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1.
Environ Sci Process Impacts ; 25(4): 805-817, 2023 Apr 26.
Article in English | MEDLINE | ID: mdl-36883522

ABSTRACT

Plug-in fragrance diffusers are one of myriad volatile organic compound-containing consumer products that are commonly found in homes. The perturbing effects of using a commercial diffuser indoors were evaluated using a study group of 60 homes in Ashford, UK. Air samples were taken over 3 day periods with the diffuser switched on and in a parallel set of control homes where it was off. At least four measurements were taken in each home using vacuum-release into 6 L silica-coated canisters and with >40 VOCs quantified using gas chromatography with FID and MS (GC-FID-QMS). Occupants self-reported their use of other VOC-containing products. The variability between homes was very high with the 72 hour sum of all measured VOCs ranging between 30 and >5000 µg m-3, dominated by n/i-butane, propane, and ethanol. For those homes in the lowest quartile of air exchange rate (identified using CO2 and TVOC sensors as proxies) the use of a diffuser led to a statistically significant increase (p-value < 0.02) in the summed concentration of detectable fragrance VOCs and some individual species, e.g. alpha pinene rising from a median of 9 µg m-3 to 15 µg m-3 (p-value < 0.02). The observed increments were broadly in line with model-calculated estimates based on fragrance weight loss, room sizes and air exchange rates.


Subject(s)
Air Pollutants , Air Pollution, Indoor , Volatile Organic Compounds , Humans , Volatile Organic Compounds/analysis , Environmental Monitoring/methods , Air Pollution, Indoor/analysis , Air Pollutants/analysis , Odorants/analysis
2.
Expert Rev Med Devices ; 19(10): 763-778, 2022 Oct.
Article in English | MEDLINE | ID: mdl-36373162

ABSTRACT

INTRODUCTION: Image-guided endovascular interventions, performed using the insertion and navigation of catheters through the vasculature, have been increasing in number over the years, as minimally invasive procedures continue to replace invasive surgical procedures. Such endovascular interventions are almost exclusively performed under x-ray fluoroscopy, which has the best spatial and temporal resolution of all clinical imaging modalities. Magnetic resonance imaging (MRI) offers unique advantages and could be an attractive alternative to conventional x-ray guidance, but also brings with it distinctive challenges. AREAS COVERED: In this review, the benefits and limitations of MRI-guided endovascular interventions are addressed, systems and devices for guiding such interventions are summarized, and clinical applications are discussed. EXPERT OPINION: MRI-guided endovascular interventions are still relatively new to the interventional radiology field, since significant technical hurdles remain to justify significant costs and demonstrate safety, design, and robustness. Clinical applications of MRI-guided interventions are promising but their full potential may not be realized until proper tools designed to function in the MRI environment are available. Translational research and further preclinical studies are needed before MRI-guided interventions will be practical in a clinical interventional setting.


Subject(s)
Catheters , Magnetic Resonance Imaging , Humans
3.
J Vasc Interv Radiol ; 33(6): 687-694, 2022 06.
Article in English | MEDLINE | ID: mdl-35301127

