A New Approach to Accessibility – Perceived accessibility versus objectively measured accessibility in daily travel

Accessibility has conventionally been measured and evaluated ignoring the user-perspective in favor for focus on travel time and distance to a number of pre-determined destinations. Acknowledging this gap, we recently developed a scale for perceived accessibility PAC (Lättman, Friman, & Olsson 2016) aimed at capturing the individual perspective of accessibility within a certain travel mode. In this paper, we 1) further develop the PAC measure of perceived accessibility in order to capture the perceived accessibility of the individuals’ actual daily travel 2) compare residents’ perceived accessibility to the objective accessibility level for the same residential area, and 3) compare levels of perceived accessibility between residential areas and main travel modes. Data from 2711 residents of Malmö, Sweden show that perceived accessibility is consistently higher than objective accessibility across 13 residential areas, with minor differences in levels of perceived accessibility between areas. Surprisingly, bicycle users rate their accessibility significantly higher than those who mainly use the car or public transport for daily travel, contrary to objective accessibility assumptions. These differences point at the importance of including perceived accessibility as a complementary tool when planning for and evaluating the transport systems.Institute of Transport and Logistics Studies. Faculty of Economics and Business. The University of Sydne

In Vivo Measurements of T2 Relaxation Time of Mouse Lungs during Inspiration and Expiration

Abstract Purpose The interest in measurements of magnetic resonance imaging relaxation times, T1, T2, T2*, with intention to characterize healthy and diseased lungs has increased recently. Animal studies play an important role in this context providing models for understanding and linking the measured relaxation time changes to the underlying physiology or disease. The aim of this work was to study how the measured transversal relaxation time (T2) in healthy lungs is affected by normal respiration in mouse. Method T2 of lung was measured in anaesthetized freely breathing mice. Image acquisition was performed on a 4.7 T, Bruker BioSpec with a multi spin-echo sequence (Car-Purcell-MeiboomGill) in both end-expiration and end-inspiration. The echo trains consisted of ten echoes of inter echo time 3.5 ms or 4.0 ms. The proton density, T2 and noise floor were fitted to the measured signals of the lung parenchyma with a Levenberg-Marquardt least-squares threeparameter fit. Results T2 in the lungs was longer (p<0.01) at end-expiration (9.7±0.7 ms) than at end-inspiration (9.0±0.8 ms) measured with inter-echo time 3.5 ms. The corresponding relative proton density (lung/muscle tissue) was higher (p<0.001) during end-expiration, (0.61±0.06) than during end-inspiration (0.48±0.05). The ratio of relative proton density at end-inspiration to that at end-expiration was 0.78±0.09. Similar results were found for inter-echo time 4.0 ms and there was no significant difference between the T2 values or proton densities acquired with different interecho times. The T2 value increased linearly (p< 0.001) with proton density

Radiometric Correction of Multispectral UAS Images: Evaluating the Accuracy of the Parrot Sequoia Camera and Sunshine Sensor

Unmanned aerial systems (UAS) carrying commercially sold multispectral sensors equipped with a sunshine sensor, such as Parrot Sequoia, enable mapping of vegetation at high spatial resolution with a large degree of flexibility in planning data collection. It is, however, a challenge to perform radiometric correction of the images to create reflectance maps (orthomosaics with surface reflectance) and to compute vegetation indices with sufficient accuracy to enable comparisons between data collected at different times and locations. Studies have compared different radiometric correction methods applied to the Sequoia camera, but there is no consensus about a standard method that provides consistent results for all spectral bands and for different flight conditions. In this study, we perform experiments to assess the accuracy of the Parrot Sequoia camera and sunshine sensor to get an indication if the quality of the data collected is sufficient to create accurate reflectance maps. In addition, we study if there is an influence of the atmosphere on the images and suggest a workflow to collect and process images to create a reflectance map. The main findings are that the sensitivity of the camera is influenced by camera temperature and that the atmosphere influences the images. Hence, we suggest letting the camera warm up before image collection and capturing images of reflectance calibration panels at an elevation close to the maximum flying height to compensate for influence from the atmosphere. The results also show that there is a strong influence of the orientation of the sunshine sensor. This introduces noise and limits the use of the raw sunshine sensor data to compensate for differences in light conditions. To handle this noise, we fit smoothing functions to the sunshine sensor data before we perform irradiance normalization of the images. The developed workflow is evaluated against data from a handheld spectroradiometer, giving the highest correlation (R-2 = 0.99) for the normalized difference vegetation index (NDVI). For the individual wavelength bands, R-2 was 0.80-0.97 for the red-edge, near-infrared, and red bands

In vivo MRI and PET imaging in a translational ILD mouse model expressing non-resolving fibrosis and bronchiectasis-like pathology after repeated systemic exposure to bleomycin

