215 research outputs found
Improving Maize Production and Ground-Water Quality through Nitrogen Management in Minnesota’s Irrigated Coarse-Textured Soils
University of Minnesota M.S. thesis. March 2016. Major: Land and Atmospheric Science. Advisor: Fabián Fernández. 1 computer file (PDF); vi, 69 pages.Elevated groundwater nitrate (NO3-N) concentrations in irrigated sandy soils under corn (Zea mays L.) production in the Midwest is of increasing concern, and has prompted the need to identify new or enhanced nitrogen (N) management practices in these areas. The objective of this study was to evaluate agricultural technologies that may improve N management for profitable corn production and mitigate negative effects of NO3-N in groundwater. From 2011 to 2014 corn was grown at two sites in Minnesota on sandy soils, Dakota County, MN with a continuous corn (CC) rotation and Pope County, MN with a CC, corn after soybeans (CSB), and soybean after corn (SbC) rotations. Twelve treatments were applied including urea broadcast at rates of 0, 45, 90, 135, 180, 225, 270, and 315 kg N ha-1 as a split application, half at pre-plant and half at the V4 development stage, pre-plant Super U at 180 kg N ha-1, and pre-plant ESN at 180 and 225 kg N ha-1. Canopy sensing with SPAD, GreenSeeker, and Crop Circle was done at V8 and V12 and NO3-N basal stalk measurements at R6 development stage. Soil water NO3-N samples were collected weekly throughout the growing season below the rooting zone using suction lysimeters. The mean Maximum Return to N (MRTN) was 231 kg ha-1 and produced a mean-yield increase above the unfertilized check of 6.5 Mg ha-1. Canopy sensors and plant measurements provided limited utility and generally under-predicted N needs. Nitrogen use efficiency and yields were increased with split-applied urea compared to all other pre-plant sources at 180 kg N ha-1, but no reduction in NO3-N leaching occurred. Season-long NO3-N concentrations ranged from 10 to 46 mg L-1 and overall annual loss was 27 to 41 kg NO3-N ha-1. Reducing N rate below the MRTN substantially reduced yield without reducing NO3-N leaching losses.Struffert, Anne. (2016). Improving Maize Production and Ground-Water Quality through Nitrogen Management in Minnesota’s Irrigated Coarse-Textured Soils. Retrieved from the University Digital Conservancy, https://hdl.handle.net/11299/180198
Changes of Radial Diffusivity and Fractional Anisotopy in the Optic Nerve and Optic Radiation of Glaucoma Patients
Purpose of this study was to evaluate with diffusion-tensor imaging (DTI) changes of radial diffusivity (RD) and fractional anisotropy (FA) in the optic nerve (ON) and optic radiation (OR) in glaucoma and to determine whether changes in RD and FA correlate with disease severity. Therefore, glaucoma patients and controls were examined using 3T. Regions of interest were positioned on RD and FA maps, and mean values were calculated for ON and OR and correlated with optic nerve atrophy and reduced spatial-temporal contrast sensitivity (STCS) of the retina. We found, that RD in glaucoma patients was significantly higher in the ON (0.74 ± 0.21 versus 0.58 ± 0.17·10−3 mm2 s−1; P < 0.05) and OR (0.79 ± 0.23 versus 0.62 ± 0.14·10−3 mm2 s−1; P < 0.05) compared to controls. Aside, FA was significantly decreased (0.48 ± 0.15 versus 0.66 ± 0.12 and 0.50 ± 0.20 versus 0.66 ± 0.11; P < 0.05). Hereby, correlation between changes in RD/FA and optic nerve atrophy/STCS was observed (r > 0.77). In conclusion, DTI at 3 Tesla allows robust RD and FA measurements in the ON and OR. Hereby, the extent of RD increase and FA decrease in glaucoma correlate with established ophthalmological examinations
Bacteria on Shared Mobile Phones Can Lead to Infections
It\u27s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs) if they aren\u27t properly disinfected. The Guidelines for Disinfection and Sterilization in Healthcare Facilities describe non-critical environmental surfaces as items that are frequently touched by the hand and may pose a risk of secondary infection transmission
Disinfection of Shared Mobile Phones Carried by Registered Nurses: A Comparison of Two Methods
This study determined the efficacy of cleaning products on mobile phones. Previous research has demonstrated the risk for bacterial cross contamination between healthcare workers\u27 hands, close contact equipment, and mobile communication devices. There is extensive literature on survival of organisms on inanimate objects. Mobile communication devices can act as a reservoir for bacteria associated with nosocomial infection. Additional studies show cross contamination between the healthcare workers hands, the mobile phones, and the patient.https://digitalcommons.centracare.com/nursing_posters/1025/thumbnail.jp
You Missed a Spot! Disinfecting Shared Mobile Phones
The use of portable mobile devices has facilitated timely communication among healthcare team members. It\u27s now a common practice for hospital-owned mobile phones to be shared among healthcare employees from shift to shift. Despite the benefit of increased, timely communication between caregivers, sharing mobile devices can lead to the spread of healthcare-associated infections (HAIs). This article looks at the efficacy of two types of cleaning products on shared mobile phones carried by RNs at a 489-bed, Magnet-designated, Midwestern regional medical center. The cleaning methods evaluated were 70% isopropyl alcohol wipes and ethyl alcohol wipes
Optimized Flat-Detector CT in Stroke Imaging: Ready for First-Line Use?