ABSTRACT

PURPOSE: To evaluate radiolabeled doxorubicin (Dox) analogs as tracers of baseline Dox biodistribution in vivo during hepatic intra-arterial chemotherapy and to assess the efficacy of ChemoFilter devices to bind Dox in vitro. MATERIALS AND METHODS: In an in vitro static experiment, [fluorine-18]N-succinimidyl 4-fluorobenzoate ([18F]SFB) and [fluorine-18]fluorobenzoyl-doxorubicin ([18F]FB-Dox) were added to a beaker containing a filter material (Dowex cation exchange resin, single-stranded DNA (ssDNA) resin, or sulfonated polymer coated mesh). In an in vitro flow model, [18F]FB-Dox was added into a Dox solution in phosphate-buffered saline, and the solution flowed via a syringe column containing the filter materials. In an in vitro flow experiment, using micro-positron emission tomography (PET), images were taken as [18F]SFB and [18F]FB-Dox moved through a phantom. For in vivo biodistribution testing, a catheter was placed into the common hepatic artery of a swine, and [18F]FB-Dox was infused over 30 seconds. A 10-minute dynamic image and three 20-minute static images were acquired using 3T PET/MR imaging. RESULTS: In the in vitro static experiment, [18F]FB-Dox demonstrated 76.7%, 88.0%, and 52.4% binding to the Dowex resin, ssDNA resin, and coated mesh, respectively. In the in vitro flow model, the first-pass binding of [18F]FB-Dox to the Dowex resin, ssDNA resin, and coated mesh was 76.7%, 74.2%, and 76.2%, respectively, and the total bound fraction was 80.9%, 84.6%, and 79.9%, respectively. In the in vitro flow experiment using micro-PET, the phantom demonstrated a greater amount of [18F]FB-Dox bound to both filter cartridges than of the control [18F]SFB. In in vivo biodistribution testing, the first 10 minutes depicted [18F]FB-Dox moving through the right upper quadrant of the abdomen. A region-of-interest analysis showed that the relative amount increased by 2.97 times in the gallbladder and 1.08 times in the kidney. The amount decreased by 0.74 times in the brain and 0.57 times in the heart. CONCLUSIONS: [18F]FB-Dox can be used to assess Dox binding to ChemoFilters as well as in vivo biodistribution. This sets the stage for the evaluation of ChemoFilter effectiveness in reducing systemic toxicity from intra-arterial chemotherapy.


Subject(s)
Doxorubicin , Positron-Emission Tomography , Animals , Hepatic Artery , Humans , Magnetic Resonance Imaging , Positron-Emission Tomography/methods , Swine , Tissue Distribution
4.
Environ Sci Process Impacts ; 23(5): 699-713, 2021 May 26.
Article in English | MEDLINE | ID: mdl-34037627

ABSTRACT

Volatile organic compounds (VOCs) are a key class of atmospheric emission released from highly complex petrochemical, transport and solvent sources both outdoors and indoors. This study established the concentrations and speciation of VOCs in 60 homes (204 individuals, 360 × 72 h samples, 40 species) in summer and winter, along with outdoor controls. Self-reported daily statistics were collected in each home on the use of cleaning, household and personal care products, all of which are known to release VOCs. Frequency of product use varied widely: deodorants: 2.9 uses home per day; sealant-mastics 0.02 uses home per day. The total concentration of VOCs indoors (range C2-C10) was highly variable between homes e.g. range 16.6-8150 µg m-3 in winter. Indoor concentrations of VOCs exceeded outdoor for 84% of households studied in summer and 100% of homes in winter. The most abundant VOCs found indoors in this study were n-butane (wintertime range: 1.5-4630 µg m-3), likely released as aerosol propellant, ethanol, acetone and propane. The cumulative use VOC-containing products over multiday timescales by occupants provided little predictive power to infer 72 hour averaged indoor concentrations. However, there was weak covariance between the cumulative usage of certain products and individual VOCs. From a domestic emissions perspective, reducing the use of hydrocarbon-based aerosol propellants indoors would likely have the largest impact.


Subject(s)
Air Pollutants , Air Pollution, Indoor , Volatile Organic Compounds , Air Pollutants/analysis , Air Pollution, Indoor/analysis , Environmental Monitoring , Household Products , Humans , Seasons , Volatile Organic Compounds/analysis
5.
Int J Pharm X ; 3: 100087, 2021 Dec.
Article in English | MEDLINE | ID: mdl-34977556

ABSTRACT

We report here the potential role of a 4-strain probiotic suspension for use with patients with Parkinson's disease (PD). Stool samples from a group of three patients with diagnosed PD were used to create microbiotas in an in-vitro gut model. The effects of dosing with an oral probiotic suspension (Symprove) on bacterial composition and metabolic activity in the microbiotas was evaluated over 48 h and compared with healthy controls. Additionally, the effect of probiotic dosing on epithelial tight-junction integrity, production of inflammatory markers and wound healing were evaluated in cell culture models. In general, the relative proportions of the main bacterial phyla in the microbiotas of PD patients differed from those of healthy subjects, with levels of Firmicutes raised and levels of Bacteroidetes reduced. Dosing with probiotic resulted in a change in bacterial composition in the microbiotas over a 48 h period. Several other indicators of gut health changed upon dosing with the probiotic; production of short chain fatty acids (SCFAs) and lactate was stimulated, levels of anti-inflammatory cytokines (IL-6, IL-10) increased and levels of pro-inflammatory cytokines and chemokines (MCP-1 and IL-8) decreased. Tight junction integrity was seen to improve with probiotic dosing and wound healing was seen to occur faster than a control. The data suggest that if development and/or progression of PD is influenced by gut microbiota dysbiosis then supplementation of the diet with a properly formulated probiotic may be a useful adjunct to standard treatment in clinic.

