Association between cartilage degeneration and subchondral bone remodeling in patients with knee osteoarthritis comparing MRI and 99mTc-DPD-SPECT/CT

SummaryObjectiveThe purpose of this retrospective cross-sectional study was to investigate the association between cartilage lesions assessed with 3T-MRI and remodeling of the subchondral bone detected by 99mTc-DPD-SPECT/CT.Design99mTc-DPD-SPECT/CT and MRI of 27 knees of 25 patients with chronic knee pain and risk factors for osteoarthritis (OA) were evaluated by one nuclear physician and one radiologist. Six regions of the knee (in total 162 regions in 27 knees) were assessed according to structural joint lesions graded with a modified Whole Organ MR imaging score (WORMS) and according to subchondral 99mTc-DPD-SPECT uptake. Relationships between regional WORMS scores and uptake were quantified using general estimating equations. In a secondary analysis the uptake sum with the WORMS sum per joint was compared using Spearman correlations.ResultsElevated subchondral uptake was significantly associated with the grade of cartilage lesions (P < 0.0001). Mean uptake was significantly higher subjacent to full thickness cartilage lesions compared to partial thickness lesions (P < 0.0001). A similar association was observed between bone marrow edema pattern (BMEP) and cartilage lesions. The sum of uptakes per joint was positively correlated to the WORMS sum (rs = 0.42) and to the sum of cartilage lesions per joint (rs = 0.50).ConclusionBoth functional and structural changes of the subchondral bone in terms of scintigraphic osseous activity and the presence and degree of BMEP were significantly associated with cartilage lesions in patients with OA of the knee. This association was pronounced with full thickness lesions, indicating a possible protective effect of the cartilage layer for the subjacent bone

T1ρ and T2 relaxation times predict progression of knee osteoarthritis

SummaryObjectiveTo evaluate whether T2 and T1ρ relaxation times of knee cartilage determined with 3T magnetic resonance imaging (MRI) at baseline predict longitudinal progression of cartilage degenerative changes.MethodsQuantitative analysis of cartilage was performed using 3T MRI with both T2 and T1ρ mapping techniques in 55 subjects without evidence of severe osteoarthritis (OA) [Kellgren–Lawrence (KL) score of 0–3] at baseline. Morphological abnormalities of cartilage, menisci, ligaments and bone marrow were analyzed on sagittal fat-saturated intermediate-weighted fast spin echo (FSE) sequences. Progression of degenerative changes was analyzed over a period of 2 years. Progression was detected in 27 subjects while in 28 subjects no changes were found. Differences between T2 and T1ρ relaxation times in these two cohorts were compared using one-way analysis of variance (ANOVA) and t tests.ResultsBaseline T2 and T1ρ values were significantly higher in the progression cohort in all compartments (P < 0.05) except the lateral tibia (LT) for T2 and the medial tibia (MT) for T1ρ. Progression of cartilage degenerative disease was most pronounced at the medial femoral condyles and at the femoro-patellar joint; differences between the two cohorts for T2 and T1ρ were also most significant in these compartments.ConclusionsT2 and T1ρ measurements were significantly higher at baseline in individuals that showed progression of cartilage abnormalities over a period of 2 years and may therefore serve as potential predictors for progression of degenerative cartilage abnormalities in knee OA

Hierarchical Concurrent Engineering in a Multiagent Framework

Our experience indicates coordination in concurrent engineering (CE) requires support for two types of relationships among decision makers supervisor/subordinate and peer-to-peer Supervisor/subordinate relationships are created by the standard hierarchical decomposition process that is required to solve any large design problem Peer-to-peer relationships arise when teams of decision makers must interact, without direct guidance, to achieve individual and common goals In this paper, we describe a general decision-making methodology, which we call hierarchical CE The emphasis of hierarchical CE is to provide support for both supervisor/subordinate and peer-to-peer relationships In addition to the concept of hierarchical CE, we present a supporting agent-based framework in which the preferences and constraints of a design supervi sor are distributed to design subordinates, who are expected to exploit their local expertise within the context provided by this global information A distinct separation between feasibility and value facilitates optimal decision-making by design agents, since the bounds on feasibility do not include arbitrary statements about value This distinction may prove useful for other problem domains as wellPeer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68258/2/10.1177_1063293X9600400105.pd

The Effects of Shopping Well-Being and Shopping Ill-Being on Consumer Life Satisfaction

Individuals hold two distinct sets of beliefs about shopping activities: Positive beliefs regarding the degree to which shopping contributes to quality of life (shopping well-being), and negative beliefs related to the degree to which shopping activities result in overspending time, effort, and money (shopping ill-being). Shopping well-being and shopping ill-being are conceptualized as independent constructs in that shopping ill-being is not treated as negative polar of a single dimension. That is, one can experience both shopping well-being as well as shopping ill-being, simultaneously. We hypothesized that (1) shopping well-being is a positive predictor of life satisfaction, (2) shopping ill-being is a negative predictor of life satisfaction, and (3) shopping well-being does contribute to life satisfaction under conditions of low than high shopping ill-being. The study surveyed 1035 respondents in the UK. The study results supported hypotheses 1 and 3, not Hypothesis 2. The paper discusses the implications of these findings for retailers, macro-marketers, and policy makers. © 2017 Springer Science+Business Media Dordrecht and The International Society for Quality-of-Life Studies (ISQOLS

