2D-3D registration of CT vertebra volume to fluoroscopy projection: A calibration model assessment (doi:10.1155/2010/806094)

This study extends a previous research concerning intervertebral motion registration by means of 2D dynamic fluoroscopy to obtain a more comprehensive 3D description of vertebral kinematics. The problem of estimating the 3D rigid pose of a CT volume of a vertebra from its 2D X-ray fluoroscopy projection is addressed. 2D-3D registration is obtained maximising a measure of similarity between Digitally Reconstructed Radiographs (obtained from the CT volume) and real fluoroscopic projection. X-ray energy correction was performed. To assess the method a calibration model was realised a sheep dry vertebra was rigidly fixed to a frame of reference including metallic markers. Accurate measurement of 3D orientation was obtained via single-camera calibration of the markers and held as true 3D vertebra position; then, vertebra 3D pose was estimated and results compared. Error analysis revealed accuracy of the order of 0.1 degree for the rotation angles of about 1?mm for displacements parallel to the fluoroscopic plane, and of order of 10?mm for the orthogonal displacement.<br/

Understanding trauma in children and young people in the school setting

Aim: Educational practitioners are increasingly aware of trauma experiences in students as a factor in child disturbance and schooling problems. This discussion paper aims to clarify definitions of trauma and differentiate them from other adverse childhood experiences (ACE), describe trauma impact in terms of clinical outcomes (PTSD, emotional and behavioural disorder) and how attachment factors mediate risk and discuss the challenges and ethics of identifying and enquiring about trauma experience in a school setting. Rationale: Schools are increasingly required to be 'trauma sensitive' and to intervene where possible, with government requirements of improving mental health in schools. However, this poses a real challenge for educationalists given the barriers due to ethics, stigma/secrecy, referral implications and measurement availability for whole school approaches. Universal screening may provide a framework that helps schools recognise, measure and treat trauma. Findings: A conceptual model clarifying trauma exposure, trauma impact and mediating factors is identified to aid understanding for teachers. Use of technological screening methods for whole school monitoring of trauma impacts, including mediating risks, are outlined. Limitations: A full literature review of trauma or school-based interventions is not provided. Nor are biological impacts of trauma at different developmental stages described. Conclusion: Teachers would benefit from having a psychological understanding of trauma models and their component parts in order to identify what lies within the remit of schools for identification and intervention

Relevance of motion artifact in electromyography recordings during vibration treatment

Electromyography readings (EMGs) from quadriceps of fifteen subjects were recorded during whole body vibration treatment at different frequencies (10-50 Hz). Additional electrodes were placed on the patella to monitor the occurrence of motion artifact, triaxial accelerometers were placed onto quadriceps to monitor motion. Signal spectra revealed sharp peaks corresponding to vibration frequency and its harmonics, in accordance with the accelerometer data. EMG total power was compared to that associated with vibration harmonics narrow bands, before and during vibration. On average, vibration associated power resulted in only 3% (±0.9%) of the total power prior to vibration and 29% (±13.4%) during vibration. Often, studies employ surface EMG to quantitatively evaluate vibration evoked muscular activity and to set stimulation frequency. However, previous research has not accounted for motion artifacts. The data presented in this study emphasize the need for the removal of motion artifacts, as they consistently affect RMS estimation, which is often used as a concise muscle activity index during vibrations. Such artifacts, rather unpredictable in amplitude, might be the cause of large inter-study differences and must be eliminated before analysis. Motion artifact filtering will contribute to thorough and precise interpretation of neuromuscular response to vibration treatment. © 2008 Elsevier Ltd. All rights reserved

Associations between depression and specific childhood experiences of abuse and neglect: a meta-analysis