Background:
Using flat-detector CT (FD-CT) for stroke imaging has the advantage that both diagnostic imaging and endovascular therapy can be performed directly within the Angio Suite without any patient transfer and time delay. Thus, stroke management could be speeded up significantly, and patient outcome might be improved. But as precondition for using FD-CT as primary imaging modality, a reliable exclusion of intracranial hemorrhage (ICH) has to be possible. This study aimed to investigate whether optimized native FD-CT, using a newly implemented reconstruction algorithm, may reliably detect ICH in stroke patients. Additionally, the potential to identify ischemic changes was evaluated.
Methods:
Cranial FD-CT scans were obtained in 102 patients presenting with acute ischemic stroke (n = 32), ICH (n = 45) or transient ischemic attack (n = 25). All scans were reconstructed with a newly implemented half-scan cone-beam algorithm. Two experienced neuroradiologists, unaware of clinical findings, evaluated independently the FD-CTs screening for hemorrhage or ischemic signs. The findings were correlated to CT, and rater and inter-rater agreement was assessed.
Results:
FD-CT demonstrated high sensitivity (95-100%) and specificity (100%) in detecting intracerebral and intraventricular hemorrhage (IVH). Overall, interobserver agreement (κ = 0.92) was almost perfect and rater agreement to CT highly significant (r = 0.81). One infratentorial ICH and 10 or 11 of 22 subarachnoid hemorrhages (SAHs) were missed of whom 7 were perimesencephalic. The sensitivity for detecting acute ischemic signs was poor in blinded readings (0 or 25%, respectively).
Conclusions:
Optimized FD-CT, using a newly implemented reconstruction algorithm, turned out as a reliable tool for detecting supratentorial ICH and IVH. However, detection of infratentorial ICH and perimesencephalic SAH is limited. The potential of FD-CT in detecting ischemic changes is poor in blinded readings. Thus, plain FD-CT seems insufficient as a standalone modality in acute stroke, but within a multimodal imaging approach primarily using the FD technology, native FD-CT seems capable to exclude reliably supratentorial hemorrhage. Currently, FD-CT imaging seems not yet ready for wide adoption, replacing regular CT, and should be reserved for selected patients. Furthermore, prospective evaluations are necessary to validate this approach in the clinical setting
Flat-detector computed tomography evaluation in an experimental animal aneurysm model after endovascular treatment: A pilot study
We compared flat-detector computed tomography angiography (FD-CTA) to multislice computed tomography (MS-CTA) and digital subtracted angiography (DSA) for the visualization of experimental aneurysms treated with stents, coils or a combination of both.
In 20 rabbits, aneurysms were created using the rabbit elastase aneurysm model. Seven aneurysms were treated with coils, seven with coils and stents, and six with self-expandable stents alone. Imaging was performed by DSA, MS-CTA and FD-CTA immediately after treatment. Multiplanar reconstruction (MPR) was performed and two experienced reviewers compared aneurysm/coil package size, aneurysm occlusion, stent diameters and artifacts for each modality.
In aneurysms treated with stents alone, the visualization of the aneurysms was identical in all three imaging modalities. Residual aneurysm perfusion was present in two cases and visible in DSA and FD-CTA but not in MS-CTA. The diameter of coil-packages was overestimated in MS-CT by 56% and only by 16% in FD-CTA compared to DSA (p < 0.05). The diameter of stents was identical for DSA and FD-CTA and was significantly overestimated in MS-CTA (p < 0.05). Beam/metal hardening artifacts impaired image quality more severely in MS-CTA compared to FD-CTA.
MS-CTA is impaired by blooming and beam/metal hardening artifacts in the visualization of implanted devices. There was no significant difference between measurements made with noninvasive FD-CTA compared to gold standard of DSA after stenting and after coiling/stent-assisted coiling of aneurysms. FD-CTA may be considered as a non-invasive alternative to the gold standard 2D DSA in selected patients that require follow up imaging after stenting
Visualization of large vessel occlusion, clot extent, and collateral supply using volume perfusion flat detector computed tomography in acute stroke patients
Background
Flat detector computed tomography angiography (FDCTA) can be reconstructed from volume perfusion flat detector computed tomography (VP-FDCT). Thus, CTA equivalent stroke imaging might be feasible within the angio suite.