6.
IEEE Trans Biomed Eng ; 67(3): 876-882, 2020 03.
Article in English | MEDLINE | ID: mdl-31247538

ABSTRACT

Interventional magnetic resonance imaging (MRI) could allow for diagnosis and immediate treatment of ischemic stroke; however, such endovascular catheter-based procedures under MRI guidance are inherently difficult. One major challenge is tracking the tip of the catheter, as standard fabrication methods for building inductively coupled coil markers are rigid and bulky. Here, we report a new approach that uses aerosol jet deposition to three-dimensional (3-D) print an inductively coupled RF coil marker on a polymer catheter. Our approach enables lightweight conforming markers on polymer catheters and these low-profile markers allow the catheter to be more safely navigated in small caliber vessels. Prototype markers with an inductor with the geometry of a double helix are incorporated on catheters for in vitro studies, and we show that these markers exhibit good signal amplification. We report temperature measurements and, finally, demonstrate feasibility in a preliminary in vivo experiment. We provide material properties and electromagnetic simulation performance analysis. This paper presents fully aerosol jet-deposited and functional wireless resonant markers on polymer catheters for use in 3T clinical scanners.


Subject(s)
Catheters , Magnetic Resonance Imaging, Interventional/instrumentation , Magnetic Resonance Imaging, Interventional/methods , Wireless Technology/instrumentation , Animals , Equipment Design , Female , Swine , Temperature
7.
Radiol Imaging Cancer ; 1(1): e190009, 2019 09 27.
Article in English | MEDLINE | ID: mdl-32300759

ABSTRACT

Purpose: To determine if endovascular chemofiltration with an ionic device (ChemoFilter [CF]) can be used to reduce systemic exposure and off-target biodistribution of doxorubicin (DOX) during hepatic intra-arterial chemotherapy (IAC) in a preclinical model. Materials and Methods: Hepatic IAC infusions were performed in six pigs with normal livers. Animals underwent two 10-minute intra-arterial infusions of DOX (200 mg) into the common hepatic artery. Both the treatment group and the control group received initial IAC at 0 minutes and a second dose at 200 minutes. Prior to the second dose, CF devices were deployed in and adjacent to the hepatic venous outflow tract of treatment animals. Systemic exposure to DOX was monitored via blood samples taken during IAC procedures. After euthanasia, organ tissue DOX concentrations were analyzed. Alterations in systemic DOX exposure and biodistribution were compared by using one-tailed t tests. Results: CF devices were well tolerated, and no hemodynamic, thrombotic, or immunologic complications were observed. Animals treated with a CF device had a significant reduction in systemic exposure when compared with systemic exposure in the control group (P <.009). Treatment with a CF device caused a significant decrease in peak DOX concentration (31%, P <.01) and increased the time to maximum concentration (P <.03). Tissue analysis was used to confirm significant reduction in DOX accumulation in the heart and kidneys (P <.001 and P <.022, respectively). Mean tissue concentrations in the heart, kidneys, and liver of animals treated with CF compared with those in control animals were 14.2 µg/g ± 1.9 (standard deviation) versus 26.0 µg/g ± 1.8, 46.4 µg/g ± 4.6 versus 172.6 µg/g ± 40.2, and 217.0 µg/g ± 5.1 versus 236.8 µg/g ± 9.0, respectively. Fluorescence imaging was used to confirm in vivo DOX binding to CF devices. Conclusion: Reduced systemic exposure and heart bioaccumulation of DOX during local-regional chemotherapy to the liver can be achieved through in situ adsorption by minimally invasive image-guided CF devices.© RSNA, 2019.


