Monitoring Locally Induced Hyperthermia with Magnetic Resonance Imaging

__Abstract__ Magnetic resonance thermometry is a relatively new and unique technology for non-invasive monitoring of (local) therapeutic temperature changes that is not yet in common use. Temperature measurements using magnetic resonance heat thermometry can be performed in several ways. Four common methods are described. Spin-lattice (T1) relaxation thermometry seems robust and viable, but relatively inaccurate. Diffusion thermometry is slightly more accurate at the cost of increased scan time. Chemical shift thermometry is most accurate but inherently slow and therefore impracticable. Its derivative, phase shift thermometry seems most promising for monitoring mild temperature changes. Phase shift imaging is, however, difficult to implement due to motion artifacts and susceptibility effects. Apparently two fields for use of MR thermometry in practical therapeutic applications emerge: high temperature gradients for thermoablation that need not be quantified exactly, and low temperature gradients for heat related biological effects that must be controlled precisely

Implementation and validation of ASL perfusion measurements for population imaging

Purpose: Pseudocontinuous arterial spin labeling (pCASL) allows for noninvasive measurement of regional cerebral blood flow (CBF), which has the potential to serve as biomarker for neurodegenerative and cardiovascular diseases. This work aimed to implement and validate pCASL on the dedicated MRI system within the population-based Rotterdam Study, which was installed in 2005 and for which software and hardware configurations have remained fixed. Methods: Imaging was performed on two 1.5T MRI systems (General Electric); (I) the Rotterdam Study system, and (II) a hospital-based system with a product pCASL sequence. An in-house implementation of pCASL was created on scanner I. A flow phantom and three healthy volunteers (<27 years) were scanned on both systems for validation purposes. The data of the first 30 participants (86 ± 4 years) of the Rotterdam Study undergoing pCASL scans on scanner I only were analyzed with and without partial volume correction for gray matter. Results: The validation study showed a difference in blood flow velocity, sensitivity, and spatial coefficient of variation of the perfusion-weighted signal between the two scanners, which was accounted for during post-processing. Gray matter CBF for the Rotterdam Study participants was 52.4 ± 8.2 ml/100 g/min, uncorrected for partial volume effects of gray matter. In this elderly cohort, partial volume correction for gray matter had a variable effect on measured CBF in a range of cortical and sub-cortical regions of interest. Conclusion: Regional CBF measurements are now included to investigate novel biomarkers in the Rotterdam Study. This work highlights that when it is not feasible to purchase a novel ASL sequence, an in-house implementation is valuable

Updating of a clinical protocol for the prevention and management of postpartum haemorrhage at Kenyatta National Hospital, Nairobi, Kenya

Background: Postpartum haemorrhage (PPH) affects 6% of births and accounts for almost 30% of maternal deaths. The use of clinical protocols for preventing and treating PPH is recommended by WHO. Protocols should be evidence-based, regularly updated, widely available and routinely adhered to.Broad Objective: To update the Kenyatta National Hospital (KNH) PPH prevention and management protocol based on latest recommendations, and ensure its dissemination and use by providers.Materials and Methods: A literature search identified selected PPH-related guidelines which were assessed using the AGREE-II tool for guideline quality. A matrix was created to compare recommendations across  guidelines. Recommendations included in the KNH protocol were based on agreement across guidelines, guideline quality, publication year, and  contextual factors in our setting. To aid implementation, an updated KNH protocol document, a clinical algorithm and a PPH management checklist were developed. These were reviewed and accepted as best practice by KNH and University of Nairobi.Results: Six PPH-related guidelines were used (WHO, FIGO, RCOG, ACOG, FOGSI, and the Kenya National Guidelines for Quality Obstetrics and  Perinatal care). The KNH protocol covers PPH prevention, including: active management of third stage, oxytocin after vaginal or caesarean delivery, other drugs for prevention (when oxytocin is not available), controlled cord traction and delayed cord clamping. It also covers PPH management (supportive and definitive measures).Conclusion: An updated PPH prevention and management protocol for KNH was developed. Implementation and adherence will help standardize PPH-related care and improve health outcomes for women

Microscopic Structure of High-Spin Vibrational Excitations in Superdeformed 190,192,194Hg

