The clinical impact of phase offset errors and different correction methods in cardiovascular magnetic resonance phase contrast imaging: a multi-scanner study

Background: Cardiovascular magnetic resonance (CMR) phase contrast (PC) flow measurements suffer from phase offset errors. Background subtraction based on stationary phantom measurements can most reliably be used to overcome this inaccuracy. Stationary tissue correction is an alternative and does not require additional phantom scanning. The aim of this study was 1) to compare measurements with and without stationary tissue correction to phantom corrected measurements on different GE Healthcare CMR scanners using different software packages and 2) to evaluate the clinical implications of these methods. Methods: CMR PC imaging of both the aortic and pulmonary artery flow was performed in patients on three different 1.5 T CMR scanners (GE Healthcare) using identical scan parameters. Uncorrected, first, second and third order stationary tissue corrected flow measurement were compared to phantom corrected flow measurements, our reference method, using Medis QFlow, Circle cvi42 and MASS software. The optimal (optimized) stationary tissue order was determined per scanner and software program. Velo

Estimating Acceleration and Lane-Changing Dynamics Based on NGSIM Trajectory Data

The NGSIM trajectory data sets provide longitudinal and lateral positional information for all vehicles in certain spatiotemporal regions. Velocity and acceleration information cannot be extracted directly since the noise in the NGSIM positional information is greatly increased by the necessary numerical differentiations. We propose a smoothing algorithm for positions, velocities and accelerations that can also be applied near the boundaries. The smoothing time interval is estimated based on velocity time series and the variance of the processed acceleration time series. The velocity information obtained in this way is then applied to calculate the density function of the two-dimensional distribution of velocity and inverse distance, and the density of the distribution corresponding to the ``microscopic'' fundamental diagram. Furthermore, it is used to calculate the distributions of time gaps and times-to-collision, conditioned to several ranges of velocities and velocity differences. By simulating virtual stationary detectors we show that the probability for critical values of the times-to-collision is greatly underestimated when estimated from single-vehicle data of stationary detectors. Finally, we investigate the lane-changing process and formulate a quantitative criterion for the duration of lane changes that is based on the trajectory density in normalized coordinates. Remarkably, there is a very noisy but significant velocity advantage in favor of the targeted lane that decreases immediately before the change due to anticipatory accelerations

Analysis of pedestrian-vehicle traffic conflicts in street designs with elements of shared space

This paper investigates changes in pedestrian-vehicle traffic conflicts in urban streets redesigned according to the principles of shared space, using a recently developed Pedestrian-Vehicle Conflicts Analysis (PVCA) method. In a first step, the PVCA method is revised to more accurately reflect the features of shared space: this includes the definition of a systematic process for identifying conflict occurrences on one hand, and the full quantification of the conflict severity grading process on the other. Then, the refined PVCA method is applied to a case study in London, using video data from periods before and after the redevelopment of the Exhibition Road site from a conventional dual carriageway to a modern design with some elements of shared space. The results of the comparative analysis carried out indicate a general decrease in traffic conflict rates as a result of the redesign, but also highlight specific issues that may require additional analysis

Survival of massive allografts in segmental oncological bone defect reconstructions

Reconstructions of large segmental bone defects after resection of bone tumours with massive structural allografts have a high number of reported complications including fracture, infection and non-union. Our goal is to report the survival and complications of massive allografts in our patients. A total of 32 patients were evaluated for fracture, infection, non-union rate and survival of their massive allograft reconstructions. The average follow-up for this group was five years and three months. The total fracture rate was 13% with a total infection rate of 16%. We found a low union rate of 25%. The total survival of the allografts was 80.8% (± 18.7%) after five years. We found a five-year allograft survival of 80.8% which is comparable with other studies

Antidepressant activity of anti-cytokine treatment: a systematic review and meta-analysis of clinical trials of chronic inflammatory conditions.