Subject(s)
Doxorubicin , Hepatic Artery , Infusions, Intra-Arterial , Animals , Doxorubicin/administration & dosage , Doxorubicin/adverse effects , Heart , Ion Exchange , Liver , Swine , Tissue Distribution
9.
Biomed Microdevices ; 19(4): 88, 2017 Sep 25.
Article in English | MEDLINE | ID: mdl-28948399

ABSTRACT

To assess the visualization and efficacy of a wireless resonant circuit (wRC) catheter system for carotid artery occlusion and embolectomy under real-time MRI guidance in vivo, and to compare MR imaging modality with x-ray for analysis of qualitative physiological measures of blood flow at baseline and after embolectomy. The wRC catheter system was constructed using a MR compatible PEEK fiber braided catheter (Penumbra, Inc, Alameda, CA) with a single insulated longitudinal copper loop soldered to a printed circuit board embedded within the catheter wall. In concordance with IACUC protocol (AN103047), in vivo carotid artery navigation and embolectomy were performed in four farm pigs (40-45 kg) under real-time MRI at 1.5T. Industry standard clots were introduced in incremental amounts until adequate arterial occlusion was noted in a total of n=13 arteries. Baseline vasculature and restoration of blood flow were confirmed via MR and x-ray imaging, and graded by the Thrombolysis in Cerebral Infarction (TICI) scale. Wilcoxon signed-rank tests were used to analyze differences in recanalization status between DSA and MRA imaging. Successful recanalizations (TICI 2b/3) were compared to clinical rates reported in literature via binomial tests. The wRC catheter system was visible both on 5° sagittal bSSFP and coronal GRE sequence. Successful recanalization was demonstrated in 11 of 13 occluded arteries by DSA analysis and 8 of 13 by MRA. Recanalization rates based on DSA (0.85) and MRA (0.62) were not significantly different from the clinical rate of mechanical aspiration thrombectomy reported in literature. Lastly, a Wilcoxon signed rank test indicated no significant difference between TICI scores analyzed by DSA and MRA. With demonstrated compatibility and visualization under MRI, the wRC catheter system is effective for in vivo endovascular embolectomy, suggesting progress towards clinical endovascular interventional MRI.


Subject(s)
Carotid Arteries/diagnostic imaging , Catheterization , Catheters , Embolectomy , Magnetic Resonance Imaging , Animals , Catheterization/instrumentation , Catheterization/methods , Embolectomy/instrumentation , Embolectomy/methods , Magnetic Resonance Imaging/instrumentation , Magnetic Resonance Imaging/methods , Swine
10.
Quant Imaging Med Surg ; 7(2): 187-194, 2017 Apr.
Article in English | MEDLINE | ID: mdl-28516044

ABSTRACT

BACKGROUND: It is technically challenging to design compact yet sensitive miniature catheter radio frequency (RF) coils for endovascular interventional MR imaging. METHODS: In this work, a new design method for catheter RF coils is proposed based on the coaxial transmission line resonator (TLR) technique. Due to its distributed circuit, the TLR catheter coil does not need any lumped capacitors to support its resonance, which simplifies the practical design and construction and provides a straightforward technique for designing miniature catheter-mounted imaging coils that are appropriate for interventional neurovascular procedures. The outer conductor of the TLR serves as an RF shield, which prevents electromagnetic energy loss, and improves coil Q factors. It also minimizes interaction with surrounding tissues and signal losses along the catheter coil. To investigate the technique, a prototype catheter coil was built using the proposed coaxial TLR technique and evaluated with standard RF testing and measurement methods and MR imaging experiments. Numerical simulation was carried out to assess the RF electromagnetic field behavior of the proposed TLR catheter coil and the conventional lumped-element catheter coil. RESULTS: The proposed TLR catheter coil was successfully tuned to 64 MHz for proton imaging at 1.5 T. B1 fields were numerically calculated, showing improved magnetic field intensity of the TLR catheter coil over the conventional lumped-element catheter coil. MR images were acquired from a dedicated vascular phantom using the TLR catheter coil and also the system body coil. The TLR catheter coil is able to provide a significant signal-to-noise ratio (SNR) increase (a factor of 200 to 300) over its imaging volume relative to the body coil. CONCLUSIONS: Catheter imaging RF coil design using the proposed coaxial TLR technique is feasible and advantageous in endovascular interventional MR imaging applications.