Microscopic RPA calculations based on the cranked shell model are performed to investigate the quadrupole and octupole correlations for excited superdeformed bands in 190Hg, 192Hg, and 194Hg. The K=2 octupole vibrations are predicted to be the lowest excitation modes at zero rotational frequency. At finite frequency, however, the interplay between rotation and vibrations produces different effects depending on neutron number: The lowest octupole phonon is rotationally aligned in 190Hg, is crossed by the aligned two-quasiparticle bands in 192Hg, and retains the K=2 octupole vibrational character up to the highest frequency in 194Hg. The gamma vibrations are predicted to be higher in energy and less collective than the octupole vibrations. From a comparison with the experimental dynamic moments of inertia, a new interpretation of the observed excited bands invoking the K=2 octupole vibrations is proposed, which suggests those octupole vibrations may be prevalent in SD Hg nuclei.Comment: 22 pages, REVTeX, 12 postscript figures are available on reques

Measurement of W Polarisation at LEP

The three different helicity states of W bosons produced in the reaction e+ e- -> W+ W- -> l nu q q~ at LEP are studied using leptonic and hadronic W decays. Data at centre-of-mass energies \sqrt s = 183-209 GeV are used to measure the polarisation of W bosons, and its dependence on the W boson production angle. The fraction of longitudinally polarised W bosons is measured to be 0.218 \pm 0.027 \pm 0.016 where the first uncertainty is statistical and the second systematic, in agreement with the Standard Model expectation

Search for Anomalous Couplings in the Higgs Sector at LEP

Anomalous couplings of the Higgs boson are searched for through the processes e^+ e^- -> H gamma, e^+ e^- -> e^+ e^- H and e^+ e^- -> HZ. The mass range 70 GeV < m_H < 190 GeV is explored using 602 pb^-1 of integrated luminosity collected with the L3 detector at LEP at centre-of-mass energies sqrt(s)=189-209 GeV. The Higgs decay channels H -> ffbar, H -> gamma gamma, H -> Z\gamma and H -> WW^(*) are considered and no evidence is found for anomalous Higgs production or decay. Limits on the anomalous couplings d, db, Delta(g1z), Delta(kappa_gamma) and xi^2 are derived as well as limits on the H -> gamma gamma and H -> Z gamma decay rates

Measurement of W Polarisation at LEP

The three different helicity states of W bosons produced in the reaction e+ e- -> W+ W- -> l nu q q~ at LEP are studied using leptonic and hadronic W decays. Data at centre-of-mass energies \sqrt s = 183-209 GeV are used to measure the polarisation of W bosons, and its dependence on the W boson production angle. The fraction of longitudinally polarised W bosons is measured to be 0.218 \pm 0.027 \pm 0.016 where the first uncertainty is statistical and the second systematic, in agreement with the Standard Model expectation

Bose-Einstein Correlations of Neutral and Charged Pions in Hadronic Z Decays

Bose-Einstein correlations of both neutral and like-sign charged pion pairs are measured in a sample of 2 million hadronic Z decays collected with the L3 detector at LEP. The analysis is performed in the four-momentum difference range 300 MeV < Q < 2 GeV. The radius of the neutral pion source is found to be smaller than that of charged pions. This result is in qualitative agreement with the string fragmentation model

Z Boson Pair-Production at LEP

Events stemming from the pair-production of Z bosons in e^+e^- collisions are studied using 217.4 pb^-1 of data collected with the L3 detector at centre-of-mass energies from 200 GeV up to 209 GeV. The special case of events with b quarks is also investigated. Combining these events with those collected at lower centre-of-mass energies, the Standard Model predictions for the production mechanism are verified. In addition, limits are set on anomalous couplings of neutral gauge bosons and on effects of extra space dimensions

Neutral-Current Four-Fermion Production in e+e- Interactions at LEP

Neutral-current four-fermion production, e+e- -> ffff is studied in 0.7/fb of data collected with the L3 detector at LEP at centre-of-mass energies root(s)=183-209GeV. Four final states are considered: qqvv, qqll, llll and llvv, where l denotes either an electron or a muon. Their cross sections are measured and found to agree with the Standard Model predictions. In addition, the e+e- -> Zgamma* -> ffff process is studied and its total cross section at the average centre-of-mass energy 196.6GeV is found to be 0.29 +/- 0.05 +/- 0.03 pb, where the first uncertainty is statistical and the second systematic, in agreement with the Standard Model prediction of 0.22 pb. Finally, the mass spectra of the qqll final states are analysed to search for the possible production of a new neutral heavy particle, for which no evidence is found