computation time decreased by as much as 50%, while accuracy improved from 96.81% to 98.26%. The use of FSA was observed to allow the iterative estimation methodology to converge more precisely. By utilizing a forward iterative approach to solve the inverse elasticity problem, this work indicates the feasibility and potential of the fast reconstruction of breast tissue elasticity using supine/prone patient postures.

First case report of staghorn calculi successfully removed by mini-endoscopic combined intrarenal surgery in a 2-year-old boy.

PubMed

Taguchi, Kazumi; Hamamoto, Shuzo; Okada, Atsushi; Mizuno, Kentaro; Tozawa, Keiichi; Hayashi, Yutaro; Kohri, Kenjiro; Yasui, Takahiro

2015-10-01

Less-invasive therapy for pediatric urolithiasis is available due to the miniaturization of equipment and improved optics; however, surgical treatment strategies, especially for large calculi, remain controversial. We describe here our experience of treating a 2-year-old boy with left renal staghorn calculi with a single session of mini-endoscopic combined intrarenal surgery in the prone split-leg position with pre-ureteral stenting and the directional enhanced flow imaging ultrasound technique. This is the first report of successful pediatric mini-endoscopic combined intrarenal surgery without any major complications. We believe this technique provides an important therapeutic option for large renal calculus in pediatric patients. © 2015 The Japanese Urological Association.

Childhood memories of threatening experiences and submissiveness and its relationship to hallucination proneness and ideas of reference: The mediating role of dissociation.

PubMed

Bellido-Zanin, Gloria; Perona-Garcelán, Salvador; Senín-Calderón, Cristina; López-Jiménez, Ana María; Ruiz-Veguilla, Miguel; Rodríguez-Testal, Juan Francisco

2018-05-29

Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES-II scale for measuring dissociation, the LSHS-R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness. © 2018 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

3D/2D image registration using weighted histogram of gradient directions

NASA Astrophysics Data System (ADS)

Ghafurian, Soheil; Hacihaliloglu, Ilker; Metaxas, Dimitris N.; Tan, Virak; Li, Kang

2015-03-01

Three dimensional (3D) to two dimensional (2D) image registration is crucial in many medical applications such as image-guided evaluation of musculoskeletal disorders. One of the key problems is to estimate the 3D CT- reconstructed bone model positions (translation and rotation) which maximize the similarity between the digitally reconstructed radiographs (DRRs) and the 2D fluoroscopic images using a registration method. This problem is computational-intensive due to a large search space and the complicated DRR generation process. Also, finding a similarity measure which converges to the global optimum instead of local optima adds to the challenge. To circumvent these issues, most existing registration methods need a manual initialization, which requires user interaction and is prone to human error. In this paper, we introduce a novel feature-based registration method using the weighted histogram of gradient directions of images. This method simplifies the computation by searching the parameter space (rotation and translation) sequentially rather than simultaneously. In our numeric simulation experiments, the proposed registration algorithm was able to achieve sub-millimeter and sub-degree accuracies. Moreover, our method is robust to the initial guess. It can tolerate up to +/-90°rotation offset from the global optimal solution, which minimizes the need for human interaction to initialize the algorithm.

Modeling and simulation of tumor-influenced high resolution real-time physics-based breast models for model-guided robotic interventions

NASA Astrophysics Data System (ADS)

Neylon, John; Hasse, Katelyn; Sheng, Ke; Santhanam, Anand P.

2016-03-01

Breast radiation therapy is typically delivered to the patient in either supine or prone position. Each of these positioning systems has its limitations in terms of tumor localization, dose to the surrounding normal structures, and patient comfort. We envision developing a pneumatically controlled breast immobilization device that will enable the benefits of both supine and prone positioning. In this paper, we present a physics-based breast deformable model that aids in both the design of the breast immobilization device as well as a control module for the device during every day positioning. The model geometry is generated from a subject's CT scan acquired during the treatment planning stage. A GPU based deformable model is then generated for the breast. A mass-spring-damper approach is then employed for the deformable model, with the spring modeled to represent a hyperelastic tissue behavior. Each voxel of the CT scan is then associated with a mass element, which gives the model its high resolution nature. The subject specific elasticity is then estimated from a CT scan in prone position. Our results show that the model can deform at >60 deformations per second, which satisfies the real-time requirement for robotic positioning. The model interacts with a computer designed immobilization device to position the breast and tumor anatomy in a reproducible location. The design of the immobilization device was also systematically varied based on the breast geometry, tumor location, elasticity distribution and the reproducibility of the desired tumor location.

Prone position for acute respiratory failure in adults.

PubMed

Bloomfield, Roxanna; Noble, David W; Sudlow, Alexis

2015-11-13

Acute hypoxaemia de novo or on a background of chronic hypoxaemia is a common reason for admission to intensive care and for provision of mechanical ventilation. Various refinements of mechanical ventilation or adjuncts are employed to improve patient outcomes. Mortality from acute respiratory distress syndrome, one of the main contributors to the need for mechanical ventilation for hypoxaemia, remains approximately 40%. Ventilation in the prone position may improve lung mechanics and gas exchange and could improve outcomes. The objectives of this review are (1) to ascertain whether prone ventilation offers a mortality advantage when compared with traditional supine or semi recumbent ventilation in patients with severe acute respiratory failure requiring conventional invasive artificial ventilation, and (2) to supplement previous systematic reviews on prone ventilation for hypoxaemic respiratory failure in an adult population. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; 2014, Issue 1), Ovid MEDLINE (1950 to 31 January 2014), EMBASE (1980 to 31 January 2014), the Cumulative Index to Nursing and Allied Health Literature (CINAHL) (1982 to 31 January 2014) and Latin American Caribbean Health Sciences Literature (LILACS) (1992 to 31 January 2014) in Ovid MEDLINE for eligible randomized controlled trials. We also searched for studies by handsearching reference lists of relevant articles, by contacting colleagues and by handsearching published proceedings of relevant journals. We applied no language constraints, and we reran the searches in CENTRAL, MEDLINE, EMBASE, CINAHL and LILACS in June 2015. We added five new studies of potential interest to the list of "Studies awaiting classification" and will incorporate them into formal review findings during the review update. We included randomized controlled trials (RCTs) that examined the effects of prone position versus supine/semi recumbent position during conventional mechanical ventilation in adult participants with acute hypoxaemia. Two review authors independently reviewed all trials identified by the search and assessed them for suitability, methods and quality. Two review authors extracted data, and three review authors reviewed the data extracted. We analysed data using Review Manager software and pooled included studies to determine the risk ratio (RR) for mortality and the risk ratio or mean difference (MD) for secondary outcomes; we also performed subgroup analyses and sensitivity analyses. We identified nine relevant RCTs, which enrolled a total of 2165 participants (10 publications). All recruited participants suffered from disorders of lung function causing moderate to severe hypoxaemia and requiring mechanical ventilation, so they were fairly comparable, given the heterogeneity of specific disease diagnoses in intensive care. Risk of bias, although acceptable in the view of the review authors, was inevitable: Blinding of participants and carers to treatment allocation was not possible (face-up vs face-down).Primary analyses of short- and longer-term mortality pooled from six trials demonstrated an RR of 0.84 to 0.86 in favour of the prone position (PP), but findings were not statistically significant: In the short term, mortality for those ventilated prone was 33.4% (363/1086) and supine 38.3% (395/1031). This resulted in an RR of 0.84 (95% confidence interval (CI) 0.69 to 1.02) marginally in favour of PP. For longer-term mortality, results showed 41.7% (462/1107) for prone and 47.1% (490/1041) for supine positions, with an RR of 0.86 (95% CI 0.72 to 1.03). The quality of the evidence for both outcomes was rated as low as a result of important potential bias and serious inconsistency.Subgroup analyses for mortality identified three groups consistently favouring PP: those recruited within 48 hours of meeting entry criteria (five trials; 1024 participants showed an RR of 0.75 (95% CI 0.59 to 94)); those treated in the PP for 16 or more hours per day (five trials; 1005 participants showed an RR of 0.77 (95% CI 0.61 to 0.99)); and participants with more severe hypoxaemia at trial entry (six trials; 1108 participants showed an RR of 0.77 (95% CI 0.65 to 0.92)). The quality of the evidence for these outcomes was rated as moderate as a result of potentially important bias.Prone positioning appeared to influence adverse effects: Pressure sores (three trials; 366 participants) with an RR of 1.37 (95% CI 1.05 to 1.79) and tracheal tube obstruction with an RR of 1.78 (95% CI 1.22 to 2.60) were increased with prone ventilation. Reporting of arrhythmias was reduced with PP, with an RR of 0.64 (95% CI 0.47 to 0.87). We found no convincing evidence of benefit nor harm from universal application of PP in adults with hypoxaemia mechanically ventilated in intensive care units (ICUs). Three subgroups (early implementation of PP, prolonged adoption of PP and severe hypoxaemia at study entry) suggested that prone positioning may confer a statistically significant mortality advantage. Additional adequately powered studies would be required to confirm or refute these possibilities of subgroup benefit but are unlikely, given results of the most recent study and recommendations derived from several published subgroup analyses. Meta-analysis of individual patient data could be useful for further data exploration in this regard. Complications such as tracheal obstruction are increased with use of prone ventilation. Long-term mortality data (12 months and beyond), as well as functional, neuro-psychological and quality of life data, are required if future studies are to better inform the role of PP in the management of hypoxaemic respiratory failure in the ICU.

SU-E-T-603: Analysis of Optical Tracked Head Inter-Fraction Movements Within Masks to Access Intracranial Immobilization Techniques in Proton Therapy

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

Hsi, W; Zeidan, O

2014-06-01

Purpose: We present a quantitative methodology utilizing an optical tracking system for monitoring head inter-fraction movements within brain masks to assess the effectiveness of two intracranial immobilization techniques. Methods and Materials: A 3-point-tracking method was developed to measure the mask location for a treatment field at each fraction. Measured displacement of mask location to its location at first fraction is equivalent to the head movement within the mask. Head movements for each of treatment fields were measured over about 10 fractions at each patient for seven patients; five treated in supine and two treated in prone. The Q-fix Base-of-Skull headmore » frame was used in supine while the CIVCO uni-frame baseplate was used in prone. Displacements of recoded couch position of each field post imaging at each fraction were extracted for those seven patients. Standard deviation (S.D.) of head movements and couch displacements was scored for statistical analysis. Results: The accuracy of 3PtTrack method was within 1.0 mm by phantom measurements. Patterns of head movement and couch displacement were similar for patients treated in either supine or prone. In superior-inferior direction, mean value of scored standard deviations over seven patients were 1.6 mm and 3.4 mm for the head movement and the couch displacement, respectively. The result indicated that the head movement combined with a loose fixation between the mask-to-head frame results large couch displacements for each patient, and also large variation between patients. However, the head movement is the main cause for the couch displacement with similar magnitude of around 1.0 mm in anterior-posterior and lateral directions. Conclusions: Optical-tracking methodology independently quantifying head movements could improve immobilization devices by correctly acting on causes for head motions within mask. A confidence in the quality of intracranial immobilization techniques could be more efficient by eliminating the need for frequent imaging.« less

Thrombus segmentation by texture dynamics from microscopic image sequences

NASA Astrophysics Data System (ADS)

Brieu, Nicolas; Serbanovic-Canic, Jovana; Cvejic, Ana; Stemple, Derek; Ouwehand, Willem; Navab, Nassir; Groher, Martin

2010-03-01

The genetic factors of thrombosis are commonly explored by microscopically imaging the coagulation of blood cells induced by injuring a vessel of mice or of zebrafish mutants. The latter species is particularly interesting since skin transparency permits to non-invasively acquire microscopic images of the scene with a CCD camera and to estimate the parameters characterizing the thrombus development. These parameters are currently determined by manual outlining, which is both error prone and extremely time consuming. Even though a technique for automatic thrombus extraction would be highly valuable for gene analysts, little work can be found, which is mainly due to very low image contrast and spurious structures. In this work, we propose to semi-automatically segment the thrombus over time from microscopic image sequences of wild-type zebrafish larvae. To compensate the lack of valuable spatial information, our main idea consists of exploiting the temporal information by modeling the variations of the pixel intensities over successive temporal windows with a linear Markov-based dynamic texture formalization. We then derive an image from the estimated model parameters, which represents the probability of a pixel to belong to the thrombus. We employ this probability image to accurately estimate the thrombus position via an active contour segmentation incorporating also prior and spatial information of the underlying intensity images. The performance of our approach is tested on three microscopic image sequences. We show that the thrombus is accurately tracked over time in each sequence if the respective parameters controlling prior influence and contour stiffness are correctly chosen.

Molecular Imaging of Atherothrombotic Diseases: Seeing Is Believing.

PubMed

Wang, Xiaowei; Peter, Karlheinz

2017-06-01

Molecular imaging, with major advances in the development of both innovative targeted contrast agents/particles and radiotracers, as well as various imaging technologies, is a fascinating, rapidly growing field with many preclinical and clinical applications, particularly for personalized medicine. Thrombosis in either the venous or the arterial system, the latter typically caused by rupture of unstable atherosclerotic plaques, is a major determinant of mortality and morbidity in patients. However, imaging of the various thrombotic complications and the identification of plaques that are prone to rupture are at best indirect, mostly unreliable, or not available at all. The development of molecular imaging toward diagnosis and prevention of thrombotic disease holds promise for major advance in this clinically important field. Here, we review the medical need and clinical importance of direct molecular imaging of thrombi and unstable atherosclerotic plaques that are prone to rupture, thereby causing thrombotic complications such as myocardial infarction and ischemic stroke. We systematically compare the advantages/disadvantages of the various molecular imaging modalities, including X-ray computed tomography, magnetic resonance imaging, positron emission tomography, single-photon emission computed tomography, fluorescence imaging, and ultrasound. We further systematically discuss molecular targets specific for thrombi and those characterizing unstable, potentially thrombogenic atherosclerotic plaques. Finally, we provide examples for first theranostic approaches in thrombosis, combining diagnosis, targeted therapy, and monitoring of therapeutic success or failure. Overall, molecular imaging is a rapidly advancing field that holds promise of major benefits to many patients with atherothrombotic diseases. © 2017 American Heart Association, Inc.

Gas gangrene (image)

MedlinePlus

Gas gangrene is a severe form of gangrene (tissue death) caused by the bacterium Clostridium perfringens. Patients with ... vascular diseases are more prone to spontaneously develop gas gangrene, which is rapidly progressive and often fatal.

A hydrostatic weighing method using total lung capacity and a small tank.

PubMed Central

Warner, J G; Yeater, R; Sherwood, L; Weber, K

1986-01-01

The purpose of this study was to establish the validity and reliability of a hydrostatic weighing method using total lung capacity (measuring vital capacity with a respirometer at the time of weighing) the prone position, and a small oblong tank. The validity of the method was established by comparing the TLC prone (tank) method against three hydrostatic weighing methods administered in a pool. The three methods included residual volume seated, TLC seated and TLC prone. Eighty male and female subjects were underwater weighed using each of the four methods. Validity coefficients for per cent body fat between the TLC prone (tank) method and the RV seated (pool), TLC seated (pool) and TLC prone (pool) methods were .98, .99 and .99, respectively. A randomised complete block ANOVA found significant differences between the RV seated (pool) method and each of the three TLC methods with respect to both body density and per cent body fat. The differences were negligible with respect to HW error. Reliability of the TLC prone (tank) method was established by weighing twenty subjects three different times with ten-minute time intervals between testing. Multiple correlations yielded reliability coefficients for body density and per cent body fat values of .99 and .99, respectively. It was concluded that the TLC prone (tank) method is valid, reliable and a favourable method of hydrostatic weighing. PMID:3697596

A hydrostatic weighing method using total lung capacity and a small tank.

PubMed

Warner, J G; Yeater, R; Sherwood, L; Weber, K

1986-03-01

The purpose of this study was to establish the validity and reliability of a hydrostatic weighing method using total lung capacity (measuring vital capacity with a respirometer at the time of weighing) the prone position, and a small oblong tank. The validity of the method was established by comparing the TLC prone (tank) method against three hydrostatic weighing methods administered in a pool. The three methods included residual volume seated, TLC seated and TLC prone. Eighty male and female subjects were underwater weighed using each of the four methods. Validity coefficients for per cent body fat between the TLC prone (tank) method and the RV seated (pool), TLC seated (pool) and TLC prone (pool) methods were .98, .99 and .99, respectively. A randomised complete block ANOVA found significant differences between the RV seated (pool) method and each of the three TLC methods with respect to both body density and per cent body fat. The differences were negligible with respect to HW error. Reliability of the TLC prone (tank) method was established by weighing twenty subjects three different times with ten-minute time intervals between testing. Multiple correlations yielded reliability coefficients for body density and per cent body fat values of .99 and .99, respectively. It was concluded that the TLC prone (tank) method is valid, reliable and a favourable method of hydrostatic weighing.

Schizophrenia Spectrum Disorders Show Reduced Specificity and Less Positive Events in Mental Time Travel

PubMed Central

Chen, Xing-jie; Liu, Lu-lu; Cui, Ji-fang; Wang, Ya; Chen, An-tao; Li, Feng-hua; Wang, Wei-hong; Zheng, Han-feng; Gan, Ming-yuan; Li, Chun-qiu; Shum, David H. K.; Chan, Raymond C. K.

2016-01-01

Mental time travel refers to the ability to recall past events and to imagine possible future events. Schizophrenia (SCZ) patients have problems in remembering specific personal experiences in the past and imagining what will happen in the future. This study aimed to examine episodic past and future thinking in SCZ spectrum disorders including SCZ patients and individuals with schizotypal personality disorder (SPD) proneness who are at risk for developing SCZ. Thirty-two SCZ patients, 30 SPD proneness individuals, and 33 healthy controls participated in the study. The Sentence Completion for Events from the Past Test (SCEPT) and the Sentence Completion for Events in the Future Test were used to measure past and future thinking abilities. Results showed that SCZ patients showed significantly reduced specificity in recalling past and imagining future events, they generated less proportion of specific and extended events compared to healthy controls. SPD proneness individuals only generated less extended events compared to healthy controls. The reduced specificity was mainly manifested in imagining future events. Both SCZ patients and SPD proneness individuals generated less positive events than controls. These results suggest that mental time travel impairments in SCZ spectrum disorders and have implications for understanding their cognitive and emotional deficits. PMID:27507958

Presence of a consensus DNA motif at nearby DNA sequence of the mutation susceptible CG nucleotides.

PubMed

Chowdhury, Kaushik; Kumar, Suresh; Sharma, Tanu; Sharma, Ankit; Bhagat, Meenakshi; Kamai, Asangla; Ford, Bridget M; Asthana, Shailendra; Mandal, Chandi C

2018-01-10

Complexity in tissues affected by cancer arises from somatic mutations and epigenetic modifications in the genome. The mutation susceptible hotspots present within the genome indicate a non-random nature and/or a position specific selection of mutation. An association exists between the occurrence of mutations and epigenetic DNA methylation. This study is primarily aimed at determining mutation status, and identifying a signature for predicting mutation prone zones of tumor suppressor (TS) genes. Nearby sequences from the top five positions having a higher mutation frequency in each gene of 42 TS genes were selected from a cosmic database and were considered as mutation prone zones. The conserved motifs present in the mutation prone DNA fragments were identified. Molecular docking studies were done to determine putative interactions between the identified conserved motifs and enzyme methyltransferase DNMT1. Collective analysis of 42 TS genes found GC as the most commonly replaced and AT as the most commonly formed residues after mutation. Analysis of the top 5 mutated positions of each gene (210 DNA segments for 42 TS genes) identified that CG nucleotides of the amino acid codons (e.g., Arginine) are most susceptible to mutation, and found a consensus DNA "T/AGC/GAGGA/TG" sequence present in these mutation prone DNA segments. Similar to TS genes, analysis of 54 oncogenes not only found CG nucleotides of the amino acid Arg as the most susceptible to mutation, but also identified the presence of similar consensus DNA motifs in the mutation prone DNA fragments (270 DNA segments for 54 oncogenes) of oncogenes. Docking studies depicted that, upon binding of DNMT1 methylates to this consensus DNA motif (C residues of CpG islands), mutation was likely to occur. Thus, this study proposes that DNMT1 mediated methylation in chromosomal DNA may decrease if a foreign DNA segment containing this consensus sequence along with CG nucleotides is exogenously introduced to dividing cancer cells. Copyright © 2017 Elsevier B.V. All rights reserved.

The current epidemiology of SIDS in Ireland.

PubMed

Mehanni, M; Cullen, A; Kiberd, B; McDonnell, M; O'Regan, M; Matthews, T

2000-12-01

This paper examines some epidemiological factors associated with SIDS to give a general profile of SIDS cases occurring in Ireland between the years 1993 to 1997. There has been a dramatic decrease in the incidence of the Sudden Infant Death Syndrome (SIDS) in the Republic of Ireland in the last decade from an average rate of 2.2/1000 live-births in the 1980s to 0.8/1000 live-births in the years 1993-1997, a decrease of 100 deaths a year. The fall in the SIDS rate has been seen in many countries and is felt to be associated with Reduce The Risks (RTR) of SIDS campaigns and the avoidance of the prone sleeping position. The use of the prone sleep position averaged at 6% of children being put prone in the years 1993-1997 but the prone position has progressively decreased from 13% of children being put prone in 1994 to only 2% in 1997. The profile of the Irish SIDS cases is similar to that of SIDS cases in other countries following similar RTR campaigns with a male predominance, the characteristic clustering of deaths in the first six months of life and the majority of cases (75%) occuring in the night sleep period. The loss of the seasonal variation of the time of death is also shown and factors such as lower socio-economic status, unemployment and medical card eligibility were seen in higher proportions in SIDS families than in the general population. A high percentage of SIDS mothers smoked (73%). Higher smoking rates were seen among younger and single mothers and smoking rates were inversely related to educational level and socioeconomic grouping. An urgent question that needs to be addressed is how socioeconomic disadvantage increases the SIDS risk and what factors influence socioeconomically disadvantaged families to adopt life style and parenting practices such as smoking that influence their children's health.

Effect of a pelvic wedge and belt on the medial and lateral hamstring muscles during knee flexion.

PubMed

Yoo, Won-Gyu

2017-01-01

[Purpose] This study developed a pelvic wedge and belt and investigated their effects on the selective activation of medial and lateral hamstring muscles during knee flexion. [Subjects and Methods] Nine adults were enrolled. The participants performed exercises without and with the pelvic wedge and belt, and the electromyographic activities of the medial and lateral hamstring muscles were recorded. [Results] The activity of the medial hamstring was increased significantly when using the pelvic wedge and belt, while the activity of the lateral hamstring did not differ significantly. [Conclusion] The pelvic wedge and belt provide a self-locked position during knee flexion in the prone position. Prone knee flexion in this position is an effective self-exercise for balanced strengthening of the medial hamstring.

Effect of a pelvic wedge and belt on the medial and lateral hamstring muscles during knee flexion

PubMed Central

Yoo, Won-gyu

2017-01-01

[Purpose] This study developed a pelvic wedge and belt and investigated their effects on the selective activation of medial and lateral hamstring muscles during knee flexion. [Subjects and Methods] Nine adults were enrolled. The participants performed exercises without and with the pelvic wedge and belt, and the electromyographic activities of the medial and lateral hamstring muscles were recorded. [Results] The activity of the medial hamstring was increased significantly when using the pelvic wedge and belt, while the activity of the lateral hamstring did not differ significantly. [Conclusion] The pelvic wedge and belt provide a self-locked position during knee flexion in the prone position. Prone knee flexion in this position is an effective self-exercise for balanced strengthening of the medial hamstring. PMID:28210048

Images of Africa: A Case Study of Pre-Service Candidates' Perceptions of Teaching Africa

ERIC Educational Resources Information Center

Kim, Hannah

2017-01-01

As much as the history and study of Africa have been incorporated into social studies curricula, Africa is still a region that is prone to misperceptions and misconceptions. Social studies teachers could provide students with an alternative image, but what if they only perpetuate misperceptions of Africa? This case study examines preservice…

Shame and Guilt-Proneness in Adolescents: Gene-Environment Interactions

PubMed Central

Szentágotai-Tătar, Aurora; Chiș, Adina; Vulturar, Romana; Dobrean, Anca; Cândea, Diana Mirela; Miu, Andrei C.

2015-01-01

Rooted in people’s preoccupation with how they are perceived and evaluated, shame and guilt are self-conscious emotions that play adaptive roles in social behavior, but can also contribute to psychopathology when dysregulated. Shame and guilt-proneness develop during childhood and adolescence, and are influenced by genetic and environmental factors that are little known to date. This study investigated the effects of early traumatic events and functional polymorphisms in the brain-derived neurotrophic factor (BDNF) gene and the serotonin transporter gene promoter (5-HTTLPR) on shame and guilt in adolescents. A sample of N = 271 healthy adolescents between 14 and 17 years of age filled in measures of early traumatic events and proneness to shame and guilt, and were genotyped for the BDNF Val66Met and 5-HTTLPR polymorphisms. Results of moderator analyses indicated that trauma intensity was positively associated with guilt-proneness only in carriers of the low-expressing Met allele of BDNF Val66Met. This is the first study that identifies a gene-environment interaction that significantly contributes to guilt proneness in adolescents, with potential implications for developmental psychopathology. PMID:26230319

Shame and Guilt-Proneness in Adolescents: Gene-Environment Interactions.

PubMed

Szentágotai-Tătar, Aurora; Chiș, Adina; Vulturar, Romana; Dobrean, Anca; Cândea, Diana Mirela; Miu, Andrei C

2015-01-01

Rooted in people's preoccupation with how they are perceived and evaluated, shame and guilt are self-conscious emotions that play adaptive roles in social behavior, but can also contribute to psychopathology when dysregulated. Shame and guilt-proneness develop during childhood and adolescence, and are influenced by genetic and environmental factors that are little known to date. This study investigated the effects of early traumatic events and functional polymorphisms in the brain-derived neurotrophic factor (BDNF) gene and the serotonin transporter gene promoter (5-HTTLPR) on shame and guilt in adolescents. A sample of N = 271 healthy adolescents between 14 and 17 years of age filled in measures of early traumatic events and proneness to shame and guilt, and were genotyped for the BDNF Val66Met and 5-HTTLPR polymorphisms. Results of moderator analyses indicated that trauma intensity was positively associated with guilt-proneness only in carriers of the low-expressing Met allele of BDNF Val66Met. This is the first study that identifies a gene-environment interaction that significantly contributes to guilt proneness in adolescents, with potential implications for developmental psychopathology.

RGB-to-RGBG conversion algorithm with adaptive weighting factors based on edge detection and minimal square error.

PubMed

Huang, Chengqiang; Yang, Youchang; Wu, Bo; Yu, Weize

2018-06-01

The sub-pixel arrangement of the RGBG panel and the image with RGB format are different and the algorithm that converts RGB to RGBG is urgently needed to display an image with RGB arrangement on the RGBG panel. However, the information loss is still large although color fringing artifacts are weakened in the published papers that study this conversion. In this paper, an RGB-to-RGBG conversion algorithm with adaptive weighting factors based on edge detection and minimal square error (EDMSE) is proposed. The main points of innovation include the following: (1) the edge detection is first proposed to distinguish image details with serious color fringing artifacts and image details which are prone to be lost in the process of RGB-RGBG conversion; (2) for image details with serious color fringing artifacts, the weighting factor 0.5 is applied to weaken the color fringing artifacts; and (3) for image details that are prone to be lost in the process of RGB-RGBG conversion, a special mechanism to minimize square error is proposed. The experiment shows that the color fringing artifacts are slightly improved by EDMSE, and the values of MSE of the image processed are 19.6% and 7% smaller than those of the image processed by the direct assignment and weighting factor algorithm, respectively. The proposed algorithm is implemented on a field programmable gate array to enable the image display on the RGBG panel.

Reducing 4D CT artifacts using optimized sorting based on anatomic similarity.

PubMed

Johnston, Eric; Diehn, Maximilian; Murphy, James D; Loo, Billy W; Maxim, Peter G

2011-05-01

Four-dimensional (4D) computed tomography (CT) has been widely used as a tool to characterize respiratory motion in radiotherapy. The two most commonly used 4D CT algorithms sort images by the associated respiratory phase or displacement into a predefined number of bins, and are prone to image artifacts at transitions between bed positions. The purpose of this work is to demonstrate a method of reducing motion artifacts in 4D CT by incorporating anatomic similarity into phase or displacement based sorting protocols. Ten patient datasets were retrospectively sorted using both the displacement and phase based sorting algorithms. Conventional sorting methods allow selection of only the nearest-neighbor image in time or displacement within each bin. In our method, for each bed position either the displacement or the phase defines the center of a bin range about which several candidate images are selected. The two dimensional correlation coefficients between slices bordering the interface between adjacent couch positions are then calculated for all candidate pairings. Two slices have a high correlation if they are anatomically similar. Candidates from each bin are then selected to maximize the slice correlation over the entire data set using the Dijkstra's shortest path algorithm. To assess the reduction of artifacts, two thoracic radiation oncologists independently compared the resorted 4D datasets pairwise with conventionally sorted datasets, blinded to the sorting method, to choose which had the least motion artifacts. Agreement between reviewers was evaluated using the weighted kappa score. Anatomically based image selection resulted in 4D CT datasets with significantly reduced motion artifacts with both displacement (P = 0.0063) and phase sorting (P = 0.00022). There was good agreement between the two reviewers, with complete agreement 34 times and complete disagreement 6 times. Optimized sorting using anatomic similarity significantly reduces 4D CT motion artifacts compared to conventional phase or displacement based sorting. This improved sorting algorithm is a straightforward extension of the two most common 4D CT sorting algorithms.

Alcohol Use, Depressive Symptoms, and Impulsivity as Risk Factors for Suicide Proneness among College Students

PubMed Central

Dvorak, Robert D.; Lamis, Dorian A.; Malone, Patrick S.

2013-01-01

BACKGROUND Alcohol use, depression, and suicide are significant public health problems, particularly among college students. Impulsivity is associated with all of these factors. Additionally, impulsivity increases the effects of negative mood and alcohol use on maladaptive behavior. METHODS The current cross-sectional study examined the association between the four-factor model of impulsivity (urgency, (lack of) perseverance, (lack of) premeditation, and sensation seeking), depressive symptoms, and alcohol use as predictors of suicide proneness among college students. Participants (n =1100) completed online assessments of demographics, impulsivity, depressive symptoms, and suicide proneness. RESULTS All predictors were positively related to suicide proneness. The relation between depressive symptoms and suicide proneness was moderated by (lack of) perseverance, alcohol use, and joint interactions of urgency × alcohol use and sensation seeking × alcohol use. Despite some paradoxical findings regarding the depressive symptoms-suicide proneness relation when only one risk factor was elevated, the average level of suicide proneness increased as risk factors increased. LIMITATIONS This cross-sectional self-report data comes from a non-clinical sample of college students from a homogeneous background, limiting generalizability and causal predictions. CONCLUSIONS Overall, these findings indicate that the association between depressive symptoms and suicide proneness varies considerably by different facets of impulsivity and alcohol use. The results suggest that clinical risk-assessments should weigh two forms of impulsivity (urgency and sensation seeking) as particularly vital in the presence of heavy alcohol use. These findings highlight the importance of considering and exploring moderators of the mood-suicide relationship. PMID:23474093

Alcohol use, depressive symptoms, and impulsivity as risk factors for suicide proneness among college students.

PubMed

Dvorak, Robert D; Lamis, Dorian A; Malone, Patrick S

2013-07-01

Alcohol use, depression, and suicide are significant public health problems, particularly among college students. Impulsivity is associated with all of these factors. Additionally, impulsivity increases the effects of negative mood and alcohol use on maladaptive behavior. The current cross-sectional study examined the association between the four-factor model of impulsivity (urgency, (lack of) perseverance, (lack of) premeditation, and sensation seeking), depressive symptoms, and alcohol use as predictors of suicide proneness among college students. Participants (n=1100) completed online assessments of demographics, impulsivity, depressive symptoms, and suicide proneness. All predictors were positively related to suicide proneness. The relation between depressive symptoms and suicide proneness was moderated by (lack of) perseverance, alcohol use, and joint interactions of urgency×alcohol use and sensation seeking×alcohol use. Despite some paradoxical findings regarding the depressive symptoms-suicide proneness relation when only one risk factor was elevated, the average level of suicide proneness increased as risk factors increased. This cross-sectional self-report data comes from a non-clinical sample of college students from a homogeneous background, limiting generalizability and causal predictions. Overall, these findings indicate that the association between depressive symptoms and suicide proneness varies considerably by different facets of impulsivity and alcohol use. The results suggest that clinical risk-assessments should weigh two forms of impulsivity (urgency and sensation seeking) as particularly vital in the presence of heavy alcohol use. These findings highlight the importance of considering and exploring moderators of the mood-suicide relationship. Copyright © 2013 Elsevier B.V. All rights reserved.

Reproducibility of patient positioning for fractionated extracranial stereotactic radiotherapy using a double-vacuum technique.

PubMed

Nevinny-Stickel, Meinhard; Sweeney, Reinhart A; Bale, Reto J; Posch, Andrea; Auberger, Thomas; Lukas, Peter

2004-02-01

Precise reproducible patient positioning is a prerequisite for conformal fractionated radiotherapy. A fixation system based on double-vacuum technology is presented which can be used for conventional as well as hypofractionated stereotactic extracranial radiotherapy. To form the actual vacuum mattress, the patient is pressed into the mattress with a vacuum foil which can also be used for daily repositioning and fixation. A stereotactic frame can be positioned over the region of interest on an indexed base plate. Repositioning accuracy was determined by comparing daily, pretreatment, orthogonal portal images to the respective digitally reconstructed radiographs (DRRs) in ten patients with abdominal and pelvic lesions receiving extracranial fractionated (stereotactic) radiotherapy. The three-dimensional (3-D) vectors and 95% confidence intervals (CI) were calculated from the respective deviations in the three axes. Time required for initial mold production and daily repositioning was also determined. The mean 3-D repositioning error (187 fractions) was 2.5 +/- 1.1 mm. The largest single deviation (10 mm) was observed in a patient treated in prone position. Mold production took an average of 15 min (10-30 min). Repositioning times are not necessarily longer than using no positioning aid at all. The presented fixation system allows reliable, flexible and efficient patient positioning for extracranial stereotactic radiotherapy.

Reducing the Radiation Dose for CT Colonography: Effect of Low Tube Voltage and Iterative Reconstruction.

PubMed

Yamamura, Sadahiro; Oda, Seitaro; Imuta, Masanori; Utsunomiya, Daisuke; Yoshida, Morikatsu; Namimoto, Tomohiro; Yuki, Hideaki; Kidoh, Masafumi; Funama, Yoshinori; Baba, Hideo; Yamashita, Yasuyuki

2016-02-01

The purpose of this study was to assess the effect of a low-tube-voltage technique and iterative reconstruction (IR) on the radiation dose and image quality of computed tomography colonography (CTC). We studied 30 patients (14 women and 16 men; mean age, 64.5 ± 13.1 years; range, 39-90 years) with colorectal cancer referred for surgical treatment. All underwent CTC with fecal tagging under a standard 120-kVp protocol in the supine position and a 100-kVp protocol in the prone position. The 120-kVp images were reconstructed with filtered back projection (FBP). The 100-kVp images were postprocessed using FBP and a hybrid type of IR (adaptive iterative dose reduction 3D). The effective radiation dose (ED), image noise, and contrast-to-noise ratio (CNR) were compared among the three protocols. The visual image quality was scored on a four-point scale. The mean ED was significantly lower under the 100-kVp protocol than the 120-kVp protocol, resulting in a 27% radiation dose decrease (3.5 ± 2.0 vs 2.5 ± 1.5 mSv; P < .01). Image noise decreased by 48%, and the mean attenuation of tagged fluid increased from 452 to 558 HU on images acquired at 100 kVp with IR compared to that in the 120-kVp protocol; these differences were significant. The mean CNR was significantly higher under the 100 kVp with IR than the other two protocols. We found no significant differences in the visual scores for diagnostic utility between the 100 kVp with IR and the 120 kVp with FBP protocol (P = .10). Low-tube-voltage CTC reduced the radiation dose by approximately 27% while maintaining the image quality. Copyright © 2016 AUR. Published by Elsevier Inc. All rights reserved.

Abnormal TNF-alpha production in diabetes-prone BB rats: enhanced TNF-alpha expression and defective PGE2 feedback inhibition.