11.
Biomed Microdevices ; 18(6): 109, 2016 12.
Article in English | MEDLINE | ID: mdl-27830455

ABSTRACT

To computationally optimize the design of an endovascular magnetic filtration device that binds iron oxide nanoparticles and to validate simulations with experimental results of prototype devices in physiologic flow testing. Three-dimensional computational models of different endovascular magnetic filter devices assessed magnetic particle capture. We simulated a series of cylindrical neodymium N52 magnets and capture of 1500 iron oxide nanoparticles infused in a simulated 14 mm-diameter vessel. Device parameters varied included: magnetization orientation (across the diameter, "D", along the length, "L", of the filter), magnet outer diameter (3, 4, 5 mm), magnet length (5, 10 mm), and spacing between magnets (1, 3 mm). Top designs were tested in vitro using 89Zr-radiolabeled iron oxide nanoparticles and gamma counting both in continuous and multiple pass flow model. Computationally, "D" magnetized devices had greater capture than "L" magnetized devices. Increasing outer diameter of magnets increased particle capture as follows: "D" designs, 3 mm: 12.8-13.6 %, 4 mm: 16.6-17.6 %, 5 mm: 21.8-24.6 %; "L" designs, 3 mm: 5.6-10 %, 4 mm: 9.4-15.8 %, 5 mm: 14.8-21.2 %. In vitro, while there was significant capture by all device designs, with most capturing 87-93 % within the first two minutes, compared to control non-magnetic devices, there was no significant difference in particle capture with the parameters varied. The computational study predicts that endovascular magnetic filters demonstrate maximum particle capture with "D" magnetization. In vitro flow testing demonstrated no difference in capture with varied parameters. Clinically, "D" magnetized devices would be most practical, sized as large as possible without causing intravascular flow obstruction.


Subject(s)
Blood Vessels/chemistry , Ferric Compounds/chemistry , Ferric Compounds/isolation & purification , Filtration/instrumentation , Magnetic Fields , Nanoparticles/chemistry
12.
Biomed Microdevices ; 18(6): 98, 2016 12.
Article in English | MEDLINE | ID: mdl-27778226

ABSTRACT

To report a novel method using immobilized DNA within mesh to sequester drugs that have intrinsic DNA binding characteristics directly from flowing blood. DNA binding experiments were carried out in vitro with doxorubicin in saline (PBS solution), porcine serum, and porcine blood. Genomic DNA was used to identify the concentration of DNA that shows optimum binding clearance of doxorubicin from solution. Doxorubicin binding kinetics by DNA enclosed within porous mesh bags was evaluated. Flow model simulating blood flow in the inferior vena cava was used to determine in vitro binding kinetics between doxorubicin and DNA. The kinetics of doxorubicin binding to free DNA is dose-dependent and rapid, with 82-96 % decrease in drug concentration from physiologic solutions within 1 min of reaction time. DNA demonstrates faster binding kinetics by doxorubicin as compared to polystyrene resins that use an ion exchange mechanism. DNA contained within mesh yields an approximately 70 % decrease in doxorubicin concentration from solution within 5 min. In the IVC flow model, there is a 70 % drop in doxorubicin concentration at 60 min. A DNA-containing ChemoFilter device can rapidly clear clinical doses of doxorubicin from a flow model in simple and complex physiological solutions, thereby suggesting a novel approach to reduce the toxicity of DNA-binding drugs.