Background Research documents a strong relationship between childhood maltreatment and depression. However, only few studies have examined the specific effects of various types of childhood abuse/neglect on depression. This meta-analysis estimated the associations between depression and different types of childhood maltreatment (antipathy, neglect, physical abuse, sexual abuse, and psychological abuse) assessed with the same measure, the Childhood Experience of Care and Abuse (CECA) interview. Method A systematic search in scientific databases included use of CECA interview and strict clinical assessment for major depression as criteria. Our meta-analysis utilized Cohen's d and relied on a random-effects model. Results The literature search yielded 12 primary studies (reduced from 44), with a total of 4372 participants and 34 coefficients. Separate meta-analyses for each type of maltreatment revealed that psychological abuse and neglect were most strongly associated with the outcome of depression. Sexual abuse, although significant, was less strongly related. Furthermore, the effects of specific types of childhood maltreatment differed across adult and adolescent samples. Limitations Our strict criteria for selecting the primary studies resulted in a small numbers of available studies. It restricted the analyses for various potential moderators. Conclusion This meta-analysis addressed the differential effects of type of childhood maltreatment on major depression, partially explaining between-study variance. The findings clearly highlight the potential impact of the more “silent” types of childhood maltreatment (other than physical and sexual abuse) on the development of depression

The challenge of perioperative pain management in opioid-tolerant patients

The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone

Measurement of intervertebral cervical motion by means of dynamic X-ray image processing and data interpolation

Accurate measurement of intervertebral kinematics of the cervical spine can support the diagnosis of widespread diseases related to neck pain, such chronic whiplash dysfunction, arthritis, segmental degeneration. The natural inaccessibility of the spine, its complex anatomy and the small range of motion only permit concise measurement in-vivo. Low dose X-ray fluoroscopy allows time-continuous screening of cervical spine during patient’s spontaneous motion. To obtain accurate motion measurements, each vertebra was tracked by means of image processing along a sequence of radiographic images. To obtain a time-continuous representation of motion and to reduce noise in the experimental data, smoothing spline interpolation was used. Estimation of intervertebral motion for cervical segments was obtained by processing patient’s fluoroscopic sequence: intervertebral angle and displacement and the instantaneous centre of rotation were computed. The RMS value of fitting errors resulted about 0.2 degree for rotation and 0.2 mm for displacement

Exploring disorganized attachment style among Malay mothers in Malaysia: a study using the Attachment Style Interview

This article explores emerging themes involving disorganized attachment style among Malay Muslim mothers using the Attachment Style Interview (ASI). Analysis of the 18 mothers with disorganized attachment style (those with combined anxious and avoidant styles) utilized themes deemed important from the attachment research literature and selected based on a careful reading of the narrative cases. These include more extreme negative interpersonal experiences than found in other insecure attachment style descriptors, and included partner violence and related isolation/social exclusion. It also indicated more complex cognitive-affective disturbance including mixed or contradictory dependency patterns and both angry and fearful attitudes to others. We discuss the concept of disorganized attachment style in relation to abuse, social exclusion, and its implication for psychopathology, intervention, and treatment

Interview investigation of insecure attachment styles as mediators between poor childhood care and schizophrenia-spectrum phenomenology

Background Insecure attachment styles have received theoretical attention and some initial empirical support as mediators between childhood adverse experiences and psychotic phenomena; however, further specificity needs investigating. The present interview study aimed to examine (i) whether two forms of poor childhood care, namely parental antipathy and role reversal, were associated with subclinical positive and negative symptoms and schizophrenia-spectrum personality disorder (PD) traits, and (ii) whether such associations were mediated by specific insecure attachment styles. Method A total of 214 nonclinical young adults were interviewed for subclinical symptoms (Comprehensive Assessment of At-Risk Mental States), schizophrenia-spectrum PDs (Structured Clinical Interview for DSM-IV Axis II Disorders), poor childhood care (Childhood Experience of Care and Abuse Interview), and attachment style (Attachment Style Interview). Participants also completed the Beck Depression Inventory-II and all the analyses were conducted partialling out the effects of depressive symptoms. Results Both parental antipathy and role reversal were associated with subclinical positive symptoms and with paranoid and schizotypal PD traits. Role reversal was also associated with subclinical negative symptoms. Angry-dismissive attachment mediated associations between antipathy and subclinical positive symptoms and both angry-dismissive and enmeshed attachment mediated associations of antipathy with paranoid and schizotypal PD traits. Enmeshed attachment mediated associations of role reversal with paranoid and schizotypal PD traits. Conclusions Attachment theory can inform lifespan models of how adverse developmental environments may increase the risk for psychosis. Insecure attachment provides a promising mechanism for understanding the development of schizophrenia-spectrum phenomenology and may offer a useful target for prophylactic intervention