PubMed Central

Rothe, H; Ongören, C; Martin, S; Rösen, P; Kolb, H

1994-01-01

Upon stimulation with lipopolysaccharide (LPS), peritoneal macrophages from diabetes-prone Bio-Breeding (BB) rats secrete more tumour necrosis factor-alpha (TNF-alpha) than macrophages from diabetes-resistant BB or normal Wistar rats. Enhanced transcription was demonstrated by Northern blot analysis and at the single cell level by mRNA: RNA hybridization. Cytofluorometry analysis showed 2-4 times more plasma membrane and total cell-associated TNF-alpha in macrophages of diabetes-prone BB rats. The analysis of fluorescence intensity showed a single peak, and TNF-alpha mRNA was found in > 90% of macrophages. These findings exclude TNF hypersecretion as being due to an abnormal subfraction of cells. TNF-alpha gene hyperexpression in diabetes-prone BB rats was not due to mutations in the regulatory regions of the promoter, which could be shown by cloning and sequencing of the TNF-alpha promoter in the three rat strains. When searching for other regulatory defects we found the production of prostaglandin E2 (PGE2) in response to LPS to be up to 10 times lower in macrophages from diabetes-prone BB rats than from Wistar rats. Furthermore, BB rats macrophages required significantly higher concentrations of PGE2 for suppression of TNF-alpha secretion. We conclude that abnormal TNF-alpha production in macrophages from diabetes-prone BB rats is due to enhanced gene transcription and translation and that this is associated with defective PGE2 feedback inhibition. Images Figure 1 Figure 2 PMID:8206514

Charged-particle emission tomography

NASA Astrophysics Data System (ADS)

Ding, Yijun

Conventional charged-particle imaging techniques--such as autoradiography-- provide only two-dimensional (2D) images of thin tissue slices. To get volumetric information, images of multiple thin slices are stacked. This process is time consuming and prone to distortions, as registration of 2D images is required. We propose a direct three-dimensional (3D) autoradiography technique, which we call charged-particle emission tomography (CPET). This 3D imaging technique enables imaging of thick sections, thus increasing laboratory throughput and eliminating distortions due to registration. In CPET, molecules or cells of interest are labeled so that they emit charged particles without significant alteration of their biological function. Therefore, by imaging the source of the charged particles, one can gain information about the distribution of the molecules or cells of interest. Two special case of CPET include beta emission tomography (BET) and alpha emission tomography (alphaET), where the charged particles employed are fast electrons and alpha particles, respectively. A crucial component of CPET is the charged-particle detector. Conventional charged-particle detectors are sensitive only to the 2-D positions of the detected particles. We propose a new detector concept, which we call particle-processing detector (PPD). A PPD measures attributes of each detected particle, including location, direction of propagation, and/or the energy deposited in the detector. Reconstruction algorithms for CPET are developed, and reconstruction results from simulated data are presented for both BET and alphaET. The results show that, in addition to position, direction and energy provide valuable information for 3D reconstruction of CPET. Several designs of particle-processing detectors are described. Experimental results for one detector are discussed. With appropriate detector design and careful data analysis, it is possible to measure direction and energy, as well as position of each detected particle. The null functions of CPET with PPDs that measure different combinations of attributes are calculated through singular-value decomposition. In general, the more particle attributes are measured from each detection event, the smaller the null space of CPET is. In other words, the higher dimension the data space is, the more information about an object can be recovered from CPET.

Kernelized correlation tracking with long-term motion cues

NASA Astrophysics Data System (ADS)

Lv, Yunqiu; Liu, Kai; Cheng, Fei

2018-04-01

Robust object tracking is a challenging task in computer vision due to interruptions such as deformation, fast motion and especially, occlusion of tracked object. When occlusions occur, image data will be unreliable and is insufficient for the tracker to depict the object of interest. Therefore, most trackers are prone to fail under occlusion. In this paper, an occlusion judgement and handling method based on segmentation of the target is proposed. If the target is occluded, the speed and direction of it must be different from the objects occluding it. Hence, the value of motion features are emphasized. Considering the efficiency and robustness of Kernelized Correlation Filter Tracking (KCF), it is adopted as a pre-tracker to obtain a predicted position of the target. By analyzing long-term motion cues of objects around this position, the tracked object is labelled. Hence, occlusion could be detected easily. Experimental results suggest that our tracker achieves a favorable performance and effectively handles occlusion and drifting problems.

Towards Automated Large-Scale 3D Phenotyping of Vineyards under Field Conditions

PubMed Central

Rose, Johann Christian; Kicherer, Anna; Wieland, Markus; Klingbeil, Lasse; Töpfer, Reinhard; Kuhlmann, Heiner

2016-01-01

In viticulture, phenotypic data are traditionally collected directly in the field via visual and manual means by an experienced person. This approach is time consuming, subjective and prone to human errors. In recent years, research therefore has focused strongly on developing automated and non-invasive sensor-based methods to increase data acquisition speed, enhance measurement accuracy and objectivity and to reduce labor costs. While many 2D methods based on image processing have been proposed for field phenotyping, only a few 3D solutions are found in the literature. A track-driven vehicle consisting of a camera system, a real-time-kinematic GPS system for positioning, as well as hardware for vehicle control, image storage and acquisition is used to visually capture a whole vine row canopy with georeferenced RGB images. In the first post-processing step, these images were used within a multi-view-stereo software to reconstruct a textured 3D point cloud of the whole grapevine row. A classification algorithm is then used in the second step to automatically classify the raw point cloud data into the semantic plant components, grape bunches and canopy. In the third step, phenotypic data for the semantic objects is gathered using the classification results obtaining the quantity of grape bunches, berries and the berry diameter. PMID:27983669

Towards Automated Large-Scale 3D Phenotyping of Vineyards under Field Conditions.

PubMed

Rose, Johann Christian; Kicherer, Anna; Wieland, Markus; Klingbeil, Lasse; Töpfer, Reinhard; Kuhlmann, Heiner

2016-12-15

In viticulture, phenotypic data are traditionally collected directly in the field via visual and manual means by an experienced person. This approach is time consuming, subjective and prone to human errors. In recent years, research therefore has focused strongly on developing automated and non-invasive sensor-based methods to increase data acquisition speed, enhance measurement accuracy and objectivity and to reduce labor costs. While many 2D methods based on image processing have been proposed for field phenotyping, only a few 3D solutions are found in the literature. A track-driven vehicle consisting of a camera system, a real-time-kinematic GPS system for positioning, as well as hardware for vehicle control, image storage and acquisition is used to visually capture a whole vine row canopy with georeferenced RGB images. In the first post-processing step, these images were used within a multi-view-stereo software to reconstruct a textured 3D point cloud of the whole grapevine row. A classification algorithm is then used in the second step to automatically classify the raw point cloud data into the semantic plant components, grape bunches and canopy. In the third step, phenotypic data for the semantic objects is gathered using the classification results obtaining the quantity of grape bunches, berries and the berry diameter.

Proneness to guilt, shame, and pride in children with Autism Spectrum Disorders and neurotypical children.

PubMed

Davidson, Denise; Hilvert, Elizabeth; Misiunaite, Ieva; Giordano, Michael

2018-06-01

Self-conscious emotions (e.g., guilt, shame, and pride) are complex emotions that require self-reflection and self-evaluation, and are thought to facilitate the maintenance of societal norms and personal standards. Despite the importance of self-conscious emotions, most research has focused on basic emotion processing in children with Autism Spectrum Disorders (ASD). Therefore, in the present study, we used the Test of Self-Conscious Affect for Children (TOSCA-C) to assess proneness to, or propensity to experience, the self-conscious emotions guilt, shame, and pride in children with ASD and neurotypical children. The TOSCA-C is designed to capture a child's natural tendency to experience a given emotion across a range of everyday situations [Tangney, Stuewig, & Mashek, 2007]. We also assessed how individual characteristics contribute to the development of proneness to self-conscious emotions, including theory of mind (ToM) and ASD symptomatology. In comparison to neurotypical children, children with ASD showed less proneness to guilt, although all children showed relatively high levels of proneness to guilt. Greater ToM ability was related to more proneness to guilt and authentic pride in children with ASD. Additionally, we found that children with ASD with more severe symptomatology were more prone to hubristic pride. Our results provide evidence of differences in proneness to self-conscious emotions in children with ASD, as well as highlight important mechanisms contributing to how children with ASD may experience self-conscious emotions. Autism Res 2018,11:883-892. ©2017 International Society for Autism Research, Wiley Periodicals, Inc. This research examined proneness to guilt, shame, and pride in children with Autism Spectrum Disorders (ASD) and neurotypical children. We found that children with ASD showed less proneness to guilt than neurotypical children. Better understanding of theory of mind was related to greater proneness to guilt and pride, but only for children with ASD. These findings are important because these complex emotions are linked with both positive and negative social behaviors towards others and oneself. © 2018 International Society for Autism Research, Wiley Periodicals, Inc.

Using SAR Interferograms and Coherence Images for Object-Based Delineation of Unstable Slopes

NASA Astrophysics Data System (ADS)

Friedl, Barbara; Holbling, Daniel

2015-05-01

This study uses synthetic aperture radar (SAR) interferometric products for the semi-automated identification and delineation of unstable slopes and active landslides. Single-pair interferograms and coherence images are therefore segmented and classified in an object-based image analysis (OBIA) framework. The rule-based classification approach has been applied to landslide-prone areas located in Taiwan and Southern Germany. The semi-automatically obtained results were validated against landslide polygons derived from manual interpretation.

The child's perspective on discomfort during medical research procedures: a descriptive study.

PubMed

Staphorst, Mira S; Benninga, Marc A; Bisschoff, Margriet; Bon, Irma; Busschbach, Jan J V; Diederen, Kay; van Goudoever, Johannes B; Haarman, Eric G; Hunfeld, Joke A M; Jaddoe, Vincent V W; de Jong, Karin J M; de Jongste, Johan C; Kindermann, Angelika; Königs, Marsh; Oosterlaan, Jaap; Passchier, Jan; Pijnenburg, Mariëlle W; Reneman, Liesbeth; Ridder, Lissy de; Tamminga, Hyke G; Tiemeier, Henning W; Timman, Reinier; van de Vathorst, Suzanne

2017-08-01

The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a 'minimal discomfort' medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort. Cross-sectional descriptive study. Paediatric research at three academic hospitals. 357 children with and without illnesses (8-18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care. We measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures. Most children reported limited discomfort during the research procedures (means: 1-2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort. The findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

The child's perspective on discomfort during medical research procedures: a descriptive study

PubMed Central

Staphorst, Mira S; Benninga, Marc A; Bisschoff, Margriet; Bon, Irma; Busschbach, Jan J V; Diederen, Kay; van Goudoever, Johannes B; Haarman, Eric G; Hunfeld, Joke A M; Jaddoe, Vincent V W; de Jong, Karin J M; de Jongste, Johan C; Kindermann, Angelika; Königs, Marsh; Oosterlaan, Jaap; Passchier, Jan; Pijnenburg, Mariëlle W; Reneman, Liesbeth; de Ridder, Lissy; Tamminga, Hyke G; Tiemeier, Henning W; Timman, Reinier; van de Vathorst, Suzanne

2017-01-01

Objective The evaluation of discomfort in paediatric research is scarcely evidence-based. In this study, we make a start in describing children's self-reported discomfort during common medical research procedures and compare this with discomfort during dental check-ups which can be considered as a reference level of a ‘minimal discomfort’ medical procedure. We exploratory study whether there are associations between age, anxiety-proneness, gender, medical condition, previous experiences and discomfort. We also describe children's suggestions for reducing discomfort. Design Cross-sectional descriptive study. Setting Paediatric research at three academic hospitals. Patients 357 children with and without illnesses (8–18 years, mean=10.6 years) were enrolled: 307 from paediatric research studies and 50 from dental care. Main outcome measures We measured various generic forms of discomfort (nervousness, annoyance, pain, fright, boredom, tiredness) due to six common research procedures: buccal swabs, MRI scans, pulmonary function tests, skin prick tests, ultrasound imaging and venepunctures. Results Most children reported limited discomfort during the research procedures (means: 1–2.6 on a scale from 1 to 5). Compared with dental check-ups, buccal swab tests, skin prick tests and ultrasound imaging were less discomforting, while MRI scans, venepunctures and pulmonary function tests caused a similar degree of discomfort. 60.3% of the children suggested providing distraction by showing movies to reduce discomfort. The exploratory analyses suggested a positive association between anxiety-proneness and discomfort. Conclusions The findings of this study support the acceptability of participation of children in the studied research procedures, which stimulates evidence-based research practice. Furthermore, the present study can be considered as a first step in providing benchmarks for discomfort of procedures in paediatric research. PMID:28765130

Automated image analysis reveals the dynamic 3-dimensional organization of multi-ciliary arrays

PubMed Central

Galati, Domenico F.; Abuin, David S.; Tauber, Gabriel A.; Pham, Andrew T.; Pearson, Chad G.

2016-01-01

ABSTRACT Multi-ciliated cells (MCCs) use polarized fields of undulating cilia (ciliary array) to produce fluid flow that is essential for many biological processes. Cilia are positioned by microtubule scaffolds called basal bodies (BBs) that are arranged within a spatially complex 3-dimensional geometry (3D). Here, we develop a robust and automated computational image analysis routine to quantify 3D BB organization in the ciliate, Tetrahymena thermophila. Using this routine, we generate the first morphologically constrained 3D reconstructions of Tetrahymena cells and elucidate rules that govern the kinetics of MCC organization. We demonstrate the interplay between BB duplication and cell size expansion through the cell cycle. In mutant cells, we identify a potential BB surveillance mechanism that balances large gaps in BB spacing by increasing the frequency of closely spaced BBs in other regions of the cell. Finally, by taking advantage of a mutant predisposed to BB disorganization, we locate the spatial domains that are most prone to disorganization by environmental stimuli. Collectively, our analyses reveal the importance of quantitative image analysis to understand the principles that guide the 3D organization of MCCs. PMID:26700722

Are infants with torticollis at risk of a delay in early motor milestones compared with a control group of healthy infants?

PubMed

Ohman, Anna; Nilsson, Staffan; Lagerkvist, Anna-Lena; Beckung, Eva

2009-07-01

Recently it has been claimed that infants with congenital muscular torticollis (CMT) are at risk of a delay in early motor milestones. The aim of the present study was to investigate whether infants with CMT are indeed at risk in comparison with a control group of healthy infants. A second aim was to investigate whether the time spent in a prone position and plagiocephaly had any influence on motor development. Eighty-two infants with CMT (35 females and 47 males) were compared with 40 healthy infants (18 females and 22 males). Motor development was assessed with the Alberta Infant Motor scale (AIMS). Multiple regression showed that infants in the CMT group had a significantly lower AIMS score than the control group at 2 months (p=0.03) and 6 months of age (p=0.05). Infants who spent at least three occasions daily in a prone position when awake had significantly higher AIMS scores than infants who spent less time prone at 2 months (p=0.001), 6 months (p<0.001), and 10 months of age (p<0.001). The CMT group achieved early motor milestones significantly later than the control group until the age of 10 months, but the risk of delay seems to be more strongly associated with little or no time prone when awake than with CMT.

Changes in cardiac index and blood pressure on positioning children prone for scoliosis surgery.

PubMed

Brown, Z E; Görges, M; Cooke, E; Malherbe, S; Dumont, G A; Ansermino, J M

2013-07-01

In this prospective observational study we investigated the changes in cardiac index and mean arterial pressure in children when positioned prone for scoliosis correction surgery. Thirty children (ASA 1-2, aged 13-18 years) undergoing primary, idiopathic scoliosis repair were recruited. The cardiac index and mean arterial blood pressure (median (IQR [range])) were 2.7 (2.3-3.1 [1.4-3.7]) l.min(-1).m(-2) and 73 (66-80 [54-91]) mmHg, respectively, at baseline; 2.9 (2.5-3.2 [1.7-4.4]) l.min(-1).m(-2) and 73 (63-81 [51-96]) mmHg following a 5-ml.kg(-1) fluid bolus; and 2.5 (2.2-2.7 [1.4-4.8]) l.min(-1).m(-2) and 69 (62-73 [46-85]) mmHg immediately after turning prone. Turning prone resulted in a median reduction in cardiac index of 0.5 l.min(-1).m(-2) (95% CI 0.3-0.7 l.min(-1).m(-2), p=0.001), or 18.5%, with a large degree of inter-subject variability (+10.3% to -40.9%). The changes in mean arterial blood pressure were not significant. Strategies to predict, prevent and treat decreases in cardiac index need to be developed. © 2013 The Association of Anaesthetists of Great Britain and Ireland.

A Comparison of Lumpectomy Cavity Delineations Between Use of Magnetic Resonance Imaging and Computed Tomography Acquired With Patient in Prone Position for Radiation Therapy Planning of Breast Cancer

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

Huang, Wei; Department of Radiation Oncology, Shandong's Key Laboratory of Radiation Oncology, Shandong Cancer Hospital and Institute, Jinan; Currey, Adam

2016-03-15

Purpose: To compare lumpectomy cavity (LC) and planning target volume (PTV) delineated with the use of magnetic resonance imaging (MRI) and computed tomography (CT) and to examine the possibility of replacing CT with MRI for radiation therapy (RT) planning for breast cancer. Methods and Materials: MRI and CT data were acquired for 15 patients with early-stage breast cancer undergoing lumpectomy during RT simulation in prone positions, the same as their RT treatment positions. The LCs were delineated manually on both CT (LC-CT) and MRI acquired with 4 sequences: T1, T2, STIR, and DCE. Various PTVs were created by expanding amore » 15-mm margin from the corresponding LCs and from the union of the LCs for the 4 MRI sequences (PTV-MRI). Differences were measured in terms of cavity visualization score (CVS) and dice coefficient (DC). Results: The mean CVSs for T1, T2, STIR, DCE, and CT defined LCs were 3.47, 3.47, 3.87, 3.50. and 2.60, respectively, implying that the LC is mostly visible with a STIR sequence. The mean reductions of LCs from those for CT were 22%, 43%, 36%, and 17% for T1, T2, STIR, and DCE, respectively. In 14 of 15 cases, MRI (union of T1, T2, STIR, and DCE) defined LC included extra regions that would not be visible from CT. The DCs between CT and MRI (union of T1, T2, STIR, and DCE) defined volumes were 0.65 ± 0.20 for LCs and 0.85 ± 0.06 for PTVs. There was no obvious difference between the volumes of PTV-MRI and PTV-CT, and the average PTV-STIR/PTV-CT volume ratio was 0.83 ± 0.23. Conclusions: The use of MRI improves the visibility of LC in comparison with CT. The volumes of LC and PTV generated based on a MRI sequence are substantially smaller than those based on CT, and the PTV-MRI volumes, defined by the union of T1, T2, STIR, and DCE, were comparable with those of PTV-CT for most of the cases studied.« less

Alcohol-Related Problems and Risk for Suicide among College Students: The Mediating Roles of Belongingness and Burdensomeness

PubMed Central

Lamis, Dorian A.; Malone, Patrick S.

2012-01-01

This study examined the relations among alcohol-related problems, perceived burdensomeness, thwarted belongingness, and suicide proneness in undergraduate college students (N = 996). As hypothesized, alcohol-related problems, perceived burdensomeness, and thwarted belongingness were all significantly and positively correlated with suicide proneness. The relation between experiencing alcohol-related problems and suicide proneness was, in part, accounted for by perceived burdensomeness and thwarted belongingness. Additionally, the mediation via perceived burdensomeness was significantly stronger than the mediation via thwarted belongingness. Results suggest that it would be advisable for clinicians to be aware of students’ experiences with alcohol-related problems in conjunction with their levels of burdensomeness and belongingness when assessing for suicide risk PMID:21883409

The prone bridge test: Performance, validity, and reliability among older and younger adults.

PubMed

Bohannon, Richard W; Steffl, Michal; Glenney, Susan S; Green, Michelle; Cashwell, Leah; Prajerova, Kveta; Bunn, Jennifer

2018-04-01

The prone bridge maneuver, or plank, has been viewed as a potential alternative to curl-ups for assessing trunk muscle performance. The purpose of this study was to assess prone bridge test performance, validity, and reliability among younger and older adults. Sixty younger (20-35 years old) and 60 older (60-79 years old) participants completed this study. Groups were evenly divided by sex. Participants completed surveys regarding physical activity and abdominal exercise participation. Height, weight, body mass index (BMI), and waist circumference were measured. On two occasions, 5-9 days apart, participants held a prone bridge until volitional exhaustion or until repeated technique failure. Validity was examined using data from the first session: convergent validity by calculating correlations between survey responses, anthropometrics, and prone bridge time, known groups validity by using an ANOVA comparing bridge times of younger and older adults and of men and women. Test-retest reliability was examined by using a paired t-test to compare prone bridge times for Session1 and Session 2. Furthermore, an intraclass correlation coefficient (ICC) was used to characterize relative reliability and minimal detectable change (MDC 95% ) was used to describe absolute reliability. The mean prone bridge time was 145.3 ± 71.5 s, and was positively correlated with physical activity participation (p ≤ 0.001) and negatively correlated with BMI and waist circumference (p ≤ 0.003). Younger participants had significantly longer plank times than older participants (p = 0.003). The ICC between testing sessions was 0.915. The prone bridge test is a valid and reliable measure for evaluating abdominal performance in both younger and older adults. Copyright © 2017 Elsevier Ltd. All rights reserved.

High-performance serial block-face SEM of nonconductive biological samples enabled by focal gas injection-based charge compensation.

PubMed

Deerinck, T J; Shone, T M; Bushong, E A; Ramachandra, R; Peltier, S T; Ellisman, M H

2018-05-01

A longstanding limitation of imaging with serial block-face scanning electron microscopy is specimen surface charging. This charging is largely due to the difficulties in making biological specimens and the resins in which they are embedded sufficiently conductive. Local accumulation of charge on the specimen surface can result in poor image quality and distortions. Even minor charging can lead to misalignments between sequential images of the block-face due to image jitter. Typically, variable-pressure SEM is used to reduce specimen charging, but this results in a significant reduction to spatial resolution, signal-to-noise ratio and overall image quality. Here we show the development and application of a simple system that effectively mitigates specimen charging by using focal gas injection of nitrogen over the sample block-face during imaging. A standard gas injection valve is paired with a precisely positioned but retractable application nozzle, which is mechanically coupled to the reciprocating action of the serial block-face ultramicrotome. This system enables the application of nitrogen gas precisely over the block-face during imaging while allowing the specimen chamber to be maintained under high vacuum to maximise achievable SEM image resolution. The action of the ultramicrotome drives the nozzle retraction, automatically moving it away from the specimen area during the cutting cycle of the knife. The device described was added to a Gatan 3View system with minimal modifications, allowing high-resolution block-face imaging of even the most charge prone of epoxy-embedded biological samples. © 2017 The Authors Journal of Microscopy © 2017 Royal Microscopical Society.

Improving In Vivo High-Resolution CT Imaging of the Tumour Vasculature in Xenograft Mouse Models through Reduction of Motion and Bone-Streak Artefacts

PubMed Central

Kersemans, Veerle; Kannan, Pavitra; Beech, John S.; Bates, Russell; Irving, Benjamin; Gilchrist, Stuart; Allen, Philip D.; Thompson, James; Kinchesh, Paul; Casteleyn, Christophe; Schnabel, Julia; Partridge, Mike; Muschel, Ruth J.; Smart, Sean C.

2015-01-01

Introduction Preclinical in vivo CT is commonly used to visualise vessels at a macroscopic scale. However, it is prone to many artefacts which can degrade the quality of CT images significantly. Although some artefacts can be partially corrected for during image processing, they are best avoided during acquisition. Here, a novel imaging cradle and tumour holder was designed to maximise CT resolution. This approach was used to improve preclinical in vivo imaging of the tumour vasculature. Procedures A custom built cradle containing a tumour holder was developed and fix-mounted to the CT system gantry to avoid artefacts arising from scanner vibrations and out-of-field sample positioning. The tumour holder separated the tumour from bones along the axis of rotation of the CT scanner to avoid bone-streaking. It also kept the tumour stationary and insensitive to respiratory motion. System performance was evaluated in terms of tumour immobilisation and reduction of motion and bone artefacts. Pre- and post-contrast CT followed by sequential DCE-MRI of the tumour vasculature in xenograft transplanted mice was performed to confirm vessel patency and demonstrate the multimodal capacity of the new cradle. Vessel characteristics such as diameter, and branching were quantified. Results Image artefacts originating from bones and out-of-field sample positioning were avoided whilst those resulting from motions were reduced significantly, thereby maximising the resolution that can be achieved with CT imaging in vivo. Tumour vessels ≥ 77 μm could be resolved and blood flow to the tumour remained functional. The diameter of each tumour vessel was determined and plotted as histograms and vessel branching maps were created. Multimodal imaging using this cradle assembly was preserved and demonstrated. Conclusions The presented imaging workflow minimised image artefacts arising from scanner induced vibrations, respiratory motion and radiopaque structures and enabled in vivo CT imaging and quantitative analysis of the tumour vasculature at higher resolution than was possible before. Moreover, it can be applied in a multimodal setting, therefore combining anatomical and dynamic information. PMID:26046526

THE DIAGNOSTIC ACCURACY OF THE LEVER SIGN FOR DETECTING ANTERIOR CRUCIATE LIGAMENT INJURY

PubMed Central

Anderson, Amanda; Watson, Seth; Dimeff, Robert J.

2017-01-01

Background An alternative physical examination procedure for evaluating the integrity of the anterior cruciate ligament (ACL) has been proposed in the literature but has not been validated in a broad population of patients with a symptomatic complaint of knee pain for its diagnostic value. Purpose To investigate the diagnostic accuracy of the Lever Sign to detect ACL tears and compare the results to Lachman testing in both supine and prone positions. Study design Prospective, blinded, diagnostic accuracy study. Methods Sixty-two consecutive patients with a complaint of knee pain were independently evaluated for the status of the ACL's integrity with the Lever Sign and the Lachman test in a prone and supine by a blinded examiner before any other diagnostic assessments were completed. Results Twenty-four of the 60 patients included in the analysis had a torn ACL resulting in a prevalence of 40%. The sensitivity of the Lever Sign, prone, and supine Lachman tests were 38, 83, and 67 % respectively and the specificity was 72, 89, and 97% resulting in positive likelihood ratios of 1.4, 7.5, and 24 and negative likelihood ratios of 0.86, 0.19, and 0.34 respectively. The positive predictive values were 47, 83, and 94% and the negative predictive values were 63, 89, and 81% respectively. The diagnostic odds ratios were 1.6, 40, and 70 with a number needed to diagnose of 10.3, 1.4, and 1.6 respectively. Conclusions The results of this study suggest that Lever Sign, in isolation, does not accurately detect the status of the ACL. During the clinical examination, the Lever Sign should be used as an adjunct to the gold standard assessment technique of anterior tibial translation assessment as employed in the Lachman tests in either prone or supine position. Level of Evidence 2 PMID:29234557

Statistical approaches to account for false-positive errors in environmental DNA samples.

PubMed

Lahoz-Monfort, José J; Guillera-Arroita, Gurutzeta; Tingley, Reid

2016-05-01

Environmental DNA (eDNA) sampling is prone to both false-positive and false-negative errors. We review statistical methods to account for such errors in the analysis of eDNA data and use simulations to compare the performance of different modelling approaches. Our simulations illustrate that even low false-positive rates can produce biased estimates of occupancy and detectability. We further show that removing or classifying single PCR detections in an ad hoc manner under the suspicion that such records represent false positives, as sometimes advocated in the eDNA literature, also results in biased estimation of occupancy, detectability and false-positive rates. We advocate alternative approaches to account for false-positive errors that rely on prior information, or the collection of ancillary detection data at a subset of sites using a sampling method that is not prone to false-positive errors. We illustrate the advantages of these approaches over ad hoc classifications of detections and provide practical advice and code for fitting these models in maximum likelihood and Bayesian frameworks. Given the severe bias induced by false-negative and false-positive errors, the methods presented here should be more routinely adopted in eDNA studies. © 2015 John Wiley & Sons Ltd.

Quantitative metrics for evaluating parallel acquisition techniques in diffusion tensor imaging at 3 Tesla.

PubMed

Ardekani, Siamak; Selva, Luis; Sayre, James; Sinha, Usha

2006-11-01

Single-shot echo-planar based diffusion tensor imaging is prone to geometric and intensity distortions. Parallel imaging is a means of reducing these distortions while preserving spatial resolution. A quantitative comparison at 3 T of parallel imaging for diffusion tensor images (DTI) using k-space (generalized auto-calibrating partially parallel acquisitions; GRAPPA) and image domain (sensitivity encoding; SENSE) reconstructions at different acceleration factors, R, is reported here. Images were evaluated using 8 human subjects with repeated scans for 2 subjects to estimate reproducibility. Mutual information (MI) was used to assess the global changes in geometric distortions. The effects of parallel imaging techniques on random noise and reconstruction artifacts were evaluated by placing 26 regions of interest and computing the standard deviation of apparent diffusion coefficient and fractional anisotropy along with the error of fitting the data to the diffusion model (residual error). The larger positive values in mutual information index with increasing R values confirmed the anticipated decrease in distortions. Further, the MI index of GRAPPA sequences for a given R factor was larger than the corresponding mSENSE images. The residual error was lowest in the images acquired without parallel imaging and among the parallel reconstruction methods, the R = 2 acquisitions had the least error. The standard deviation, accuracy, and reproducibility of the apparent diffusion coefficient and fractional anisotropy in homogenous tissue regions showed that GRAPPA acquired with R = 2 had the least amount of systematic and random noise and of these, significant differences with mSENSE, R = 2 were found only for the fractional anisotropy index. Evaluation of the current implementation of parallel reconstruction algorithms identified GRAPPA acquired with R = 2 as optimal for diffusion tensor imaging.

Characterization of posture and comfort in laptop users in non-desk settings.

PubMed

Gold, J E; Driban, J B; Yingling, V R; Komaroff, E

2012-03-01

Laptop computers may be used in a variety of postures not coupled to the office workstation. Using passive motion analysis, this study examined mean joint angles during a short typing/editing task in college students (n=20), in up to seven positions. Comfort was assessed after task execution through a body map. For three required postures, joint angles in a prone posture were different than those while seated at a couch with feet either on floor or on ottoman. Specifically, the prone posture was characterized by comparatively non-neutral shoulders, elbows and wrists, and pronounced neck extension. Significantly greater intensity and more regions of discomfort were marked for the prone posture than for the seated postures. It is recommended that the prone posture only be assumed briefly during laptop use. Exposure to laptops outside of the office setting should be assessed in future epidemiologic studies of musculoskeletal complaints and computer use. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Stretching position can affect levator scapular muscle activity, length, and cervical range of motion in people with a shortened levator scapulae.

PubMed

Jeong, Hyo-Jung; Cynn, Heon-Seock; Yi, Chung-Hwi; Yoon, Jang-Whon; Lee, Ji-Hyun; Yoon, Tae-Lim; Kim, Bo-Been

2017-07-01

Levator scapulae (LS) muscle stretching exercises are a common method of lengthening a shortened muscle; however, the appropriate stretching position for lengthening the LS in people with a shortened LS remains unclear. The purpose of this study was to compare the effects of different stretching exercise positions on the LS and introduce effective stretching exercise methods to clinicians. Twenty-four university students (12 men, 12 women) with a shortened LS were recruited. LS muscle activity, LS index (LSI), and cervical range of motion (ROM) were measured pre (baseline) and post three different stretching exercise positions (sitting, quadruped, and prone). The LSI and cervical ROM exceeded the minimal detectable change and had significant changes. The LSI was greater in the sitting position than at the baseline (p = 0.01), quadruped position (p < 0.01); the LSI in the prone position presented a higher increase than the quadruped position (p = 0.01). The cervical ROM increased in the sitting position when compared to the baseline (p < 0.01) and quadruped position (p < 0.01). Stretching the LS in the sitting position was the most effective exercise for improving LS muscle length and cervical ROM. Copyright © 2017 Elsevier Ltd. All rights reserved.

An accurate method to quantify breathing-induced prostate motion for patients implanted with electromagnetic transponders.

PubMed

Giandini, Tommaso; Panaino, Costanza M V; Avuzzi, Barbara; Morlino, Sara; Villa, Sergio; Bedini, Nice; Carabelli, Gabriele; Frasca, Sarah C; Romanyukha, Anna; Rosenfeld, Anatoly; Pignoli, Emanuele; Valdagni, Riccardo; Carrara, Mauro

2017-03-24

To validate and apply a method for the quantification of breathing-induced prostate motion (BIPM) for patients treated with radiotherapy and implanted with electromagnetic transponders for prostate localization and tracking. For the analysis of electromagnetic transponder signal, dedicated software was developed and validated with a programmable breathing simulator phantom. The software was then applied to 1,132 radiotherapy fractions of 30 patients treated in supine position, and to a further 61 fractions of 2 patients treated in prone position. Application of the software in phantom demonstrated reliability of the developed method in determining simulated breathing frequencies and amplitudes. For supine patients, the in vivo analysis of BIPM resulted in median (maximum) amplitudes of 0.10 mm (0.35 mm), 0.24 mm (0.66 mm), and 0.17 mm (0.61 mm) in the left-right (LR), cranio-caudal (CC), and anterior-posterior (AP) directions, respectively. Breathing frequency ranged between 7.73 and 29.43 breaths per minute. For prone patients, the ranges of the BIPM amplitudes were 0.1-0.5 mm, 0.5-1.3 mm, and 0.7-1.7 mm in the LR, CC, and AP directions, respectively. The developed method was able to detect the BIPM with sub-millimeter accuracy. While for patients treated in supine position the BIPM represents a reduced source of treatment uncertainty, for patients treated in prone position, it can be higher than 3 mm.

Multi-frequency time-difference complex conductivity imaging of canine and human lungs using the KHU Mark1 EIT system.

PubMed

Kuen, Jihyeon; Woo, Eung Je; Seo, Jin Keun

2009-06-01

We evaluated the performance of the lately developed electrical impedance tomography (EIT) system KHU Mark1 through time-difference imaging experiments of canine and human lungs. We derived a multi-frequency time-difference EIT (mftdEIT) image reconstruction algorithm based on the concept of the equivalent homogeneous complex conductivity. Imaging experiments were carried out at three different frequencies of 10, 50 and 100 kHz with three different postures of right lateral, sitting (or prone) and left lateral positions. For three normal canine subjects, we controlled the ventilation using a ventilator at three tidal volumes of 100, 150 and 200 ml. Three human subjects were asked to breath spontaneously at a normal tidal volume. Real- and imaginary-part images of the canine and human lungs were reconstructed at three frequencies and three postures. Images showed different stages of breathing cycles and we could interpret them based on the understanding of the proposed mftdEIT image reconstruction algorithm. Time series of images were further analyzed by using the functional EIT (fEIT) method. Images of human subjects showed the gravity effect on air distribution in two lungs. In the canine subjects, the morphological change seems to dominate the gravity effect. We could also observe that two different types of ventilation should have affected the results. The KHU Mark1 EIT system is expected to provide reliable mftdEIT images of the human lungs. In terms of the image reconstruction algorithm, it would be worthwhile including the effects of three-dimensional current flows inside the human thorax. We suggest clinical trials of the KHU Mark1 for pulmonary applications.

Motor Development of Infants with Positional Plagiocephaly

ERIC Educational Resources Information Center

Kennedy, Eileen; Majnemer, Annette; Farmer, Jean-Pierre; Barr, Ronald G.; Platt, Robert W.

2009-01-01

Concurrent with recommendations to place infants to sleep in supine, there has been a dramatic increase in the number of infants with positional plagiocephaly (PP). Recent evidence suggests that infants who have decreased exposure to prone position may have a higher incidence of PP and may be at risk for a delay in the acquisition of certain motor…

Sensing Super-Position: Human Sensing Beyond the Visual Spectrum

NASA Technical Reports Server (NTRS)

Maluf, David A.; Schipper, John F.