Subject(s)
Arteries , DNA/chemistry , Doxorubicin/chemistry , Doxorubicin/isolation & purification , Filtration/instrumentation , Animals , Doxorubicin/blood , Doxorubicin/therapeutic use , Equipment Design , Feasibility Studies , Kinetics , Swine
13.
Heart Rhythm ; 12(6): 1250-8, 2015 Jun.
Article in English | MEDLINE | ID: mdl-25678057

ABSTRACT

BACKGROUND: Cardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing [MPP], St. Jude Medical) improves acute LV function and LV reverse remodeling at 3 months. OBJECTIVE: The purpose of this study was to test the hypothesis that MPP can also improve LV function at 12 months. METHODS: Consecutive patients receiving a CRT implant (Unify Quadra MP™ or Quadra Assura MP™ CRT-D and Quartet™ LV lead, St. Jude Medical) were randomized to receive pressure-volume (PV) loop optimized biventricular pacing with either conventional cardiac resynchronization therapy (CONV) or MPP. CRT response was defined by a reduction in end-systolic volume (ESV) ≥15% relative to BASELINE as determined by a blinded observer and alive status. RESULTS: Forty-four patients (New York Heart Association class III, ejection fraction [EF] 29% ± 6%, QRS 152 ± 17 ms) were enrolled and randomized to either CONV (N = 22) or MPP (N = 22). During the observation period, 2 patients died of noncardiac causes and 2 patients were lost to follow-up. After 12 months, 12 of 21 patients (57%) in the CONV group and 16 of 21 patients (76%) in the MPP group were classified as CRT responders (P = .33). ESV reduction and EF increase relative to BASELINE were significantly greater with MPP than with CONV (ESV: median -25%, interquartile range [IQR] [-39% to -20%] vs median -18%, IQR [-25% to -2%], P = .03; EF: median +15%, IQR [8% to 20%] vs median +5%, IQR [-1% to 8%], P <.001). CONCLUSION: Sustaining the trend observed 3 months postimplant, PV loop-guided multipoint LV pacing resulted in greater LV reverse remodeling and increased LV function at 12 months compared to PV loop-guided conventional CRT.


Subject(s)
Cardiac Pacing, Artificial/methods , Cardiac Resynchronization Therapy/methods , Aged , Echocardiography , Female , Follow-Up Studies , Heart Ventricles , Humans , Male , Ventricular Function, Left/physiology
14.
Fetal Pediatr Pathol ; 34(2): 120-7, 2015 Apr.
Article in English | MEDLINE | ID: mdl-25454817

ABSTRACT

Xeroderma pigmentosum (XP) is a rare autosomal recessive disorder characterized by hypersensitivity of the skin and eyes to UV-radiation as a result of a defect in one of eight genes. Seven genes (XPA-XPG) have a defect in Nucletoide Excision Repair (NER), while the eighth gene XPV has a defect in polymerase η, which is responsible for replication of UV-damaged DNA to produce corrected daughter strands. We present the varied clinical courses of three African-American female patients with XP. Additionally, we present a review of the literature that focuses on the various clinical manifestations as well as the genetic and molecular mechanisms underlying this disease.


Subject(s)
DNA Damage/genetics , DNA Repair/physiology , Xeroderma Pigmentosum/pathology , Brain/pathology , Child , Child, Preschool , DNA Repair/genetics , Female , Humans , Mutation/genetics , Xeroderma Pigmentosum/diagnosis , Xeroderma Pigmentosum/genetics
15.
J Magn Reson Imaging ; 41(3): 684-93, 2015 Mar.
Article in English | MEDLINE | ID: mdl-24677296

ABSTRACT

PURPOSE: To demonstrate improved frequency selective fat suppression in MRI using a magnetic susceptibility matching foam by reducing B0 inhomogeneities induced within the body by air-tissue interfaces. MATERIALS AND METHODS: Flexible pyrolytic graphite (PG) composite foam was tailored to match the magnetic susceptibility of human tissue and was shaped to surround the cervical spine region. Field maps and frequency selective fat suppressed T1 -weighted FLASH images were acquired at 3 Tesla in both phantoms and six healthy necks. RESULTS: B0 field uniformity was shimmed to a target critical threshold of 1 ppm for fat suppression. The percentage of voxels in the phantom that did not achieve the critical threshold was reduced from 64% without the PG foam to only 1% with the foam. A similar decrease from 16% to 2% was observed in the in vivo region of interest. CONCLUSION: PG foam improved B0 field uniformity by moving air-tissue field gradients outside of the neck where they cannot cause MRI artifacts. The PG foams consistently mitigated signal dropout, improved overall SNR, and enabled more robust frequency selective fat suppression.


