147 research outputs found
NEMA NU 2-2018 performance evaluation of a new generation digital 32-cm axial field-of-view Omni Legend PET-CT
A NEMA performance evaluation was conducted on the new General Electric (GE)
digital Omni Legend PET-CT system with 32-cm extended field-of-view. This study
marks the introduction of the first-ever commercially available clinical
digital bismuth germanate technology. Testing was performed in accordance with
the NEMA NU2-2018 standard. A comparison was made with the performance of two
other commercial GE scanners with extended fields-of-view. A digital lutetium
yttrium orthosilicate system (Discovery MI - 6 ring) and a non-digital bismuth
germanate system (Discovery IQ). For the Omni assessment, the tangential,
radial, and axial spatial resolutions at 1 cm radial offset were measured as
3.76 mm, 3.73 mm, and 4.25 mm FWHM. The total system sensitivity to a line
source at the center was 44.36 cps/kBq. The peak NECR was 501 kcps at 17.8
kBq/mL. The scatter fraction at NECR peak was 35.48%, and the maximum
count-rate error at and below NEC peak was 5.5%. Sphere contrast recovery
coefficients were from 52% (10 mm) to 93% (37 mm). The system does not use time
of flight; thus, no assessment of timing resolution was made. The PET-CT
co-registration accuracy was 2.4 mm. The performance of the Omni Legend
surpassed that of the Discovery MI on all NEMA tests, except for assessments of
background variability (image noise). Time of flight is associated with
inherent improvements in signal-to-noise ratio. In lieu of time of flight
capabilities, the Omni provides software corrections in the form of a
pre-trained neural network (trained on non-ToF to ToF). With such corrections,
average performance is competitive when compared to ToF systems. Further
validation is required to optimize clinical imaging protocols and
hyperparameters associated with such software corrections and to examine the
effect of non-linear corrections with varying target size, particularly for
real world, clinical scans
Biocompatible packaging solutions for implantable electronic systems for medical applications
Our biocompatible packaging concept for implantable electronic systems combines biocompatibility, hermeticity and extreme miniaturization. In a first phase, all chips are encapsulated in order to realize a bi-directional diffusion barrier preventing body fluids to leach into the package causing corrosion, and preventing IC materials such as Cu to diffuse into the body, causing various adverse effects. Various clean room materials are tested with respect to their suitability as encapsulation material. In a second phase of the packaging process, all chips of the final device should be electrically connected, applying a biocompatible metallization scheme using eg. gold or platinum. Device assembly is the final packaging step, during which all system components will be interconnected. To provide sufficient mechanical support, all these components are embedded using a biocompatible elastomer such as PDMS
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Advantages of the net benefit regression framework for trial-based economic evaluations of cancer treatments: an example from the Canadian Cancer Trials Group CO.17 trial.
BackgroundEconomic evaluations commonly accompany trials of new treatments or interventions; however, regression methods and their corresponding advantages for the analysis of cost-effectiveness data are not widely appreciated.MethodsTo illustrate regression-based economic evaluation, we review a cost-effectiveness analysis conducted by the Canadian Cancer Trials Group's Committee on Economic Analysis and implement net benefit regression.ResultsNet benefit regression offers a simple option for cost-effectiveness analyses of person-level data. By placing economic evaluation in a regression framework, regression-based techniques can facilitate the analysis and provide simple solutions to commonly encountered challenges (e.g., the need to adjust for potential confounders, identify key patient subgroups, and/or summarize "challenging" findings, like when a more effective regimen has the potential to be cost-saving).ConclusionsEconomic evaluations of patient-level data (e.g., from a clinical trial) can use net benefit regression to facilitate analysis and enhance results
The Behaviour of Both Listeria monocytogenes and Rat Ciliated Ependymal Cells Is Altered during Their Co-Culture
Ciliated ependymal cells line the cerebral ventricles and aqueducts separating the infected CSF from the brain parenchyma in meningitis
Systematic review and metaanalysis comparing the bias and accuracy of the modification of diet in renal disease and chronic kidney disease epidemiology collaboration equations in community-based population
BACKGROUND
The majority of patients with chronic kidney disease are diagnosed and monitored in primary care. Glomerular filtration rate (GFR) is a key marker of renal function, but direct measurement is invasive; in routine practice, equations are used for estimated GFR (eGFR) from serum creatinine. We systematically assessed bias and accuracy of commonly used eGFR equations in populations relevant to primary care.