2007-01-01

The coming decade of fast, cheap and miniaturized electronics and sensory devices opens new pathways for the development of sophisticated equipment to overcome limitations of the human senses. This paper addresses the technical feasibility of augmenting human vision through Sensing Super-position by mixing natural Human sensing. The current implementation of the device translates visual and other passive or active sensory instruments into sounds, which become relevant when the visual resolution is insufficient for very difficult and particular sensing tasks. A successful Sensing Super-position meets many human and pilot vehicle system requirements. The system can be further developed into cheap, portable, and low power taking into account the limited capabilities of the human user as well as the typical characteristics of his dynamic environment. The system operates in real time, giving the desired information for the particular augmented sensing tasks. The Sensing Super-position device increases the image resolution perception and is obtained via an auditory representation as well as the visual representation. Auditory mapping is performed to distribute an image in time. The three-dimensional spatial brightness and multi-spectral maps of a sensed image are processed using real-time image processing techniques (e.g. histogram normalization) and transformed into a two-dimensional map of an audio signal as a function of frequency and time. This paper details the approach of developing Sensing Super-position systems as a way to augment the human vision system by exploiting the capabilities of Lie human hearing system as an additional neural input. The human hearing system is capable of learning to process and interpret extremely complicated and rapidly changing auditory patterns. The known capabilities of the human hearing system to learn and understand complicated auditory patterns provided the basic motivation for developing an image-to-sound mapping system. The human brain is superior to most existing computer systems in rapidly extracting relevant information from blurred, noisy, and redundant images. From a theoretical viewpoint, this means that the available bandwidth is not exploited in an optimal way. While image-processing techniques can manipulate, condense and focus the information (e.g., Fourier Transforms), keeping the mapping as direct and simple as possible might also reduce the risk of accidentally filtering out important clues. After all, especially a perfect non-redundant sound representation is prone to loss of relevant information in the non-perfect human hearing system. Also, a complicated non-redundant image-to-sound mapping may well be far more difficult to learn and comprehend than a straightforward mapping, while the mapping system would increase in complexity and cost. This work will demonstrate some basic information processing for optimal information capture for headmounted systems.

A hybrid segmentation approach for geographic atrophy in fundus auto-fluorescence images for diagnosis of age-related macular degeneration.

PubMed

Lee, Noah; Laine, Andrew F; Smith, R Theodore

2007-01-01

Fundus auto-fluorescence (FAF) images with hypo-fluorescence indicate geographic atrophy (GA) of the retinal pigment epithelium (RPE) in age-related macular degeneration (AMD). Manual quantification of GA is time consuming and prone to inter- and intra-observer variability. Automatic quantification is important for determining disease progression and facilitating clinical diagnosis of AMD. In this paper we describe a hybrid segmentation method for GA quantification by identifying hypo-fluorescent GA regions from other interfering retinal vessel structures. First, we employ background illumination correction exploiting a non-linear adaptive smoothing operator. Then, we use the level set framework to perform segmentation of hypo-fluorescent areas. Finally, we present an energy function combining morphological scale-space analysis with a geometric model-based approach to perform segmentation refinement of false positive hypo- fluorescent areas due to interfering retinal structures. The clinically apparent areas of hypo-fluorescence were drawn by an expert grader and compared on a pixel by pixel basis to our segmentation results. The mean sensitivity and specificity of the ROC analysis were 0.89 and 0.98%.

a Gaussian Process Based Multi-Person Interaction Model

NASA Astrophysics Data System (ADS)

Klinger, T.; Rottensteiner, F.; Heipke, C.

2016-06-01

Online multi-person tracking in image sequences is commonly guided by recursive filters, whose predictive models define the expected positions of future states. When a predictive model deviates too much from the true motion of a pedestrian, which is often the case in crowded scenes due to unpredicted accelerations, the data association is prone to fail. In this paper we propose a novel predictive model on the basis of Gaussian Process Regression. The model takes into account the motion of every tracked pedestrian in the scene and the prediction is executed with respect to the velocities of all interrelated persons. As shown by the experiments, the model is capable of yielding more plausible predictions even in the presence of mutual occlusions or missing measurements. The approach is evaluated on a publicly available benchmark and outperforms other state-of-the-art trackers.

Children who had congenital torticollis as infants are not at higher risk for a delay in motor development at preschool age.

PubMed

Öhman, Anna; Beckung, Eva

2013-10-01

To investigate whether congenital muscular torticollis (CMT) or the time in a prone position as an infant had any influence on motor development at preschool age. A case-control study. Eighty-one children who had participated in a previous study that investigated motor development in infants with CMT and a control group of infants without CMT. A follow-up at the age of 3.5-5 years; the Movement Assessment Battery for Children was used with the earlier CMT group and the control group to assess their motor development. An independent physiotherapist, who was blinded of the children's previous group belonging, assessed the children. Percentile scores of motor development. Multiple regression showed no impact on earlier group belonging or the amount of time spent in a prone position as an infant. The left-handed children had a significantly (P < .01) lower percentile in the Movement Assessment Battery for Children. Neither CMT nor spending limited periods of time as an infant in the prone position when awake have any significant long-term effects on motor development. Children who had CMT as infants were not at higher risk for a delay in motor development at preschool age. Copyright © 2013 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

An Analysis of Muscle Activities of Healthy Women during Pilates Exercises in a Prone Position.

PubMed

Kim, Bo-In; Jung, Ju-Hyeon; Shim, Jemyung; Kwon, Hae-Yeon; Kim, Haroo

2014-01-01

[Purpose] This study analyzed the activities of the back and hip muscles during Pilates exercises conducted in a prone position. [Subjects] The subjects were 18 healthy women volunteers who had practiced at a Pilates center for more than three months. [Methods] The subjects performed three Pilates exercises. To examine muscle activity during the exercises, 8-channel surface electromyography (Noraxon USA, Inc., Scottsdale, AZ) was used. The surface electrodes were attached to the bilateral latissimus dorsi muscle, multifidus muscle, gluteus maximus, and semitendinous muscle. Three Pilates back exercises were compared: (1) double leg kick (DLK), (2) swimming (SW), and (3) leg beat (LB). Electrical muscle activation was normalized to maximal voluntary isometric contraction. Repeated measures analysis of variance was performed to assess the differences in activation levels among the exercises. [Results] The activity of the multifidus muscle was significantly high for the SW (52.3±11.0, 50.9±9.8) and LB exercises(51.8±12.8, 48.3±13.9) and the activity of the semitendinosus muscle was higher for the LB exercise (49.2±8.7, 52.9±9.3) than for the DLK and SW exercises. [Conclusion] These results may provide basic material for when Pilates exercises are performed in a prone position and may be useful information on clinical Pilates for rehabilitation programs.

Magnetic Resonance Imaging and Arthroscopic Correlation in Shoulder Instability.

PubMed

Knapik, Derrick M; Voos, James E

2017-12-01

The shoulder is the most inherently unstable joint in the body, prone to high rates of anterior dislocations with subsequent injuries to soft tissue and bony stabilizing structures, resulting in recurrent shoulder instability. Advanced imaging utilizing magnetic resonance (MR) imaging and MR arthrography allows for thorough evaluation of lesions present in the unstable shoulder and is critical for preoperative planning. Arthroscopic shoulder stabilization in the appropriately selected patient can help restore stability and function. This review highlights correlations between MR imaging and arthroscopy of the most commonly reported soft tissue and bony injuries present in patients with shoulder instability.

Lung volumes and lung volume recruitment in ARDS: a comparison between supine and prone position.

PubMed

Aguirre-Bermeo, Hernan; Turella, Marta; Bitondo, Maddalena; Grandjean, Juan; Italiano, Stefano; Festa, Olimpia; Morán, Indalecio; Mancebo, Jordi

2018-02-14

The use of positive end-expiratory pressure (PEEP) and prone position (PP) is common in the management of severe acute respiratory distress syndrome patients (ARDS). We conducted this study to analyze the variation in lung volumes and PEEP-induced lung volume recruitment with the change from supine position (SP) to PP in ARDS patients. The investigation was conducted in a multidisciplinary intensive care unit. Patients who met the clinical criteria of the Berlin definition for ARDS were included. The responsible physician set basal PEEP. To avoid hypoxemia, FiO 2 was increased to 0.8 1 h before starting the protocol. End-expiratory lung volume (EELV) and functional residual capacity (FRC) were measured using the nitrogen washout/washin technique. After the procedures in SP, the patients were turned to PP and 1 h later the same procedures were made in PP. Twenty-three patients were included in the study, and twenty were analyzed. The change from SP to PP significantly increased FRC (from 965 ± 397 to 1140 ± 490 ml, p = 0.008) and EELV (from 1566 ± 476 to 1832 ± 719 ml, p = 0.008), but PEEP-induced lung volume recruitment did not significantly change (269 ± 186 ml in SP to 324 ± 188 ml in PP, p = 0.263). Dynamic strain at PEEP decreased with the change from SP to PP (0.38 ± 0.14 to 0.33 ± 0.13, p = 0.040). As compared to supine, prone position increases resting lung volumes and decreases dynamic lung strain.

Image-Based Collection and Measurements for Construction Pay Items

DOT National Transportation Integrated Search

2017-07-01

Prior to each payment to contractors and suppliers, measurements are made to document the actual amount of pay items placed at the site. This manual process has substantial risk for personnel, and could be made more efficient and less prone to human ...

Reduced vision selectively impairs spatial updating in fall-prone older adults.

PubMed

Barrett, Maeve M; Doheny, Emer P; Setti, Annalisa; Maguinness, Corrina; Foran, Timothy G; Kenny, Rose Anne; Newell, Fiona N

2013-01-01

The current study examined the role of vision in spatial updating and its potential contribution to an increased risk of falls in older adults. Spatial updating was assessed using a path integration task in fall-prone and healthy older adults. Specifically, participants conducted a triangle completion task in which they were guided along two sides of a triangular route and were then required to return, unguided, to the starting point. During the task, participants could either clearly view their surroundings (full vision) or visuo-spatial information was reduced by means of translucent goggles (reduced vision). Path integration performance was measured by calculating the distance and angular deviation from the participant's return point relative to the starting point. Gait parameters for the unguided walk were also recorded. We found equivalent performance across groups on all measures in the full vision condition. In contrast, in the reduced vision condition, where participants had to rely on interoceptive cues to spatially update their position, fall-prone older adults made significantly larger distance errors relative to healthy older adults. However, there were no other performance differences between fall-prone and healthy older adults. These findings suggest that fall-prone older adults, compared to healthy older adults, have greater difficulty in reweighting other sensory cues for spatial updating when visual information is unreliable.

Preliminary Study of Ground Movement in Prone Landslide Area by Means of MAI InSAR A Case Study: Ciloto, West Java, Indonesia

NASA Astrophysics Data System (ADS)

Hayati, Noorlaila; Riedel, Björn; Niemeier, Wolfgang

2016-04-01

Ciloto is one of the most prone landslide hazard areas in Indonesia. Several landslides in 2012 and 2013 had been recorded in Ciloto and damaged infrastructure around the area. Investigating the history of ground movement along slope area before the landslide happened could support the hazard mitigation in the future. Considering to an efficient surveying method, space-borne SAR processing is the one appropriate way to monitor the phenomenon in past years. The purpose of this study is detecting ground movement using multi-temporal synthetic aperture radar images. We use 13 ALOS PALSAR images from 2007 to 2009 with combination Fine Beam Single (FBS) and Fine Beam Double (FBD) polarization to investigate the slow movement on slope topography. MAI (Multiple Aperture Interferometry) InSAR method is used to analyze the ground movement from both line-of-sight and along-track direction. We split the synthetic aperture into two-looking aperture so that along-track displacement could be created by the difference of forward-backward looking interferograms. With integration of both methods, we could more precisely detect the movement in prone landslide area and achieve two measurements produced by the same interferogram. However, InSAR requires smaller baseline and good temporal baseline between master and slave images to avoid decorellation. There are only several pairs that meet the condition of proper length and temporal baseline indeed the location is also on the agriculture area where is mostly covered by vegetation. The result for two years observation shows that there is insignificant slow movement along slope surface in Ciloto with -2 - -7 cm in range looks or line of sight and 9-40 cm in along track direction. Based on geometry SAR , the most visible detecting of displacement is on the north-west area due to utilization of ascending SAR images.

Noninvasive imaging of brain oxygen metabolism in children with primary nocturnal enuresis during natural sleep.

PubMed

Yu, Bing; Huang, Mingzhu; Zhang, Xu; Ma, Hongwei; Peng, Miao; Guo, Qiyong

2017-05-01

A series of studies have revealed that nocturnal enuresis is closely related to hypoxia in children with primary nocturnal enuresis (PNE). However, brain oxygen metabolism of PNE children has not been investigated before. The purpose of this study was to investigate changes in whole-brain cerebral metabolic rate of oxygen (CMRO 2 ), cerebral blood flow (CBF), and oxygen extraction fraction (OEF) in children suffering from PNE. We used the newly developed T2-relaxation-under-spin-tagging (TRUST) magnetic resonance imaging technique. Neurological evaluation, structural imaging, phase-contrast, and the TRUST imaging method were applied in children with PNE (n = 37) and healthy age- and sex-matched control volunteers (n = 39) during natural sleep to assess whole-brain CMRO 2 , CBF, OEF, and arousal from sleep scores. Results showed that whole-brain CMRO 2 and OEF values of PNE children were higher in controls, while there was no significant difference in CBF. Consequently, OEF levels of PNE children were increased to maintain oxygen supply. The elevation of OEF was positively correlated with the difficulty of arousal. Our results provide the first evidence that high oxygen consumption and high OEF values could make PNE children more susceptible to hypoxia, which may induce cumulative arousal deficits and make them more prone to nocturnal enuresis. Hum Brain Mapp 38:2532-2539, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Enhancing Comparative Effectiveness Research With Automated Pediatric Pneumonia Detection in a Multi-Institutional Clinical Repository: A PHIS+ Pilot Study.

PubMed

Meystre, Stephane; Gouripeddi, Ramkiran; Tieder, Joel; Simmons, Jeffrey; Srivastava, Rajendu; Shah, Samir

2017-05-15

Community-acquired pneumonia is a leading cause of pediatric morbidity. Administrative data are often used to conduct comparative effectiveness research (CER) with sufficient sample sizes to enhance detection of important outcomes. However, such studies are prone to misclassification errors because of the variable accuracy of discharge diagnosis codes. The aim of this study was to develop an automated, scalable, and accurate method to determine the presence or absence of pneumonia in children using chest imaging reports. The multi-institutional PHIS+ clinical repository was developed to support pediatric CER by expanding an administrative database of children's hospitals with detailed clinical data. To develop a scalable approach to find patients with bacterial pneumonia more accurately, we developed a Natural Language Processing (NLP) application to extract relevant information from chest diagnostic imaging reports. Domain experts established a reference standard by manually annotating 282 reports to train and then test the NLP application. Findings of pleural effusion, pulmonary infiltrate, and pneumonia were automatically extracted from the reports and then used to automatically classify whether a report was consistent with bacterial pneumonia. Compared with the annotated diagnostic imaging reports reference standard, the most accurate implementation of machine learning algorithms in our NLP application allowed extracting relevant findings with a sensitivity of .939 and a positive predictive value of .925. It allowed classifying reports with a sensitivity of .71, a positive predictive value of .86, and a specificity of .962. When compared with each of the domain experts manually annotating these reports, the NLP application allowed for significantly higher sensitivity (.71 vs .527) and similar positive predictive value and specificity . NLP-based pneumonia information extraction of pediatric diagnostic imaging reports performed better than domain experts in this pilot study. NLP is an efficient method to extract information from a large collection of imaging reports to facilitate CER. ©Stephane Meystre, Ramkiran Gouripeddi, Joel Tieder, Jeffrey Simmons, Rajendu Srivastava, Samir Shah. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 15.05.2017.

Biopsy system guided by positron emission tomography in real-time

NASA Astrophysics Data System (ADS)

Moliner, L.; Álamo, J.; Hellingman, D.; Peris, J. L.; Gomez, J.; Tattersall, P.; Carrilero, V.; Orero, A.; Correcher, C.; Benlloch, J. M.

2016-03-01

In this work we present the MAMMOCARE prototype, a biopsy guided system based on PET. The system is composed by an examination table where the patient is situated in prone position, a PET detector and a biopsy device. The PET detector is composed by two rings. These rings can be separated mechanically in order to allow the needle insertion. The first acquisition is performed with the closed ring configuration in order to obtain a high quality image to locate the lesion. Then, the software calculates the optimum path for the biopsy and moves the biopsy and PET systems to the desired position. At this point, two compression pallets are used to hold the breast. Then, the PET system opens and the biopsy procedure starts. The images are obtained at several steps to ensure the correct location of the needle during the procedure. The performance of the system is evaluated measuring the spatial resolution and sensitivity according the NEMA standard. The uniformity of the reconstructed images is also estimated. The radial resolution is 1.62mm in the center of the FOV and 3.45mm at 50mm off the center in the radial direction using the closed configuration. In the open configuration the resolution reaches 1.85mm at center and 3.65mm at 50mm. The sensitivity using an energy window of 250keV-750keV is 3.6% for the closed configuration and 2.5% for the open configuration. The uniformity measured in the center of the FOV is 14% and 18% for the closed and open configurations respectively.

Brain structure predicts risk for obesity ☆

PubMed Central

Smucny, Jason; Cornier, Marc-Andre; Eichman, Lindsay C.; Thomas, Elizabeth A.; Bechtell, Jamie L.; Tregellas, Jason R.

2014-01-01

The neurobiology of obesity is poorly understood. Here we report findings of a study designed to examine the differences in brain regional gray matter volume in adults recruited as either Obese Prone or Obese Resistant based on self-identification, body mass index, and personal/family weight history. Magnetic resonance imaging was performed in 28 Obese Prone (14 male, 14 female) and 25 Obese Resistant (13 male, 12 female) healthy adults. Voxel-based morphometry was used to identify gray matter volume differences between groups. Gray matter volume was found to be lower in the insula, medial orbitofrontal cortex and cerebellum in Obese Prone, as compared to Obese Resistant individuals. Adjusting for body fat mass did not impact these results. Insula gray matter volume was negatively correlated with leptin concentration and measures of hunger. These findings suggest that individuals at risk for weight gain have structural differences in brain regions known to be important in energy intake regulation, and that these differences, particularly in the insula, may be related to leptin. PMID:22963736

Identifying environmental features for land management decisions

NASA Technical Reports Server (NTRS)

1983-01-01

Pairs of HCMM day-night thermal infrared (IR) data were selected to examine patterns of surface temperature and thermal inertia (TI) of peninsular Florida. GOES and NOAA-6 thermal IR, as well as National Climatic Center temperatures and rainfall, were also used. The HCMM apparent thermal inertia (ATI) images closely correspond to the General Soil Map of Florida, based on soil drainage classes. Areas with low ATI overlay well-drained soils, such as deep sands and drained organic soils. Areas with high ATI overlay areas with wetlands and bodies of water. The HCMM ATI images also correspond well with GOES-detected winter nocturnal cold-prone areas. Use of HCMM data with Carlson's energy balance model shows both high moisture availability (MA) and high thermal inertia (TI) of wetland-type surfaces and low MA and low TI of upland, well-drained soils. Since soil areas with low TI develop higher temperatures during the day, then antecedent patterns of highest maximum daytime surface temperature can also be used to predict nocturnal cold-prone areas in Florida.

SU-F-T-418: Evaluation of Organs at Risk (OAR) Sparing in Left Breast Irradiation Techniques

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

Saini, A; Hwang, C; Das, I

Purpose: To compare dose to organs at risk (OAR) for left sided breast radiation therapy with comparable planning target volume (PTV) coverage in three techniques; free breathing in supine position (FB), deep inspirational breath hold in supine (DIBH) and free breathing in prone position (PP). Methods: Ten left sided breast cancer patients suitable for this study underwent a CT scan in three techniques e.g. supine, FB and DIBH and prone position (PP). One radiation oncologist contoured the PTV and OAR (cardiac components) based on RTOG guidelines. Treatment plans were optimized using field-in-field technique with AAA algorithm. Each plan was optimizedmore » to provide identical coverage to PTV such that a reasonable comparison in OAR dosimetry can be evaluated. The prescribed dose to PTV were 42.56 Gy; 2.66 Gy in 16 fractions. Results: Average lung dose parameters; Dmean, V10, V20 and V30 were 0.5 Gy, 0.6%, 0.2%, and 0.1% respectively in PP which is significantly lower than FB (5.9 Gy, 14.2%, 10.7 %, and 8.4%) and DIBH (5.8 Gy, 14.3%, 10.2%, 7.8%). Similarly average heart Dmean, V2.5, V5, V10, and V20 were much lower in PP (1.2Gy, 9.1%, 2.1%, 0.8%, and 0.4%), and in DIBH (1.2 Gy, 10.6%, 1.7%, 0.5%, and 0.1%) compared to FB (2.6 Gy, 21%, 7.2%, 4.4% and 3.3%) respectively. Similar findings were also noted in the heart component left anterior descending artery (LAD) and Left ventricle (LV) which are correlated to radiation related toxicity. Conclusion: Based on the calculated dose, FB technique provides highest heart and lung dose. Prone has lowest lung dose, and DIBH has lowest LAD dose. It is found that PP is always superior for heart, LV, LAD and lung as compared to FB. This conclusion is in contrast to some published study concluding that prone position has no benefit for heart sparing.« less

SU-E-T-217: Comprehensive Dosimetric Evaluation On 3D-CRT, IMRT and Non-Coplanar Arc Treatment for Prone Accelerated Partial Breast Irradiation (APBI)

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

Chiu, T; Yan, Y; Ramirez, E

2015-06-15

Purpose: Accelerated partial breast irradiation (APBI) is an effective treatment for early stage breast-cancer. Irradiation in a prone position can mitigate breast motion and spare heart and lung. In this study, a comprehensive study is performed to evaluate various treatment techniques for prone APBI treatment including: 3D-CRT, IMRT, co-planar and non-coplanar partial arcs treatment. Methods: In this treatment planning study, a left breast patient treated in prone position in our clinic was imported into Varian Eclipse TPS. Six beams tangential to chest wall were used in both 3D-CRT and IMRT plans. These six beams were coplanar in a transactional planemore » achieved by both gantry and couch rotation. A 60-beam IMRT plan was also created to explore the maximum benefit of co-planar IMRT. Within deliverable couch rotation range (±30°), partial arc treatment plans with one and up to ten couch positions were generated for comparison. For each plan, 30Gy in 6 fractions was prescribed to 95% PTV volume. Critical dosimetric parameters, such as conformity index, mean, maximum, and volume dose of organ at risk, are evaluated. Results: The conformity indexes (CI) are 3.53, 3.17, 2.21 and 1.08 respectively to 3D-CRT, 6-beam IMRT, 60-beam IMRT, and two-partial-arcs coplanar plans. However, arc plans increase heart dose. CI for non-coplanar arc plans decreases from 1.19 to 1.10 when increases couch positions. Maximum dose in ipsilateral lung (1.98 to 1.13 Gy), and heart (0.62 to 0.43 Gy) are steadily decreased with the increased number of non-coplanar arcs. Conclusions: The dosimetric evaluation results show that partial arc plans have improved CIs compared to conventional 3D-CRT and IMRT plans. Increasing number of partial arcs decreases lung and heart dose. The dosimetric benefit obtained from non-coplanar arcs should be considered with treatment delivery time.« less

Shame and Guilt and Their Relationship to Positive Expectations and Anger Expressiveness.

ERIC Educational Resources Information Center

Lutwak, Nita; Panish, Jacqueline B.; Ferrari, Joseph R.; Razzino, Brian E.

2001-01-01

Theories regarding expressions of hostility and anger, and expectations of success were tested with college students (174 females, 91 males). Significant gender differences were found in proneness for shame and guilt in females. Guilt-proness was negatively related to outward anger but positively related to anger control. Guilt-proness was also…

Mobility and Human Factors Evaluation of Three Prototype Assault Snowshoes.

DTIC Science & Technology

1994-01-01

toe of snowshoe beats shins (bruised) when running (3) Snowshoe tails strike your back when falling in prone position (n) - Number of subjects who...user’s boot and cradle his forefoot in the proper position. This feature worked adequately with the vapor barrier boot but was not compatible with the

Toddlers' Temperament Profiles: Stability and Relations to Negative and Positive Parenting

ERIC Educational Resources Information Center

van den Akker, Alithe L.; Dekovic, Maja; Prinzie, Peter; Asscher, Jessica J.

2010-01-01

This study investigated the type and stability of temperament profiles in toddlers, and relations of profile probability to negative and positive parenting trajectories. Mothers (N = 96) rated their child's (41 girls and 54 boys) Sociability, Anger Proneness, and Activity Level four times during 1 year. The assessment of parenting included both…

Divergent Effects of Different Positive Emotions on Moral Judgment

ERIC Educational Resources Information Center

Strohminger, Nina; Lewis, Richard L.; Meyer, David E.

2011-01-01

Positive emotions are often treated as relatively similar in their cognitive-behavioral effects, and as having unambiguously beneficial consequences. For example, Valdesolo and DeSteno (2006) reported that a humorous video made people more prone to choose a utilitarian solution to a moral dilemma. They attributed this finding to increased positive…

Preliminary study of copper oxide nanoparticles acoustic and magnetic properties for medical imaging

NASA Astrophysics Data System (ADS)

Perlman, Or; Weitz, Iris S.; Azhari, Haim

2015-03-01

The implementation of multimodal imaging in medicine is highly beneficial as different physical properties may provide complementary information, augmented detection ability, and diagnosis verification. Nanoparticles have been recently used as contrast agents for various imaging modalities. Their significant advantage over conventional large-scale contrast agents is the ability of detection at early stages of the disease, being less prone to obstacles on their path to the target region, and possible conjunction to therapeutics. Copper ions play essential role in human health. They are used as a cofactor for multiple key enzymes involved in various fundamental biochemistry processes. Extremely small size copper oxide nanoparticles (CuO-NPs) are readily soluble in water with high colloidal stability yielding high bioavailability. The goal of this study was to examine the magnetic and acoustic characteristics of CuO-NPs in order to evaluate their potential to serve as contrast imaging agent for both MRI and ultrasound. CuO-NPs 7nm in diameter were synthesized by hot solution method. The particles were scanned using a 9.4T MRI and demonstrated a concentration dependent T1 relaxation time shortening phenomenon. In addition, it was revealed that CuO-NPs can be detected using the ultrasonic B-scan imaging. Finally, speed of sound based ultrasonic computed tomography was applied and showed that CuO-NPs can be clearly imaged. In conclusion, the preliminary results obtained, positively indicate that CuO-NPs may be imaged by both MRI and ultrasound. The results motivate additional in-vivo studies, in which the clinical utility of fused images derived from both modalities for diagnosis improvement will be studied.

New cardiac cameras: single-photon emission CT and PET.

PubMed

Slomka, Piotr J; Berman, Daniel S; Germano, Guido

2014-07-01

Nuclear cardiology instrumentation has evolved significantly in the recent years. Concerns about radiation dose and long acquisition times have propelled developments of dedicated high-efficiency cardiac SPECT scanners. Novel collimator designs, such as multipinhole or locally focusing collimators arranged in geometries that are optimized for cardiac imaging, have been implemented to enhance photon-detection sensitivity. Some of these new SPECT scanners use solid-state photon detectors instead of photomultipliers to improve image quality and to reduce the scanner footprint. These new SPECT devices allow dramatic up to 7-fold reduction in acquisition times or similar reduction in radiation dose. In addition, new hardware for photon attenuation correction allowing ultralow radiation doses has been offered by some vendors. To mitigate photon attenuation artifacts for the new SPECT scanners not equipped with attenuation correction hardware, 2-position (upright-supine or prone-supine) imaging has been proposed. PET hardware developments have been primarily driven by the requirements of oncologic imaging, but cardiac imaging can benefit from improved PET image quality and improved sensitivity of 3D systems. The time-of-flight reconstruction combined with resolution recovery techniques is now implemented by all major PET vendors. These new methods improve image contrast and image resolution and reduce image noise. High-sensitivity 3D PET without interplane septa allows reduced radiation dose for cardiac perfusion imaging. Simultaneous PET/MR hybrid system has been developed. Solid-state PET detectors with avalanche photodiodes or digital silicon photomultipliers have been introduced, and they offer improved imaging characteristics and reduced sensitivity to electromagnetic MR fields. Higher maximum count rate of the new PET detectors allows routine first-pass Rb-82 imaging, with 3D PET acquisition enabling clinical utilization of dynamic imaging with myocardial flow measurements for this tracer. The availability of high-end CT component in most PET/CT configurations enables hybrid multimodality cardiac imaging protocols with calcium scoring or CT angiography or both. Copyright © 2014. Published by Elsevier Inc.

A SYSTEMATIC REVIEW OF THE EXERCISES THAT PRODUCE OPTIMAL MUSCLE RATIOS OF THE SCAPULAR STABILIZERS IN NORMAL SHOULDERS

PubMed Central

Schory, Abbey; Bidinger, Erik; Wolf, Joshua

2016-01-01

ABSTRACT Purpose The purpose of this systematic review was to determine the exercises that optimize muscle ratios of the periscapular musculature for scapular stability and isolated strengthening. Methods A systematic search was performed in PubMed, CINAHL, SPORTDiscus, Scopus, and Discovery Layer. Studies were included if they examined the muscle activation of the upper trapezius compared to the middle trapezius, lower trapezius, or serratus anterior using EMG during open chain exercises. The participants were required to have healthy, nonpathological shoulders. Information obtained included maximal voluntary isometric contraction (MVIC) values, ratios, standard deviations, exercises, and exercise descriptions. The outcome of interest was determining exercises that create optimal muscle activation ratios between the scapular stabilizers. Results Fifteen observational studies met the inclusion criteria for the systematic review. Exercises with optimal ratios were eccentric exercises in the frontal and sagittal planes, especially flexion between 180 ° and 60 °. External rotation exercises with the elbow flexed to 90 ° also had optimal ratios for activating the middle trapezius in prone and side-lying positions. Exercises with optimal ratios for the lower trapezius were prone flexion, high scapular retraction, and prone external rotation with the shoulder abducted to 90 ° and elbow flexed. Exercises with optimal ratios for the serratus anterior were the diagonal exercises and scapular protraction. Conclusion This review has identified optimal positions and exercises for periscapular stability exercises. Standing exercises tend to activate the upper trapezius at a higher ratio, especially during the 60-120 ° range. The upper trapezius was the least active, while performing exercises in prone, side-lying, and supine positions. More studies need to be conducted to examine these exercises in greater detail and confirm their consistency in producing the optimal ratios determined in this review. Level of evidence 1a PMID:27274418

First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery

PubMed Central

Munoz-Bendix, Christopher; Beseoglu, Kerim; Steiger, Hans-Jakob; Ahmadi, Sebastian A

2018-01-01

The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany). Experiences were retrospectively evaluated with five-level Likert items regarding ease of preparation, image definition, magnification, illumination, field of view, ergonomics, accessibility of the surgical field, and general user-friendliness. Three operations were performed: supratentorial open biopsy in the supine position, infratentorial brain tumor resection in the park bench position, and myelomeningocele closure in the prone position. While preparation and image definition were rated equal for microscope and exoscope, the microscope’s field of view, illumination, and user-friendliness were considered superior, while the advantages of the exoscope were seen in ergonomics and the accessibility of the surgical field. No complications attributed to visualization mode occurred. In our experience, the VITOM 3D exoscope is an innovative visualization tool with advantages over the microscope in ergonomics and the accessibility of the surgical field. However, improvements were deemed necessary with regard to field of view, illumination, and user-friendliness. While the debate of a “perfect” visualization modality is influenced by personal preference, this novel visualization device has the potential to become a valuable tool in the neurosurgeon’s armamentarium. PMID:29581920

First Clinical Applications of a High-Definition Three-Dimensional Exoscope in Pediatric Neurosurgery.

PubMed

Beez, Thomas; Munoz-Bendix, Christopher; Beseoglu, Kerim; Steiger, Hans-Jakob; Ahmadi, Sebastian A

2018-01-24

The ideal visualization tools in microneurosurgery should provide magnification, illumination, wide fields of view, ergonomics, and unobstructed access to the surgical field. The operative microscope was the predominant innovation in modern neurosurgery. Recently, a high-definition three-dimensional (3D) exoscope was developed. We describe the first applications in pediatric neurosurgery. The VITOM 3D exoscope (Karl Storz GmbH, Tuttlingen, Germany) was used in pediatric microneurosurgical operations, along with an OPMI PENTERO operative microscope (Carl Zeiss AG, Jena, Germany). Experiences were retrospectively evaluated with five-level Likert items regarding ease of preparation, image definition, magnification, illumination, field of view, ergonomics, accessibility of the surgical field, and general user-friendliness. Three operations were performed: supratentorial open biopsy in the supine position, infratentorial brain tumor resection in the park bench position, and myelomeningocele closure in the prone position. While preparation and image definition were rated equal for microscope and exoscope, the microscope's field of view, illumination, and user-friendliness were considered superior, while the advantages of the exoscope were seen in ergonomics and the accessibility of the surgical field. No complications attributed to visualization mode occurred. In our experience, the VITOM 3D exoscope is an innovative visualization tool with advantages over the microscope in ergonomics and the accessibility of the surgical field. However, improvements were deemed necessary with regard to field of view, illumination, and user-friendliness. While the debate of a "perfect" visualization modality is influenced by personal preference, this novel visualization device has the potential to become a valuable tool in the neurosurgeon's armamentarium.

On the usefulness of gradient information in multi-objective deformable image registration using a B-spline-based dual-dynamic transformation model: comparison of three optimization algorithms

NASA Astrophysics Data System (ADS)

Pirpinia, Kleopatra; Bosman, Peter A. N.; Sonke, Jan-Jakob; van Herk, Marcel; Alderliesten, Tanja

2015-03-01

The use of gradient information is well-known to be highly useful in single-objective optimization-based image registration methods. However, its usefulness has not yet been investigated for deformable image registration from a multi-objective optimization perspective. To this end, within a previously introduced multi-objective optimization framework, we use a smooth B-spline-based dual-dynamic transformation model that allows us to derive gradient information analytically, while still being able to account for large deformations. Within the multi-objective framework, we previously employed a powerful evolutionary algorithm (EA) that computes and advances multiple outcomes at once, resulting in a set of solutions (a so-called Pareto front) that represents efficient trade-offs between the objectives. With the addition of the B-spline-based transformation model, we studied the usefulness of gradient information in multiobjective deformable image registration using three different optimization algorithms: the (gradient-less) EA, a gradientonly algorithm, and a hybridization of these two. We evaluated the algorithms to register highly deformed images: 2D MRI slices of the breast in prone and supine positions. Results demonstrate that gradient-based multi-objective optimization significantly speeds up optimization in the initial stages of optimization. However, allowing sufficient computational resources, better results could still be obtained with the EA. Ultimately, the hybrid EA found the best overall approximation of the optimal Pareto front, further indicating that adding gradient-based optimization for multiobjective optimization-based deformable image registration can indeed be beneficial

Correlating Intravital Multi-Photon Microscopy to 3D Electron Microscopy of Invading Tumor Cells Using Anatomical Reference Points

PubMed Central

Karreman, Matthia A.; Mercier, Luc; Schieber, Nicole L.; Shibue, Tsukasa; Schwab, Yannick; Goetz, Jacky G.