Subject(s)
Adipose Tissue , Artifacts , Carbon , Image Enhancement/methods , Magnetic Resonance Imaging/methods , Neck/anatomy & histology , Adult , Analysis of Variance , Female , Humans , Male , Phantoms, Imaging , Reference Values , Young Adult
16.
PLoS One ; 8(12): e84224, 2013.
Article in English | MEDLINE | ID: mdl-24376797

ABSTRACT

INTRODUCTION: Mathematical modelling of Clostridium difficile infection dynamics could contribute to the optimisation of strategies for its prevention and control. The objective of this systematic review was to summarise the available literature specifically identifying the quantitative parameters required for a compartmental mathematical model of Clostridium difficile transmission. METHODS: Six electronic healthcare databases were searched and all screening, data extraction and study quality assessments were undertaken in duplicate. Results were synthesised using a narrative approach. RESULTS: Fifty-four studies met the inclusion criteria. Reproduction numbers for hospital based epidemics were described in two studies with a range from 0.55 to 7. Two studies provided consistent data on incubation periods. For 62% of cases, symptoms occurred in less than 4 weeks (3-28 days) after infection. Evidence on contact patterns was identified in four studies but with limited data reported for populating a mathematical model. Two studies, including one without clinically apparent donor-recipient pairs, provided information on serial intervals for household or ward contacts, showing transmission intervals of <1 week in ward based contacts compared to up to 2 months for household contacts. Eight studies reported recovery rates of between 75%-100% for patients who had been treated with either metronidazole or vancomycin. Forty-nine studies gave recurrence rates of between 3% and 49% but were limited by varying definitions of recurrence. No study was found which specifically reported force of infection or net reproduction numbers. CONCLUSIONS: There is currently scant literature overtly citing estimates of the parameters required to inform the quantitative modelling of Clostridium difficile transmission. Further high quality studies to investigate transmission parameters are required, including through review of published epidemiological studies where these quantitative estimates may not have been explicitly estimated, but that nonetheless contain the relevant data to allow their calculation.


Subject(s)
Clostridioides difficile , Enterocolitis, Pseudomembranous/epidemiology , Enterocolitis, Pseudomembranous/transmission , Models, Biological , Contact Tracing , Enterocolitis, Pseudomembranous/prevention & control , Humans , Infectious Disease Incubation Period , Recurrence
17.
Appetite ; 69: 108-13, 2013 Oct.
Article in English | MEDLINE | ID: mdl-23742944

ABSTRACT

The aim of the current study was to discriminate between clinical and non-clinical samples on the Behavioural Pediatrics Feeding Assessment Scale (BPFAS). The objective was to present a cut-off value, that was derived statistically, which could be used to screen for feeding disorders. A sample of five hundred and seventy-three families with a target child ranging in age from 20 to 85 months took part in the current study. Sixty-four children had a known diagnosis of a feeding disorder and were embedded into a typically developing sample of families that had not sought professional intervention. All families completed the BPFAS in order to provide a known database to measure discriminative statistics. The Receiver Operating Characteristic (ROC) analysis indicated that the cut off value for the BPFAS was a Child Frequency score of 61 and a Child Problem score of six. This offered an 87% accuracy rate at these values. The current study offered definitive evidence that the BPFAS was accurate (both sensitive and specific) to determine differences between clinical and non-clinical samples in the United Kingdom. It is therefore advocated that BPFAS should be adopted in future studies exploring the impact of feeding disorders and problems in both clinical and research settings.


Subject(s)
Feeding and Eating Disorders of Childhood/diagnosis , Child , Child, Preschool , Feeding Behavior , Female , Humans , Infant , Male , Mass Screening/methods , Parents , Pediatrics/methods , Psychology, Child/methods , ROC Curve , Reference Values , Surveys and Questionnaires , United Kingdom
18.
Eur J Radiol ; 82(5): 734-9, 2013 May.
Article in English | MEDLINE | ID: mdl-22172536

