Regression models for analyzing radiological visual grading studies – an empirical comparison

Background: For optimizing and evaluating image quality in medical imaging, one can use visual grading experiments, where observers rate some aspect of image quality on an ordinal scale. To analyze the grading data, several regression methods are available, and this study aimed at empirically comparing such techniques, in particular when including random effects in the models, which is appropriate for observers and patients. Methods: Data were taken from a previous study where 6 observers graded or ranked in 40 patients the image quality of four imaging protocols, differing in radiation dose and image reconstruction method. The models tested included linear regression, the proportional odds model for ordinal logistic regression, the partial proportional odds model, the stereotype logistic regression model and rank-order logistic regression (for ranking data). In the first two models, random effects as well as fixed effects could be included; in the remaining three, only fixed effects. Results: In general, the goodness of fit (AIC and McFaddens Pseudo R-2) showed small differences between the models with fixed effects only. For the mixed-effects models, higher AIC and lower Pseudo R-2 was obtained, which may be related to the different number of parameters in these models. The estimated potential for dose reduction by new image reconstruction methods varied only slightly between models. Conclusions: The authors suggest that the most suitable approach may be to use ordinal logistic regression, which can handle ordinal data and random effects appropriately

Long-Term Effect of Motivational Interviewing on Dietary Intake and Weight Loss in Iranian Obese/Overweight Women

Background: This study aimed to determine whether motivational interviewing (MI) could change dietary habit and body mass index (BMI) in obese/overweight women. Methods: A cluster-randomized controlled study was performed in four health centers in Qazvin, central Iran. In total, 327 obese/overweight women were selected by a multi-stage sampling method and randomly assigned into control and experimental groups. Food frequency (using questionnaire; FFQ), BMI, and metabolic markers including blood pressure, total serum cholesterol and fasting blood glucose levels were measured in all participants. Data were collected twice (before and one year after the MI interventions). Data were analyzed using student t-test, and Stepwise Linear Regression. Results: There was a significant increase in daily consumption of dietary fiber, whole grain products, fruits and vegetables in the MI group (P<0.05). The consumption of meat product, total fat, saturated fat, carbohydrate and total energy intake were also significantly reduced after MI intervention (P<0.05). As a result, body weight and BMI were significantly reduced in the intervention group compared to the control group (P<0.05). Conclusion: MI is suggested to be an effective strategy to change life style and reduce BMI in overweight/obese women in the long term. This effect needs to be further investigated in different gender and age populations

The interaction of shockwaves with a vapour bubble in boiling histotripsy: The shock scattering effect

Boiling histotripsy is a High Intensity Focused Ultrasound (HIFU) technique which uses a number of short pulses with high acoustic pressures at the HIFU focus to induce mechanical tissue fractionation. In boiling histotripsy, two different types of acoustic cavitation contribute towards mechanical tissue destruction: a boiling vapour bubble and cavitation clouds. An understanding of the mechanisms underpinning these phenomena and their dynamics is therefore paramount to predicting and controlling the overall size of a lesion produced for a given boiling histotripsy exposure condition. A number of studies have shown the effects of shockwave heating in generating a boiling bubble at the HIFU focus and have studied its dynamics under boiling histotripsy insonation. However, not much is known about the subsequent production of cavitation clouds that form between the HIFU transducer and the boiling bubble. The main objective of the present study is to examine what causes this bubble cluster formation after the generation of a boiling vapour bubble. A numerical simulation of 2D nonlinear wave propagation with the presence of a bubble at the focus of a HIFU field was performed using the k-Wave MATLAB toolbox for time domain ultrasound simulations, which numerically solves the generalised Westervelt equation. The numerical results clearly demonstrate the appearance of the constructive interference of a backscattered shockwave by a bubble with incoming incident shockwaves. This interaction (i.e., the reflected and inverted peak positive phase from the bubble with the incoming incident rarefactional phase) can eventually induce a greater peak negative pressure field compared to that without the bubble at the HIFU focus. In addition, the backscattered peak negative pressure magnitude gradually increased from 17.4 MPa to 31.6 MPa when increasing the bubble size from 0.2 mm to 1.5 mm. The latter value is above the intrinsic cavitation threshold of –28 MPa in soft tissue. Our results suggest that the formation of a cavitation cloud in boiling histotripsy is a threshold effect which primarily depends (a) the size and location of a boiling bubble, and (b) the sum of the incident field and that scattered by a bubble