2014-01-01

Correlative microscopy combines the advantages of both light and electron microscopy to enable imaging of rare and transient events at high resolution. Performing correlative microscopy in complex and bulky samples such as an entire living organism is a time-consuming and error-prone task. Here, we investigate correlative methods that rely on the use of artificial and endogenous structural features of the sample as reference points for correlating intravital fluorescence microscopy and electron microscopy. To investigate tumor cell behavior in vivo with ultrastructural accuracy, a reliable approach is needed to retrieve single tumor cells imaged deep within the tissue. For this purpose, fluorescently labeled tumor cells were subcutaneously injected into a mouse ear and imaged using two-photon-excitation microscopy. Using near-infrared branding, the position of the imaged area within the sample was labeled at the skin level, allowing for its precise recollection. Following sample preparation for electron microscopy, concerted usage of the artificial branding and anatomical landmarks enables targeting and approaching the cells of interest while serial sectioning through the specimen. We describe here three procedures showing how three-dimensional (3D) mapping of structural features in the tissue can be exploited to accurately correlate between the two imaging modalities, without having to rely on the use of artificially introduced markers of the region of interest. The methods employed here facilitate the link between intravital and nanoscale imaging of invasive tumor cells, enabling correlating function to structure in the study of tumor invasion and metastasis. PMID:25479106

Influenceable and Avoidable Risk Factors for Systemic Air Embolism due to Percutaneous CT-Guided Lung Biopsy: Patient Positioning and Coaxial Biopsy Technique—Case Report, Systematic Literature Review, and a Technical Note

PubMed Central

2014-01-01

Following the first case of a systemic air embolism due to percutaneous CT-guided lung biopsy in our clinic we analysed the literature regarding this matter in view of influenceable or avoidable risk factors. A systematic review of literature reporting cases of systemic air embolism due to CT-guided lung biopsy was performed to find out whether prone positioning might be a risk factor regarding this issue. In addition, a technical note concerning coaxial biopsy practice is presented. Prone position seems to have relevance for the development and/or clinical manifestation of air embolism due to CT-guided lung biopsy and should be considered a risk factor, at least as far as lesions in the lower parts of the lung are concerned. Biopsies of small or cavitary lesions in coaxial technique should be performed using a hemostatic valve. PMID:25431666

A fully automatic approach to register mobile mapping and airborne imagery to support the correction of platform trajectories in GNSS-denied urban areas

NASA Astrophysics Data System (ADS)

Jende, Phillipp; Nex, Francesco; Gerke, Markus; Vosselman, George

2018-07-01

Mobile Mapping (MM) solutions have become a significant extension to traditional data acquisition methods over the last years. Independently from the sensor carried by a platform, may it be laser scanners or cameras, high-resolution data postings are opposing a poor absolute localisation accuracy in urban areas due to GNSS occlusions and multipath effects. Potentially inaccurate position estimations are propagated by IMUs which are furthermore prone to drift effects. Thus, reliable and accurate absolute positioning on a par with MM's high-quality data remains an open issue. Multiple and diverse approaches have shown promising potential to mitigate GNSS errors in urban areas, but cannot achieve decimetre accuracy, require manual effort, or have limitations with respect to costs and availability. This paper presents a fully automatic approach to support the correction of MM imaging data based on correspondences with airborne nadir images. These correspondences can be employed to correct the MM platform's orientation by an adjustment solution. Unlike MM as such, aerial images do not suffer from GNSS occlusions, and their accuracy is usually verified by employing well-established methods using ground control points. However, a registration between MM and aerial images is a non-standard matching scenario, and requires several strategies to yield reliable and accurate correspondences. Scale, perspective and content strongly vary between both image sources, thus traditional feature matching methods may fail. To this end, the registration process is designed to focus on common and clearly distinguishable elements, such as road markings, manholes, or kerbstones. With a registration accuracy of about 98%, reliable tie information between MM and aerial data can be derived. Even though, the adjustment strategy is not covered in its entirety in this paper, accuracy results after adjustment will be presented. It will be shown that a decimetre accuracy is well achievable in a real data test scenario.

Imaging inflammatory acne: lesion detection and tracking

NASA Astrophysics Data System (ADS)

Cula, Gabriela O.; Bargo, Paulo R.; Kollias, Nikiforos

2010-02-01

It is known that effectiveness of acne treatment increases when the lesions are detected earlier, before they could progress into mature wound-like lesions, which lead to scarring and discoloration. However, little is known about the evolution of acne from early signs until after the lesion heals. In this work we computationally characterize the evolution of inflammatory acne lesions, based on analyzing cross-polarized images that document acne-prone facial skin over time. Taking skin images over time, and being able to follow skin features in these images present serious challenges, due to change in the appearance of skin, difficulty in repositioning the subject, involuntary movement such as breathing. A computational technique for automatic detection of lesions by separating the background normal skin from the acne lesions, based on fitting Gaussian distributions to the intensity histograms, is presented. In order to track and quantify the evolution of lesions, in terms of the degree of progress or regress, we designed a study to capture facial skin images from an acne-prone young individual, followed over the course of 3 different time points. Based on the behavior of the lesions between two consecutive time points, the automatically detected lesions are classified in four categories: new lesions, resolved lesions (i.e. lesions that disappear completely), lesions that are progressing, and lesions that are regressing (i.e. lesions in the process of healing). The classification our methods achieve correlates well with visual inspection of a trained human grader.

Management of Foramen Magnum Meningioma During Pregnancy: Literature Review and Case Report.

PubMed

Casabella, Amanda M; Urakov, Timur M; Basil, Gregory; Morcos, Jacques J

2017-01-01

Foramen magnum meningiomas are very rare and challenging lesions. Their presentation in women during pregnancy tremendously complicates the course of gestation. Conservative management is always the first option, but in cases of a deteriorating clinical picture, there are currently no clear guidelines on best management. A woman presents in the 30th week of pregnancy with pain and progressive numbness in right posterior aspect of neck and right arm. Foramen magnum meningioma was diagnosed and successful surgical resection was performed with intraoperative fetal hearth monitoring and three fourths prone position of the patient. We believe a three fourths prone position of a pregnant patient is safe and adequate for the far-lateral exposure of craniocervical lesions. Rapid growing of tumor can be precipitated by steroids management during pregnancy. Published by Elsevier Inc.

Intraoperative visible bubbling of air may be the first sign of venous air embolism during posterior surgery for scoliosis.

PubMed

Wills, John; Schwend, Richard M; Paterson, Andrew; Albin, Maurice S

2005-10-15

Case report of two children sustaining venous air embolism (VAE) during posterior surgery for scoliosis. To report 2 cases where visible bubbling at the operative site was the first clinical indication of VAE-induced cardiovascular collapse and to raise the level of consciousness that VAE in the prone position can occur, often with serious consequences. Twenty-two cases of VAE during surgery for scoliosis in the prone position have been reported. Ten were fatal and ten were in children. Visible bubbling at the operative site was noted in two published cases. Retrospective study of 2 cases of VAE at one institution. Clinical, anesthetic, and radiographic features are presented. Details of previously published cases are reviewed and discussed. Both patients were girls with adolescent scoliosis who underwent prone positioned posterior spinal fusion with instrumentation. Visible bubbling of air at the thoracic aspect of the surgical site was noted near the completion of instrumentation and was the first indication of VAE. In both cases, this was clinically recognized and promptly treated. One patient survived normally and the other died. Visible air bubbling at the operative site may herald the onset of massive VAE during multilevel posterior spinal fusion and instrumentation. A prospective multicenter study using precordial Doppler, central venous catheter, and end-tidal CO2 is recommended to determine the true incidence of VAE in spinal deformity surgery and to evaluate monitoring and treatment methods.

MR signal intensity: staying on the bright side in MR image interpretation

PubMed Central

Bloem, Johan L; Reijnierse, Monique; Huizinga, Tom W J

2018-01-01

In 2003, the Nobel Prize for Medicine was awarded for contribution to the invention of MRI, reflecting the incredible value of MRI for medicine. Since 2003, enormous technical advancements have been made in acquiring MR images. However, MRI has a complicated, accident-prone dark side; images are not calibrated and respective images are dependent on all kinds of subjective choices in the settings of the machine, acquisition technique parameters, reconstruction techniques, data transmission, filtering and postprocessing techniques. The bright side is that understanding MR techniques increases opportunities to unravel characteristics of tissue. In this viewpoint, we summarise the different subjective choices that can be made to generate MR images and stress the importance of communication between radiologists and rheumatologists to correctly interpret images.

Finite element simulation of light transfer in turbid media under structured illumination

USDA-ARS?s Scientific Manuscript database

Spatial-frequency domain (SFD) imaging technique allows to estimate the optical properties of biological tissues in a wide field of view. The technique is, however, prone to error in measurement because the two crucial assumptions used for deriving the analytical solution to diffusion approximation ...

Maximum likelihood positioning algorithm for high-resolution PET scanners

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

Gross-Weege, Nicolas, E-mail: nicolas.gross-weege@pmi.rwth-aachen.de, E-mail: schulz@pmi.rwth-aachen.de; Schug, David; Hallen, Patrick

2016-06-15

Purpose: In high-resolution positron emission tomography (PET), lightsharing elements are incorporated into typical detector stacks to read out scintillator arrays in which one scintillator element (crystal) is smaller than the size of the readout channel. In order to identify the hit crystal by means of the measured light distribution, a positioning algorithm is required. One commonly applied positioning algorithm uses the center of gravity (COG) of the measured light distribution. The COG algorithm is limited in spatial resolution by noise and intercrystal Compton scatter. The purpose of this work is to develop a positioning algorithm which overcomes this limitation. Methods:more » The authors present a maximum likelihood (ML) algorithm which compares a set of expected light distributions given by probability density functions (PDFs) with the measured light distribution. Instead of modeling the PDFs by using an analytical model, the PDFs of the proposed ML algorithm are generated assuming a single-gamma-interaction model from measured data. The algorithm was evaluated with a hot-rod phantom measurement acquired with the preclinical HYPERION II {sup D} PET scanner. In order to assess the performance with respect to sensitivity, energy resolution, and image quality, the ML algorithm was compared to a COG algorithm which calculates the COG from a restricted set of channels. The authors studied the energy resolution of the ML and the COG algorithm regarding incomplete light distributions (missing channel information caused by detector dead time). Furthermore, the authors investigated the effects of using a filter based on the likelihood values on sensitivity, energy resolution, and image quality. Results: A sensitivity gain of up to 19% was demonstrated in comparison to the COG algorithm for the selected operation parameters. Energy resolution and image quality were on a similar level for both algorithms. Additionally, the authors demonstrated that the performance of the ML algorithm is less prone to missing channel information. A likelihood filter visually improved the image quality, i.e., the peak-to-valley increased up to a factor of 3 for 2-mm-diameter phantom rods by rejecting 87% of the coincidences. A relative improvement of the energy resolution of up to 12.8% was also measured rejecting 91% of the coincidences. Conclusions: The developed ML algorithm increases the sensitivity by correctly handling missing channel information without influencing energy resolution or image quality. Furthermore, the authors showed that energy resolution and image quality can be improved substantially by rejecting events that do not comply well with the single-gamma-interaction model, such as Compton-scattered events.« less

Effects of Access to a Stimulating Object on Infant Behavior during Tummy Time

ERIC Educational Resources Information Center

Kadey, Heather J.; Roane, Henry S.

2012-01-01

Placing infants in a prone position for "tummy time" often is recommended to ensure appropriate infant development and to combat the effects associated with infants spending extended periods of time in a supine position. However, tummy time may be associated with inappropriate infant behavior such as crying and noncompliance. We provided…

Validation of Noninvasive In Vivo Compound Ultrasound Strain Imaging Using Histologic Plaque Vulnerability Features.

PubMed

Hansen, Hendrik H G; de Borst, Gert Jan; Bots, Michiel L; Moll, Frans L; Pasterkamp, Gerard; de Korte, Chris L

2016-11-01

Carotid plaque rupture is a major cause of stroke. Key issue for risk stratification is early identification of rupture-prone plaques. A noninvasive technique, compound ultrasound strain imaging, was developed providing high-resolution radial deformation/strain images of atherosclerotic plaques. This study aims at in vivo validation of compound ultrasound strain imaging in patients by relating the measured strains to typical features of vulnerable plaques derived from histology after carotid endarterectomy. Strains were measured in 34 severely stenotic (>70%) carotid arteries at the culprit lesion site within 48 hours before carotid endarterectomy. In all cases, the lumen-wall boundary was identifiable on B-mode ultrasound, and the imaged cross-section did not move out of the imaging plane from systole to diastole. After endarterectomy, the plaques were processed using a validated histology analysis technique. Locally elevated strain values were observed in regions containing predominantly components related to plaque vulnerability, whereas lower values were observed in fibrous, collagen-rich plaques. The median strain of the inner plaque layer (1 mm thickness) was significantly higher (P<0.01) for (fibro)atheromatous (n=20, strain=0.27%) than that for fibrous plaques (n=14, strain=-0.75%). Also, a significantly larger area percentage of the inner layer revealed strains above 0.5% for (fibro)atheromatous (45.30%) compared with fibrous plaques (31.59%). (Fibro)atheromatous plaques were detected with a sensitivity, specificity, positive predictive value, and negative predictive value of 75%, 86%, 88%, and 71%, respectively. Strain did not significantly correlate with fibrous cap thickness, smooth muscle cell, or macrophage concentration. Compound ultrasound strain imaging allows differentiating (fibro)atheromatous from fibrous carotid artery plaques. © 2016 American Heart Association, Inc.

An Improved Unsupervised Image Segmentation Evaluation Approach Based on - and Over-Segmentation Aware

NASA Astrophysics Data System (ADS)

Su, Tengfei

2018-04-01

In this paper, an unsupervised evaluation scheme for remote sensing image segmentation is developed. Based on a method called under- and over-segmentation aware (UOA), the new approach is improved by overcoming the defect in the part of estimating over-segmentation error. Two cases of such error-prone defect are listed, and edge strength is employed to devise a solution to this issue. Two subsets of high resolution remote sensing images were used to test the proposed algorithm, and the experimental results indicate its superior performance, which is attributed to its improved OSE detection model.

In Vivo Myeloperoxidase Imaging and Flow Cytometry Analysis of Intestinal Myeloid Cells.

PubMed

Hülsdünker, Jan; Zeiser, Robert

2016-01-01

Myeloperoxidase (MPO) imaging is a non-invasive method to detect cells that produce the enzyme MPO that is most abundant in neutrophils, macrophages, and inflammatory monocytes. While lacking specificity for any of these three cell types, MPO imaging can provide guidance for further flow cytometry-based analysis of tissues where these cell types reside. Isolation of leukocytes from the intestinal tract is an error-prone procedure. Here, we describe a protocol for intestinal leukocyte isolation that works reliable in our hands and allows for flow cytometry-based analysis, in particular of neutrophils.

Predicting motor outcomes with 3 month prone hip angles in premature infants.

PubMed

Shehee, Lindsey; Coker-Bolt, Patty; Barbour, Andrew; Moss, Hunter; Brown, Truman; Jenkins, Dorothea

2016-09-02

This study used kinematic analysis to identify a reliable and rapid assessment method for abnormal patterns of motor development in preterm infants. In a retrospective analysis, we examined video of n= 35 preterm infants at 3mo corrected age (CA) who had concurrent Test of Infant Motor Performance (TIMP) scores. Hyperflexion at the hip produces common gait anomalies seen in children with CP, therefore we analyzed hip angle in the prone head lift position at 3 months CA. Magnetic Resonance Spectroscopy (MRS) was performed at term equivalent (n= 23) and Bayley-III neurodevelopmental tests were performed at 1 year (n= 28). We correlated hip angles with TIMP and Bayley-III scores, and MRS neuronal metabolites. Hip angle positively correlated with TIMP at 3 months (r= 0.642, p≤ 0.001), but not with Bayley-III at 1 year (r= 0.122, p= 0.529). Hip angle correlated negatively with myo-inositol (mI) ratios in frontal white matter tracts (mI/Cr r= -0.520, p= 0.011). These results suggest prone hip angle may be a quantitative proxy for the 42-item TIMP at 3 months, and that hypertonicity in the hip flexor musculature is a manifestation of white matter metabolic abnormalities (elevated mI ratios) that may indicate occult white matter injury.

Comparative accuracy of supine-only and combined supine-prone myocardial perfusion imaging in men.

PubMed

Taasan, Vicente; Wokhlu, Anita; Taasan, Michael V; Dusaj, Raman S; Mehta, Ajay; Kraft, Steven; Winchester, David; Wymer, David

2016-12-01

Combined supine-prone myocardial perfusion imaging (CSP MPI) has been shown to reduce attenuation artifact in comparison to supine-only (SU) MPI in mixed-gender populations with varying risk for coronary artery disease (CAD), often where patients served as their own controls. However, there is limited direct comparison of these imaging strategies in men. 934 male patients underwent CSP or SU MPI. Diagnostic certainty of interpretation was compared. Within the cohort, 116 were referred for left heart catheterization (LHC) to assess for CAD. Sensitivity, specificity, and area under the curve (AUC) were compared with additional analysis based on body mass index (BMI). 597 patients completed the SU protocol and 337 patients completed the CSP protocol. Equivocal studies were seen more frequently in the SU group (13%) than in the CSP group (4%, P < .001). At catheterization, the specificity for CSP MPI of 70% was higher than 40% for SU MPI (P = .032). The CSP AUC (0.80 ± 0.06) was significantly larger than SU AUC (0.57 ± 0.05, P = .004). CSP specificity was significantly higher in obese patients. CSP MPI increases diagnostic certainty and improves test accuracy for CAD detection in men with CAD risk factors, especially obese patients, compared to SU MPI.

The evaluation of lateral pterygoid muscle pathologic changes and insertion patterns in temporomandibular joints with or without disc displacement using magnetic resonance imaging.

PubMed

Imanimoghaddam, M; Madani, A S; Hashemi, E M

2013-09-01

Temporomandibular joint (TMJ) disc displacement is a common disorder in patients with internal derangement. Certain anatomic features of TMJ may make the patient prone to this condition, namely lateral pterygoid muscle (LPM) insertion variations. The aim of this study was to investigate LPM attachments and their relationships with disc displacement and subsequent pathologic changes. A total of 26 patients with clinical temporomandibular disorders (TMDs) and a control group of 14 unaffected individuals were studied. Magnetic resonance images (MRIs) were taken to evaluate LPM insertion patterns, superior LPM head pathologic changes, and relative disc to condyle position. Data registration and analysis were done using SPSS v. 16.0. The most common variation (type I) was shown to be the superior head with two bundles, one attached to the disc and another to the condyle. No significant relationship between LPM insertion type and disc displacement or pathologic changes of the muscle was found. However, a link between disc displacement and muscle pathologic changes was established (P=0.001). Copyright © 2013 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Progress in atherosclerotic plaque imaging

PubMed Central

Soloperto, Giulia; Casciaro, Sergio

2012-01-01

Cardiovascular diseases are the primary cause of mortality in the industrialized world, and arterial obstruction, triggered by rupture-prone atherosclerotic plaques, lead to myocardial infarction and cerebral stroke. Vulnerable plaques do not necessarily occur with flow-limiting stenosis, thus conventional luminographic assessment of the pathology fails to identify unstable lesions. In this review we discuss the currently available imaging modalities used to investigate morphological features and biological characteristics of the atherosclerotic plaque. The different imaging modalities such as ultrasound, magnetic resonance imaging, computed tomography, nuclear imaging and their intravascular applications are illustrated, highlighting their specific diagnostic potential. Clinically available and upcoming methodologies are also reviewed along with the related challenges in their clinical translation, concerning the specific invasiveness, accuracy and cost-effectiveness of these methods. PMID:22937215

The Effect of Pressure-Controlled Ventilation and Volume-Controlled Ventilation in Prone Position on Pulmonary Mechanics and Inflammatory Markers.

PubMed

Şenay, Hasan; Sıvacı, Remziye; Kokulu, Serdar; Koca, Buğra; Bakı, Elif Doğan; Ela, Yüksel

2016-08-01

The aim of this present study is to compare the effect of pressure-controlled ventilation and volume-controlled ventilation on pulmonary mechanics and inflammatory markers in prone position. The study included 41 patients undergoing to vertebrae surgery. The patients were randomized into two groups: Group 1 received volume-controlled ventilation, while group 2 received pressure-controlled ventilation. The demographic data, pulmonary mechanics, the inflammatory marker levels just after the induction of anesthetics, at the 6th and 12th hours, and gas analysis from arterial blood samples taken at the beginning and the 30th minute were recorded. The inflammatory marker levels increased in both groups, without any significant difference among groups. Peak inspiratory pressure level was higher in the volume-controlled ventilation group. This study revealed that there is no difference regarding inflammatory marker levels between volume- and pressure-controlled ventilation.

The Hydrodynamic Study of the Swimming Gliding: a Two-Dimensional Computational Fluid Dynamics (CFD) Analysis.

PubMed

Marinho, Daniel A; Barbosa, Tiago M; Rouboa, Abel I; Silva, António J

2011-09-01

Nowadays the underwater gliding after the starts and the turns plays a major role in the overall swimming performance. Hence, minimizing hydrodynamic drag during the underwater phases should be a main aim during swimming. Indeed, there are several postures that swimmers can assume during the underwater gliding, although experimental results were not conclusive concerning the best body position to accomplish this aim. Therefore, the purpose of this study was to analyse the effect in hydrodynamic drag forces of using different body positions during gliding through computational fluid dynamics (CFD) methodology. For this purpose, two-dimensional models of the human body in steady flow conditions were studied. Two-dimensional virtual models had been created: (i) a prone position with the arms extended at the front of the body; (ii) a prone position with the arms placed alongside the trunk; (iii) a lateral position with the arms extended at the front and; (iv) a dorsal position with the arms extended at the front. The drag forces were computed between speeds of 1.6 m/s and 2 m/s in a two-dimensional Fluent(®) analysis. The positions with the arms extended at the front presented lower drag values than the position with the arms aside the trunk. The lateral position was the one in which the drag was lower and seems to be the one that should be adopted during the gliding after starts and turns.

Elevated Plasma Levels of sRAGE Are Associated With Nonfocal CT-Based Lung Imaging in Patients With ARDS: A Prospective Multicenter Study.

PubMed

Mrozek, Segolene; Jabaudon, Matthieu; Jaber, Samir; Paugam-Burtz, Catherine; Lefrant, Jean-Yves; Rouby, Jean-Jacques; Asehnoune, Karim; Allaouchiche, Bernard; Baldesi, Olivier; Leone, Marc; Lu, Qin; Bazin, Jean-Etienne; Roszyk, Laurence; Sapin, Vincent; Futier, Emmanuel; Pereira, Bruno; Constantin, Jean-Michel

2016-11-01

During ARDS, CT can reveal two distinct lung imaging patterns, focal or nonfocal, with different responses to positive end-expiratory pressure, recruitment maneuvers, and prone position. Nevertheless, their association with plasma biomarkers and their distinct functional/pathobiological mechanisms are unknown. The objective of this study was to characterize focal and nonfocal patterns of lung CT-based imaging with plasma markers of lung injury. A prospective multicenter cohort study involving 119 consecutive patients with ARDS. Plasma biomarkers (soluble form of the receptor for advanced glycation end product [sRAGE], plasminogen activator inhibitor-1, soluble intercellular adhesion molecule-1, and surfactant protein-D) were measured within 24 h of ARDS onset. Lung CT scan was performed within the first 48 h to assess lung morphology. Thirty-two (27%) and 87 (73%) patients had focal and nonfocal ARDS, respectively. Plasma levels of sRAGE were significantly higher in nonfocal ARDS, compared with focal ARDS. A cut-off of 1,188 pg/mL differentiated focal from nonfocal ARDS with a sensitivity of 94% and a specificity of 84%. Nonfocal patterns were associated with higher 28- and 90-day mortality than focal patterns (31% vs 12%, P = .038 and 46% vs 21%, P = .026, respectively). Plasma levels of plasminogen activator inhibitor-1 were significantly higher in nonfocal ARDS. There was no difference in other biomarkers. Plasma sRAGE is associated with a nonfocal ARDS. Such novel findings may suggest a role for RAGE pathway in an underlying endotype of impaired alveolar fluid clearance and stimulate future research on the association between ARDS phenotypes and therapeutic responses. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

The Magnitude and Time Course of IOP Change in Response to Body Position Change in Nonhuman Primates Measured Using Continuous IOP Telemetry

PubMed Central

Turner, Daniel C.; Samuels, Brian C.; Huisingh, Carrie; Girkin, Christopher A.

2017-01-01

Purpose To study the effect and time course of body position changes on IOP in nonhuman primates. Methods We recorded continuous bilateral IOP measurements with a wireless telemetry implant in three rhesus macaques in seven different body positions. IOP measurements were acquired in the seated-upright, standing, prone, supine, right and left lateral decubitus positions (LDPs), and head-down inverted positions. Continuous IOP was recorded for 90 seconds in each position before returning to a supine reference position until IOP stabilized; measurements were averaged after IOP stabilized at each position. Results Head-down inversion increased IOP an average of 8.9 mm Hg, compared to the supine reference. In the LDP, IOP decreased an average of 0.5 mm Hg in the nondependent eye (i.e., the higher eye), while the fellow dependent (i.e., lower) eye increased an average of 0.5 mm Hg, compared to supine reference. Standing and seated positions decreased IOP 1.5 and 2.2 mm Hg, respectively, compared with supine reference. IOP changes occurred within 4 to 15 seconds of a body position change, and timing was affected by the speed at which body position was changed. Compared to the IOP in the supine position, the IOP in the inverted, prone, and seated positions was significantly different (P = 0.0313 for all). The IOP in the standing position was not statistically different from the IOP in the supine position (P = 0.094). In addition, the IOP was significantly different between the nondependent eye and the dependent eye in the LDPs compared to the supine position (P = 0.0313). Conclusions Body position has a significant effect on IOP and those changes persist over time. PMID:29228251

Ventilator-associated pneumonia: role of positioning.

PubMed

Li Bassi, Gianluigi; Torres, Antoni

2011-02-01

Ventilator-associated pneumonia (VAP) is a lung infection commonly acquired following tracheal intubation. This review assesses the role of the supine semirecumbent and the prone position as VAP preventive strategies and calls attention for further investigation on novel body positions that could potentially reduce risks of VAP. The most recent studies on the semirecumbent position failed to achieve an orientation of the head of the bed higher than 30° and did not corroborate any benefit of the semirecumbent position on VAP, as reported in earlier studies. To date, there is clear evidence that the supine horizontal body position increases risks of pulmonary aspiration and VAP, particularly when patients are enterally fed. Laboratory reports are emphasizing the importance of an endotracheal tube-oropharynx-trachea axis below horizontal to avoid VAP. The prone position potentially increases drainage of oropharyngeal and airways secretions and recent evidence is supporting its beneficial effects. However, several associated adverse effects preclude its regular use as a VAP preventive strategy for patients other than those with acute respiratory distress syndrome. Body position greatly affects several pathogenetic mechanisms of VAP. The current evidence recommends avoidance of supine horizontal position in order to prevent aspiration of colonized gastric contents. The semirecumbent position has proven benefits and should be routinely used but there is still limited evidence to recommend the lowest orientation of the bed at which the patient can be safely maintained. Results from pioneering laboratory investigation call attention to new possible positions, that is lateral Trendelenburg position, aimed to avoid pulmonary aspiration and to enhance mucus clearance in intubated patients.

A Novel ImageJ Macro for Automated Cell Death Quantitation in the Retina

PubMed Central

Maidana, Daniel E.; Tsoka, Pavlina; Tian, Bo; Dib, Bernard; Matsumoto, Hidetaka; Kataoka, Keiko; Lin, Haijiang; Miller, Joan W.; Vavvas, Demetrios G.

2015-01-01

Purpose TUNEL assay is widely used to evaluate cell death. Quantification of TUNEL-positive (TUNEL+) cells in tissue sections is usually performed manually, ideally by two masked observers. This process is time consuming, prone to measurement errors, and not entirely reproducible. In this paper, we describe an automated quantification approach to address these difficulties. Methods We developed an ImageJ macro to quantitate cell death by TUNEL assay in retinal cross-section images. The script was coded using IJ1 programming language. To validate this tool, we selected a dataset of TUNEL assay digital images, calculated layer area and cell count manually (done by two observers), and compared measurements between observers and macro results. Results The automated macro segmented outer nuclear layer (ONL) and inner nuclear layer (INL) successfully. Automated TUNEL+ cell counts were in-between counts of inexperienced and experienced observers. The intraobserver coefficient of variation (COV) ranged from 13.09% to 25.20%. The COV between both observers was 51.11 ± 25.83% for the ONL and 56.07 ± 24.03% for the INL. Comparing observers' results with macro results, COV was 23.37 ± 15.97% for the ONL and 23.44 ± 18.56% for the INL. Conclusions We developed and validated an ImageJ macro that can be used as an accurate and precise quantitative tool for retina researchers to achieve repeatable, unbiased, fast, and accurate cell death quantitation. We believe that this standardized measurement tool could be advantageous to compare results across different research groups, as it is freely available as open source. PMID:26469755

WE-EF-BRA-12: Magnetic Resonance- Guided High-Intensity Focused Ultrasound for Localized Ablation of Head and Neck Tissue Structures: A Feasibility Study in An Animal Model

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

Partanen, A; Ellens, N; Noureldine, S

Purpose: High-intensity focused ultrasound (HIFU) ablation is feasible in the head and neck [1]. This study aims to expand upon these findings to assess the feasibility of treatment planning and monitoring via magnetic resonance imaging (MRI) guidance using a clinical MR-guided HIFU platform. Methods: Two 31 kg pigs were anaesthetized, shaved, and positioned prone on the HIFU table (Sonalleve, Philips Healthcare, Vantaa, Finland). The necks were acoustically coupled to the integrated transducer using gel pads and degassed water. MR imaging verified acoustic coupling and facilitated target selection in the thyroid and thymus. Targets were thermally ablated with 130–200 W ofmore » acoustic power over a period of 16 s at a frequency of 1.2 MHz while being monitored through real-time, multi-planar MR-thermometry. Contrast-enhanced MR imaging was used to assess treatment efficacy. Post-treatment, animals were euthanized and sonicated tissues were harvested for histology assessment. Results: MR-thermometry, post-contrast-imaging, and gross pathology demonstrated that the system was capable of causing localized thermal ablation in both the thyroid and the thymus without damaging the aerodigestive tract. In one animal, superficial bruising was observed in the ultrasound beam path. Otherwise, there were no adverse events. Analysis of the tissue histology found regions of damage consistent with acute thermal injury at the targeted locations. Conclusion: It is feasible to use a clinical MR-guided HIFU platform for extracorporeal ablation of porcine head and neck tissues. MR guidance and thermometry are sufficient to target and monitor treatment in the thyroid region, despite the presence of the inhomogeneous aerodigestive tract. Further study is necessary to assess efficacy and survival using a tumor model, and to examine what modifications should be made to the transducer positioning system and associated patient positioning aids to adapt it for clinical head and neck targets.Reference:[1] Esnault et al. (2011). Thyroid, 21(9), 965– 973. Funding support provided by Philips Healthcare. Ari Partanen is a paid employee of Philips Healthcare.« less

Biological Effects of Electromagnetic Fields

DTIC Science & Technology

2006-11-27

cerebral activity reflected by high levels of c-Fos- positive neurons in certain brain areas (14). The brain tissue of seizure proneness can be...radiation triggers seizures and increases cerebral c-Fos positivity in rats pretreated with subconvulsive doses of...psychiatric, cardiovascular or neurological diseases); or have a cardiac or cerebral pacemaker. They have no history of head, eye or thorax injury involving

Utility of eButton images for identifying food preparation behaviors and meal-related tasks in adolescents

USDA-ARS?s Scientific Manuscript database

Food preparation skills may encourage healthy eating. Traditional assessment of child food preparation employs self- or parent proxy-reporting methods, which are prone to error. The eButton is a wearable all-day camera that has promise as an objective, passive method for measuring child food prepara...

Ultrafast Brain MRI: Clinical Deployment and Comparison to Conventional Brain MRI at 3T.

PubMed

Prakkamakul, Supada; Witzel, Thomas; Huang, Susie; Boulter, Daniel; Borja, Maria J; Schaefer, Pamela; Rosen, Bruce; Heberlein, Keith; Ratai, Eva; Gonzalez, Gilberto; Rapalino, Otto

2016-09-01

To compare an ultrafast brain magnetic resonance imaging (MRI) protocol to the conventional protocol in motion-prone inpatient clinical settings. This retrospective study was HIPAA compliant and approved by the Institutional Review Board with waived inform consent. Fifty-nine inpatients (30 males, 29 females; mean age 55.1, range 23-93 years)who underwent 3-Tesla brain MRI using ultrafast and conventional protocols, both including five sequences, were included in the study. The total scan time for five ultrafast sequences was 4 minutes 59 seconds. The ideal conventional acquisition time was 10 minutes 32 seconds but the actual acquisition took 15-20 minutes. The average scan times for ultrafast localizers, T1-weighted, T2-weighted, fluid-attenuated inversion recovery (FLAIR), diffusion-weighted, T2*-weighted sequences were 14, 41, 62, 96, 80, 6 seconds, respectively. Two blinded neuroradiologists independently assessed three aspects: (1) image quality, (2) gray-white matter (GM-WM) differentiation, and (3) diagnostic concordance for the detection of six clinically relevant imaging findings. Wilcoxon signed-rank test was used to compare image quality and GM-WM scores. Interobserver reproducibility was calculated. The ultrafast T1-weighted sequence demonstrated significantly better image quality (P = .005) and GM-WM differentiation (P < .001) compared to the conventional sequence. There was high agreement (>85%) between both protocols for the detection of mass-like lesion, hemorrhage, diffusion restriction, WM FLAIR hyperintensities, subarachnoid FLAIR hyperintensities, and hydrocephalus. The ultrafast protocol achieved at least comparable image quality and high diagnostic concordance compared to the conventional protocol. This fast protocol can be a viable option to replace the conventional protocol in motion-prone inpatient clinical settings. Copyright © 2016 by the American Society of Neuroimaging.

Feasibility of ultra low-dose thallium stress-redistribution protocol including prone imaging in obese patients using CZT camera.

PubMed

Kincl, Vladimír; Kamínek, Milan; Vašina, Jiří; Panovský, Roman; Havel, Martin

2016-09-01

High efficiency cadmium-zinc-telluride (CZT) cameras provide an opportunity to lower the injected activities of radiopharmaceuticals for single photon emission tomography (SPECT) myocardial perfusion imaging (MPI). The limits for reducing activities of thallium have not been determined, particularly in obese patients. After an injection of 0.7 megabecquerel (MBq) of thallium/kg, we collected an average 1.5 million counts for the 10-min acquisition in a pilot cohort of ten patients. After extrapolation, we reduced the administered activity to 0.5 MBq/kg to obtain the expected 1 million counts. We studied the image quality in 124 patients (86 men, 43 obese with body mass index over 30 kg/m 2 ) referred for MPI. The quality of images was assessed by a number of recorded counts and visually by a four-grade scale (one-poor quality, four-excellent quality). In non-obese and obese patients, the average number of recorded counts was 1.1 vs. 1.07 million counts for the 10-min stress acquisition, 1.04 vs. 1.06 million counts for the 13-min rest acquisition, and the average quality score was 3.97 vs. 3.90, respectively (p = NS).The mean administered activity was 39.2 ± 7 MBq for non-obese and 48.7 ± 6 for obese patients (p < 0.0001), and the calculated effective dose was 4.0 ± 0.7 and 4.9 ± 0.6 mSv respectively (p < 0.0001). The ultra-low-dose thallium stress-redistribution protocol, including post-stress prone imaging, provides good quality of images with a low radiation burden, even in obese patients.

Ultrasonographic measurements of lower trapezius muscle thickness at rest and during isometric contraction: a reliability study.

PubMed

Talbott, Nancy R; Witt, Dexter W

2014-07-01

The purpose of this study was to determine the intra-rater reliability and inter-rater reliability of ultrasound imaging (USI) thickness measurements of the lower trapezius (LT) at rest and during active contractions when the transverse process and the lamina were used as reference sites for the measurement process. Twenty healthy individuals between the ages of 22 and 32 years volunteered. With the subject prone and the shoulder in 145° of abduction, images of the LT were taken bilaterally by one examiner as the subject: (1) rested; (2) actively held the test position; and (3) actively held the test position while holding a weight. Ten subjects returned and testing was repeated by the same examiner and by a second examiner. LT thickness measurements were recorded at the level of the transverse process and at the level of the lamina. Intra-class correlation coefficients (ICC) for within session intra-rater reliability (ICC3,3) ranged from 0.951 to 0.986 for both measurement sites while between session intra-rater reliability (ICC3,2) ranged from 0.935 to 0.962. Within session inter-rater reliability (ICC2,2) ranged from 0.934 to 0.973. USI can be used to reliably measure LT thickness at rest, during active contraction and during active contraction when holding a weight. The described protocol can be utilized during shoulder examinations to provide an additional assessment tool for monitoring changes in LT thickness.

B cells regulate thymic CD8+T cell differentiation in lupus-prone mice.

PubMed

Xing, Chen; Zhu, Gaizhi; Xiao, He; Fang, Ying; Liu, Xiaoling; Han, Gencheng; Chen, Guojiang; Hou, Chunmei; Shen, Beifen; Li, Yan; Ma, Ning; Wang, Renxi

2017-10-27

Previous studies have shown that under normal physiological conditions thymic B cells play a critical function in T cell negative selection. We tested the effect of thymic B cells on thymic T-cell differentiation in autoimmune diseases including systemic lupus erythematosus (SLE). We found that thymic B cells and CD8 - CD4 + and CD4 - CD8 + T cells increased, whereas CD4 + CD8 + T cells decreased in lupus-prone mice. Once B cells were reduced, the change was reversed. Furthermore, we found that B cells blocked thymic immature single positive (ISP) CD4 - CD8 + CD3 lo/- RORγt - T cells progression into CD4 + CD8 + T cells. Interestingly, we found a novel population of thymic immature T cells (CD4 - CD8 + CD3 lo RORγt + ) that were induced into mature CD4 - CD8 + CD3 + RORγt + T cells by B cells in lupus-prone mice. Importantly, we found that IgG, produced by thymic B cells, played a critical role in the differentiation of thymic CD8 + ISP and mature RORγt + CD8 + T cells in lupus-prone mice. In conclusion, B cells blocked the differentiation from thymic CD8 + ISP and induced the differentiation of a novel immature CD4 - CD8 + CD3 lo RORγt + T cells into mature RORγt + CD8 + T cells by secreting IgG antibody in lupus-prone mice.