Drug-induced interstitial lung disease (ILD) is crucial to detect early to achieve the best treatment outcome. Optimally, non-invasive imaging biomarkers can be used for early detection of disease progression and treatment follow-up. Therefore, reliable in vivo models are warranted in new imaging biomarker development to accelerate better-targeted treatment options. Single-dose bleomycin models have, for a long time, served as a reference model in fibrosis and lung injury research. Here, we aimed to use a clinically more relevant animal model by systemic exposure to bleomycin and assessing disease progression over time by combined magnetic resonance imaging (MRI) and positron emission tomography (PET) imaging.MethodsC57BL/6 mice received bleomycin (i.p. 35iU/kg) or saline as control twice per week for 4 weeks. Mice were monitored until 2 weeks after cessation of bleomycin administration (w4 + 1 and w4 + 2), referred to as the resting period. MRI scans were performed in weeks 3 and 4 and during the resting weeks. [18F]FDG-PET was performed at the last week of dosing (w4) and 2 weeks after the last dosing (w4 + 2). Lung tissue sections were stained with Masson’s trichrome and evaluated by modified Ashcroft scoring. Lung volume and lesion volumes were assessed using MRI, as well as 3D mapping of the central airways.Results and discussionBleomycin-challenged mice showed increased lung weights (p < 0.05), while total lung volume was unchanged (w4 and onward). Histology analysis demonstrated fibrotic lesions emanating from the distal parts of the lung. Fibrosis progression was visualized by MRI with significantly increased high signal in bleomycin-exposed lungs compared to controls (p < 0.05). In addition, a significant increase in central airway diameter (p < 0.01) was displayed in bleomycin-exposed animals compared to controls and further continued to dilate as the disease progressed, comparing the bleomycin groups over time (p < 0.05–0.001). Lung [18F]FDG uptake was significantly elevated in bleomycin-exposed mice compared to controls (p < 0.05).ConclusionNon-invasive imaging displayed progressing lesions in the lungs of bleomycin-exposed mice, using two distinct MRI sequences and [18F]FDG-PET. With observed fibrosis progression emanating from distal lung areas, dilation of the central airways was evident. Taken together, this chronic bleomycin-exposure model is translationally more relevant for studying lung injury in ILD and particularly in the context of DIILD

Intensity-based dual model method for generation of synthetic CT images from standard T2-weighted MR images - Generalized technique for four different MR scanners

Background and purpose: Recent studies have shown that it is possible to conduct entire radiotherapy treatment planning (RTP) workflow using only MR images. This study aims to develop a generalized intensity-based method to generate synthetic CT (sCT) images from standard T2-weighted (T2(W)) MR images of the pelvis. Materials and methods: This study developed a generalized dual model HU conversion method to convert standard T2(W) MR image intensity values to synthetic HU values, separately inside and outside of atlas-segmented bone volume contour. The method was developed and evaluated with 20 and 35 prostate cancer patients, respectively. MR images with scanning sequences in clinical use were acquired with four different MR scanners of three vendors. Results: For the generated synthetic CT (sCT) images of the 35 prostate patients, the mean (and maximal) HU differences in soft and bony tissue volumes were 16 +/- 6 HUs (34 HUs) and -46 +/- 56 HUs (181 HUs), respectively, against the true CT images. The average of the PTV mean dose difference in sCTs compared to those in true CTs was -0.6 +/- 0.4% (-1.3%). Conclusions: The study provides a generalized method for sCT creation from standard T2(W) images of the pelvis. The method produced clinically acceptable dose calculation results for all the included scanners and MR sequences. (c) 2017 Elsevier B.V. All rights reserved.Peer reviewe

Estimation of forest stem volume using ALOS-2 PALSAR-2 satellite images

A first evaluation of ALOS-2 PALSAR-2 data for forest stem volume estimation has been performed at a coniferous dominated test site in southern Sweden. Both the Fine Beam Dual (FBD) polarization and the Quad-polarimetric mode were investigated. Forest plots with stem volume reaching up to a maximum of about 620 m3 ha-1 (corresponding to 370 tons ha-1) were analyzed by relating backscatter intensity to field data using an exponential model derived from the Water Cloud Model. The estimation accuracy of stem volume at plot level (0.5 ha) was calculated in terms of Root Mean Square Error (RMSE). For the best case investigated an RMSE of 43.1% was obtained using one of the FBD HV-polarized images. The corresponding RMSE for the FBD HH-polarized images was 43.9%. In the Quadpolarimetric mode the lowest RMSE at HV- and HHpolarization was found to be 39.8% and 47.4%, respectively

The integrated care pathway reduced the number of hospital days by half: a prospective comparative study of patients with acute hip fracture