Coupling of wideband impulses generated by granular chains into liquids for biomedical applications

An ultrasonic transducer technology to generate wideband impulses using a one-dimensional chain of spheres was previously presented. The Hertzian contact between the spheres causes the nonlinearity of the system to increase, which transforms high amplitude narrowband sinusoidal input into a train of wideband impulses. Generation of short duration ultrasonic pulses is desirable both in diagnostic and therapeutic ultrasound. Nevertheless, the biggest challenge in terms of adaptation to biomedical ultrasound is the coupling of the ultrasonic energy into biological tissue. An analytical model was created to address the coupling issue. Effect of the matching layer was modelled as a flexible thin plate clamped from the edges. Model was verified against hydrophone measurements. Different coupling materials, such as glass, aluminium, acrylic, silicon rubber, and vitreous carbon, was analysed with this model. Results showed that soft matching layers such as acrylic and rubber inhibit the generation of higher order harmonics. Between the hard matching materials, vitreous carbon achieved the best results due to its acoustic impedance

Analysis of solitary wave impulses in granular chains using ultrasonic excitation

The propagation of broad bandwidth solitary wave impulses, generated within granular chains by narrow bandwidth ultrasonic excitation, is studied in detail. Theoretical predictions are compared to experimental results. It is demonstrated that the observed effects result from a sum of a solitary wave traveling out from the source with a wave that reflects from the far end of the chain. It is shown that this combination, when used with an excitation in the form of a long-duration tone burst, encourages the generation of multiple impulses with a characteristic periodicity. This study shows that the properties of the chain structure and the excitation can be adjusted so as to generate ultrasonic solitary wave impulses with a high amplitude and known frequency content, which are of interest in applications such as biomedical ultrasound

Plant glutathione S-transferase classification, structure and evolution

Glutathione S-transferases are multifunctional proteins involved in diverse intracellular events such as primary and secondary metabolisms, stress metabolism, herbicide detoxification and plant protection against ozone damages, heavy metals and xenobiotics. The plant glutathione S-transferase superfamily have been subdivided into eight classes. Phi, tau, zeta, theta, lambda, dehydroascorbate reductase and tetrachlorohydroquinone dehalogenase classes are soluble and one class is microsomal. Glutathione S-transferases are mostly soluble cytoplasmic enzymes. To date, the crystal structures of over 200 soluble glutathione S-transferases, present in plants, animals and bacteria have been resolved. The structures of glutathione S-transferase influence its function. Phylogenetic analysis suggests that all soluble glutathione S-transferases have arisen from an ancient progenitor gene, through both convergent and divergent pathways.Key words: Glutathione S-transferases (GST), classification, structure, evolution, phylogenetic analysis, xenobiotics

Ultrasonic propagation in finite-length granular chains

A narrowband ultrasound source has been used to generate solitary wave impulses in finite-length chains of spheres. Once the input signal is of sufficient amplitude, both harmonics and sub-harmonics of the input frequency can be generated as non-linear normal modes of the system, allowing a train of impulses to be established from a sinusoidal input. The characteristics of the response have been studied as a function of the physical properties of the chain, the input waveform and the level of static pre-compression. The results agree with the predictions of a theoretical model, based on a set of discrete dynamic equations for the spheres for finite-length chains. Impulses are only created for very small pre-compression forces of the order of 0.01 N, where strongly non-linear behaviour is expected

The effect of boundary conditions on resonant ultrasonic spherical chains

The response of a resonant chain of spheres to changes in holder material and pre-compression is studied at ultrasonic frequencies. The system is found to be very sensitive to these parameters, with the creation of impulsive waveforms from a narrow bandwidth input seen only for certain chain lengths and holder materials. In addition, careful experiments were performed using known amounts of pre-compression force, using a calibrated stylus arrangement. At negligible pre-compression levels, impulses were generated within the chain, which were then suppressed by increased pre-compression. This was accompanied by large changes in propagation velocity as the system gradually changes from being strongly nonlinear to being more linear. Simulations using a discrete model for the motion of each sphere agree well with experimental data