Modulational Instability in Equations of KdV Type

It is a matter of experience that nonlinear waves in dispersive media, propagating primarily in one direction, may appear periodic in small space and time scales, but their characteristics --- amplitude, phase, wave number, etc. --- slowly vary in large space and time scales. In the 1970's, Whitham developed an asymptotic (WKB) method to study the effects of small "modulations" on nonlinear periodic wave trains. Since then, there has been a great deal of work aiming at rigorously justifying the predictions from Whitham's formal theory. We discuss recent advances in the mathematical understanding of the dynamics, in particular, the instability of slowly modulated wave trains for nonlinear dispersive equations of KdV type.Comment: 40 pages. To appear in upcoming title in Lecture Notes in Physic

Thermodynamic Measurements in a Strongly Interacting Fermi Gas

We conduct a series of measurements on the thermodynamic properties of an optically-trapped strongly interacting Fermi gas, including the energy $E$, entropy $S$, and sound velocity $c$. Our model-independent measurements of $E$ and $S$ enable a precision study of the finite temperature thermodynamics. The $E(S)$ data are directly compared to several recent predictions. The temperature in both the superfluid and normal fluid regime is obtained from the fundamental thermodynamic relation $T=\partial E/\partial S$ by parameterizing the $E(S)$ data. Our $E(S)$ data are also used to experimentally calibrate the endpoint temperatures obtained for adiabatic sweeps of the magnetic field between the ideal and strongly interacting regimes. This enables the first experimental calibration of the temperature scale used in experiments on fermionic pair condensation. Our calibration shows that the ideal gas temperature measured for the onset of pair condensation corresponds closely to the critical temperature estimated in the strongly interacting regime from the fits to our $E(S)$ data. The results are in very good agreement with recent predictions. Finally, using universal thermodynamic relations, we estimate the chemical potential and heat capacity of the trapped gas from the $E(S)$ data.Comment: 29 pages, 12 figures. To appear in JLTP online, and in the January, 2009 volum

NMR and Mossbauer study of spin dynamics and electronic structure of Fe{2+x}V{1-x}Al and Fe2VGa

In order to assess the magnetic ordering process in Fe2VAl and the related material Fe2VGa, we have carried out nuclear magnetic resonance (NMR) and Mossbauer studies. 27Al NMR relaxation measurements covered the temperature range 4 -- 500 K in Fe(2+x)V(1-x)Al samples. We found a peak in the NMR spin-lattice relaxation rate, 27T1^-1, corresponding to the magnetic transitions in each of these samples. These peaks appear at 125 K, 17 K, and 165 K for x = 0.10, 0, and - 0.05 respectively, and we connect these features with critical slowing down of the localized antisite defects. Mossbauer measurements for Fe2VAl and Fe2VGa showed lines with no hyperfine splitting, and isomer shifts nearly identical to those of the corresponding sites in Fe3Al and Fe3Ga, respectively. We show that a model in which local band filling leads to magnetic regions in the samples, in addition to the localized antisite defects, can account for the observed magnetic ordering behavior.Comment: 5 pages, 3 figure

Toward a 21st-century health care system: Recommendations for health care reform

The coverage, cost, and quality problems of the U.S. health care system are evident. Sustainable health care reform must go beyond financing expanded access to care to substantially changing the organization and delivery of care. The FRESH-Thinking Project (www.fresh-thinking.org) held a series of workshops during which physicians, health policy experts, health insurance executives, business leaders, hospital administrators, economists, and others who represent diverse perspectives came together. This group agreed that the following 8 recommendations are fundamental to successful reform: 1. Replace the current fee-for-service payment system with a payment system that encourages and rewards innovation in the efficient delivery of quality care. The new payment system should invest in the development of outcome measures to guide payment. 2. Establish a securely funded, independent agency to sponsor and evaluate research on the comparative effectiveness of drugs, devices, and other medical interventions. 3. Simplify and rationalize federal and state laws and regulations to facilitate organizational innovation, support care coordination, and streamline financial and administrative functions. 4. Develop a health information technology infrastructure with national standards of interoperability to promote data exchange. 5. Create a national health database with the participation of all payers, delivery systems, and others who own health care data. Agree on methods to make de-identified information from this database on clinical interventions, patient outcomes, and costs available to researchers. 6. Identify revenue sources, including a cap on the tax exclusion of employer-based health insurance, to subsidize health care coverage with the goal of insuring all Americans. 7. Create state or regional insurance exchanges to pool risk, so that Americans without access to employer-based or other group insurance could obtain a standard benefits package through these exchanges. Employers should also be allowed to participate in these exchanges for their employees' coverage. 8. Create a health coverage board with broad stakeholder representation to determine and periodically update the affordable standard benefit package available through state or regional insurance exchanges