The immediate reduction in low back pain intensity following lumbar joint mobilization and prone press-ups is associated with increased diffusion of water in the L5-S1 intervertebral disc.

PubMed

Beattie, Paul F; Arnot, Cathy F; Donley, Jonathan W; Noda, Harmony; Bailey, Lane

2010-05-01

Single-group, prospective, repeated-measures design. To determine differences in the changes of diffusion of water in the L5-S1 intervertebral disc between subjects with nonspecific low back pain (LBP) who reported an immediate reduction in pain intensity of 2 or greater on an 11-point (0-10) numeric rating scale after a 10-minute session of lumbar joint mobilization, followed by prone press-up exercises, compared to those who did not report an immediate reduction in pain intensity of 2 or greater on the pain scale. Combining lumbar joint mobilization and prone press-up exercises is a common intervention for patients with LBP; however, there is conflicting evidence regarding the effectiveness and efficacy of this approach. Increased knowledge of the physiologic effects of the combined use of these treatments, and the relationship to pain reports, can lead to refinement of their clinical application. Twenty adults, aged 22 to 54, participated in this study. All subjects reported LBP of at least 2 on an 11-point (0-10) verbally administered numeric rating scale at the time of enrollment in the study and were classified as being candidates for the combination of joint mobilization and prone press-ups. Subjects underwent T2- and diffusion-weighted lumbar magnetic resonance imaging scans before and immediately after receiving a 10-minute session of lumbar pressures in a posterior-to-anterior direction and prone press-up exercises. Subjects who reported a decrease in current pain intensity of 2 or greater immediately following treatment were classified as immediate responders, while the remainder were classified as not-immediate responders. The apparent diffusion coefficient, representing the diffusion of water in the nucleus pulposis, was calculated from the midsagittal diffusion-weighted images. Following treatment, immediate responders (n = 10) had a mean increase in the apparent diffusion coefficient in the middle portion of the L5-S1 intervertebral disc of 4.2% compared to a mean decrease of 1.6% for the not-immediate responders (P<.005). In a group of subjects with LBP, who were classified as being candidates for extension-based treatment, the report of an immediate reduction in pain intensity of 2/10 of greater after a treatment of posterior-to-anterior-directed pressures, followed by prone press-up exercises, was associated with an increase in diffusion of water in the nuclear region of the L5-S1 intervertebral disc. Subjects who did not report a pain reduction of at least 2/10 did not have a change in diffusion. J Orthop Sports Phys Ther 2010;40(5):256-264, Epub 12 March 2010. doi:10.2519/jospt.2010.3284.

Proliferation assessment in breast carcinomas using digital image analysis based on virtual Ki67/cytokeratin double staining.

PubMed

Røge, Rasmus; Riber-Hansen, Rikke; Nielsen, Søren; Vyberg, Mogens

2016-07-01

Manual estimation of Ki67 Proliferation Index (PI) in breast carcinoma classification is labor intensive and prone to intra- and interobserver variation. Standard Digital Image Analysis (DIA) has limitations due to issues with tumor cell identification. Recently, a computer algorithm, DIA based on Virtual Double Staining (VDS), segmenting Ki67-positive and -negative tumor cells using digitally fused parallel cytokeratin (CK) and Ki67-stained slides has been introduced. In this study, we compare VDS with manual stereological counting of Ki67-positive and -negative cells and examine the impact of the physical distance of the parallel slides on the alignment of slides. TMAs, containing 140 cores of consecutively obtained breast carcinomas, were stained for CK and Ki67 using optimized staining protocols. By means of stereological principles, Ki67-positive and -negative cell profiles were counted in sampled areas and used for the estimation of PIs of the whole tissue core. The VDS principle was applied to both the same sampled areas and the whole tissue core. Additionally, five neighboring slides were stained for CK in order to examine the alignment algorithm. Correlation between manual counting and VDS in both sampled areas and whole core was almost perfect (correlation coefficients above 0.97). Bland-Altman plots did not reveal any skewness in any data ranges. There was a good agreement in alignment (>85 %) in neighboring slides, whereas agreement decreased in non-neighboring slides. VDS gave similar results compared with manual counting using stereological principles. Introduction of this method in clinical and research practice may improve accuracy and reproducibility of Ki67 PI.

The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study.

PubMed

Hebert, Jeffrey J; Koppenhaver, Shane L; Magel, John S; Fritz, Julie M

2010-01-01

Hebert JJ, Koppenhaver SL, Magel JS, Fritz JM. The relationship of transversus abdominis and lumbar multifidus activation and prognostic factors for clinical success with a stabilization exercise program: a cross-sectional study. To examine the relationship between prognostic factors for clinical success with a stabilization exercise program and lumbar multifidus (LM) and transversus abdominis (TrA) muscle activation assessed using rehabilitative ultrasound imaging (RUSI). Cross-sectional study. Outpatient physical therapy clinic. Volunteers with current low back pain (N=40). Not applicable. We examined the relationship between prognostic factors associated with clinical success with a stabilization exercise program (positive prone instability test, age <40y, aberrant movements, straight leg raise >91 degrees , presence of lumbar hypermobility) and degree of TrA and LM muscle activation assessed by RUSI. Significant univariate relationships were identified between LM muscle activation and the number of prognostic factors present (Pearson correlation coefficient [r] =-.558, P=.001), as well as the individual factors of a positive prone instability test (point biserial correlation coefficient [r(pbis)]=.376, P=.018) and segmental hypermobility (r(pbis)=.358, P=.025). The multivariate analyses indicated that after controlling for other variables, the addition of the variable "number of prognostic factors present" resulted in a significant increase in R(2) (P=.006). No significant univariate or multivariate relationships were observed between the prognostic factors and TrA muscle activation. Decreased LM muscle activation, but not TrA muscle activation, is associated with the presence of factors predictive of clinical success with a stabilization exercise program. Our findings provide researchers and clinicians with evidence regarding the construct validity of the prognostic factors examined in this study, as well as the potential clinical importance of the LM muscle as a target for stabilization exercises. Copyright (c) 2010 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Position of pelvis in the 3rd month of life predicts further motor development.

PubMed

Gajewska, Ewa; Sobieska, Magdalena; Moczko, Jerzy

2018-06-01

The aim of the study is to select elements of motor skills assessed at 3 months that provide the best predictive properties for motor development at 9 months. In all children a physiotherapeutic assessment of the quantitative and qualitative development at the age of 3 months was performed in the prone and supine positions, which was presented in previous papers as the quantitative and qualitative assessment sheet of motor development. The neurological examination at the age of 9 months was based on the Denver Development Screening Test II and the evaluation of reflexes, muscle tone (hypotony and hypertony), and symmetry. The particular elements of motor performance assessment were shown to have distinct predictive value for further motor development (as assessed at 9 months), and the pelvis position was the strongest predictive element. Irrespective of the symptomatic and anamnestic factors the inappropriate motor performance may already be detected in the 3rd month of life and is predictive for further motor development. The assessment of the motor performance should be performed in both supine and prone positions. The proper position of pelvis summarizes the proper positioning of the whole spine and ensures proper further motor development. To our knowledge, the presented motor development assessment sheet allows the earliest prediction of motor disturbances. Copyright © 2018 Elsevier B.V. All rights reserved.

[Medical image elastic registration smoothed by unconstrained optimized thin-plate spline].

PubMed

Zhang, Yu; Li, Shuxiang; Chen, Wufan; Liu, Zhexing

2003-12-01

Elastic registration of medical image is an important subject in medical image processing. Previous work has concentrated on selecting the corresponding landmarks manually and then using thin-plate spline interpolating to gain the elastic transformation. However, the landmarks extraction is always prone to error, which will influence the registration results. Localizing the landmarks manually is also difficult and time-consuming. We the optimization theory to improve the thin-plate spline interpolation, and based on it, used an automatic method to extract the landmarks. Combining these two steps, we have proposed an automatic, exact and robust registration method and have gained satisfactory registration results.

Multichannel blind deconvolution of spatially misaligned images.

PubMed

Sroubek, Filip; Flusser, Jan

2005-07-01

Existing multichannel blind restoration techniques assume perfect spatial alignment of channels, correct estimation of blur size, and are prone to noise. We developed an alternating minimization scheme based on a maximum a posteriori estimation with a priori distribution of blurs derived from the multichannel framework and a priori distribution of original images defined by the variational integral. This stochastic approach enables us to recover the blurs and the original image from channels severely corrupted by noise. We observe that the exact knowledge of the blur size is not necessary, and we prove that translation misregistration up to a certain extent can be automatically removed in the restoration process.

Multimodal image registration of the scoliotic torso for surgical planning

PubMed Central

2013-01-01

Background This paper presents a method that registers MRIs acquired in prone position, with surface topography (TP) and X-ray reconstructions acquired in standing position, in order to obtain a 3D representation of a human torso incorporating the external surface, bone structures, and soft tissues. Methods TP and X-ray data are registered using landmarks. Bone structures are used to register each MRI slice using an articulated model, and the soft tissue is confined to the volume delimited by the trunk and bone surfaces using a constrained thin-plate spline. Results The method is tested on 3 pre-surgical patients with scoliosis and shows a significant improvement, qualitatively and using the Dice similarity coefficient, in fitting the MRI into the standing patient model when compared to rigid and articulated model registration. The determinant of the Jacobian of the registration deformation shows higher variations in the deformation in areas closer to the surface of the torso. Conclusions The novel, resulting 3D full torso model can provide a more complete representation of patient geometry to be incorporated in surgical simulators under development that aim at predicting the effect of scoliosis surgery on the external appearance of the patient’s torso. PMID:23289431

Evidence for an Evolutionary Cheater Strategy--Relationships Between Primary and Secondary Psychopathy, Parenting, and Shame and Guilt.

PubMed

Lyons, Minna T

2015-01-01

In the present study, shame and guilt proneness were investigated in relation to primary and secondary psychopathy, looking at parental care as a possible mediator. A sample of 388 volunteers participated in an on-line study, completing several self-report measurements. Primary psychopathy, robust to parental care and sex of the participant, was associated with lower guilt proneness after a private transgression and lower negative self-evaluations after a public transgression. Secondary psychopathy was not associated with guilt or shame proneness. Paternal care played a mediating role between primary psychopathy and guilt, but only in male participants. High paternal care was associated with lower guilt repair in high psychopathy males, suggesting that a positive father-son relationship might be essential for development of exploitive strategies in primary psychopathy. The results highlight the fundamental differences between primary and secondary psychopathy, and provide support for the idea that primary psychopathy is an evolutionary cheater-strategy.

Relations among behavioral inhibition, shame- and guilt-proneness, and anxiety disorders symptoms in non-clinical children.

PubMed

Muris, Peter; Meesters, Cor; Bouwman, Leanne; Notermans, Sabine

2015-04-01

This study examined relationships between the self-conscious emotions of shame and guilt, behavioral inhibition (as an index of anxiety proneness), and anxiety disorder symptoms in non-clinical children aged 8-13 years (N = 126), using children's self-report data. Results showed that there were positive and significant correlations between shame and guilt, behavioral inhibition, and anxiety disorders symptoms. When controlling for the overlap between shame and guilt, it was found that shame (but not guilt) remained significantly associated with higher levels of anxiety proneness and anxiety symptoms. Further, when controlling for the effect of behavioral inhibition, shame still accounted for a significant proportion of the variance of total anxiety and generalized anxiety scores. For these anxiety problems, support emerged for a model in which shame acted as a partial mediator in the relation between behavioral inhibition and anxiety. These results indicate that the self-conscious emotion of shame is a robust correlate of anxiety pathology in children.

Social Support and Violence-prone Relationships as Predictors of Disclosure of HIV Status Among Newly Diagnosed HIV-positive South Africans.

PubMed

Fifield, Jocelyn; O'Sullivan, Lucia; Kelvin, Elizabeth A; Mantell, Joanne E; Exner, Theresa; Ramjee, Gita; Blanchard, Kelly; Hoffman, Susie

2018-05-09

Despite the salience of social support and violence as potential outcomes of disclosure, how pre-existing social support and relationship violence among people living with HIV shapes and influences HIV status disclosure has received limited attention. Following the Disclosure Process Model, this study investigated pre-disclosure support and violence-prone relationships as predictors of disclosure using data from a prospective study of 459 newly diagnosed South African women and men. Most (88%) disclosed their status to at least one person by their 8-month interview. Level of social support was unrelated to disclosure to a partner. However, those with higher levels of support had higher odds of disclosing to family and to others. Women in violence-prone relationships were more likely to report disclosure to a partner than were those not in such relationships, counter to expectations. The findings suggest that the same mechanisms may not explain processes of disclosure across all relationship types.

50 CFR 14.161 - Primary enclosures.

Code of Federal Regulations, 2010 CFR

2010-10-01

... Wild Mammals and Birds to the United States Specifications for Other Terrestrial Mammals § 14.161... primary enclosure shall provide adequate space for the animal to stand upright in a normal posture with... lie in a full prone position. Specifications for Birds ...

Haemodynamic Changes During Anaesthesia in the Prone Position, Evaluated Using Transoesophageal Ultrasound

ClinicalTrials.gov

2015-11-02

Obesity; Spinal Surgery; Anaesthesia; Changes in Left and Right Ventricle Dimension; Changes in Bloodflow Across Cardiac Valves; Changes in Dimensions of Inferior Caval Dimension and Hepatic Venous Bloodflow; Changes i Myocardial Velocities; Changes in Diastolic Function

An Exploration of Positional Response Sets in Disadvantaged Children and a Technique for Reduction of Such Sets. Final Report.

ERIC Educational Resources Information Center

Victor, Jack

This study is concerned with an examination of tendencies among individuals or groups to vary in their selection of certain types of responses when the same choice is presented in some other form, the tendencies being termed "response sets." Positional response sets (PRS), to which multiple-choice type items are prone, have reportedly…

Eliminating log rolling as a spine trauma order.

PubMed

Conrad, Bryan P; Rossi, Gianluca Del; Horodyski, Mary Beth; Prasarn, Mark L; Alemi, Yara; Rechtine, Glenn R

2012-01-01

Currently, up to 25% of patients with spinal cord injuries may experience neurologic deterioration during the initial management of their injuries. Therefore, more effective procedures need to be established for the transportation and care of these to reduce the risk of secondary neurologic damage. Here, we present more acceptable methods to minimize motion in the unstable spine during the management of patients with traumatic spine injuries. This review summarizes more than a decade of research aimed at evaluating different methods of caring for patients with spine trauma. The most commonly utilized technique to transport spinal cord injured patients, the log rolling maneuver, produced more motion than placing a patient on a spine board, removing a spine board, performing continuous lateral therapy, and positioning a patient prone for surgery. Alternative maneuvers that produced less motion included the straddle lift and slide, 6 + lift and slide, scoop stretcher, mechanical kinetic therapy, mechanical transfers, and the use of the operating table to rotate the patient to the prone position for surgical stabilization. The log roll maneuver should be removed from the trauma response guidelines for patients with suspected spine injuries, as it creates significantly more motion in the unstable spine than the readily available alternatives. The only exception is the patient who is found prone, in which case the patient should then be log rolled directly on to the spine board utilizing a push technique.

Study of prone positioning to reduce ventilator-associated pneumonia in hypoxaemic patients.

PubMed

Mounier, R; Adrie, C; Français, A; Garrouste-Orgeas, M; Cheval, C; Allaouchiche, B; Jamali, S; Dinh-Xuan, A T; Goldgran-Toledano, D; Cohen, Y; Azoulay, E; Timsit, J-F; Ricard, J-D

2010-04-01

The aim of the present study was to examine whether prone positioning (PP) affects ventilator associated-pneumonia (VAP) and mortality in patients with acute lung injury/adult respiratory distress syndrome. 2,409 prospectively included patients were admitted over 9 yrs (2000-2008) to 12 French intensive care units (ICUs) (OUTCOMEREA). The patients required invasive mechanical ventilation (MV) and had arterial oxygen tension/inspiratory oxygen fraction ratios <300 during the first 48 h. Controls were matched to PP patients on the PP propensity score (+/-10%), MV duration longer than that in PP patients before the first turn prone, and centre. VAP incidence was similar in the PP and control groups (24 versus 13 episodes.1,000 patient-days MV(-1) respectively, p = 0.14). After adjustment, PP did not decrease VAP occurrence (HR 1.64 (95% CI 0.70-3.84); p = 0.25) but significantly delayed hospital mortality (HR 0.56 (95% CI 0.39-0.79); p = 0.001), without decreasing 28-day mortality (37% in both groups). Post hoc analyses indicated that PP did not protect against VAP but, when used for >1 day, might decrease mortality and benefit the sickest patients (Simplified Acute Physiology Score >50). In ICU patients with hypoxaemic acute respiratory failure, PP had no effect on the risk of VAP. PP delayed mortality without decreasing 28-day mortality. PP >1 day might decrease mortality, particularly in the sickest patients.

Infant rolling abilities--the same or different 20 years after the back to sleep campaign?

PubMed

Darrah, Johanna; Bartlett, Doreen J

2013-05-01

To compare the order and age of emergence of rolling prone to supine and supine to prone before the introduction of back to sleep guidelines and 20 years after their introduction. The original normative data for the Alberta Infant Motor Scale (AIMS) were collected just prior to the introduction of back to sleep guidelines in 1992. Currently these norms are being re-evaluated. Data of rolling patterns of infants 36 weeks of age or younger from the original sample (n=1114) and the contemporary sample (n=351) were evaluated to compare the sequence of appearance of prone to supine and supine to prone rolls (proportion of infants passing each roll) and the ages of emergence (estimated age when 50% of infants passed each roll). The sequence of emergence and estimated age of appearance of both rolling directions were similar between the two time periods. The introduction of the supine sleep position to reduce the prevalence of Sudden Infant Death Syndrome (SIDS) has not altered the timing or sequence of infant rolling abilities. This information is valuable to health care providers involved in the surveillance of infants' development. Original normative age estimates for these two motor abilities are still appropriate. Copyright © 2012 Elsevier Ltd. All rights reserved.

Detection of Sour Skin Diseases in Vidalia Sweet Onions using Near-Infrared Hyperspectral Imaging

USDA-ARS?s Scientific Manuscript database

Vidalia sweet onion is an important specialty crop grown in southeast area of Georgia, which accounts for approximate 13% of the vegetable farm gate value in the state. However, Vidalia sweet onions are more prone to rotting and sprouting due to lacking some pungent compounds found in other onion va...

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2018-03-01

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.

Detecting ordered small molecule drug aggregates in live macrophages: a multi-parameter microscope image data acquisition and analysis strategy

PubMed Central

Rzeczycki, Phillip; Yoon, Gi Sang; Keswani, Rahul K.; Sud, Sudha; Stringer, Kathleen A.; Rosania, Gus R.

2017-01-01

Following prolonged administration, certain orally bioavailable but poorly soluble small molecule drugs are prone to precipitate out and form crystal-like drug inclusions (CLDIs) within the cells of living organisms. In this research, we present a quantitative multi-parameter imaging platform for measuring the fluorescence and polarization diattenuation signals of cells harboring intracellular CLDIs. To validate the imaging system, the FDA-approved drug clofazimine (CFZ) was used as a model compound. Our results demonstrated that a quantitative multi-parameter microscopy image analysis platform can be used to study drug sequestering macrophages, and to detect the formation of ordered molecular aggregates formed by poorly soluble small molecule drugs in animals. PMID:28270989

Development of methods for the analysis of multi-mode TFM images

NASA Astrophysics Data System (ADS)

Sy, K.; Bredif, P.; Iakovleva, E.; Roy, O.; Lesselier, D.

2018-05-01

TFM (Total Focusing Method) is an advanced post-processing imaging algorithm of ultrasonic array data that shows good potential in defect detection and characterization. It can be employed using an infinite number of paths between transducer and focusing point. Depending upon the geometry and the characteristics of the defect in a given part, there are not the same modes that are appropriate for the defect reconstruction. Furthermore, non-physical indications can be observed, prone to misinterpretation. These imaging artifacts are due to the coexistence of several contributions involving several modes of propagation and interactions with possible defects and/or the geometry of the part. Two methods for filtering artifacts and reducing the number of TFM images are developed and illustrated.

Detecting ordered small molecule drug aggregates in live macrophages: a multi-parameter microscope image data acquisition and analysis strategy.

PubMed

Rzeczycki, Phillip; Yoon, Gi Sang; Keswani, Rahul K; Sud, Sudha; Stringer, Kathleen A; Rosania, Gus R

2017-02-01

Following prolonged administration, certain orally bioavailable but poorly soluble small molecule drugs are prone to precipitate out and form crystal-like drug inclusions (CLDIs) within the cells of living organisms. In this research, we present a quantitative multi-parameter imaging platform for measuring the fluorescence and polarization diattenuation signals of cells harboring intracellular CLDIs. To validate the imaging system, the FDA-approved drug clofazimine (CFZ) was used as a model compound. Our results demonstrated that a quantitative multi-parameter microscopy image analysis platform can be used to study drug sequestering macrophages, and to detect the formation of ordered molecular aggregates formed by poorly soluble small molecule drugs in animals.

Shame and implicit self-concept in women with borderline personality disorder.

PubMed

Rüsch, Nicolas; Lieb, Klaus; Göttler, Ines; Hermann, Christiane; Schramm, Elisabeth; Richter, Harald; Jacob, Gitta A; Corrigan, Patrick W; Bohus, Martin

2007-03-01

Shame is considered to be a central emotion in borderline personality disorder and to be related to self-injurious behavior, chronic suicidality, and anger-hostility. However, its level and impact on people with borderline personality disorder are largely unknown. The authors examined levels of self-reported shame, guilt, anxiety, and implicit shame-related self-concept in women with borderline personality disorder and assessed the association of shame with self-esteem, quality of life, and anger-hostility. Sixty women with borderline personality disorder completed self-report measures of shame- and guilt-proneness, state shame, anxiety, depression, self-esteem, quality of life, and clinical symptoms. Comparison groups consisted of 30 women with social phobia and 60 healthy women. Implicit shame-related self-concept (relative to anxiety) was assessed by the Implicit Association Test. Women with borderline personality disorder reported higher levels of shame- and guilt-proneness, state shame, and anxiety than women with social phobia and healthy comparison subjects. The implicit self-concept in women with borderline personality disorder was more shame-prone (relative to anxiety-prone) than in women in the comparison groups. After depression was controlled for, shame-proneness was negatively correlated with self-esteem and quality of life and positively correlated with anger-hostility. Shame, an emotion that is prominent in women with borderline personality disorder, is associated with the implicit self-concept as well as with poorer quality of life and self-esteem and greater anger-hostility. Psychotherapeutic approaches to borderline personality disorder need to address explicit and implicit aspects of shame.

Compounds identified by virtual docking to a tetrameric EGFR extracellular domain can modulate Grb2 internalization.

PubMed

Ramirez, Ursula D; Nikonova, Anna S; Liu, Hanqing; Pecherskaya, Anna; Lawrence, Sarah H; Serebriiskii, Ilya G; Zhou, Yan; Robinson, Matthew K; Einarson, Margret B; Golemis, Erica A; Jaffe, Eileen K

2015-05-28

Overexpression or mutation of the epidermal growth factor receptor (EGFR) potently enhances the growth of many solid tumors. Tumor cells frequently display resistance to mechanistically-distinct EGFR-directed therapeutic agents, making it valuable to develop therapeutics that work by additional mechanisms. Current EGFR-targeting therapeutics include antibodies targeting the extracellular domains, and small molecules inhibiting the intracellular kinase domain. Recent studies have identified a novel prone extracellular tetrameric EGFR configuration, which we identify as a potential target for drug discovery. Our focus is on the prone EGFR tetramer, which contains a novel protein-protein interface involving extracellular domain III. This EGFR tetramer is computationally targeted for stabilization by small molecule ligand binding. This study performed virtual screening of a Life Chemicals, Inc. small molecule library of 345,232 drug-like compounds against a molecular dynamics simulation of protein-protein interfaces distinct to the novel tetramer. One hundred nine chemically diverse candidate molecules were selected and evaluated using a cell-based high-content imaging screen that directly assessed induced internalization of the EGFR effector protein Grb2. Positive hits were further evaluated for influence on phosphorylation of EGFR and its effector ERK1/2. Fourteen hit compounds affected internalization of Grb2, an adaptor responsive to EGFR activation. Most hits had limited effect on cell viability, and minimally influenced EGFR and ERK1/2 phosphorylation. Docked hit compound poses generally include Arg270 or neighboring residues, which are also involved in binding the effective therapeutic cetuximab, guiding further chemical optimization. These data suggest that the EGFR tetrameric configuration offers a novel cancer drug target.

Fall-Prone Older People's Attitudes towards the Use of Virtual Reality Technology for Fall Prevention.

PubMed

Dockx, Kim; Alcock, Lisa; Bekkers, Esther; Ginis, Pieter; Reelick, Miriam; Pelosin, Elisa; Lagravinese, Giovanna; Hausdorff, Jeffrey M; Mirelman, Anat; Rochester, Lynn; Nieuwboer, Alice

2017-01-01

Virtual reality (VR) technology is a relatively new rehabilitation tool that can deliver a combination of cognitive and motor training for fall prevention. The attitudes of older people to such training are currently unclear. This study aimed to investigate: (1) the attitudes of fall-prone older people towards fall prevention exercise with and without VR; (2) attitudinal changes after intervention with and without VR; and (3) user satisfaction following fall prevention exercise with and without VR. A total of 281 fall-prone older people were randomly assigned to an experimental group receiving treadmill training augmented by VR (TT+VR, n = 144) or a control group receiving treadmill training alone (TT, n = 137). Two questionnaires were used to measure (1) attitudes towards fall prevention exercise with and without VR (AQ); and (2) user satisfaction (USQ). AQ was evaluated at baseline and after intervention. USQ was measured after intervention only. The AQ revealed that most participants had positive attitudes towards fall prevention exercise at baseline (82.2%) and after intervention (80.6%; p = 0.144). In contrast, only 53.6% were enthusiastic about fall prevention exercise with VR at baseline. These attitudes positively changed after intervention (83.1%; p < 0.001), and 99.2% indicated that they enjoyed TT+VR. Correlation analyses showed that postintervention attitudes were strongly related to user satisfaction (USQ: r = 0.503; p < 0.001). Older people's attitudes towards fall prevention exercise with VR were positively influenced by their experience. From the perspective of the user, VR is an attractive training mode, and thus improving service provision for older people is important. © 2017 S. Karger AG, Basel.

Robot-assisted thoracoscopic lymphadenectomy along the left recurrent laryngeal nerve for esophageal squamous cell carcinoma in the prone position: technical report and short-term outcomes.

PubMed

Suda, Koichi; Ishida, Yoshinori; Kawamura, Yuichiro; Inaba, Kazuki; Kanaya, Seiichiro; Teramukai, Satoshi; Satoh, Seiji; Uyama, Ichiro

2012-07-01

Meticulous mediastinal lymphadenectomy frequently induces recurrent laryngeal nerve palsy (RLNP). Surgical robots with impressive dexterity and precise dissection skills have been developed to help surgeons perform operations. The objective of this study was to determine the impact on short-term outcomes of robot-assisted thoracoscopic radical esophagectomy performed on patients in the prone position for the treatment of esophageal squamous cell carcinoma, including its impact on RLNP. A single-institution nonrandomized prospective study was performed. The patients (n = 36) with resectable esophageal squamous cell carcinoma were divided into two groups: patients who agreed to robot-assisted thoracoscopic esophagectomy with total mediastinal lymphadenectomy performed in the prone position (n = 16, robot-assisted group) without insurance reimbursement, and those who agreed to undergo the same operation without robot assistance but with health insurance coverage (n = 20, control group). These patients were observed for 30 days following surgery to assess short-term surgical outcomes, including the incidence of vocal cord palsy, hoarseness, and aspiration. Robot assistance significantly reduced the incidence of vocal cord palsy (p = 0.018) and hoarseness (p = 0.015) and the time on the ventilator (p = 0.025). There was no in-hospital mortality in either group. There were no significant differences between the two groups with respect to patient background, except for the use of preoperative therapy (robot-assisted group

Effects of Interventions on Survival in Acute Respiratory Distress Syndrome: an Umbrella Review of 159 Published Randomized Trials and 29 Meta-analyses

PubMed Central

Tonelli, Adriano R.; Zein, Joe; Adams, Jacob; Ioannidis, John P.A.

2014-01-01

Purpose Multiple interventions have been tested in acute respiratory distress syndrome (ARDS). We examined the entire agenda of published randomized controlled trials (RCTs) in ARDS that reported on mortality and of respective meta-analyses. Methods We searched PubMed, the Cochrane Library and Web of Knowledge until July 2013. We included RCTs in ARDS published in English. We excluded trials of newborns and children; and those on short-term interventions, ARDS prevention or post-traumatic lung injury. We also reviewed all meta-analyses of RCTs in this field that addressed mortality. Treatment modalities were grouped in five categories: mechanical ventilation strategies and respiratory care, enteral or parenteral therapies, inhaled / intratracheal medications, nutritional support and hemodynamic monitoring. Results We identified 159 published RCTs of which 93 had overall mortality reported (n= 20,671 patients) - 44 trials (14,426 patients) reported mortality as a primary outcome. A statistically significant survival benefit was observed in 8 trials (7 interventions) and two trials reported an adverse effect on survival. Among RTCs with >50 deaths in at least 1 treatment arm (n=21), 2 showed a statistically significant mortality benefit of the intervention (lower tidal volumes and prone positioning), 1 showed a statistically significant mortality benefit only in adjusted analyses (cisatracurium) and 1 (high-frequency oscillatory ventilation) showed a significant detrimental effect. Across 29 meta-analyses, the most consistent evidence was seen for low tidal volumes and prone positioning in severe ARDS. Conclusions There is limited supportive evidence that specific interventions can decrease mortality in ARDS. While low tidal volumes and prone positioning in severe ARDS seem effective, most sporadic findings of interventions suggesting reduced mortality are not corroborated consistently in large-scale evidence including meta-analyses. PMID:24667919

Description of the Motor Development of 3-12 Month Old Infants with Down Syndrome: The Influence of the Postural Body Position

ERIC Educational Resources Information Center

Tudella, Eloisa; Pereira, Karina; Basso, Renata Pedrolongo; Savelsbergh, Geert J. P.

2011-01-01

The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were…

Time-frequency analysis of functional optical mammographic images

NASA Astrophysics Data System (ADS)

Barbour, Randall L.; Graber, Harry L.; Schmitz, Christoph H.; Tarantini, Frank; Khoury, Georges; Naar, David J.; Panetta, Thomas F.; Lewis, Theophilus; Pei, Yaling

2003-07-01

We have introduced working technology that provides for time-series imaging of the hemoglobin signal in large tissue structures. In this study we have explored our ability to detect aberrant time-frequency responses of breast vasculature for subjects with Stage II breast cancer at rest and in response to simple provocations. The hypothesis being explored is that time-series imaging will be sensitive to the known structural and functional malformations of the tumor vasculature. Mammographic studies were conducted using an adjustable hemisheric measuring head containing 21 source and 21 detector locations (441 source-detector pairs). Simultaneous dual-wavelength studies were performed at 760 and 830 nm at a framing rate of ~2.7 Hz. Optical measures were performed on women lying prone with the breast hanging in a pendant position. Two class of measures were performed: (1) 20- minute baseline measure wherein the subject was at rest; (2) provocation studies wherein the subject was asked to perform some simple breathing maneuvers. Collected data were analyzed to identify the time-frequency structure and central tendencies of the detector responses and those of the image time series. Imaging data were generated using the Normalized Difference Method (Pei et al., Appl. Opt. 40, 5755-5769, 2001). Results obtained clearly document three classes of anomalies when compared to the normal contralateral breast. 1) Breast tumors exhibit altered oxygen supply/demand imbalance in response to an oxidative challenge (breath hold). 2) The vasomotor response of the tumor vasculature is mainly depressed and exhibits an altered modulation. 3) The affected area of the breast wherein the altered vasomotor signature is seen extends well beyond the limits of the tumor itself.

Improved accuracy of ultrasound-guided therapies using electromagnetic tracking: in-vivo speed of sound measurements

NASA Astrophysics Data System (ADS)

Samboju, Vishal; Adams, Matthew; Salgaonkar, Vasant; Diederich, Chris J.; Cunha, J. Adam M.

2017-02-01

The speed of sound (SOS) for ultrasound devices used for imaging soft tissue is often calibrated to water, 1540 m/s1 , despite in-vivo soft tissue SOS varying from 1450 to 1613 m/s2 . Images acquired with 1540 m/s and used in conjunction with stereotactic external coordinate systems can thus result in displacement errors of several millimeters. Ultrasound imaging systems are routinely used to guide interventional thermal ablation and cryoablation devices, or radiation sources for brachytherapy3 . Brachytherapy uses small radioactive pellets, inserted interstitially with needles under ultrasound guidance, to eradicate cancerous tissue4 . Since the radiation dose diminishes with distance from the pellet as 1/r2 , imaging uncertainty of a few millimeters can result in significant erroneous dose delivery5,6. Likewise, modeling of power deposition and thermal dose accumulations from ablative sources are also prone to errors due to placement offsets from SOS errors7 . This work presents a method of mitigating needle placement error due to SOS variances without the need of ionizing radiation2,8. We demonstrate the effects of changes in dosimetry in a prostate brachytherapy environment due to patientspecific SOS variances and the ability to mitigate dose delivery uncertainty. Electromagnetic (EM) sensors embedded in the brachytherapy ultrasound system provide information regarding 3D position and orientation of the ultrasound array. Algorithms using data from these two modalities are used to correct bmode images to account for SOS errors. While ultrasound localization resulted in >3 mm displacements, EM resolution was verified to <1 mm precision using custom-built phantoms with various SOS, showing 1% accuracy in SOS measurement.

Iodine contrast cone beam CT imaging of breast cancer

NASA Astrophysics Data System (ADS)

Partain, Larry; Prionas, Stavros; Seppi, Edward; Virshup, Gary; Roos, Gerhard; Sutherland, Robert; Boone, John

2007-03-01

An iodine contrast agent, in conjunction with an X-ray cone beam CT imaging system, was used to clearly image three, biopsy verified, cancer lesions in two patients. The lesions were approximately in the 10 mm to 6 mm diameter range. Additional regions were also enhanced with approximate dimensions down to 1 mm or less in diameter. A flat panel detector, with 194 μm pixels in 2 x 2 binning mode, was used to obtain 500 projection images at 30 fps with an 80 kVp X-ray system operating at 112 mAs, for an 8-9 mGy dose - equivalent to two view mammography for these women. The patients were positioned prone, while the gantry rotated in the horizontal plane around the uncompressed, pendant breasts. This gantry rotated 360 degrees during the patient's 16.6 sec breath hold. A volume of 100 cc of 320 mg/ml iodine-contrast was power injected at 4 cc/sec, via catheter into the arm vein of the patient. The resulting 512 x 512 x 300 cone beam CT data set of Feldkamp reconstructed ~(0.3 mm) 3 voxels were analyzed. An interval of voxel contrast values, characteristic of the regions with iodine contrast enhancement, were used with surface rendering to clearly identify up to a total of 13 highlighted volumes. This included the three largest lesions, that were previously biopsied and confirmed to be malignant. The other ten highlighted regions, of smaller diameters, are likely areas of increased contrast trapping unrelated to cancer angiogenesis. However the technique itself is capable of resolving lesions that small.

