Comparison of MR pulse sequences in the detection of multiple sclerosis lesions

PURPOSE: To compare the sensitivity of conventional spin-echo, fast spin-echo, fast fluid-attenuated inversion recovery (FLAIR), and turbo gradient spin-echo MR sequences in the detection of multiple sclerosis lesions. METHODS: Conventional spin-echo, fast spin-echo, fast FLAIR, and turbo gradient spin-echo sequences were performed on a 1.0-T MR imager in seven patients with clinically definite multiple sclerosis. The images in each sequence were evaluated by two raters and consensus was reached by agreement. RESULTS: In comparing conventional spin-echo with fast spin-echo sequences, five lesions were seen only by conventional spin-echo and 63 were seen only by fast spin-echo; in comparing conventional spin-echo with fast FLAIR sequences, 18 lesions were seen only by conventional spin-echo and 109 only by fast FLAIR; in comparing conventional spin-echo with turbo gradient spin-echo sequences, 51 lesions were seen only by conventional spin-echo and seven only by turbo gradient spin-echo; in comparing fast spin-echo with fast FLAIR sequences, 45 lesions were seen only by fast spin-echo and 52 only by fast FLAIR. CONCLUSION: Fast spin-echo and fast FLAIR sequences improve the sensitivity of MR imaging in the detection of multiple sclerosis lesions with reduced acquisition time as compared with conventional spin-echo sequences. These sequences should therefore be considered for serial studies in patients with multiple sclerosis. The sensitivity of turbo gradient spin-echo was inferior to the other sequences, but its reduced acquisition time could make this technique the ideal choice for patients who cannot tolerate longer examination times

Sustainability Design and Software: The Karlskrona Manifesto

Sustainability has emerged as a broad concern for society. Many engineering disciplines have been grappling with challenges in how we sustain technical, social and ecological systems. In the software engineering community, for example, maintainability has been a concern for a long time. But too often, these issues are treated in isolation from one another. Misperceptions among practitioners and research communities persist, rooted in a lack of coherent understanding of sustainability, and how it relates to software systems research and practice. This article presents a cross-disciplinary initiative to create a common ground and a point of reference for the global community of research and practice in software and sustainability, to be used for effectively communicating key issues, goals, values and principles of sustainability design for software-intensive systems.The centrepiece of this effort is the Karlskrona Manifesto for Sustainability Design, a vehicle for a much needed conversation about sustainability within and beyond the software community, and an articulation of the fundamental principles underpinning design choices that affect sustainability. We describe the motivation for developing this manifesto, including some considerations of the genre of the manifesto as well as the dynamics of its creation. We illustrate the collaborative reflective writing process and present the current edition of the manifesto itself. We assess immediate implications and applications of the articulated principles, compare these to current practice, and suggest future steps