87th Legislature of Texas

Report from the Sunset Commission regarding the San Jacinto River Authority, including the Commission's decisions and the final actions taken by the Texas Legislature, along with information from the original staff report, such as the need for, performance by, and improvements to the San Jacinto River Authority

87th Legislature of Texas

Report from the Sunset Commission regarding the San Jacinto River Authority, including decisions on statutory recommendations for the Texas Legislature and management recommendations for the agency, as well as information from the original staff report, such as the need for, performance by, and improvements to the San Jacinto River Authority

The influence of electron multiplication and internal X-ray fluorescence on the performance of a scintillator-based gamma camera

When considering the "standard" gamma-camera, one might picture an array of photo-multiplier tubes or a similar array of small-area detectors. This array of imaging detectors would be attached to a corresponding array of scintillator modules (or a solid layer of scintillator) in order to give a high detection efficiency in the energy region of interest, usually 8-140 keV. Over recent years, developments of gamma-cameras capable of achieving much higher spatial resolutions have led to a new range of systems based on Charge-Coupled Devices with some form of signal multiplication between the scintillator and the CCD in order for one to distinguish the light output from the scintillator above the CCD noise. The use of an Electron-Multiplying Charge-Coupled Device (EM-CCD) incorporates the gain process within the CCD through a form of "impact ionisation", however, the gain process introduces an "excess noise factor" due to the probabilistic nature of impact ionisation and this additional noise consequently has an impact on the spatial and spectral resolution of the detector. Internal fluorescence in the scintillator, producing K-shell X-ray fluorescence photons that can be detected alongside the incident gamma-rays, also has a major impact on the imaging capabilities of gamma-cameras. This impact varies dramatically from the low spatial resolution to high spatial resolution camera system. Through a process of simulation and experimental testing focussed on the high spatial resolution (EM-CCD based) variant, the factors affecting the performance of gamma-camera systems are discussed and the results lead to important conclusions to be considered for the development of future systems. This paper presents a study into the influence of the EM-CCD gain process and the internal X-ray fluorescence in the scintillator on the performance of scintillator-based gamma cameras (CCD-based or otherwise), making use of Monte Carlo simulations to demonstrate the aspects involved, their influence on the imaging system and the hypotheses previously discussed in experimental studies

Urban Movement and Alcohol Intake Strongly Predict Defaulting from Tuberculosis Treatment: An Operational Study

BACKGROUND: High levels of defaulting from treatment challenge tuberculosis control in many African cities. We assessed defaulting from tuberculosis treatment in an African urban setting. METHODS: An observational study among adult patients with smear-positive pulmonary tuberculosis receiving treatment at urban primary care clinics in Kampala, Uganda. Defaulting was defined as having missed two consecutive monthly clinic visits while not being reported to have died or continued treatment elsewhere. Defaulting patients were actively followed-up and interviewed. We assessed proportions of patients abandoning treatment with and without the information obtained through active follow-up and we examined associated factors through multivariable logistic regression. RESULTS: Between April 2007 and April 2008, 270 adults aged ≥15 years were included; 54 patients (20%) were recorded as treatment defaulters. On active follow-up vital status was established of 28/54 (52%) patients. Of these, 19 (68%) had completely stopped treatment, one (4%) had died and eight (29%) had continued treatment elsewhere. Extrapolating this to all defaulters meant that 14% rather than 20% of all patients had truly abandoned treatment. Daily consumption of alcohol, recorded at the start of treatment, predicted defaulting (adjusted odds ratio [OR(adj)] 4.4, 95%CI 1.8-13.5), as did change of residence during treatment (OR(adj) 8.7, 95%CI 1.8-41.5); 32% of patients abandoning treatment had changed residence. CONCLUSIONS: A high proportion of tuberculosis patients in primary care clinics in Kampala abandon treatment. Assessing change of residence during scheduled clinic appointments may serve as an early warning signal that the patient may default and needs adherence counseling

87th Legislature of Texas

Initial report from the Sunset Commission regarding the San Jacinto River Authority, including background information, issues and recommendations, and supplementary documentation