CONTENT
MEDLINE, EMBASE, and the Cochrane Library were searched for studies comparing measured GFR (mGFR) with eGFR in adult populations comparable to primary care and reporting both the Modification of Diet in Renal Disease (MDRD) and the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations based on standardized creatinine measurements. We pooled data on mean bias (difference between eGFR and mGFR) and on mean accuracy (proportion of eGFR within 30% of mGFR) using a random-effects inverse-variance weighted metaanalysis. We included 48 studies of 26875 patients that reported data on bias and/or accuracy. Metaanalysis of within-study comparisons in which both formulae were tested on the same patient cohorts using isotope dilution-mass spectrometry-traceable creatinine showed a lower mean bias in eGFR using CKD-EPI of 2.2 mL/min/1.73 m2 (95% CI, 1.1–3.2; 30 studies; I2 = 74.4%) and a higher mean accuracy of CKD-EPI of 2.7% (1.6–3.8; 47 studies; I2 = 55.5%). Metaregression showed that in both equations bias and accuracy favored the CKD-EPI equation at higher mGFR values.
SUMMARY
Both equations underestimated mGFR, but CKD-EPI gave more accurate estimates of GFR
Antagonist HIV-1 Gag Peptides Induce Structural Changes in HLA B8
In the cellular immune response, recognition by CTL-TCRs of viral antigens presented as peptides by HLA class I molecules, triggers destruction of the virally infected cell (Townsend, A.R.M., J. Rothbard, F.M. Gotch, G. Bahadur, D. Wraith, and A.J. McMichael. 1986. Cell. 44:959–968). Altered peptide ligands (APLs) which antagonise CTL recognition of infected cells have been reported (Jameson, S.C., F.R. Carbone, and M.J. Bevan. 1993. J. Exp. Med. 177:1541–1550). In one example, lysis of antigen presenting cells by CTLs in response to recognition of an HLA B8–restricted HIV-1 P17 (aa 24–31) epitope can be inhibited by naturally occurring variants of this peptide, which act as TCR antagonists (Klenerman, P., S. Rowland Jones, S. McAdam, J. Edwards, S. Daenke, D. Lalloo, B. Koppe, W. Rosenberg, D. Boyd, A. Edwards, P. Giangrande, R.E. Phillips, and A. McMichael. 1994. Nature (Lond.). 369:403– 407). We have characterised two CTL clones and a CTL line whose interactions with these variants of P17 (aa 24–31) exhibit a variety of responses. We have examined the high resolution crystal structures of four of these APLs in complex with HLA B8 to determine alterations in the shape, chemistry, and local flexibility of the TCR binding surface. The variant peptides cause changes in the recognition surface by three mechanisms: changes contributed directly by the peptide, effects transmitted to the exposed peptide surface, and induced effects on the exposed framework of the peptide binding groove. While the first two mechanisms frequently lead to antagonism, the third has more profound effects on TCR recognition
Recognition and blocking of innate immunity cells by Candida albicans chitin
Peer reviewedPublisher PD
Prevalence of chronic kidney disease in the community in the United Kingdom in OxRen, a population-based cohort study
Background:
Chronic kidney disease (CKD) is a largely asymptomatic condition of diminished renal function, which may not be detected until advanced stages without screening.
Aim:
To establish undiagnosed and overall CKD prevalence using a cross-sectional analysis.
Design and Setting:
Longitudinal cohort study in UK primary care.
Method:
Participants aged ≥60 years were invited to attend CKD screening visits to determine whether they had reduced renal function (estimated glomerular filtration rate [eGFR]
Results:
A total of 3207 participants were recruited and 861 attended the baseline assessment. The CKD cohort consisted of 327 people with existing CKD, 257 people with CKD diagnosed through screening (CKD prevalence of 18.2%, 95% confidence interval [CI] = 16.9 to 19.6), and 277 with borderline/transient decreased renal function. In the CKD cohort, 54.4% were female, mean standard deviation (SD) age was 74.0 (SD 6.9) years, and mean eGFR was 58.0 (SD 18.4) ml/min/1.73 m2. Of the 584 with confirmed CKD, 44.0% were diagnosed through screening. Over half of the CKD cohort (51.9%, 447/861) fell into CKD stages 3–5 at their baseline assessment, giving an overall prevalence of CKD stages 3–5 of 13.9% (95% CI = 12.8 to 15.1). More people had reduced eGFR using the Modification of Diet in Renal Disease (MDRD) equation than with CKD Epidemiology Collaboration (CKD-EPI) equation in the 60–75-year age group and more had reduced eGFR using CKD-EPI in the ≥80-year age group.
Conclusion:
This study found that around 44.0% of people living with CKD are undiagnosed without screening, and prevalence of CKD stages 1–5 was 18.2% in participants aged >60 years. Follow-up will provide data on annual incidence, rate of CKD progression, determinants of rapid progression, and predictors of cardiovascular events.</p
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