Inflammatory cytokines are commonly elevated in acute depression and are associated with resistance to monoaminergic treatment. To examine the potential role of cytokines in the pathogenesis and treatment of depression, we carried out a systematic review and meta-analysis of antidepressant activity of anti-cytokine treatment using clinical trials of chronic inflammatory conditions where depressive symptoms were measured as a secondary outcome. Systematic search of the PubMed, EMBASE, PsycINFO and Cochrane databases, search of reference lists and conference abstracts, followed by study selection process yielded 20 clinical trials. Random effect meta-analysis of seven randomised controlled trials (RCTs) involving 2370 participants showed a significant antidepressant effect of anti-cytokine treatment compared with placebo (standardised mean difference (SMD)=0.40, 95% confidence interval (CI), 0.22-0.59). Anti-tumour necrosis factor drugs were most commonly studied (five RCTs); SMD=0.33 (95% CI; 0.06-0.60). Separate meta-analyses of two RCTs of adjunctive treatment with anti-cytokine therapy and eight non-randomised and/or non-placebo studies yielded similar small-to-medium effect estimates favouring anti-cytokine therapy; SMD=0.19 (95% CI, 0.00-0.37) and 0.51 (95% CI, 0.34-0.67), respectively. Adalimumab, etanercept, infliximab and tocilizumab all showed statistically significant improvements in depressive symptoms. Meta-regression exploring predictors of response found that the antidepressant effect was associated with baseline symptom severity (P=0.018) but not with improvement in primary physical illness, sex, age or study duration. The findings indicate a potentially causal role for cytokines in depression and that cytokine modulators may be novel drugs for depression in chronically inflamed subjects. The field now requires RCTs of cytokine modulators using depression as the primary outcome in subjects with high inflammation who are free of other physical illnesses.GMK is supported by a Clinical Lecturer Starter Grant from the Academy of Medical Sciences, UK (grant no. 80354) and a Gosling Fellowship from the Royal College of Psychiatrists, UK (2015). GMK also received funding support from the Wellcome Trust 094790/Z/10/Z). PBJ acknowledges grant sup port from the Wellcome Trust (095844/Z/11/Z & 088869/Z/09/Z) and NIHR (RP-PG-0606-1335, Cambridge Biomedical Research Centre and CLAHRC East of England). RD has received grants from the National Institute of Neurological Diseases and Stroke of the National Institutes of Health (grants R01 NS073939; R01 NS074999).This is the final version of the article. It first appeared from Nature Publishing Group via http://dx.doi.org/10.1038/mp.2016.16

A multiple timepoint pre-post evaluation of a ‘sexual respect’ dvd to improve competence in discussing sex with patients with disability

Sexual problems are common after chronic illnesses and disability, yet research indicates that this is a neglected area in healthcare services. Evaluation studies provide evidence of the effectiveness of education in enhancing professionals’ knowledge, skills, and comfort in addressing patients’ sexual concerns. However, there are limited evaluations aimed at improving ability to discuss sexuality when working with people with disabilities. The overall aim of this study was to evaluate a ‘Sexual Respect’ DVD as an intervention to improve competence in addressing ‘sexuality and disability’. A mixed methods design was used with both quantitative and qualitative components. Nursing students’ self-report ratings of knowledge, confidence, comfort and willingness (to discuss sexuality) levels were collected across four time points: baseline, pre-intervention, post-intervention, and follow-up. Data were analysed using one-way repeated measures ANOVAs with post hoc comparisons. Open-ended qualitative comments relating to the barriers and facilitators to discussing sexuality were analysed using content analysis and subsequent frequency analysis. Reported barriers included lack of knowledge about sex¬uality and disability issues, the patient’s level of disability, and waiting for the patient to raise sexuality issues first. Facilitators included education/training, written information, and if the patient raised it first. Overall, the DVD intervention had a significant and positive impact on nursing students’ self-reported knowledge, confidence, comfort and willingness levels. The findings are discussed in relation to the PLISSIT model, which emphasises the importance of a proactive approach to addressing sexuality issues

Serotonin and GI Disorders: An Update on Clinical and Experimental Studies

The gastrointestinal (GI) tract is the largest producer of serotonin (5-hydroxytryptamine (5-HT)) in the body, and as such it is intimately connected with GI function and physiology. 5-HT produced by enterochromaffin (EC) cells is an important enteric mucosal signaling molecule and has been implicated in a number of GI diseases, including inflammatory bowel disease and functional disorders such as irritable bowel syndrome. This review will focus on what is known of basic 5-HT physiology and also on the emerging evidence for its novel role in activation of immune response and inflammation in the gut. Utilizing pubmed.gov, search terms such as “5-HT,” “EC cell,” and “colitis,” as well as pertinent reviews, were used to develop a brief overview of EC cell biology and the association between 5-HT and various GI disorders. It is the aim of this review to provide the readers with an update on EC cell biology and current understanding on the role of 5-HT in GI disorders specifically in inflammatory conditions

Behaviour change in post-consumer recycling: Applying agent-based modelling in social experiment

Change in consumer behavior that leads to increased waste separation and recycling has been identified as a critical component of Chinese national strategy for constructing a “Circular Economy”. Various innovative solutions at community level targeting consumer behaviors are emerging in Chinese cities, using information technology that can track the volume and quality of the sorting process. In order to evaluate the potential impact of these novel solutions, we studied the behavioral change of households by initiating an experimental recycling program in a residential community in Beijing, and developed an Agent Based Model based on Theory of Planned Behavior (TPB) to identify key factors in changing behavior. The results show that the Social Norm (SN) has a decisive effect on whether an area starts recycling or not. As to the effectiveness of intervention, the Perceived Behavioral Control (PBC) plays a large role in the determination of the recycling behavior in this study, while the role of attitude is relatively small. The model outcomes can be corroborated with observations in different communities using similar technical solutions. In conclusion, we suggest that efficient local interactions among various stakeholders are needed in forming the social norm and common space that favorite recycling activities at the community level.</p