Purpose
To evaluate the diagnostic accuracy of FDCTA in detecting large vessel occlusion (LVO) and collateral supply in acute stroke patients.
Material and Methods
Sixteen patients with LVO of the anterior circulation were analyzed retrospectively. Each patient underwent a multimodal CT stroke protocol, subsequent VP-FDCT, and digital subtraction angiography (DSA) for endovascular stroke therapy. Angiographic images reconstructed secondarily from VP-FDCT were evaluated with regard to visualization of LVO, Collateral Score (CS), Clot Burden Score (CBS), and image quality.
Results
Image quality of FDCTA was sufficient for diagnosis with a strong correlation between CTA and FDCTA (median score: CTA = 4 ± 0.447; FDCTA = 4 ± 0.5). Detection of LVO could be achieved with high sensitivity and specificity for FDCTA and CTA (97.9%, 95% confidence interval [CI] = 96.0–99.9; 92.6%, 95% CI = 84.3–100.0 vs. 96.8%, 95% CI = 93.2–100.0; 86.3%, 95% CI = 88.2–95.2). CBS and CS assessment showed no significant difference between FDCTA and CTA for both readers (reader1CBS: P = 0.751, reader1CS: P = 0.718; reader2CBS: P = 0.164; reader2CS: P = 0.582) and an excellent interrater agreement (CTACBSICC = 0.984, FDCTACBSICC = 0.951; CTACSICC = 0.754, FDCTACSICC = 0.789).
Conclusion
FDCTA, reconstructed from VP-FDCT data, allows reliable detection of ICA or MCA M1 segment occlusion comparable to CTA and may provide information concerning the clot extent with sufficient image quality
Neuromyelitis optica presenting with relapses under treatment with natalizumab: a case report
Introduction
Neuromyelitis optica is an inflammatory demyelinating disease of the central nervous system. To date, optimal therapeutic approaches for neuromyelitis optica have yet to be defined. Natalizumab is highly effective in relapsing-remitting multiple sclerosis and might be considered as an option.
Case presentation
Here, we describe a 67-year-old Caucasian man with definite neuromyelitis optica with detection of anti-aquaporin-4 antibodies over the course of the disease. After initially discussing the diagnosis of multiple sclerosis at an outside hospital, our patient received interferon beta 1a as well as repeated corticosteroid pulses without success. Under subsequent therapy with natalizumab, he continued to present relapses. It was not until discontinuation of natalizumab, repeated cycles of plasma exchanges and initiation of therapy with rituxan that the disease course started to stabilize. Although B cells were completely depleted, our patient experienced another severe myelitis relapse during further follow-up and an additional immunosuppressive therapy with cyclophosphamide was started. Under this regimen, no further relapses occurred over the next 24 months.
Conclusions
This case adds further evidence to the previously discussed notion that natalizumab, while highly effective in multiple sclerosis, may not work sufficiently in neuromyelitis optica. It further advocates for repetitive testing of anti-aquaporin-4 antibodies before and after treatment initiation
Clinical Comparison of FD-CT and MS-CT in Aneurysmal Subarachnoid Haemorrhage: A Single Center Experience
Single-center comparison of postinterventional multislice computed tomography (MS-CT) and flat-detector computed tomography (FD-CT) in patients with subarachnoid haemorrhage (SAH) and endovascularly treated cerebral aneurysms with a focus on detection of posttherapeutical complications. Patients with endovascularly treated aneurysmal SAH undergoing both MS-CT and FD-CT within 24 h after intervention were included. Datasets were compared regarding image quality (IQ) as well as qualitative (detection of SAH, intracerebral haemorrhage [ICH], intraventricular haemorrhage [IVH], external ventricular drain [EVD] position, acute obstructive hydrocephalus [AOH]) and quantitative (cella media distance [CMD], modified Graeb score [GS]) parameters. 410 patients with endovascularly treated aneurysmal SAH were included. IQ was equal between MS-CT and FD-CT. FD-CT allowed equal detection of SAH and ICH in comparison to MS-CT. FD-CT allowed excellent detection of IVH and delineation of EVD position with strong agreement to MS-CT findings. FD-CT allowed equal detection of AOH in comparison to MS-CT. There was no significant difference of CMD and GS between FD-CT and MS-CT. Postinterventional FD-CT yields equivalent diagnostic value in patients with endovascular treated SAH as MS-CT. Enabling reliable detection of SAH-associated complications within the angiosuite, FD-CT might be an efficient and safe imaging modality in these clinical emergencies
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