Heads-up 3D Microscopy: An Ergonomic and Educational Approach to Microsurgery

PubMed Central

Mendez, Bernardino M.; Chiodo, Michael V.; Vandevender, Darl

2016-01-01

Summary: Traditional microsurgery can lead surgeons to use postures that cause musculoskeletal fatigue, leaving them more prone to work-related injuries. A new technology from TrueVision transmits the microscopic image onto a 3-dimensional (3D) monitor, allowing surgeons to operate while sitting/standing in a heads-up position. The purpose of this study was to evaluate the feasibility of performing heads-up 3D microscopy as a more ergonomic alternative to traditional microsurgery. A feasibility study was conducted comparing heads-up 3D microscopy and traditional microscopy by performing femoral artery anastomoses on 8 Sprague-Dawley rats. Operative times and patency rates for each technology were compared. The 8 microsurgeons completed a questionnaire comparing image quality, comfort, technical feasibility, and educational value of the 2 technologies. Rat femoral artery anastomoses were successfully carried out by all 8 microsurgeons with each technology. There was no significant difference in anastomosis time between heads-up 3D and traditional microscopy (average times, 34.5 and 33.8 minutes, respectively; P = 0.66). Heads-up 3D microscopy was rated superior in neck and back comfort by 75% of participants. Image resolution, field of view, and technical feasibility were found to be superior or equivalent in 75% of participants, whereas 63% evaluated depth perception to be superior or equivalent. Heads-up 3D microscopy is a new technology that improves comfort for the microsurgeon without compromising image quality or technical feasibility. Its use has become prevalent in the field of ophthalmology and may also have utility in plastic and reconstructive surgery. PMID:27579241

Poster — Thur Eve — 55: An automated XML technique for isocentre verification on the Varian TrueBeam

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

Asiev, Krum; Mullins, Joel; DeBlois, François

2014-08-15

Isocentre verification tests, such as the Winston-Lutz (WL) test, have gained popularity in the recent years as techniques such as stereotactic radiosurgery/radiotherapy (SRS/SRT) treatments are more commonly performed on radiotherapy linacs. These highly conformal treatments require frequent monitoring of the geometrical accuracy of the isocentre to ensure proper radiation delivery. At our clinic, the WL test is performed by acquiring with the EPID a collection of 8 images of a WL phantom fixed on the couch for various couch/gantry angles. This set of images is later analyzed to determine the isocentre size. The current work addresses the acquisition process. Amore » manual WL test acquisition performed by and experienced physicist takes in average 25 minutes and is prone to user manipulation errors. We have automated this acquisition on a Varian TrueBeam STx linac (Varian, Palo Alto, USA). The Varian developer mode allows the execution of custom-made XML script files to control all aspects of the linac operation. We have created an XML-WL script that cycles through each couch/gantry combinations taking an EPID image at each position. This automated acquisition is done in less than 4 minutes. The reproducibility of the method was verified by repeating the execution of the XML file 5 times. The analysis of the images showed variation of the isocenter size less than 0.1 mm along the X, Y and Z axes and compares favorably to a manual acquisition for which we typically observe variations up to 0.5 mm.« less

Why is a prone sleeping position dangerous for certain infants?

PubMed

Byard, Roger W; Bright, Fiona; Vink, Robert

2018-03-01

The prone (face down) sleeping position is known to be associated with a significantly increased risk of sudden and unexpected death in infancy (sudden infant death syndrome or SIDS), however, the reasons for this are unclear. Suggested mechanisms have involved suffocation from occlusion of the external airways by soft bedding/pillows or from flattening of the nose with backward displacement of the tongue, rebreathing of carbon dioxide, blunting of arousal responses with decreased cardiac responses to auditory stimulation, diaphragmatic splinting or fatigue, lowering of vasomotor tone with tachycardia, nasopharyngeal bacterial overgrowth, overheating, alteration of sleep patterns, compromise of cerebral blood flow and upper airway obstruction from distortion of nasal cartilages. Recent studies have, however, shown a significant reduction in substance P in the inferior portion of the olivo-cerebellar complex in SIDS infants which is crucial for the integration of motor and sensory information for the control of head and neck movement. This deficit may explain why some infants are not able to move their faces away from potentially dangerous sleeping environments.

[The glider. Postural kinetic behavior during the pre-locomotor period in infants].

PubMed

Auzias, M; de Ajuriaguerra, J

1980-01-01

Soaring movements-in an opisthotonic posture-which appear between 3 and 10 months when the infant is in a prone position, have been observed with cinematographic recordings. This is a postural and kinetic activity which takes place during the first year's development; i is a transitional stage leading to intentional propulsive movements. This activity may become a repetitive one for some children, especially between 4 and 7 months; at this peak period, it takes on an unusual aspect, not only because of the "aerial" attitude but also because of the rhythmicity of the postural changes which characterize it. This behavior has been studied in its evolutionary forms, its individual characteristics, and its emotional expressions. Hovering movements are localized in the neuro-psychological evolution of the infant (tonico-postural evolution, acquisition of balance in a prone position, alternating postures, propulsive movements). The conditions which set off and quieten this activity explain the dynamics of its functioning between movements to which the baby is submitted and deliberate ones, between constraint and pleasure.

Learn good from bad: Effects of good and bad neighbors in spatial prisoners' dilemma games

NASA Astrophysics Data System (ADS)

Lu, Peng

2015-10-01

Cooperation is vital for the human society and this study focuses on how to promote cooperation. In our stratification model, there exist three classes: two minorities are elites who are prone to cooperate and scoundrels who are born to defect; one majority is the class of common people. Agents of these three classes interact with each other on a square lattice. Commons' cooperation and its factors are investigated. Contradicting our common sense, it indicates that elites play a negative role while scoundrels play a positive one in promoting commons' cooperation. Besides, effects of good and bad neighbors vary with temptation. When the temptation is smaller the positive effect is able to overcome the negative effect, but the later prevails when the temptation is larger. It concludes that common people are more prone to cooperate in harsh environment with bad neighbors, and a better environment with good neighbors merely leads to laziness and free riding of commons.

The "shoulds" and "should nots" of moral emotions: a self-regulatory perspective on shame and guilt.

PubMed

Sheikh, Sana; Janoff-Bulman, Ronnie

2010-02-01

A self-regulatory framework for distinguishing between shame and guilt was tested in three studies. Recently, two forms of moral regulation based on approach versus avoidance motivation have been proposed in the literature. Proscriptive regulation is sensitive to negative outcomes, inhibition based, and focused on what we should not do. Prescriptive regulation is sensitive to positive outcomes, activation based, and focused on what we should do. In the current research, consistent support was found for shame's proscriptive and guilt's prescriptive moral underpinnings. Study 1 found a positive association between avoidance orientation and shame proneness and between approach orientation and guilt proneness. In Study 2, priming a proscriptive orientation increased shame and priming a prescriptive orientation increased guilt. In Study 3, transgressions most apt to represent proscriptive and prescriptive violations predicted subsequent judgments of shame and guilt, respectively. This self-regulatory perspective provides a broad interpretive framework for understanding and extending past research findings.

CXCL16/CXCR6-mediated adhesion of human peripheral blood mononuclear cells to inflamed endothelium.

PubMed

Linke, Bona; Meyer Dos Santos, Sascha; Picard-Willems, Bettina; Keese, Michael; Harder, Sebastian; Geisslinger, Gerd; Scholich, Klaus

2017-06-21

The endothelial chemokine CXC motif ligand 16 (CXCL16) is involved in the recruitment and firm adhesion of CXCR6 + cells to the atherosclerosis-prone aortic vessel wall. Recently we showed that CXCR6 + platelets from flowing blood attach to CXCL16 expressed by activated endothelium on the luminal side of the blood vessel. With this study we supplement these findings with the observation that platelets bound to the inflamed endothelium are presenting CXCR6 to CXCL16-positive peripheral blood mononuclear cells (PBMCs) and, thus, are mediating an increased adhesion of PBMCs to the arterial wall. Furthermore we identified endothelial CXCL16 as an important adhesion molecule promoting the firm adhesion of CXCR6-positive PBMCs to inflamed endothelium. Our results demonstrate that endothelial CXCL16 as well as platelet CXCR6 are acting as potent PBMC-adhesion ligands, inducing PBMC-adhesion to the atherosclerosis-prone vessel wall and thus promoting the progression of atherosclerosis. Copyright © 2017 Elsevier Ltd. All rights reserved.

Inducible error-prone repair in B. subtilis. Final report, September 1, 1979-June 30, 1981

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

Yasbin, R. E.

1981-06-01

The research performed under this contract has been concentrated on the relationship between inducible DNA repair systems, mutagenesis and the competent state in the gram positive bacterium Bacillus subtilis. The following results have been obtained from this research: (1) competent Bacillus subtilis cells have been developed into a sensitive tester system for carcinogens; (2) competent B. subtilis cells have an efficient excision-repair system, however, this system will not function on bacteriophage DNA taken into the cell via the process of transfection; (3) DNA polymerase III is essential in the mechanism of the process of W-reactivation; (4) B. subtilis strains curedmore » of their defective prophages have been isolated and are now being developed for gene cloning systems; (5) protoplasts of B. subtilis have been shown capable of acquiring DNA repair enzymes (i.e., enzyme therapy); and (6) a plasmid was characterized which enhanced inducible error-prone repair in a gram positive organism.« less

Direct optical mapping of transcription factor binding sites on field-stretched λ-DNA in nanofluidic devices

PubMed Central

Sriram, K. K.; Yeh, Jia-Wei; Lin, Yii-Lih; Chang, Yi-Ren; Chou, Chia-Fu

2014-01-01

Mapping transcription factor (TF) binding sites along a DNA backbone is crucial in understanding the regulatory circuits that control cellular processes. Here, we deployed a method adopting bioconjugation, nanofluidic confinement and fluorescence single molecule imaging for direct mapping of TF (RNA polymerase) binding sites on field-stretched single DNA molecules. Using this method, we have mapped out five of the TF binding sites of E. coli RNA polymerase to bacteriophage λ-DNA, where two promoter sites and three pseudo-promoter sites are identified with the corresponding binding frequency of 45% and 30%, respectively. Our method is quick, robust and capable of resolving protein-binding locations with high accuracy (∼ 300 bp), making our system a complementary platform to the methods currently practiced. It is advantageous in parallel analysis and less prone to false positive results over other single molecule mapping techniques such as optical tweezers, atomic force microscopy and molecular combing, and could potentially be extended to general mapping of protein–DNA interaction sites. PMID:24753422

Physicochemical characterization and study of in vitro interactions of pH-sensitive liposomes with the complement system.

PubMed

Carmo, Vildete A S; De Oliveira, Mônica C; Reis, Eduardo C O; Guimarães, Tânia M P D; Vilela, José M C; Andrade, Margareth S; Michalick, Marilene S M; Cardoso, Valbert N

2008-01-01

Complement activation is an important step in the acceleration of liposome clearance. The anaphylatoxins released following complement activation may motivate a wide variety of physiologic changes. We performed physicochemical characterization and in vitro studies of the interaction of complement system with both noncirculating and long-circulating pH-sensitive and nonpH-sensitive liposomes. The liposomes were characterized by diameter, zeta potential, and atomic force microscopy (AFM). The study of liposome interactions with complement system was conducted using hemolytic assay in rat serum. All liposomes presented a similar mean diameter (between 99.8 and 124.3 nm). The zeta potential was negative in all liposome preparations, except in liposomes modified with aminopoly (ethyleneglycol) 2000-distearoylphosphatidylethanolamine (aPEG(2000)-DSPE), which presented positive zeta potential. Atomic force microscopy images showed that non-long-circulating pH-sensitive liposomes are prone to vesicles aggregation. Non-pH-sensitive liposomes complement system activates, while pH-sensitive liposomes showed to be poor complement activators in rat serum.

Computer-aided target tracking in motion analysis studies

NASA Astrophysics Data System (ADS)

Burdick, Dominic C.; Marcuse, M. L.; Mislan, J. D.

1990-08-01

Motion analysis studies require the precise tracking of reference objects in sequential scenes. In a typical situation, events of interest are captured at high frame rates using special cameras, and selected objects or targets are tracked on a frame by frame basis to provide necessary data for motion reconstruction. Tracking is usually done using manual methods which are slow and prone to error. A computer based image analysis system has been developed that performs tracking automatically. The objective of this work was to eliminate the bottleneck due to manual methods in high volume tracking applications such as the analysis of crash test films for the automotive industry. The system has proven to be successful in tracking standard fiducial targets and other objects in crash test scenes. Over 95 percent of target positions which could be located using manual methods can be tracked by the system, with a significant improvement in throughput over manual methods. Future work will focus on the tracking of clusters of targets and on tracking deformable objects such as airbags.

Structural refinement of vitreous silica bilayers

NASA Astrophysics Data System (ADS)

Sadjadi, Mahdi; Wilson, Mark; Thorpe, M. F.

The importance of glasses resides not only in their applications but in fundamental questions that they put forth. The continuous random network model can successfully describe the glass structure, but determining details, like ring statistics, has always been difficult using only diffraction data. But recent atomic images of 2D vitreous silica bilayers can offer valuable new insights which are hard to be observed directly in 3D silica models/experiments (for references see). However, the experimental results are prone to uncertainty in atomic positions, systematic errors, and being finite. We employ special boundary conditions developed for such networks to refine the experimental structures. We show the best structure can be found by using various potentials to maximize information gained from the experimental samples. We find a range of densities, the so-called flexibility window, in which tetrahedra are perfect. We compare results from simulations using harmonic potentials, MD with atomic polarizabilities included and DFT. We should thank David Drabold and Bishal Bhattarai for useful discussions. Support through NSF Grant # DMS 1564468 is gratefully acknowledged.

Atlantoaxial manual realignment in a patient with traumatic atlantoaxial joint disruption.

PubMed

Goel, Atul; Figueiredo, Antonio; Maheshwari, Shradha; Shah, Abhidha

2010-05-01

We report a patient with complex traumatic translatory atlantoaxial dislocation, who we treated by joint exposure and reduction of the dislocation by facet manipulation and subsequent plate and screw atlantoaxial fixation. A 28-year-old male had fallen 7.6m (25 feet), and following the fall had severe neck pain but no neurological deficit. Investigations revealed a fracture at the base of the odontoid process and posterior displacement of the entire atlas over the axis, resulting in a translatory atlantoaxial dislocation. Head traction failed as he developed severe vertigo following its application. The patient was operated upon in a prone position. We opened the atlantoaxial joint and realigned the facets using distraction and manipulation techniques and secured the joint using a plate and screw interarticular method. The patient tolerated the treatment well and was symptom-free after 28 months. Postoperative images showed good craniovertebral alignment. Although technically challenging, direct manipulation of the facets of the atlas and axis can result in excellent craniovertebral realignment.

Thoracoscopic part of minimal invasive oesophagectomy in semiprone position: our initial experience.

PubMed

Thakkar, Chirag M; Kumar, Alankar V; Soni, Harshad N; Shah, Atul J; Patel, Kantilal S; Haribhakti, Sanjiv P

2014-08-01

Surgical resection with curative intent is till the mainstay of treatment for resectable esophageal cancer. Minimal invasive oesophagectomy has the potential to lower morbidity and mortality. In all likelihood, thoracoscopic oesophagectomy in semiprone position gives all the benefits of prone position and can be converted to thoracotomy without change in patient position if needed. The aim of this study is to analyze the feasibility of thoracoscopic oesophagectomy in semiprone position. This is a retrospective analysis of the data of thoracoscopic oesophgeactomy in semiprone position at Kaizen Hospital, a tertiary care center for gastroenterology during the period of December 2011 to December 2012. All surgeries were performed under general anesthesia with a single-lumen endotracheal tube. Esophageal mobilization was done by thoracoscopic approach in a semiprone position and an end-to-end hand-sewn cervical anastomosis was done. Abdominal part was performed by laparoscopic method in 3 patients and by laparotomy in rest of the patients. Total of 12 patients were included in this study. There was 1 conversion to thoracotomy and 1 surgical mortality. Mean operating time for the thoracoscopic part was 103 minutes, mean estimated blood loss for the thoracoscopic part was 110 mL, mean maximum end-tidal CO2 38.5 mm Hg, mean lymph nodes retrieved 14, and all patients had R0 resection. The median intensive care unit stay was 1 day and hospital stay was 8 days. Thoracoscopic part of thoracolaparoscopic oesophagectomy in semiprone position is a feasible option. It gives all advantages of prone position and thoracotomy is possible without change in patient position. However, further large-scale studies are required.

Molecular Imaging of Human Embryonic Stem Cells Stably Expressing Human PET Reporter Genes After Zinc Finger Nuclease-Mediated Genome Editing.

PubMed

Wolfs, Esther; Holvoet, Bryan; Ordovas, Laura; Breuls, Natacha; Helsen, Nicky; Schönberger, Matthias; Raitano, Susanna; Struys, Tom; Vanbilloen, Bert; Casteels, Cindy; Sampaolesi, Maurilio; Van Laere, Koen; Lambrichts, Ivo; Verfaillie, Catherine M; Deroose, Christophe M

2017-10-01

Molecular imaging is indispensable for determining the fate and persistence of engrafted stem cells. Standard strategies for transgene induction involve the use of viral vectors prone to silencing and insertional mutagenesis or the use of nonhuman genes. Methods: We used zinc finger nucleases to induce stable expression of human imaging reporter genes into the safe-harbor locus adeno-associated virus integration site 1 in human embryonic stem cells. Plasmids were generated carrying reporter genes for fluorescence, bioluminescence imaging, and human PET reporter genes. Results: In vitro assays confirmed their functionality, and embryonic stem cells retained differentiation capacity. Teratoma formation assays were performed, and tumors were imaged over time with PET and bioluminescence imaging. Conclusion: This study demonstrates the application of genome editing for targeted integration of human imaging reporter genes in human embryonic stem cells for long-term molecular imaging. © 2017 by the Society of Nuclear Medicine and Molecular Imaging.

[Subtalar arthrodesis].

PubMed

Fuhrmann, R A; Pillukat, T

2016-06-01

Realignment and stabilization of the hindfoot by subtalar joint arthrodesis. Idiopathic/posttraumatic arthritis, inflammatory arthritis of the subtalar joint with/without hindfoot malalignment. Optional flatfoot/cavovarus foot reconstruction. Inflammation, vascular disturbances, nicotine abuse. Approach dependent on assessment. Lateral approach: Supine position. Incision above the sinus tarsi. Exposure of subtalar joint. Removal of cartilage and breakage of the subchondral sclerosis. In valgus malalignment, interposition of corticocancellous bone segment; in varus malalignment resection of bone segment from the calcaneus. Reposition and temporarily stabilization with Kirschner wires. Imaging of hindfoot alignment. Stabilization with cannulated screws. Posterolateral approach: Prone position. Incision parallel to the lateral Achilles tendon border. Removal of cartilage and breakage of subchondral sclerosis. Medial approach: Supine position. Incision just above and parallel to the posterior tibial tendon. Removal of cartilage and breakage of subchondral sclerosis. Stabilization with screws. Lower leg walker with partial weightbearing. Active exercises of the ankle. After a 6‑week X‑ray, increase of weightbearing. Full weightbearing not before 8 weeks; with interpositioning bone grafts not before 10-12 weeks. Stable walking shoes. Active mobilization of the ankle. Of 43 isolated subtalar arthrodesis procedures, 5 wound healing disorders and no infections developed. Significantly improved AOFAS hindfood score. Well-aligned heel observed in 34 patients; 5 varus and 2 valgus malalignments. Sensory disturbances in 8 patients; minor ankle flexion limitations. Full bone healing in 36 subtalar joints, pseudarthrosis in 4 patients.

Comparison of 68Ga- and fluorescence-labeled microspheres for measurement of relative pulmonary perfusion in anesthetized pigs.

PubMed

Braune, Anja; Scharffenberg, Martin; Naumann, Anne; Bluth, Thomas; de Abreu, Marcelo Gama; Kotzerke, Jörg

2018-06-01

We compared 68 Gallium ( 68 Ga)- and fluorescence-labeled microspheres for measurement of pulmonary perfusion distribution in anesthetized pigs without lung injury. In two mechanically ventilated pigs, the distribution of pulmonary perfusion was marked in vivo with 68 Ga- and fluorescence-labeled microspheres in supine and prone position. After each injection, the distribution of 68 Ga-labeled microspheres was measured in vivo with positron emission tomography/ computed tomography (PET/CT) in the position in which microspheres were injected and vice versa. The distribution of fluorescence-labeled microspheres was measured ex vivo . Perfusion distributions were compared between methods and postures within four lung regions and along the ventro-dorsal gradient. After each injection of 68 Ga-labeled microspheres, changes in ventro-dorsal perfusion gradients induced by repositioning were compared for volume- and mass-normalized PET/CT measurements. Regional and gradient analyses of in vivo and ex vivo measurements, respectively, consistently revealed higher pulmonary perfusion in dorsal than ventral regions in supine positioned animals. Both methods showed more pronounced perfusion gradients in supine compared to prone position. Changes in animal position were associated with alterations in the ventro-dorsal perfusion gradient when volume-, but not mass-normalization was conducted for PET/CT data. Ex vivo fluorescence- and in vivo 68 Ga-labeled microspheres measurements revealed similar perfusion distributions. Mass-normalized perfusion measurements by 68 Ga-labeled microspheres and PET/CT were not affected by positioning artifacts. Schattauer GmbH.

Use of thermal inertia determined by HCMM to predict nocturnal cold prone areas in Florida

NASA Technical Reports Server (NTRS)

Allen, L. H., Jr. (Principal Investigator); Chen, E.; Martsolf, J. D.; Jones, P. H.

1981-01-01

The HCMM transparency scenes for the available winter of 1978-1979 were evaluated; scenes were identified on processed magnetic tapes; other remote sensing information was identified; and a soil heat flux model with variable-depth thermal profile was developed. The Image 100 system was used to compare HCMM and GOES transparent images of surface thermal patterns. Excellent correspondence of patterns was found, with HCMM giving the greater resolution. One image shows details of thermal patterns in Florida that are attributable to difference in near surface water contents. The wide range of surface temperatures attributable to surface thermal inertia that exist in the relatively flat Florida topography is demonstrated.

Stochastic Optical Reconstruction Microscopy (STORM).

PubMed

Xu, Jianquan; Ma, Hongqiang; Liu, Yang

2017-07-05

Super-resolution (SR) fluorescence microscopy, a class of optical microscopy techniques at a spatial resolution below the diffraction limit, has revolutionized the way we study biology, as recognized by the Nobel Prize in Chemistry in 2014. Stochastic optical reconstruction microscopy (STORM), a widely used SR technique, is based on the principle of single molecule localization. STORM routinely achieves a spatial resolution of 20 to 30 nm, a ten-fold improvement compared to conventional optical microscopy. Among all SR techniques, STORM offers a high spatial resolution with simple optical instrumentation and standard organic fluorescent dyes, but it is also prone to image artifacts and degraded image resolution due to improper sample preparation or imaging conditions. It requires careful optimization of all three aspects-sample preparation, image acquisition, and image reconstruction-to ensure a high-quality STORM image, which will be extensively discussed in this unit. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

Description of the motor development of 3-12 month old infants with Down syndrome: the influence of the postural body position.

PubMed

Tudella, Eloisa; Pereira, Karina; Basso, Renata Pedrolongo; Savelsbergh, Geert J P

2011-01-01

The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down syndrome and 25 healthy full term typical infants were assessed using the Alberta Infant Motor Scale (AIMS) monthly from 3 to 12 months of age. The infants with Down syndrome achieved significant later the level of motor performance of the typical infants. In the supine posture, the performance was significantly lesser for the Down syndrome infants in comparison to the typical infants from the 3rd to 6th month and in the 8th month. In the prone, sitting and standing postures this difference is found for all the months. In conclusion, the sequence of motor development of the Down syndrome is the same as the typical infants. However infants with Down syndrome need more time to acquire skills, mainly antigravitational ones, among them the standing position. Copyright © 2011 Elsevier Ltd. All rights reserved.

Is the dissociative adult suggestible? A test of the trauma and fantasy models of dissociation.

PubMed

Kluemper, Nicole S; Dalenberg, Constance

2014-01-01

Psychologists have long assumed a connection between traumatic experience and psychological dissociation. This hypothesis is referred to as the trauma model of dissociation. In the past decade, a series of papers have been published that question this traditional causal link, proposing an alternative fantasy model of dissociation. In the present research, the relationship among dissociation, suggestibility, and fantasy proneness was examined. Suggestibility was measured through the Gudjonsson Scale of Interrogative Suggestibility (GSS) as well as an autobiographically based version of this measure based on the events of September 11, 2001. Consistent with prior research and with the trauma model, dissociation correlated positively with trauma severity (r = .32, p < .01) and fantasy proneness (r = .60, p < .01). Inconsistent with the fantasy model, dissociation did not correlate with the neutral form of the GSS and correlated negatively (r = -.24, p < .05) with the trauma-focused form of this suggestibility measure. Although some participants did become quite emotional during the procedure, the risk/benefit ratio was perceived by almost all participants to be positive, with more reactive individuals evaluating the procedure more positively. The results consistently support the trauma model of dissociation and fail to support the fantasy model of dissociation.

Poster - 42: TB - ARC: A Total Body photon ARC technique using a commercially available linac

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

Evans, Michael D. C.; Ruo, Russell; Patrocinio, Ho

We have developed a total body photon irradiation technique using multiple overlapping open field arcs (TB-ARC). This simple technique uses predetermined arc-weights, with MUs calculated as a function of prescription depth only. Patients lie on a stretcher, in the prone/supine treatment position with AP/PA arcs. This treatment position has many advantages including ease of delivery (especially for tall, pediatric or compromised patients), dose uniformity, simplicity for organ shielding, and imaging capabilities. Using a Varian TrueBeam linac, 14 arcs using 40×40 cm{sup 2} 6 MV open photon beams, sweeping across 10 degrees each, complete a 140 degree arc. The nominal SSDmore » at zero degrees is 200 cm. Arcs at the sweep limits (+/− 70 degrees) are differentially weighted and deliver a dose within 10% of the prescription on central axis, at a depth of 10 cm over a superior-inferior length of 275 cm. CT planning using Varian Eclipse enables dose evaluation. A custom made beam spoiler, consisting of a 2.5 m sheet of polycarbonate (6 mm thick) increases the surface dose from 45% to 90%. This beam spoiler also serves as a support in the event that differential attenuation is required for organs such as lung, heart, liver, kidneys. The geometry of the sweeping beam technique limits organ dose (using varying thicknesses of melting alloy) to about 20% and 40% of prescription at dmax and midplane respectively. Digital imaging with a portable DR cassette enables proper attenuator location prior to treatment.« less

Interaction between bedding and sleeping position in the sudden infant death syndrome: a population based case-control study.

PubMed Central

Fleming, P J; Gilbert, R; Azaz, Y; Berry, P J; Rudd, P T; Stewart, A; Hall, E

1990-01-01

OBJECTIVE--To determine the relation between sleeping position and quantity of bedding and the risk of sudden unexpected infant death. DESIGN--A study of all infants dying suddenly and unexpectedly and of two controls matched for age and date with each index case. The parents of control infants were interviewed within 72 hours of the index infant's death. Information was collected on bedding, sleeping position, heating, and recent signs of illness for index and control infants. SETTING--A defined geographical area comprising most of the county of Avon and part of Somerset. SUBJECTS--72 Infants who had died suddenly and unexpectedly (of whom 67 had died from the sudden infant death syndrome) and 144 control infants. RESULTS--Compared with the control infants the infants who had died from the sudden infant death syndrome were more likely to have been sleeping prone (relative risk 8.8; 95% confidence interval 7.0 to 11.0; p less than 0.001), to have been more heavily wrapped (relative risk 1.14 per tog above 8 tog; 1.03 to 1.28; p less than 0.05), and to have had the heating on all night (relative risk 2.7; 1.4 to 5.2; p less than 0.01). These differences were less pronounced in the younger infants (less than 70 days) than the older ones. The risk of sudden unexpected death among infants older than 70 days, nursed prone, and with clothing and bedding of total thermal resistance greater than 10 tog was increased by factors of 15.1 (2.6 to 89.6) and 25.2 (3.7 to 169.0) respectively compared with the risk in infants of the same age nursed supine or on their side and under less than 6 tog of bedding. CONCLUSIONS--Overheating and the prone position are independently associated with an increased risk of sudden unexpected infant death, particularly in infants aged more than 70 days. Educating parents about appropriate thermal care and sleeping position of infants may help to reduce the incidence of the sudden infant death syndrome. PMID:2390588

Influence of supine sleep positioning on early motor milestone acquisition.

PubMed

Majnemer, Annette; Barr, Ronald G

2005-06-01

This study aimed to determine whether supine sleep-positioned infants have delayed motor skills at age 4 and 6 months, and if delays are associated with decreased exposure to prone position. One 4 and one 6-month-old sample of healthy infants born at term were recruited. Motor assessments included the Peabody Developmental Motor Scale (PDMS) and Alberta Infant Motor Scale (AIMS). Parents completed an infant behavior diary for 3 consecutive days. Seventy-one 4-month-old infants were assessed (38 males; mean age 4.4 mo, standard deviation [SD] 0.2). Mean motor scores were close to normative standards (AIMS 47.7, SD 19.6; PDMS gross motor quotient [GMQ] 96.3, SD 6.5; PDMS fine motor quotient [FMQ] 99.2, SD 4.8). No infant scored below cut-off values used to identify motor delay. Milestones less likely to be achieved included extended arm support in prone, hands to feet in supine, and sitting with arm support. Exposure to 'tummy time' while awake was correlated with AIMS scores (r = 0.38, p < 0.01). F i fty 6-month-old infants were assessed (21 males; mean age 6.4 mo, SD 0.4). Mean scores were shifted down for all scales, and as much as 1 SD for PDMS (AIMS 44.5, SD 21.6; PDMS GMQ 85.7, SD 7.6; PDMS FMQ 88.9, SD 9.0). Only 22% of 6-month-olds could sit without arm support versus 50% expected in a normative sample. Remarkably, 22% of our sample exhibited gross motor delays (quotient <78). Tummy time (awake) was significantly associated with the AIMS (r = 0.64) and PDMS GMQ (r = 0.55) and FMQ (r = 0.33) quotients, even after adjusting for confounders. Typically developing infants who were sleep-positioned in supine had delayed motor development by age 6 months, and this was significantly associated with limited exposure to awake prone positioning. This has important implications for interpreting motor assessments of infants at risk and for preventing inappropriate referrals.

Comparison of Radiation Treatment Plans for Breast Cancer between 3D Conformal in Prone and Supine Positions in Contrast to VMAT and IMRT Supine Positions

NASA Astrophysics Data System (ADS)

Bejarano Buele, Ana Isabel

The treatment regimen for breast cancer patients typically involves Whole Breast Irradiation (WBI). The coverage and extent of the radiation treatment is dictated by location of tumor mass, breast tissue distribution, involvement of lymph nodes, and other factors. The current standard treatment approach used at our institution is a 3D tangential beam geometry, which involves two fields irradiating the breast, or a four field beam arrangement covering the whole breast and involved nodes, while decreasing the dose to organs as risk (OARs) such as the lung and heart. The coverage of these targets can be difficult to achieve in patients with unfavorable thoracic geometries, especially in those cases in which the planning target volume (PTV) is extended to the chest wall. It is a well-known fact that exposure of the heart to ionizing radiation has been proved to increase the subsequent rate of ischemic heart disease. In these cases, inverse planned treatments have become a proven alternative to the 3D approach. The goal of this research project is to evaluate the factors that affect our current techniques as well as to adapt the development of inverse modulated techniques for our clinic, in which breast cancer patients are one of the largest populations treated. For this purpose, a dosimetric comparison along with the evaluation of immobilization devices was necessary. Radiation treatment plans were designed and dosimetrically compared for 5 patients in both, supine and prone positions. For 8 patients, VMAT and IMRT plans were created and evaluated in the supine position. Skin flash incorporation for inverse modulated plans required measurement of the surface dose as well as an evaluation of breast volume changes during a treatment course. It was found that prone 3D conformal plans as well as the VMAT and IMRT plans are generally superior in sparing OARs to supine plans with comparable PTV coverage. Prone setup leads to larger shifts in breast volume as well as in positioning due to the difference in target geometry and nature of the immobilization device. IMRT and VMAT plans offer sparing of OARs from high dose regions with an increase of irradiated volume in the low dose regions. Skin flash incorporation was found to be accurate with the use of virtual bolus in the TPS for inverse modulated plans. Various factors influencing dose delivery in breast cancer radiation treatments were examined and quantified. Practical recommendations developed in the course of this project can improve our current techniques and provide alternatives to treat unique and challenging clinical cases.

Effects of imperfect automation and individual differences on concurrent performance of military and robotics tasks in a simulated multitasking environment.

PubMed

Chen, J Y C; Terrence, P I

2009-08-01

This study investigated the performance and workload of the combined position of gunner and robotics operator in a simulated military multitasking environment. Specifically, the study investigated how aided target recognition (AiTR) capabilities for the gunnery task with imperfect reliability (false-alarm-prone vs. miss-prone) might affect the concurrent robotics and communication tasks. Additionally, the study examined whether performance was affected by individual differences in spatial ability and attentional control. Results showed that when the robotics task was simply monitoring the video, participants had the best performance in their gunnery and communication tasks and the lowest perceived workload, compared with the other robotics tasking conditions. There was a strong interaction between the type of AiTR unreliability and participants' perceived attentional control. Overall, for participants with higher perceived attentional control, false-alarm-prone alerts were more detrimental; for low attentional control participants, conversely, miss-prone automation was more harmful. Low spatial ability participants preferred visual cueing and high spatial ability participants favoured tactile cueing. Potential applications of the findings include personnel selection for robotics operation, robotics user interface designs and training development. The present results will provide further understanding of the interplays among automation reliability, multitasking performance and individual differences in military tasking environments. These results will also facilitate the implementation of robots in military settings and will provide useful data to military system designs.

Simple shielding reduces dose to the contralateral breast during prone breast cancer radiotherapy

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

Goyal, Uma, E-mail: uma.goyal@gmail.com; Locke, Angela; Smith-Raymond, Lexie

Our goal was to design a prone breast shield for the contralateral breast and study its efficacy in decreasing scatter radiation to the contralateral breast in a prone breast phantom setup receiving radiation therapy designed for breast cancer. We constructed a prone breast phantom setup consisting of (1) A thermoplastic mask with a left-sided depression created by a water balloon for a breast shape; (2) 2 plastic bags to hold water in the thermoplastic mask depression; (3) 2000 mL of water to fill the thermoplastic mask depression to create a water-based false breast; (4) 1-cm thick bolus placed in themore » contralateral breast holder; (5) 2 lead (Pb) sheets, each 0.1-cm thick for blocking scatter radiation in the contralateral bolus-based false breast; (6) a prone breast board to hold the thermoplastic mask, water, bolus, and lead; (7) 9 cm solid water on top of the breast board to simulate body; (8) a diode was used to verify dose for each treatment field of the treated water-based breast; (9) metal–oxide–semiconductor-field effect transistor (MOSFET) dosimeters to measure dose to the contralateral bolus-based breast. The phantom prone breast setup was CT simulated and treatment was designed with 95% isodose line covering the treated breast. The maximum dose was 107.1%. Megavoltage (MV) port images ensured accurate setup. Measurements were done using diodes on the treated water-based breast and MOSFET dosimeters at the medial and lateral sides of the contralateral bolus-based breast without and with the Pb shield. Five treatments were done for each of the 3 data sets and recorded individually for statistical purposes. All treatments were completed with 6 MV photons at 200 cGy per treatment. The dose contributions from each of the 3 data sets including 15 treatments total without and with the prone lead shield to the medial and lateral portions of contralateral bolus-based breast were averaged individually. Unshielded dose means were 37.11 and 2.94 cGy, and shielded dose means were 12.68 and 1.54 cGy, respectively. When comparing medial and lateral portions of the contralateral bolus-based doses without and with Pb, the shield significantly reduced dose to both sides of the contralateral breast (medial p = 2.64 × 10{sup −14}, lateral p = 4.91 × 10{sup −6}). The prone 0.2-cm Pb shield significantly reduced scatter dose to the contralateral breast on the order of 2 to 3 times. Reductions may be clinically relevant for women younger than 45 years by decreasing the risk of contralateral radiation-induced breast cancer in patients receiving radiation therapy for breast cancer. This shield is simple as it would be a part of the prone breast board during treatments, but future studies are warranted for safety and efficacy clinically.« less

Editorial Commentary: Ankle Arthroscopy: Correct Portals and Distraction Are the Keys to Success.

PubMed

Ferkel, Richard D

2016-07-01

Access to all areas of the ankle during arthroscopy is always problematic. The use of the correct portals and distraction increases access in both the supine and prone positions. Noninvasive distraction up to 30 pounds is safe and effective to perform arthroscopy in the supine position, and avoids the potential complications of pin distraction. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

Novel application of red-light runner proneness theory within traffic microsimulation to an actual signal junction.