BACKGROUND: The incidence of hip fracture is expected to increase during the coming years, demanding greater resources and improved effectiveness on this group of patients. The aim of the present study was to evaluate the effectiveness of an integrated care pathway (ICP) in patients with an acute fracture of the hip. METHODS: A nonrandomized prospective study comparing a consecutive series of patients treated by the conventional pathway to a newer intervention. 112 independently living patients aged 65 years or older admitted to the hospital with a hip fracture were consecutively selected. Exclusion criteria were pathological fracture and severe cognitive impairment. An ICP was developed with the intention of creating a care path with rapid pre-operative attention, increased continuity and an accelerated training programme based on the individual patient's prerequisites and was used as a guidance for each patient's tailored care in the intervention group (N = 56) The main outcome measure was the length of hospital stay. Secondary outcomes were the amount of time from the emergency room to the ward, to surgery and to first ambulation, as well as in-hospital complications and 30-day readmission rate. RESULTS: The intervention group had a significantly shorter length of hospital stay (12.2 vs. 26.3 days; p < 0.000), a shorter time to first ambulation (41 vs. 49 h; p = 0.01), fewer pressure wounds (8 vs. 19; p = 0.02) and medical complications (5 vs. 14; p = 0.003) than the comparison group. No readmissions occurred within 30 days post-intervention in either group. CONCLUSION: Implementing an ICP for patients with a hip fracture was found to significantly reduce the length of hospital stay and improve the quality of care

Exploring childhood cancer survivors' views about sex and sexual experiences -findings from online focus group discussions

PURPOSE: To explore childhood cancer survivors' views about sex and sexual experiences and, as an additional aim, their possible needs for care and support from health care professionals regarding sexual life. METHODS: Written online focus group discussions were performed with survivors of childhood cancer, identified through the Swedish Childhood Cancer Registry; 133 (36%; aged 16-25) participated. Written text was analysed using qualitative content analysis. RESULTS: The analysis resulted in one main category: Could my cancer experience have an impact on my sexual life? with four generic categories: Sex considered to be good, Feeling insecure and falling behind, Relating sex to a stable relationship and Concerns related to the physical body. In general, participants had not reflected on the possibility that their cancer experience could impact on sexual life. Sex was often considered to be something natural, important and taken for granted. However, thoughts and worries were expressed including being shy, feeling insecure and falling behind peers. Physical concerns included vaginal dryness and difficulties related to erection and reaching orgasm. Many participants stated that sexual issues had not been discussed with health care professionals, however, the need for such support differed. CONCLUSIONS: Many of the childhood cancer survivors' did not relate their sexual experiences to previous cancer treatment. However, problems were expressed, both of emotional and physical nature. Many participants stated that they had not received any information or support regarding sexual issues from health care professionals, why it is recommended to be regularly addressed in follow-up care

Neuroinflammation in Lyme neuroborreliosis affects amyloid metabolism

<p>Abstract</p> <p>Background</p> <p>The metabolism of amyloid precursor protein (APP) and β-amyloid (Aβ) is widely studied in Alzheimer's disease, where Aβ deposition and plaque development are essential components of the pathogenesis. However, the physiological role of amyloid in the adult nervous system remains largely unknown. We have previously found altered cerebral amyloid metabolism in other neuroinflammatory conditions. To further elucidate this, we investigated amyloid metabolism in patients with Lyme neuroborreliosis (LNB).</p> <p>Methods</p> <p>The first part of the study was a cross-sectional cohort study in 61 patients with acute facial palsy (19 with LNB and 42 with idiopathic facial paresis, Bell's palsy) and 22 healthy controls. CSF was analysed for the β-amyloid peptides Aβ38, Aβ40 and Aβ42, and the amyloid precursor protein (APP) isoforms α-sAPP and β-sAPP. CSF total-tau (T-tau), phosphorylated tau (P-tau) and neurofilament protein (NFL) were measured to monitor neural cell damage. The second part of the study was a prospective cohort-study in 26 LNB patients undergoing consecutive lumbar punctures before and after antibiotic treatment to study time-dependent dynamics of the biomarkers.</p> <p>Results</p> <p>In the cross-sectional study, LNB patients had lower levels of CSF α-sAPP, β-sAPP and P-tau, and higher levels of CSF NFL than healthy controls and patients with Bell's palsy. In the prospective study, LNB patients had low levels of CSF α-sAPP, β-sAPP and P-tau at baseline, which all increased towards normal at follow-up.</p> <p>Conclusions</p> <p>Amyloid metabolism is altered in LNB. CSF levels of α-sAPP, β-sAPP and P-tau are decreased in acute infection and increase after treatment. In combination with earlier findings in multiple sclerosis, cerebral SLE and HIV with cerebral engagement, this points to an influence of neuroinflammation on amyloid metabolism.</p