PubMed

Bell, Margaret Carol; Galatioto, Fabio; Giuffrè, Tullio; Tesoriere, Giovanni

2012-05-01

Building on previous research a conceptual framework, based on potential conflicts analysis, has provided a quantitative evaluation of 'proneness' to red-light running behaviour at urban signalised intersections of different geometric, flow and driver characteristics. The results provided evidence that commonly used violation rates could cause inappropriate evaluation of the extent of the red-light running phenomenon. Initially, an in-depth investigation of the functional form of the mathematical relationship between the potential and actual red-light runners was carried out. The application of the conceptual framework was tested on a signalised intersection in order to quantify the proneness to red-light running. For the particular junction studied proneness for daytime was found to be 0.17 north and 0.16 south for opposing main road approaches and 0.42 east and 0.59 west for the secondary approaches. Further investigations were carried out using a traffic microsimulation model, to explore those geometric features and traffic volumes (arrival patterns at the stop-line) that significantly affect red-light running. In this way the prediction capability of the proposed potential conflict model was improved. A degree of consistency in the measured and simulated red-light running was observed and the conceptual framework was tested through a sensitivity analysis applied to different stop-line positions and traffic volume variations. The microsimulation, although at its early stages of development, has shown promise in its ability to model unintentional red light running behaviour and following further work through application to other junctions, potentially provides a tool for evaluation of alternative junction designs on proneness. In brief, this paper proposes and applies a novel approach to model red-light running using a microsimulation and demonstrates consistency with the observed and theoretical results. Copyright © 2011 Elsevier Ltd. All rights reserved.

[Reactance proneness, collectivism, uniqueness, and resistance to persuasion].

PubMed

Imajo, Shuzo

2002-10-01

This study examined the reliability and validity of Japanese psychological reactance scales. A total of 167 undergraduates completed a questionnaire of Therapeutic Reactance Scale (TRS), the Hong Reactance Scale (HRS), the Uniqueness Scale, and the Collectivism Scale. They also received messages involving three persuasion situations that were either high or low in terms of threat, and were asked to describe their reactions to them. The author categorized the reactions into three: acceptance, indirect resistance, and direct resistance. Reliabilities of the reactance scales were satisfactory. Their scores positively correlated with uniqueness scores, and negatively with collectivism scores. Those high on reactance proneness were less persuaded in two of the three situations. But in the third, an HRS by threat interaction was observed, indicating that only those who were high on reactance proneness under the high-threat condition showed resistance to persuasion. These results suggest that the Japanese versions of reactance scale were reliable and valid. However, the assertiveness aspect of TRS may not be appropriate for the definition of reactance. The influence of culture on psychological reactance was also discussed.

WE-G-207-04: Non-Local Total-Variation (NLTV) Combined with Reweighted L1-Norm for Compressed Sensing Based CT Reconstruction

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

Kim, H; Chen, J; Pouliot, J

2015-06-15

Purpose: Compressed sensing (CS) has been used for CT (4DCT/CBCT) reconstruction with few projections to reduce dose of radiation. Total-variation (TV) in L1-minimization (min.) with local information is the prevalent technique in CS, while it can be prone to noise. To address the problem, this work proposes to apply a new image processing technique, called non-local TV (NLTV), to CS based CT reconstruction, and incorporate reweighted L1-norm into it for more precise reconstruction. Methods: TV minimizes intensity variations by considering two local neighboring voxels, which can be prone to noise, possibly damaging the reconstructed CT image. NLTV, contrarily, utilizes moremore » global information by computing a weight function of current voxel relative to surrounding search area. In fact, it might be challenging to obtain an optimal solution due to difficulty in defining the weight function with appropriate parameters. Introducing reweighted L1-min., designed for approximation to ideal L0-min., can reduce the dependence on defining the weight function, therefore improving accuracy of the solution. This work implemented the NLTV combined with reweighted L1-min. by Split Bregman Iterative method. For evaluation, a noisy digital phantom and a pelvic CT images are employed to compare the quality of images reconstructed by TV, NLTV and reweighted NLTV. Results: In both cases, conventional and reweighted NLTV outperform TV min. in signal-to-noise ratio (SNR) and root-mean squared errors of the reconstructed images. Relative to conventional NLTV, NLTV with reweighted L1-norm was able to slightly improve SNR, while greatly increasing the contrast between tissues due to additional iterative reweighting process. Conclusion: NLTV min. can provide more precise compressed sensing based CT image reconstruction by incorporating the reweighted L1-norm, while maintaining greater robustness to the noise effect than TV min.« less

Sports and the Growing Musculoskeletal System: Sports Imaging Series.

PubMed

Nguyen, Jie C; Sheehan, Scott E; Davis, Kirkland W; Gill, Kara G

2017-07-01

Increased youth participation in sports has resulted in increased injury tolls due to shifts toward participation in competitive sports at earlier ages, increased training intensity and competition schedules, as well as specialization into one sport. The physiology of the growing musculoskeletal system makes the growing athlete particularly vulnerable to specific types of injuries. Radiologists must understand the differences between pediatric and adult athletes to recognize the particular injuries to which these young athletes are prone. Imaging and pertinent clinical details of major representative acute and overuse injuries characteristic to pediatric athletes will be discussed. © RSNA, 2017.

Near-Death Experiences and the "Fantasy-Prone" Personality: Preliminary Findings.

ERIC Educational Resources Information Center

Council, James R.; Greyson, Bruce

Near-death experiences (NDEs) are subjective experiences at the threshold of death which can include strong positive affect, dissociation from the physical body, and paranormal/transcendental phenomena. Empirical investigation of NDEs has typically relied upon retrospective reports and personality studies of individuals who have come close to…

Nicotine dependence, PTSD symptoms, and depression proneness among male and female smokers.

PubMed

Thorndike, Frances P; Wernicke, Rachel; Pearlman, Michelle Y; Haaga, David A F

2006-02-01

Several studies have linked posttraumatic stress disorder with heavy smoking. It is not known to what extent this association is specific, as opposed to being a function of a joint association of PTSD and heavy smoking with a third variable such as depression proneness. In a cross-sectional study of 157 current regular smokers, severity of nicotine dependence (but not cigarettes smoked per day) was positively correlated with total PTSD symptoms, hyperarousal symptoms, and avoidance symptoms. These correlations were not eliminated by controlling statistically for depression vulnerability, whether it was measured on a continuous self-rating scale or on the basis of interview-diagnosed history of major depression. The association between PTSD and nicotine dependence was stronger among men than among women.

Registration-based segmentation with articulated model from multipostural magnetic resonance images for hand bone motion animation.

PubMed

Chen, Hsin-Chen; Jou, I-Ming; Wang, Chien-Kuo; Su, Fong-Chin; Sun, Yung-Nien

2010-06-01

The quantitative measurements of hand bones, including volume, surface, orientation, and position are essential in investigating hand kinematics. Moreover, within the measurement stage, bone segmentation is the most important step due to its certain influences on measuring accuracy. Since hand bones are small and tubular in shape, magnetic resonance (MR) imaging is prone to artifacts such as nonuniform intensity and fuzzy boundaries. Thus, greater detail is required for improving segmentation accuracy. The authors then propose using a novel registration-based method on an articulated hand model to segment hand bones from multipostural MR images. The proposed method consists of the model construction and registration-based segmentation stages. Given a reference postural image, the first stage requires construction of a drivable reference model characterized by hand bone shapes, intensity patterns, and articulated joint mechanism. By applying the reference model to the second stage, the authors initially design a model-based registration pursuant to intensity distribution similarity, MR bone intensity properties, and constraints of model geometry to align the reference model to target bone regions of the given postural image. The authors then refine the resulting surface to improve the superimposition between the registered reference model and target bone boundaries. For each subject, given a reference postural image, the proposed method can automatically segment all hand bones from all other postural images. Compared to the ground truth from two experts, the resulting surface image had an average margin of error within 1 mm (mm) only. In addition, the proposed method showed good agreement on the overlap of bone segmentations by dice similarity coefficient and also demonstrated better segmentation results than conventional methods. The proposed registration-based segmentation method can successfully overcome drawbacks caused by inherent artifacts in MR images and obtain more accurate segmentation results automatically. Moreover, realistic hand motion animations can be generated based on the bone segmentation results. The proposed method is found helpful for understanding hand bone geometries in dynamic postures that can be used in simulating 3D hand motion through multipostural MR images.

Recent advances in quantitative analysis of fluid interfaces in multiphase fluid flow measured by synchrotron-based x-ray microtomography

NASA Astrophysics Data System (ADS)

Schlueter, S.; Sheppard, A.; Wildenschild, D.

2013-12-01

Imaging of fluid interfaces in three-dimensional porous media via x-ray microtomography is an efficient means to test thermodynamically derived predictions on the relationship between capillary pressure, fluid saturation and specific interfacial area (Pc-Sw-Anw) in partially saturated porous media. Various experimental studies exist to date that validate the uniqueness of the Pc-Sw-Anw relationship under static conditions and with current technological progress direct imaging of moving interfaces under dynamic conditions is also becoming available. Image acquisition and subsequent image processing currently involves many steps each prone to operator bias, like merging different scans of the same sample obtained at different beam energies into a single image or the generation of isosurfaces from the segmented multiphase image on which the interface properties are usually calculated. We demonstrate that with recent advancements in (i) image enhancement methods, (ii) multiphase segmentation methods and (iii) methods of structural analysis we can considerably decrease the time and cost of image acquisition and the uncertainty associated with the measurement of interfacial properties. In particular, we highlight three notorious problems in multiphase image processing and provide efficient solutions for each: (i) Due to noise, partial volume effects, and imbalanced volume fractions, automated histogram-based threshold detection methods frequently fail. However, these impairments can be mitigated with modern denoising methods, special treatment of gray value edges and adaptive histogram equilization, such that most of the standard methods for threshold detection (Otsu, fuzzy c-means, minimum error, maximum entropy) coincide at the same set of values. (ii) Partial volume effects due to blur may produce apparent water films around solid surfaces that alter the specific fluid-fluid interfacial area (Anw) considerably. In a synthetic test image some local segmentation methods like Bayesian Markov random field, converging active contours and watershed segmentation reduced the error in Anw associated with apparent water films from 21% to 6-11%. (iii) The generation of isosurfaces from the segmented data usually requires a lot of postprocessing in order to smooth the surface and check for consistency errors. This can be avoided by calculating specific interfacial areas directly on the segmented voxel image by means of Minkowski functionals which is highly efficient and less error prone.

Feasibility of Using the Marginal Blood Vessels as Reference Landmarks for CT Colonography

PubMed Central

Wei, Zhuoshi; Yao, Jianhua; Wang, Shijun; Liu, Jiamin; Dwyer, Andrew J.; Pickhardt, Perry J.; Nowinski, Wieslaw L.; Summers, Ronald M.

2015-01-01

OBJECTIVE The purpose of this study was to show the spatial relationship of the colonic marginal blood vessels and the teniae coli on CT colonography (CTC) and the use of the marginal blood vessels for supine-prone registration of polyps and for determination of proper connectivity of collapsed colonic segments. MATERIALS AND METHODS We manually labeled the marginal blood vessels on 15 CTC examinations. Colon segmentation, centerline extraction, teniae detection, and teniae identification were automatically performed. For assessment of their spatial relationships, the distances from the marginal blood vessels to the three teniae coli and to the colon were measured. Student t tests (paired, two-tailed) were performed to evaluate the differences among these distances. To evaluate the reliability of the marginal vessels as reference points for polyp correlation, we analyzed 20 polyps from 20 additional patients who underwent supine and prone CTC. The average difference of the circumferential polyp position on the supine and prone scans was computed. Student t tests (paired, two-tailed) were performed to evaluate the supine-prone differences of the distance. We performed a study on 10 CTC studies from 10 patients with collapsed colonic segments by manually tracing the marginal blood vessels near the collapsed regions to resolve the ambiguity of the colon path. RESULTS The average distances (± SD) from the marginal blood vessels to the tenia mesocolica, tenia omentalis, and tenia libera were 20.1 ± 3.1 mm (95% CI, 18.5–21.6 mm), 39.5 ± 4.8 mm (37.1–42.0 mm), and 36.9 ± 4.2 mm (34.8–39.1 mm), respectively. Pairwise comparison showed that these distances to the tenia libera and tenia omentalis were significantly different from the distance to the tenia mesocolica (p < 0.001). The average distance from the marginal blood vessels to the colon wall was 15.3 ± 2.0 mm (14.2–16.3 mm). For polyp localization, the average difference of the circumferential polyp position on the supine and prone scans was 9.6 ± 9.4 mm (5.5–13.7 mm) (p = 0.15) and expressed as a percentage of the colon circumference was 3.1% ± 2.0% (2.3–4.0%) (p = 0.83). We were able to trace the marginal blood vessels for 10 collapsed colonic segments and determine the paths of the colon in these regions. CONCLUSION The marginal blood vessels run parallel to the colon in proximity to the tenia mesocolica and enable accurate supine-prone registration of polyps and localization of the colon path in areas of collapse. Thus, the marginal blood vessels may be used as reference landmarks complementary to the colon centerline and teniae coli. PMID:24370165

Molecular intravascular imaging approaches for atherosclerosis.

PubMed

Press, Marcella Calfon; Jaffer, Farouc A

2014-10-01

Coronary artery disease (CAD) is an inflammatory process that results in buildup of atherosclerosis, typically lipid-rich plaque in the arterial wall. Progressive narrowing of the vessel wall and subsequent plaque rupture can lead to myocardial infarction and death. Recent advances in intravascular fluorescence imaging techniques have provided exciting coronary artery-targeted platforms to further characterize the molecular changes that occur within the vascular wall as a result of atherosclerosis and following coronary stent-induced vascular injury. This review will summarize exciting recent developments in catheter-based imaging of coronary arterial-sized vessels; focusing on two-dimensional near-infrared fluorescence imaging (NIRF) molecular imaging technology as an approach to specifically identify inflammation and fibrin directly within coronary artery-sized vessels. Intravascular NIRF is anticipated to provide new insights into the in vivo biology underlying high-risk plaques, as well as high-risks stents prone to stent restenosis or stent thrombosis.

Stretchable ultrasonic transducer arrays for three-dimensional imaging on complex surfaces

PubMed Central

Zhu, Xuan; Li, Xiaoshi; Chen, Zeyu; Chen, Yimu; Lei, Yusheng; Li, Yang; Nomoto, Akihiro; Zhou, Qifa; di Scalea, Francesco Lanza

2018-01-01

Ultrasonic imaging has been implemented as a powerful tool for noninvasive subsurface inspections of both structural and biological media. Current ultrasound probes are rigid and bulky and cannot readily image through nonplanar three-dimensional (3D) surfaces. However, imaging through these complicated surfaces is vital because stress concentrations at geometrical discontinuities render these surfaces highly prone to defects. This study reports a stretchable ultrasound probe that can conform to and detect nonplanar complex surfaces. The probe consists of a 10 × 10 array of piezoelectric transducers that exploit an “island-bridge” layout with multilayer electrodes, encapsulated by thin and compliant silicone elastomers. The stretchable probe shows excellent electromechanical coupling, minimal cross-talk, and more than 50% stretchability. Its performance is demonstrated by reconstructing defects in 3D space with high spatial resolution through flat, concave, and convex surfaces. The results hold great implications for applications of ultrasound that require imaging through complex surfaces. PMID:29740603

Towards Automatic Image Segmentation Using Optimised Region Growing Technique

NASA Astrophysics Data System (ADS)

Alazab, Mamoun; Islam, Mofakharul; Venkatraman, Sitalakshmi

Image analysis is being adopted extensively in many applications such as digital forensics, medical treatment, industrial inspection, etc. primarily for diagnostic purposes. Hence, there is a growing interest among researches in developing new segmentation techniques to aid the diagnosis process. Manual segmentation of images is labour intensive, extremely time consuming and prone to human errors and hence an automated real-time technique is warranted in such applications. There is no universally applicable automated segmentation technique that will work for all images as the image segmentation is quite complex and unique depending upon the domain application. Hence, to fill the gap, this paper presents an efficient segmentation algorithm that can segment a digital image of interest into a more meaningful arrangement of regions and objects. Our algorithm combines region growing approach with optimised elimination of false boundaries to arrive at more meaningful segments automatically. We demonstrate this using X-ray teeth images that were taken for real-life dental diagnosis.

Variation in the Williams syndrome GTF2I gene and anxiety proneness interactively affect prefrontal cortical response to aversive stimuli.

PubMed

Jabbi, M; Chen, Q; Turner, N; Kohn, P; White, M; Kippenhan, J S; Dickinson, D; Kolachana, B; Mattay, V; Weinberger, D R; Berman, K F

2015-08-18

Characterizing the molecular mechanisms underlying the heritability of complex behavioral traits such as human anxiety remains a challenging endeavor for behavioral neuroscience. Copy-number variation (CNV) in the general transcription factor gene, GTF2I, located in the 7q11.23 chromosomal region that is hemideleted in Williams syndrome and duplicated in the 7q11.23 duplication syndrome (Dup7), is associated with gene-dose-dependent anxiety in mouse models and in both Williams syndrome and Dup7. Because of this recent preclinical and clinical identification of a genetic influence on anxiety, we examined whether sequence variation in GTF2I, specifically the single-nucleotide polymorphism rs2527367, interacts with trait and state anxiety to collectively impact neural response to anxiety-laden social stimuli. Two hundred and sixty healthy adults completed the Tridimensional Personality Questionnaire Harm Avoidance (HA) subscale, a trait measure of anxiety proneness, and underwent functional magnetic resonance imaging (fMRI) while matching aversive (fearful or angry) facial identity. We found an interaction between GTF2I allelic variations and HA that affects brain response: in individuals homozygous for the major allele, there was no correlation between HA and whole-brain response to aversive cues, whereas in heterozygotes and individuals homozygous for the minor allele, there was a positive correlation between HA sub-scores and a selective dorsolateral prefrontal cortex (DLPFC) responsivity during the processing of aversive stimuli. These results demonstrate that sequence variation in the GTF2I gene influences the relationship between trait anxiety and brain response to aversive social cues in healthy individuals, supporting a role for this neurogenetic mechanism in anxiety.

External misattribution of internal thoughts and proneness to auditory hallucinations: the effect of emotional valence in the Deese–Roediger–McDermott paradigm

PubMed Central

Kanemoto, Mari; Asai, Tomohisa; Sugimori, Eriko; Tanno, Yoshihiko

2013-01-01

Previous studies have suggested that a tendency to externalize internal thought is related to auditory hallucinations or even proneness to auditory hallucinations (AHp) in the general population. However, although auditory hallucinations are related to emotional phenomena, few studies have investigated the effect of emotional valence on the aforementioned relationship. In addition, we do not know what component of psychotic phenomena relate to externalizing bias. The current study replicated our previous research, which suggested that individual differences in auditory hallucination-like experiences are strongly correlated with the external misattribution of internal thoughts, conceptualized in terms of false memory, using the Deese–Roediger–McDermott (DRM) paradigm. We found a significant relationship between experimental performance and total scores on the Launay–Slade Hallucination Scale (LSHS). Among the LSHS factors, only vivid mental image, which is said to be a predictor of auditory hallucinations, was significantly related to experimental performance. We then investigated the potential effect of emotional valence using the DRM paradigm. The results indicate that participants with low scores on the LSHS (the low-AHp group in the current study) showed an increased discriminability index (d′) for positive words and a decreased d′ for negative words. However, no effects of emotional valence were found for participants with high LSHS scores (high-AHp group). This study indicated that external misattribution of internal thoughts predicts AHp, and that the high-AHp group showed a smaller emotional valence effect in the DRM paradigm compared with the low-AHp group. We discuss this outcome from the perspective of the dual-process activation-monitoring framework in the DRM paradigm in regard to emotion-driven automatic thought in false memory. PMID:23847517

Toward in vivo diagnosis of skin cancer using multimode imaging dermoscopy: (II) molecular mapping of highly pigmented lesions

NASA Astrophysics Data System (ADS)

Vasefi, Fartash; MacKinnon, Nicholas; Farkas, Daniel L.

2014-03-01

We have developed a multimode imaging dermoscope that combines polarization and hyperspectral imaging with a computationally rapid analytical model. This approach employs specific spectral ranges of visible and near infrared wavelengths for mapping the distribution of specific skin bio-molecules. This corrects for the melanin-hemoglobin misestimation common to other systems, without resorting to complex and computationally intensive tissue optical models that are prone to inaccuracies due to over-modeling. Various human skin measurements including a melanocytic nevus, and venous occlusion conditions were investigated and compared with other ratiometric spectral imaging approaches. Access to the broad range of hyperspectral data in the visible and near-infrared range allows our algorithm to flexibly use different wavelength ranges for chromophore estimation while minimizing melanin-hemoglobin optical signature cross-talk.

Neuroticism modulates the effects of intranasal vasopressin treatment on the neural response to positive and negative social interactions.

PubMed

Feng, Chunliang; DeMarco, Ashley C; Haroon, Ebrahim; Rilling, James K

2015-07-01

Neuroticism is a fundamental personality trait associated with proneness to feel negative affect. Here we ask how Neuroticism influences the neural response to positive and negative social interactions and how Neuroticism modulates the effect of intranasal oxytocin (OT) and vasopressin (AVP) on the neural response to social interactions. In a double-blind, placebo-controlled study, 153 male participants were randomized to receive 24 IU intranasal OT, 20 IU AVP or placebo. Afterwards, they were imaged with fMRI while playing an iterated Prisoner's Dilemma Game. On a different day, subjects completed the NEO personality inventory to measure Neuroticism. Neuroticism was positively correlated with the neural response to negative social interactions in the anterior cingulate cortex/medial prefrontal cortex and with the neural response to positive social interactions in the insula, indicating that Neuroticism modulates neuropsychological processing of both negative and positive social interactions. Neuroticism did not modulate the effect of intranasal OT treatment on the neural response to either positive or negative social interactions. On the other hand, AVP treatment significantly interacted with Neuroticism to modulate the BOLD response to both positive and negative social interactions. Specifically, AVP increased anterior cingulate cortex/medial prefrontal cortex and lateral temporal lobe responses to negative social interactions to a greater extent in participants scoring high rather than low on Neuroticism. AVP also increased the insula response to positive social interactions to a greater extent in participants scoring high rather than low on Neuroticism. These results imply that AVP may increase emotion regulation in response to negative social interactions and the salience of positive social interactions to a greater extent in individuals high compared to low in Neuroticism. The current findings urge caution against uniform clinical application of nonapeptides and suggest that their efficacy may vary as a function of personality. Copyright © 2015 Elsevier Ltd. All rights reserved.

Weak-lensing shear estimates with general adaptive moments, and studies of bias by pixellation, PSF distortions, and noise

NASA Astrophysics Data System (ADS)

Simon, Patrick; Schneider, Peter

2017-08-01

In weak gravitational lensing, weighted quadrupole moments of the brightness profile in galaxy images are a common way to estimate gravitational shear. We have employed general adaptive moments (GLAM ) to study causes of shear bias on a fundamental level and for a practical definition of an image ellipticity. The GLAM ellipticity has useful properties for any chosen weight profile: the weighted ellipticity is identical to that of isophotes of elliptical images, and in absence of noise and pixellation it is always an unbiased estimator of reduced shear. We show that moment-based techniques, adaptive or unweighted, are similar to a model-based approach in the sense that they can be seen as imperfect fit of an elliptical profile to the image. Due to residuals in the fit, moment-based estimates of ellipticities are prone to underfitting bias when inferred from observed images. The estimation is fundamentally limited mainly by pixellation which destroys information on the original, pre-seeing image. We give an optimised estimator for the pre-seeing GLAM ellipticity and quantify its bias for noise-free images. To deal with images where pixel noise is prominent, we consider a Bayesian approach to infer GLAM ellipticity where, similar to the noise-free case, the ellipticity posterior can be inconsistent with the true ellipticity if we do not properly account for our ignorance about fit residuals. This underfitting bias, quantified in the paper, does not vary with the overall noise level but changes with the pre-seeing brightness profile and the correlation or heterogeneity of pixel noise over the image. Furthermore, when inferring a constant ellipticity or, more relevantly, constant shear from a source sample with a distribution of intrinsic properties (sizes, centroid positions, intrinsic shapes), an additional, now noise-dependent bias arises towards low signal-to-noise if incorrect prior densities for the intrinsic properties are used. We discuss the origin of this prior bias. With regard to a fully-Bayesian lensing analysis, we point out that passing tests with source samples subject to constant shear may not be sufficient for an analysis of sources with varying shear.

A Comparison of the Social-Adaptive Perspective and Functionalist Perspective on Guilt and Shame

PubMed Central

2017-01-01

Within the field of guilt and shame two competing perspectives have been advanced. The first, the social-adaptive perspective, proposes that guilt is an inherently adaptive emotion and shame is an inherently maladaptive emotion. Thus, those interested in moral character development and psychopathology should work to increase an individual’s guilt-proneness and decrease an individual’s shame-proneness. The functionalist perspective, in contrast, argues that both guilt and shame can serve a person adaptively or maladaptively—depending on the situational appropriateness, duration, intensity, and so forth. This paper reviews the research conducted supporting both positions; critiques some issues with the most widely used guilt- and shame-proneness measure in the social-adaptive research (the TOSCA) and discusses the differences in results found when assessing guilt and shame at the state versus trait level. The conclusion drawn is that although there is broad support for the functionalist perspective across a wide variety of state and trait guilt/shame studies, the functionalist perspective does not yet have the wealth of data supporting it that has been generated by the social-adaptive perspective using the TOSCA. Thus, before a dominant perspective can be identified, researchers need to (1) do more research assessing how the social-adaptive perspective compares to the functionalist perspective at the state level and (2) do more trait research within the functionalist perspective to compare functionalist guilt- and shame-proneness measures with the TOSCA. PMID:29232888

Low-energy fracture of posterolateral tibial plateau: treatment by a posterolateral prone approach.

PubMed

Yu, Guang-Rong; Xia, Jiang; Zhou, Jia-Qian; Yang, Yun-Feng

2012-05-01

Most of the posterolateral tibial plateau fractures are caused by low-energy injury. The posterior fracture fragment could not be exposed and reduced well through traditional approaches. The aim of this study was to review the results of surgical treatment of this kind of fracture using posterolateral approach with patient in prone position. The low-energy posterolateral fracture is defined as the main part of articular depression or split fragment limited within the posterior half of the lateral column. Direct reduction and buttress plate fixation through the posterolateral prone approach was applied in all the patients. In our series, 15 of 132 (11.4%) patients with tibial plateau fractures were identified as low-energy posterolateral fractures. The clinical outcomes were available in 14 of the 15 patients through phone interviews and chart reviews. Mean follow-up was 35.1 months (range: 24-48 months). All the patients had anatomic or good reductions (≤ 2 mm step/gap). Average range of motion was 0.7 degrees to 123.2 degrees (5-110 degrees to 0-140 degrees). The complications were limited to one superficial wound infection, two slight flexion contractures, and five implants removal. The average modified hospital for special surgery knee score was 93.4 (range: 86-100). The posterolateral prone approach provides excellent visualization, which can facilitate the reduction and posterior buttress plate fixation for low-energy posterolateral tibial plateau fractures and shows encouraging results. V, therapeutic study.

"The Jackson Table Is a Pain in the…": A Qualitative Study of Providers' Perception Toward a Spinal Surgery Table.

PubMed

Asiedu, Gladys B; Lowndes, Bethany R; Huddleston, Paul M; Hallbeck, Susan

2016-01-07

The aim of this study was to define health care providers' perceptions toward prone patient positioning for spine surgery using the Jackson Table, which has not been hitherto explored. We analyzed open-ended questionnaire data and interviews conducted with the spine surgical team regarding the current process of spinal positioning/repositioning using the Jackson Table. Participants were asked to provide an open-ended explanation as to whether they think the current process of spinal positioning/repositioning is safe for the staff or patients. Follow-up qualitative interviews were conducted with 11 of the participants to gain an in-depth understanding of the challenges and safety issues related to prone patient positioning. Data analysis resulted in 6 main categories: general challenges with patient positioning, role-specific challenges, challenges with the Jackson Table and the "sandwich" mechanism, safety concerns for patients, safety concerns for the medical staff, and recommendations for best practices. This study is relevant to everyday practice for spinal surgical team members and advances our understanding of how surgical teams qualitatively view the current process of patient positioning for spinal surgery. Providers recommended best practices for using the Jackson Table, which can be achieved through standardized practice for transfer of patients, educational tools, and checklists for equipment before patient transfer and positioning. This research has identified several important practice opportunities for improving provider and patient safety in spine surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/3.0.

Risk Reduction and Resource Pooling on a Cooperation Task

ERIC Educational Resources Information Center

Pietras, Cynthia J.; Cherek, Don R.; Lane, Scott D.; Tcheremissine, Oleg

2006-01-01

Two experiments investigated choice in adult humans on a simulated cooperation task to evaluate a risk-reduction account of sharing based on the energy-budget rule. The energy-budget rule is an optimal foraging model that predicts risk-averse choices when net energy gains exceed energy requirements (positive energy budget) and risk-prone choices…

SOURCE IDENTIFICATION OF PM2.5 IN AN ARID NORTHWEST U.S. CITY BY POSITIVE MATRIX FACTORIZATION. (R827355C008)

EPA Science Inventory

Spokane, WA is prone to frequent particulate pollution episodes due to dust storms, biomass burning, and periods of stagnant meteorological conditions. Spokane is the location of a long-term study examining the association between health effects and chemical or physical consti...

Laser cutting eliminates nucleic acid cross-contamination in dried-blood-spot processing.

PubMed

Murphy, Sean C; Daza, Glenda; Chang, Ming; Coombs, Robert

2012-12-01

Dried blood spots (DBS) are useful for molecular assays but are prone to false positives from cross-contamination. In our malaria DBS assay, cross-contamination was encountered despite cleaning techniques suitable for HIV-1. We therefore developed a contact-free laser cutting system that effectively eliminated cross-contamination during DBS processing.

Hydrostatic weighing at residual volume and functional residual capacity.

PubMed

Thomas, T R; Etheridge, G L

1980-07-01

Hydrostatic weighing (HW) was performed at both residual volume (RV) and functional residual capacity (FRC) to determine if underwater weighing at different lung volumes affected the measurement of body density. Subjects were 43 males, 18-25 yr. Subjects were submerged in the prone position, and the lung volume was measured by helium dilution at the time of the underwater weighing. Underwater weight was first assessed at FRC followed by assessment at RV. Changes in lung volume were accurately reflected in the underwater weight. Body density (D) was not different with the use of the FRC (mean D = 1.0778) or RV (mean D = 1.0781) data. Percent fat values for the FRC and RV data were 9.3 +/- 5.4 and 9.2 +/- 5.1%, respectively, and were not statistically different. The results indicate that the difference between percent fat determinations by HW in the prone position at FRC and RV is negligible. Because measurement of underwater weight at FRC is more comfortable for the subject, this may be the method of choice when the lung volume can be measured during the underwater weighing.

Mapping Forest Fuels through Vegetation Phenology: The Role of Coarse-Resolution Satellite Time-Series

PubMed Central

Bajocco, Sofia; Dragoz, Eleni; Gitas, Ioannis; Smiraglia, Daniela; Salvati, Luca; Ricotta, Carlo

2015-01-01

Traditionally fuel maps are built in terms of ‘fuel types’, thus considering the structural characteristics of vegetation only. The aim of this work is to derive a phenological fuel map based on the functional attributes of coarse-scale vegetation phenology, such as seasonality and productivity. MODIS NDVI 250m images of Sardinia (Italy), a large Mediterranean island with high frequency of fire incidence, were acquired for the period 2000–2012 to construct a mean annual NDVI profile of the vegetation at the pixel-level. Next, the following procedure was used to develop the phenological fuel map: (i) image segmentation on the Fourier components of the NDVI profiles to identify phenologically homogeneous landscape units, (ii) cluster analysis of the phenological units and post-hoc analysis of the fire-proneness of the phenological fuel classes (PFCs) obtained, (iii) environmental characterization (in terms of land cover and climate) of the PFCs. Our results showed the ability of coarse-resolution satellite time-series to characterize the fire-proneness of Sardinia with an adequate level of accuracy. The remotely sensed phenological framework presented may represent a suitable basis for the development of fire distribution prediction models, coarse-scale fuel maps and for various biogeographic studies. PMID:25822505

Simplified stereo-optical ultrasound plane calibration

NASA Astrophysics Data System (ADS)

Hoßbach, Martin; Noll, Matthias; Wesarg, Stefan

2013-03-01

Image guided therapy is a natural concept and commonly used in medicine. In anesthesia, a common task is the injection of an anesthetic close to a nerve under freehand ultrasound guidance. Several guidance systems exist using electromagnetic tracking of the ultrasound probe as well as the needle, providing the physician with a precise projection of the needle into the ultrasound image. This, however, requires additional expensive devices. We suggest using optical tracking with miniature cameras attached to a 2D ultrasound probe to achieve a higher acceptance among physicians. The purpose of this paper is to present an intuitive method to calibrate freehand ultrasound needle guidance systems employing a rigid stereo camera system. State of the art methods are based on a complex series of error prone coordinate system transformations which makes them susceptible to error accumulation. By reducing the amount of calibration steps to a single calibration procedure we provide a calibration method that is equivalent, yet not prone to error accumulation. It requires a linear calibration object and is validated on three datasets utilizing di erent calibration objects: a 6mm metal bar and a 1:25mm biopsy needle were used for experiments. Compared to existing calibration methods for freehand ultrasound needle guidance systems, we are able to achieve higher accuracy results while additionally reducing the overall calibration complexity. Ke

Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar State, India: an RS and GIS approach.

PubMed

Sudhakar, S; Srinivas, T; Palit, A; Kar, S K; Battacharya, S K

2006-09-01

The kala-azar fever (Visceral leishmaniasis) is continuing unabated in India for over a century, now being largely confined to the eastern part of India mainly in Bihar state and to some extent in its bordering states like West Bengal and Uttar Pradesh. Two study sites namely Patepur block in Vaishali district with high endemicity in northern part and Lohardagga block in Lohardagga district with absolute non-endemicity in southern part of Bihar were selected for the study with the following objectives : (i) to study the macro-ecosystem in relation to distribution of vector -Phlebotomus argentipes; (ii) to identify/map the risk prone areas or villages in a block for quick remedial measures; and (iii) to make use of satellite remote sensing and GIS to demonstrate the utility for rapid assessment of landuse/landcover and their relation with the incidence of kalaazar leading to the mapping of risk prone areas. Indian Remote Sensing (IRS)-1D LISS III satellite data for the periods of March and November 2000 were analysed in Silicon graphic image processing system using ERDAS software. False color composites (FCC) were generated and landuse/landcover was assessed using Maximum likelihood supervised classification techniques based on ground truth training sets. During the study the GIS functions are used to quantify the remotely sensed landscape proportions of 5 km2 buffer surrounding each known group of villages of high occurrence of sandflies in endemic and nonendemic study sites. Instead of traditional ground based survey methods to vector surveillance, the present study used a combination of remote sensing (RS) and geographical information system (GIS) approach to develop landscape predictors of sandfly abundance-an indicator of human vector contact and as a measure of risk prone areas. Statistical analysis using the remotely sensed landscape variables showed that rural villages surrounded by higher proportion of transitional swamps with soft stemmed edible plants and banana, sugarcane plantations had higher sandfly abundance and would, therefore, be at higher risk prone areas for man-vector contact. The present study clearly brought out the usefulness of satellite remote sensing technology in generating the crucial information on spatial distribution of landuse/landcover classes with special emphasis on indicator landcover classes thereby helping in prioritising the area to identify risk prone areas of kala-azar through GIS application tools.

The genome-wide associated candidate gene ZNF804A and psychosis-proneness: Evidence of sex-modulated association

PubMed Central

de Castro-Catala, Marta; Mora-Solano, Aurea; Kwapil, Thomas R.; Cristóbal-Narváez, Paula; Sheinbaum, Tamara; Racioppi, Anna; Barrantes-Vidal, Neus

2017-01-01

Background The Zinc finger protein 804A (ZNF804A) is a promising candidate gene for schizophrenia and the broader psychosis phenotype that emerged from genome-wide association studies. It is related to neurodevelopment and associated to severe symptoms of schizophrenia and alterations in brain structure, as well as positive schizotypal personality traits in non-clinical samples. Moreover, a female-specific association has been observed between ZNF804A and schizophrenia. Aim The present study examined the association of two ZNF804A polymorphisms (rs1344706 and rs7597593) with the positive dimension of schizotypy and psychotic-like experiences in a sample of 808 non-clinical subjects. Additionally, we wanted to explore whether the sexual differences reported in schizophrenia are also present in psychosis-proneness. Results Our results showed an association between rs7597593 and both schizotypy and psychotic-like experiences. These associations were driven by females, such those carrying the C allele had higher scores in the positive dimension of both variables compared to TT allele homozygotes. Conclusion The findings of the present study support the inclusion of ZNF804 variability in studies of the vulnerability for the development of psychopathology in non-clinical samples and consideration of sex as a moderator of this association. PMID:28931092

Difference in quick phases induced by horizontal and vertical vestibular stimulations: role of the otolithic input.

PubMed

Pettorossi, V E; Errico, P; Ferraresi, A

1997-01-01

Quick phases (QPs) induced by horizontal and vertical sinusoidal vestibular stimulations were studied in rabbits, cats, and humans. In all the animals, large and frequent horizontal QPs were observed following yaw stimulation in prone position. By contrast, QPs were almost absent during roll stimulation in rabbits, and they were small and oblique during pitch stimulation in cats and humans. As a result of these differences, the range of gaze displacement induced by vestibular stimulations was greater in the horizontal plane than in the vertical one. We also found that the trajectory of the QPs in rabbits was kept horizontal even when the yaw rotation was off vertical axis of +/- 45 degrees in the sagittal plane. Moreover, in the rabbit, the rare horizontal QPs induced by roll stimulation did not change their orientation at various pitch angles of roll stimulation axis. The QPs were also analyzed following roll stimulation of the rabbit in supine position. In this condition, in which the otolithic receptors were activated in the opposite way compared to prone position, large vertical QPs were elicited. We concluded that these results provide evidence that the otolithic signal plays a role in controlling occurrence and trajectory orientation of the QPs.

Adaptive and automatic red blood cell counting method based on microscopic hyperspectral imaging technology

NASA Astrophysics Data System (ADS)

Liu, Xi; Zhou, Mei; Qiu, Song; Sun, Li; Liu, Hongying; Li, Qingli; Wang, Yiting

2017-12-01

Red blood cell counting, as a routine examination, plays an important role in medical diagnoses. Although automated hematology analyzers are widely used, manual microscopic examination by a hematologist or pathologist is still unavoidable, which is time-consuming and error-prone. This paper proposes a full-automatic red blood cell counting method which is based on microscopic hyperspectral imaging of blood smears and combines spatial and spectral information to achieve high precision. The acquired hyperspectral image data of the blood smear in the visible and near-infrared spectral range are firstly preprocessed, and then a quadratic blind linear unmixing algorithm is used to get endmember abundance images. Based on mathematical morphological operation and an adaptive Otsu’s method, a binaryzation process is performed on the abundance images. Finally, the connected component labeling algorithm with magnification-based parameter setting is applied to automatically select the binary images of red blood cell cytoplasm. Experimental results show that the proposed method can perform well and has potential for clinical applications.

Measurement of thermally ablated lesions in sonoelastographic images using level set methods

NASA Astrophysics Data System (ADS)

Castaneda, Benjamin; Tamez-Pena, Jose Gerardo; Zhang, Man; Hoyt, Kenneth; Bylund, Kevin; Christensen, Jared; Saad, Wael; Strang, John; Rubens, Deborah J.; Parker, Kevin J.

2008-03-01

The capability of sonoelastography to detect lesions based on elasticity contrast can be applied to monitor the creation of thermally ablated lesion. Currently, segmentation of lesions depicted in sonoelastographic images is performed manually which can be a time consuming process and prone to significant intra- and inter-observer variability. This work presents a semi-automated segmentation algorithm for sonoelastographic data. The user starts by planting a seed in the perceived center of the lesion. Fast marching methods use this information to create an initial estimate of the lesion. Subsequently, level set methods refine its final shape by attaching the segmented contour to edges in the image while maintaining smoothness. The algorithm is applied to in vivo sonoelastographic images from twenty five thermal ablated lesions created in porcine livers. The estimated area is compared to results from manual segmentation and gross pathology images. Results show that the algorithm outperforms manual segmentation in accuracy, inter- and intra-observer variability. The processing time per image is significantly reduced.

Intravascular optical imaging of high-risk plaques in vivo by targeting macrophage mannose receptors

NASA Astrophysics Data System (ADS)

Kim, Ji Bak; Park, Kyeongsoon; Ryu, Jiheun; Lee, Jae Joong; Lee, Min Woo; Cho, Han Saem; Nam, Hyeong Soo; Park, Ok Kyu; Song, Joon Woo; Kim, Tae Shik; Oh, Dong Joo; Gweon, Daegab; Oh, Wang-Yuhl; Yoo, Hongki; Kim, Jin Won

2016-03-01

Macrophages mediate atheroma expansion and disruption, and denote high-risk arterial plaques. Therefore, they are substantially gaining importance as a diagnostic imaging target for the detection of rupture-prone plaques. Here, we developed an injectable near-infrared fluorescence (NIRF) probe by chemically conjugating thiolated glycol chitosan with cholesteryl chloroformate, NIRF dye (cyanine 5.5 or 7), and maleimide-polyethylene glycol-mannose as mannose receptor binding ligands to specifically target a subset of macrophages abundant in high-risk plaques. This probe showed high affinity to mannose receptors, low toxicity, and allowed the direct visualization of plaque macrophages in murine carotid atheroma. After the scale-up of the MMR-NIRF probe, the administration of the probe facilitated in vivo intravascular imaging of plaque inflammation in coronary-sized vessels of atheromatous rabbits using a custom-built dual-modal optical coherence tomography (OCT)-NIRF catheter-based imaging system. This novel imaging approach represents a potential imaging strategy enabling the identification of high-risk plaques in vivo and holds promise for future clinical implications.

New reference values must be established for the Alberta Infant Motor Scales for accurate identification of infants at risk for motor developmental delay in Flanders.

PubMed

De Kegel, A; Peersman, W; Onderbeke, K; Baetens, T; Dhooge, I; Van Waelvelde, H

2013-03-01

The Alberta Infant Motor Scales (AIMS) is a reliable and valid assessment tool to evaluate the motor performance from birth to independent walking. This study aimed to determine whether the Canadian reference values on the AIMS from 1990-1992 are still useful tor Flemish infants, assessed in 2007-2010. Additionally, the association between motor performance and sleep and play positioning will be determined. A total of 270 Flemish infants between 0 and 18 months, recruited by formal day care services, were assessed with the AIMS by four trained physiotherapists. Information about sleep and play positioning was collected by mean of a questionnaire. Flemish infants perform significantly lower on the AIMS compared with the reference values (P < 0.001). Especially, infants from the age groups of 4, 5, 6, 7, 8, 9, 10, 11, 12, 13 and of 15 months showed significantly lower scores. From the information collected by parental questionnaires, the lower motor scores seem to be related to the sleep position, the amount of play time in prone, in supine and in a sitting device. Infants who are exposed often to frequently to prone while awake showed a significant higher motor performance than infants who are exposed less to prone (<6 m: P = 0.002; >6 m: P = 0.013). Infants who are placed often to frequently in a sitting device in the first 6 months of life (P = 0.010) and in supine after 6 months (P = 0.001) performed significantly lower than those who are placed less in it. Flemish infants recruited by formal day care services, show significantly lower motor scores than the Canadian norm population. New reference values should be established for the AIMS for accurate identification of infants at risk. Prevention of sudden infant death syndrome by promoting supine sleep position should go together with promotion of tummy time when awake and avoiding to spent too much time in sitting devices when awake. © 2012 Blackwell Publishing Ltd.

Shaming, Blaming, and Maiming: Functional Links Among the Moral Emotions, Externalization of Blame, and Aggression

PubMed Central

Stuewig, Jeffrey; Tangney, June P.; Heigel, Caron; Harty, Laura; McCloskey, Laura

2010-01-01

Theory suggests that shame should be positively related to aggression while guilt may serve as a protective factor. Little research has examined mediators between the moral emotions and aggression. Results using path analyses in four diverse samples were consistent with a model of no direct relationship between shame-proneness and aggression. There was, however, a significant indirect relationship through externalization of blame, but mostly when aggression was measured using self-report. Guilt-proneness, on the other hand, showed a direct negative relationship to aggression whether using self-report or other reports of aggression. Guilt was also inversely related to aggression indirectly through externalization of blame and empathy. Identifying these differing mechanisms may be useful in developing more effective interventions for aggressive individuals. PMID:20369025

The Traumatized TFCC: An Illustrated Review of the Anatomy and Injury Patterns of the Triangular Fibrocartilage Complex.

PubMed

Skalski, Matthew R; White, Eric A; Patel, Dakshesh B; Schein, Aaron J; RiveraMelo, Hector; Matcuk, George R

2016-01-01

The triangular fibrocartilage complex (TFCC) plays an important role in wrist biomechanics and is prone to traumatic and degenerative injury, making it a common source of ulnar-sided wrist pain. Because of this, the TFCC is frequently imaged, and a detailed understanding of its anatomy and injury patterns is critical in generating an accurate report to help guide treatment. In this review, we provide a detailed overview of TFCC anatomy, its normal appearance on magnetic resonance imaging, the spectrum of TFCC injuries based on the Palmer classification system, and pitfalls in accurate assessment. Copyright © 2015 Mosby, Inc. All rights reserved.

Reducing uncertainty on satellite image classification through spatiotemporal reasoning

NASA Astrophysics Data System (ADS)

Partsinevelos, Panagiotis; Nikolakaki, Natassa; Psillakis, Periklis; Miliaresis, George; Xanthakis, Michail

2014-05-01

The natural habitat constantly endures both inherent natural and human-induced influences. Remote sensing has been providing monitoring oriented solutions regarding the natural Earth surface, by offering a series of tools and methodologies which contribute to prudent environmental management. Processing and analysis of multi-temporal satellite images for the observation of the land changes include often classification and change-detection techniques. These error prone procedures are influenced mainly by the distinctive characteristics of the study areas, the remote sensing systems limitations and the image analysis processes. The present study takes advantage of the temporal continuity of multi-temporal classified images, in order to reduce classification uncertainty, based on reasoning rules. More specifically, pixel groups that temporally oscillate between classes are liable to misclassification or indicate problematic areas. On the other hand, constant pixel group growth indicates a pressure prone area. Computational tools are developed in order to disclose the alterations in land use dynamics and offer a spatial reference to the pressures that land use classes endure and impose between them. Moreover, by revealing areas that are susceptible to misclassification, we propose specific target site selection for training during the process of supervised classification. The underlying objective is to contribute to the understanding and analysis of anthropogenic and environmental factors that influence land use changes. The developed algorithms have been tested upon Landsat satellite image time series, depicting the National Park of Ainos in Kefallinia, Greece, where the unique in the world Abies cephalonica grows. Along with the minor changes and pressures indicated in the test area due to harvesting and other human interventions, the developed algorithms successfully captured fire incidents that have been historically confirmed. Overall, the results have shown that the use of the suggested procedures can contribute to the reduction of the classification uncertainty and support the existing knowledge regarding the pressure among land-use changes.

Initial In Vivo Quantification of Tc-99m Sestamibi Uptake as a Function of Tissue Type in Healthy Breasts Using Dedicated Breast SPECT-CT

PubMed Central

Mann, Steve D.; Perez, Kristy L.; McCracken, Emily K. E.; Shah, Jainil P.; Wong, Terence Z.; Tornai, Martin P.

2012-01-01

A pilot study is underway to quantify in vivo the uptake and distribution of Tc-99m Sestamibi in subjects without previous history of breast cancer using a dedicated SPECT-CT breast imaging system. Subjects undergoing diagnostic parathyroid imaging studies were consented and imaged as part of this IRB-approved breast imaging study. For each of the seven subjects, one randomly selected breast was imaged prone-pendant using the dedicated, compact breast SPECT-CT system underneath the shielded patient support. Iteratively reconstructed and attenuation and/or scatter corrected images were coregistered; CT images were segmented into glandular and fatty tissue by three different methods; the average concentration of Sestamibi was determined from the SPECT data using the CT-based segmentation and previously established quantification techniques. Very minor differences between the segmentation methods were observed, and the results indicate an average image-based in vivo Sestamibi concentration of 0.10 ± 0.16 μCi/mL with no preferential uptake by glandular or fatty tissues. PMID:22956950

Rehabilitation Exercises to Induce Balanced Scapular Muscle Activity in an Anti-gravity Posture

PubMed Central

Ishigaki, Tomonobu; Yamanaka, Masanori; Hirokawa, Motoki; Tai, Keita; Ezawa, Yuya; Samukawa, Mina; Tohyama, Harukazu; Sugawara, Makoto

2014-01-01

[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively. PMID:25540485

Investigation of the accuracy of breast tissue segmentation methods for the purpose of developing breast deformation models for use in adaptive radiotherapy

NASA Astrophysics Data System (ADS)

Juneja, P.; Harris, E. J.; Evans, P. M.

2014-03-01

Realistic modelling of breast deformation requires the breast tissue to be segmented into fibroglandular and fatty tissue and assigned suitable material properties. There are a number of breast tissue segmentation methods proposed and used in the literature. The purpose of this study was to validate and compare the accuracy of various segmentation methods and to investigate the effect of the tissue distribution on the segmentation accuracy. Computed tomography (CT) data for 24 patients, both in supine and prone positions were segmented into fibroglandular and fatty tissue. The segmentation methods explored were: physical density thresholding; interactive thresholding; fuzzy c-means clustering (FCM) with three classes (FCM3) and four classes (FCM4); and k-means clustering. Validation was done in two-stages: firstly, a new approach, supine-prone validation based on the assumption that the breast composition should appear the same in the supine and prone scans was used. Secondly, outlines from three experts were used for validation. This study found that FCM3 gave the most accurate segmentation of breast tissue from CT data and that the segmentation accuracy is adversely affected by the sparseness of the fibroglandular tissue distribution.

Rehabilitation Exercises to Induce Balanced Scapular Muscle Activity in an Anti-gravity Posture.

PubMed

Ishigaki, Tomonobu; Yamanaka, Masanori; Hirokawa, Motoki; Tai, Keita; Ezawa, Yuya; Samukawa, Mina; Tohyama, Harukazu; Sugawara, Makoto

2014-12-01

[Purpose] The purpose of this study was to compare the intramuscular balance ratios of the upper trapezius muscle (UT) and the lower trapezius muscle (LT), and the intermuscular balance ratios of the UT and the serratus anterior muscle (SA) among prone extension (ProExt), prone horizontal abduction with external rotation (ProHAbd), forward flexion in the side-lying position (SideFlex), side-lying external rotation (SideEr), shoulder flexion with glenohumeral horizontal abduction load (FlexBand), and shoulder flexion with glenohumeral horizontal adduction load (FlexBall) in the standing posture. [Methods] The electromyographic (EMG) activities of the UT, LT and SA were measured during the tasks. The percentage of maximum voluntary isometric contraction (%MVIC) was calculated for each muscle, and the UT/LT ratios and the UT/SA ratios were compared among the tasks. [Results] The UT/LT ratio with the FlexBand was not significantly different from those of the four exercises in the side-lying and prone postures. The UT/SA ratio with the FlexBall demonstrated appropriate balanced activity. [Conclusion] In an anti-gravity posture, we recommend the FlexBand and the FlexBall for inducing balanced UT/LT and UT/SA ratios, respectively.

WE-AB-BRA-01: 3D-2D Image Registration for Target Localization in Spine Surgery: Comparison of Similarity Metrics Against Robustness to Content Mismatch

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

De Silva, T; Ketcha, M; Siewerdsen, J H

Purpose: In image-guided spine surgery, mapping 3D preoperative images to 2D intraoperative images via 3D-2D registration can provide valuable assistance in target localization. However, the presence of surgical instrumentation, hardware implants, and soft-tissue resection/displacement causes mismatches in image content, confounding existing registration methods. Manual/semi-automatic methods to mask such extraneous content is time consuming, user-dependent, error prone, and disruptive to clinical workflow. We developed and evaluated 2 novel similarity metrics within a robust registration framework to overcome such challenges in target localization. Methods: An IRB-approved retrospective study in 19 spine surgery patients included 19 preoperative 3D CT images and 50 intraoperativemore » mobile radiographs in cervical, thoracic, and lumbar spine regions. A neuroradiologist provided truth definition of vertebral positions in CT and radiography. 3D-2D registration was performed using the CMA-ES optimizer with 4 gradient-based image similarity metrics: (1) gradient information (GI); (2) gradient correlation (GC); (3) a novel variant referred to as gradient orientation (GO); and (4) a second variant referred to as truncated gradient correlation (TGC). Registration accuracy was evaluated in terms of the projection distance error (PDE) of the vertebral levels. Results: Conventional similarity metrics were susceptible to gross registration error and failure modes associated with the presence of surgical instrumentation: for GI, the median PDE and interquartile range was 33.0±43.6 mm; similarly for GC, PDE = 23.0±92.6 mm respectively. The robust metrics GO and TGC, on the other hand, demonstrated major improvement in PDE (7.6 ±9.4 mm and 8.1± 18.1 mm, respectively) and elimination of gross failure modes. Conclusion: The proposed GO and TGC similarity measures improve registration accuracy and robustness to gross failure in the presence of strong image content mismatch. Such registration capability could offer valuable assistance in target localization without disruption of clinical workflow. G. Kleinszig and S. Vogt are employees of Siemens Healthcare.« less

A novel model-based evolutionary algorithm for multi-objective deformable image registration with content mismatch and large deformations: benchmarking efficiency and quality

NASA Astrophysics Data System (ADS)

Bouter, Anton; Alderliesten, Tanja; Bosman, Peter A. N.

2017-02-01

Taking a multi-objective optimization approach to deformable image registration has recently gained attention, because such an approach removes the requirement of manually tuning the weights of all the involved objectives. Especially for problems that require large complex deformations, this is a non-trivial task. From the resulting Pareto set of solutions one can then much more insightfully select a registration outcome that is most suitable for the problem at hand. To serve as an internal optimization engine, currently used multi-objective algorithms are competent, but rather inefficient. In this paper we largely improve upon this by introducing a multi-objective real-valued adaptation of the recently introduced Gene-pool Optimal Mixing Evolutionary Algorithm (GOMEA) for discrete optimization. In this work, GOMEA is tailored specifically to the problem of deformable image registration to obtain substantially improved efficiency. This improvement is achieved by exploiting a key strength of GOMEA: iteratively improving small parts of solutions, allowing to faster exploit the impact of such updates on the objectives at hand through partial evaluations. We performed experiments on three registration problems. In particular, an artificial problem containing a disappearing structure, a pair of pre- and post-operative breast CT scans, and a pair of breast MRI scans acquired in prone and supine position were considered. Results show that compared to the previously used evolutionary algorithm, GOMEA obtains a speed-up of up to a factor of 1600 on the tested registration problems while achieving registration outcomes of similar quality.

Young adults' interpretations of tobacco brands: implications for tobacco control.

PubMed

Gendall, Philip; Hoek, Janet; Thomson, George; Edwards, Richard; Pene, Gina; Gifford, Heather; Pirikahu, Gill; McCool, Judith

2011-10-01

Marketers have long recognized the power and importance of branding, which creates aspirational attributes that increase products' attractiveness. Although brand imagery has traditionally been communicated via mass media, packaging's importance in promoting desirable brand-attribute associations has increased. Knowledge of how groups prone to smoking experimentation interpret tobacco branding would inform the debate over plain packaging currently occurring in many countries. We conducted 12 group discussions and four in-depth interviews with 66 young adult smokers and nonsmokers of varying ethnicities from two larger New Zealand cities and one provincial city. Participants evaluated 10 familiar and unfamiliar tobacco brands using brand personality attributes and discussed the associations they had made. Participants ascribed very different images to different brands when exposed to the packaging alone, regardless of whether they had seen or heard of the brands before. Perceptual mapping of brands and image attributes highlighted how brand positions varied from older, more traditional, and male oriented to younger, feminine, and "cool." Our findings emphasize the continuing importance of tobacco branding as a promotion tool, even when communicated only by packaging. The ease with which packaging alone enabled young people to identify brand attributes and the desirable associations these connoted illustrate how tobacco packaging functions as advertising. The results support measures such as plain packaging of tobacco products to reduce exposure to these overt behavioral cues.

Innovative anisotropic phantoms for calibration of diffusion tensor imaging sequences.

PubMed

Kłodowski, Krzysztof; Krzyżak, Artur Tadeusz

2016-05-01

The paper describes a novel type of anisotropic phantoms designed for b-matrix spatial distribution diffusion tensor imaging (BSD-DTI). Cubic plate anisotropic phantom, cylinder capillary phantom and water reference phantom are described as a complete set necessary for calibration, validation and normalization of BSD-DTI. An innovative design of the phantoms basing on enclosing the anisotropic cores in glass balls filled with liquid made for the first time possible BSD calibration with usage of echo planar imaging (EPI) sequence. Susceptibility artifacts prone to occur in EPI sequences were visibly reduced in the central region of the phantoms. The phantoms were designed for usage in a clinical scanner's head coil, but can be scaled for other coil or scanner types. The phantoms can be also used for a pre-calibration of imaging of other types of phantoms having more specific applications. Copyright © 2015 Elsevier Inc. All rights reserved.

Body Image and Nutritional Status Are Associated with Physical Activity in Men and Women: The ELSA-Brasil Study

PubMed Central

Coelho, Carolina G.; Giatti, Luana; Molina, Maria D. C. B.; Nunes, Maria A. A.; Barreto, Sandhi M.

2015-01-01

The association of body image dissatisfaction and obesity with physical activity is likely to differ according to gender. To investigate this hypothesis, we conducted a cross-sectional study among the ELSA-Brasil cohort members aged 34–65 years (n = 13,286). The body image dissatisfaction was present even among normal weight individuals of both sexes and was associated with lesser chances of practicing moderate physical activity in women and intense physical activity in men. Men and women with central obesity were less prone to practice physical activity of high or moderate intensity. Overweight and obese men were more likely to report vigorous physical activity while obese women were less likely to report this level of physical activity. Body images as well as nutritional status are related to physical activity in both sexes, but the association with physical activity differs by gender. PMID:26035664

Don’t get caught out! A rare case of a calcified urachal remnant mimicking a bladder calculus

PubMed Central

Rodrigues, Jonathan Carl Luis; Gandhi, Sanjay

2013-01-01

Computer tomography through the kidneys, ureters and bladder (CT KUB) is the mainstay investigation of suspected renal tract calculi. However, several pathologies other than renal tract calculi can cause apparent urinary bladder calcification. We describe the case of a 45 year old man who presented with left sided renal colic. Prone CT KUB performed on admission revealed a calcified urachal remnant mimicking a urinary bladder calculus in the dependent portion of the urinary bladder, confirmed by reviewing the multi-planar reformatted images. This is the first reported case in the literature of this phenomenon. We discuss the importance of using multi-planar reformatted images (MPR) and maximum intensity projection images (MIP), as well as careful review of previous imaging, in making the correct diagnosis. We also discuss the differential diagnoses that should be considered when presented with urinary bladder calcification. PMID:23705044

Iran-Iraq Border Quake Region Imaged by NASA Satellite

NASA Image and Video Library

2017-11-15

On Sunday, Nov. 12, 2017, a magnitude 7.3 earthquake struck along the Iran-Iraq border near Halabjah, Iraq. The earthquake was felt as far away as Kuwait, Qatar, Turkey, Lebanon and Israel. Extensive damage and numerous casualties were reported in the area near the epicenter (yellow star on image). The earthquake occurred along the boundary between the Arabian and Eurasian tectonic plates. This is an earthquake-prone area, and has experienced many deadly earthquakes in the past. In this perspective-view image, bright red areas are crops in fields, pale red on mountain ridges are shrubs and trees, dark gray areas are traces of earlier brush fires, and gray and tan colors are different rock types. The image was acquired Sept. 8, 2017, and the star marks the earthquake epicenter at 34.9 degrees north, 45.9 degrees east. https://photojournal.jpl.nasa.gov/catalog/PIA22112

SIFT optimization and automation for matching images from multiple temporal sources

NASA Astrophysics Data System (ADS)

Castillo-Carrión, Sebastián; Guerrero-Ginel, José-Emilio

2017-05-01

Scale Invariant Feature Transformation (SIFT) was applied to extract tie-points from multiple source images. Although SIFT is reported to perform reliably under widely different radiometric and geometric conditions, using the default input parameters resulted in too few points being found. We found that the best solution was to focus on large features as these are more robust and not prone to scene changes over time, which constitutes a first approach to the automation of processes using mapping applications such as geometric correction, creation of orthophotos and 3D models generation. The optimization of five key SIFT parameters is proposed as a way of increasing the number of correct matches; the performance of SIFT is explored in different images and parameter values, finding optimization values which are corroborated using different validation imagery. The results show that the optimization model improves the performance of SIFT in correlating multitemporal images captured from different sources.

Body Image and Nutritional Status Are Associated with Physical Activity in Men and Women: The ELSA-Brasil Study.

PubMed

Coelho, Carolina G; Giatti, Luana; Molina, Maria D C B; Nunes, Maria A A; Barreto, Sandhi M

2015-05-29

The association of body image dissatisfaction and obesity with physical activity is likely to differ according to gender. To investigate this hypothesis, we conducted a cross-sectional study among the ELSA-Brasil cohort members aged 34-65 years (n=13,286). The body image dissatisfaction was present even among normal weight individuals of both sexes and was associated with lesser chances of practicing moderate physical activity in women and intense physical activity in men. Men and women with central obesity were less prone to practice physical activity of high or moderate intensity. Overweight and obese men were more likely to report vigorous physical activity while obese women were less likely to report this level of physical activity. Body images as well as nutritional status are related to physical activity in both sexes, but the association with physical activity differs by gender.

Optimal Normalization Tests for Muscle Activation of the Levator Scapulae, Pectoralis Minor, and Rhomboid Major: An Electromyography Study Using Maximum Voluntary Isometric Contractions.

PubMed

Castelein, Birgit; Cagnie, Barbara; Parlevliet, Thierry; Danneels, Lieven; Cools, Ann

2015-10-01

To identify maximum voluntary isometric contraction (MVIC) test positions for the deeper-lying scapulothoracic muscles (ie, levator scapulae, pectoralis minor, rhomboid major), and to provide a standard set of a limited number of test positions that generate an MVIC in all scapulothoracic muscles. Cross-sectional study. Physical and rehabilitation medicine department. Healthy subjects (N=21). Not applicable. Mean peak electromyographic activity from levator scapulae, pectoralis minor, and rhomboid major (investigated with fine-wire electromyography) and from upper trapezius, middle trapezius, lower trapezius, and serratus anterior (investigated with surface electromyography) during the performance of 12 different MVICs. The results indicated that various test positions generated similar high mean electromyographic activity and that no single test generated maximum activity for a specific muscle in all subjects. The results of this study support using a series of test positions for normalization procedures rather than a single exercise to increase the likelihood of recruiting the highest activity in the scapulothoracic muscles. A standard set of 5 test positions was identified as being sufficient for generating an MVIC of all scapulothoracic muscles: seated T, seated U 135°, prone T-thumbs up, prone V-thumbs up, and supine V-thumbs up. A standard set of test positions for normalization of scapulothoracic electromyographic data that also incorporates the levator scapulae, pectoralis minor, and rhomboid major muscles is 1 step toward a more comprehensive understanding of normal and abnormal muscle function of these muscles and will help to standardize the presentation of scapulothoracic electromyographic muscle activity. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Activation of the gluteus maximus and hamstring muscles during prone hip extension with knee flexion in three hip abduction positions.

PubMed

Kang, Sun-Young; Jeon, Hye-Seon; Kwon, Ohyun; Cynn, Heon-Seock; Choi, Boram

2013-08-01

The direction of fiber alignment within a muscle is known to influence the effectiveness of muscle contraction. However, most of the commonly used clinical gluteus maximus (GM) exercises do not consider the direction of fiber alignment within the muscle. Therefore, the purpose of this study was to investigate the influence of hip abduction position on the EMG (electromyography) amplitude and onset time of the GM and hamstrings (HAM) during prone hip extension with knee flexion (PHEKF) exercise. Surface EMG signals were recorded from the GM and HAM during PHEKF exercise in three hip abduction positions: 0°, 15°, and 30°. Thirty healthy subjects voluntarily participated in this study. The results show that GM EMG amplitude was greatest in the 30° hip abduction position, followed by 15° and then 0° hip abduction during PHEKF exercise. On the other hand, the HAM EMG amplitude at 0° hip abduction was significantly greater than at 15° and 30° hip abduction. Additionally, GM EMG onset firing was delayed relative to that of the HAM at 0° hip abduction. On the contrary, the GM EMG onset occurred earlier than the HAM in the 15° and 30° hip abduction positions. These findings indicate that performing PHEKF exercise in the 30° hip abduction position may be recommended as an effective way to facilitate the GM muscle activity and advance the firing time of the GM muscle in asymptomatic individuals. This finding provides preliminary evidence that GM EMG amplitude and onset time can be modified by the degree of hip abduction. Copyright © 2012 Elsevier Ltd. All rights reserved.

Probabilistic Multi-Person Tracking Using Dynamic Bayes Networks

NASA Astrophysics Data System (ADS)

Klinger, T.; Rottensteiner, F.; Heipke, C.

2015-08-01

Tracking-by-detection is a widely used practice in recent tracking systems. These usually rely on independent single frame detections that are handled as observations in a recursive estimation framework. If these observations are imprecise the generated trajectory is prone to be updated towards a wrong position. In contrary to existing methods our novel approach uses a Dynamic Bayes Network in which the state vector of a recursive Bayes filter, as well as the location of the tracked object in the image are modelled as unknowns. These unknowns are estimated in a probabilistic framework taking into account a dynamic model, and a state-of-the-art pedestrian detector and classifier. The classifier is based on the Random Forest-algorithm and is capable of being trained incrementally so that new training samples can be incorporated at runtime. This allows the classifier to adapt to the changing appearance of a target and to unlearn outdated features. The approach is evaluated on a publicly available benchmark. The results confirm that our approach is well suited for tracking pedestrians over long distances while at the same time achieving comparatively good geometric accuracy.

A technical report on ultrasound-guided scapulocostal syndrome injection.

PubMed

McCarthy, C; Harmon, D

2016-08-01

We describe a case report and technique for using an ultrasound scanner and a linear transducer to guide serratus posterior superior (SPS) muscle injection. A 43-year-old female presented with chronic pain centered under the right upper portion of her scapula impacting her activities of daily living. For the ultrasound-guided SPS muscle injection, the patient was placed in the prone position. The transducer was oriented in a transverse orientation at the level of the C6-T1 vertebrae. Here the SPS muscle attaches to the lower portion of the ligament nuchae and the intervening interspinous ligaments. The muscle fibers run inferiorly and laterally to attach to the 2nd-5th ribs which were identified along with the lateral portion of the serratus posterior superior muscle which is covered by the scapula. Real-time imaging was used to direct a spinal needle into the trigger points of the SPS muscle, where solution was injected under direct vision. The patient's pain symptoms improved significantly. Serratus posterior superior injection can confirm a diagnosis of scapulocostal syndrome and be therapeutically beneficial.

[When shape-invariant recognition ('A' = 'a') fails. A case study of pure alexia and kinesthetic facilitation].

PubMed

Diesfeldt, H F A

2011-06-01

A right-handed patient, aged 72, manifested alexia without agraphia, a right homonymous hemianopia and an impaired ability to identify visually presented objects. He was completely unable to read words aloud and severely deficient in naming visually presented letters. He responded to orthographic familiarity in the lexical decision tasks of the Psycholinguistic Assessments of Language Processing in Aphasia (PALPA) rather than to the lexicality of the letter strings. He was impaired at deciding whether two letters of different case (e.g., A, a) are the same, though he could detect real letters from made-up ones or from their mirror image. Consequently, his core deficit in reading was posited at the level of the abstract letter identifiers. When asked to trace a letter with his right index finger, kinesthetic facilitation enabled him to read letters and words aloud. Though he could use intact motor representations of letters in order to facilitate recognition and reading, the slow, sequential and error-prone process of reading letter by letter made him abandon further training.

Does Daily Distress Make Parents Prone to Using Psychologically Controlling Parenting?

ERIC Educational Resources Information Center

Aunola, Kaisa; Viljaranta, Jaana; Tolvanen, Asko

2017-01-01

The aim of the present study was to investigate whether parental daily distress in terms of negative emotions is associated with the daily variation in parental use of psychological control with their children. Whether parental positive emotions play a role in the use of psychological control was also investigated. The participants were 149…

Laser Cutting Eliminates Nucleic Acid Cross-Contamination in Dried-Blood-Spot Processing

PubMed Central

Daza, Glenda; Chang, Ming; Coombs, Robert

2012-01-01

Dried blood spots (DBS) are useful for molecular assays but are prone to false positives from cross-contamination. In our malaria DBS assay, cross-contamination was encountered despite cleaning techniques suitable for HIV-1. We therefore developed a contact-free laser cutting system that effectively eliminated cross-contamination during DBS processing. PMID:23052309

The Influence of Culture on Strategic Decision Making in Japan and China

DTIC Science & Technology

2011-09-01

literature, with classic studies arguing that military dictatorships are actually 33 Naoko Sajima...prone than non- dictatorships .36 Recent research, however, contends this hypothesis, with quantitative analysis showing that states with strong civilian... dictatorship naturally creates conditions where the military position and solutions have precedence over civilian leadership. By that basic definition, any

A false positive food chain error associated with a generic predator gut content ELISA

USDA-ARS?s Scientific Manuscript database

Conventional prey-specific gut content ELISA and PCR assays are useful for identifying predators of insect pests in nature. However, these assays are prone to yielding certain types of food chain errors. For instance, it is possible that prey remains can pass through the food chain as the result of ...

Kinematic principles of primate rotational vestibulo-ocular reflex. I. Spatial organization of fast phase velocity axes

NASA Technical Reports Server (NTRS)

Hess, B. J.; Angelaki, D. E.

1997-01-01

The spatial organization of fast phase velocity vectors of the vestibulo-ocular reflex (VOR) was studied in rhesus monkeys during yaw rotations about an earth-horizontal axis that changed continuously the orientation of the head relative to gravity ("barbecue spit" rotation). In addition to a velocity component parallel to the rotation axis, fast phases also exhibited a velocity component that invariably was oriented along the momentary direction of gravity. As the head rotated through supine and prone positions, torsional components of fast phase velocity axes became prominent. Similarly, as the head rotated through left and right ear-down positions, fast phase velocity axes exhibited prominent vertical components. The larger the speed of head rotation the greater the magnitude of this fast phase component, which was collinear with gravity. The main sequence properties of VOR fast phases were independent of head position. However, peak amplitude as well as peak velocity of fast phases were both modulated as a function of head orientation, exhibiting a minimum in prone position. The results suggest that the fast phases of vestibulo-ocular reflexes not only redirect gaze and reposition the eye in the direction of head motion but also reorient the eye with respect to earth-vertical when the head moves relative to gravity. As further elaborated in the companion paper, the underlying mechanism could be described as a dynamic, gravity-dependent modulation of the coordinates of ocular rotations relative to the head.

Effects of body position on lung density estimated from EIT data

NASA Astrophysics Data System (ADS)

Noshiro, Makoto; Ebihara, Kei; Sato, Ena; Nebuya, Satoru; Brown, Brian H.

2010-04-01

Normal subjects took the sitting, supine, prone, right lateral and left lateral positions during the measurement procedure. One minute epochs of EIT data were collected at the levels of the 3rd, 4th, 5th and 6th intercostal spaces in each position during normal tidal breathing. Lung density was then determined from the EIT data using the method proposed by Brown5. Lung density at the electrode level of the 6th intercostal space was different from that at almost any other levels in both male and female subjects, and lung density at the electrode levels of the 4th and 5th intercostal spaces in male subjects did not depend upon position.

[Renal biopsy in the lateral position in high risk patients: an opportunity to take advantage of].

PubMed

Dugo, Mauro; Brisotto, Elisa; Vitturi, Nicola; Pasi, Alessandra; Mastrosimone, Stefania; Farneti, Fabrizio; Mangino, Margherita; Virgilio, Bice; Brunello, Anna; Pastori, Giordano; Mazzoli, Matteo; Laurino, Licia; Cova, Giandavide; Beniamin, Francesco; Maresca, Maria Cristina

2015-01-01

Percutaneous ultrasound-guided renal biopsy (RB) is the gold standard for diagnosis of renal diseases. The standard procedure involves biopsy in the prone position (PP) for the native kidneys. In high risk patients, transjugular and laparoscopic RB have been proposed. In patients suffering from obesity or respiratory diseases, the RB of the native kidney in the supine anterolateral position (SALP) represents an alternative to these invasive and expensive methods. We illustrate the technique of execution of RB in the lateral position (LP) on native kidneys. The procedure is safe, effective and has reduced the path travelled by the needle biopsy compared with PP and SALP.