ABSTRACT

OBJECTIVE: The purpose of this study was to measure and compare the relaxation times of musculoskeletal tissues at 3.0 T and 7.0 T, and to use these measurements to select appropriate parameters for musculoskeletal protocols at 7.0 T. MATERIALS AND METHODS: We measured the T1 and T2 relaxation times of cartilage, muscle, synovial fluid, bone marrow and subcutaneous fat at both 3.0 T and 7.0 T in the knees of five healthy volunteers. The T1 relaxation times were measured using a spin-echo inversion recovery sequence with six inversion times. The T2 relaxation times were measured using a spin-echo sequence with seven echo times. The accuracy of both the T1 and T2 measurement techniques was verified in phantoms at both magnetic field strengths. We used the measured relaxation times to help design 7.0 T musculoskeletal protocols that preserve the favorable contrast characteristics of our 3.0 T protocols, while achieving significantly higher resolution at higher SNR efficiency. RESULTS: The T1 relaxation times in all tissues at 7.0 T were consistently higher than those measured at 3.0 T, while the T2 relaxation times at 7.0 T were consistently lower than those measured at 3.0 T. The measured relaxation times were used to help develop high resolution 7.0 T protocols that had similar fluid-to-cartilage contrast to that of the standard clinical 3.0 T protocols for the following sequences: proton-density-weighted fast spin-echo (FSE), T2-weighted FSE, and 3D-FSE-Cube. CONCLUSION: The T1 and T2 changes were within the expected ranges. Parameters for musculoskeletal protocols at 7.0 T can be optimized based on these values, yielding improved resolution in musculoskeletal imaging with similar contrast to that of standard 3.0 T clinical protocols.


Subject(s)
Bone and Bones/anatomy & histology , Cartilage, Articular/anatomy & histology , Image Enhancement/methods , Image Interpretation, Computer-Assisted/methods , Knee Joint/anatomy & histology , Magnetic Resonance Imaging/methods , Muscle, Skeletal/anatomy & histology , Adult , Algorithms , Female , Humans , Male , Reproducibility of Results , Sensitivity and Specificity
19.
J Magn Reson Imaging ; 37(1): 227-32, 2013 Jan.
Article in English | MEDLINE | ID: mdl-22865658

ABSTRACT

PURPOSE: To rapidly calculate and validate subject-specific field maps based on the three-dimensional shape of the bilateral breast volume. MATERIALS AND METHODS: Ten healthy female volunteers were scanned at 3 Tesla using a multi-echo sequence that provides water, fat, in-phase, out-of-phase, and field map images. A shape-specific binary mask was automatically generated to calculate a computed field map using a dipole field model. The measured and computed field maps were compared by visualizing the spatial distribution of the difference field map, the mean absolute error, and the 80% distribution widths of frequency histograms. RESULTS: The 10 computed field maps had a mean absolute error of 38 Hz (0.29 ppm) compared with the measured field maps. The average 80% distribution widths for the histograms of all of the computed, measured, and difference field maps are 205 Hz, 233 Hz, and 120 Hz, respectively. CONCLUSION: The computed field maps had substantial overall agreement with the measured field maps, indicating that breast MRI field maps can be computed based on the air-tissue interfaces. These estimates may provide a predictive model for field variations and thus have the potential to improve applications in breast MRI.


Subject(s)
Breast Neoplasms/pathology , Breast/pathology , Magnetic Resonance Imaging/methods , Air , Algorithms , Breast Neoplasms/diagnosis , Computer Simulation , Female , Humans , Image Processing, Computer-Assisted/methods , Imaging, Three-Dimensional , Magnetics , Models, Statistical , Models, Theoretical , Phantoms, Imaging , Reproducibility of Results
20.
J Adolesc ; 35(3): 761-4, 2012 Jun.
Article in English | MEDLINE | ID: mdl-21820730

ABSTRACT

The aim of this brief report is to report on the utility of the Theory of Planned Behaviour (TPB) for predicting the physical activity intentions and behaviour of British adolescents from lower-than-average socio-economic backgrounds. A prospective questionnaire design was employed with 197, 13-14 year olds (76 males, 121 females). At time 1 participant completed standard measures of TPB variables. One week later (Time 2), participants completed the Physical Activity Questionnaire for Adolescents (PAQ-A) as a measure of physical activity behaviour. Hierarchical regression analyses showed that attitude and perceived behavioural control jointly accounted for 25% of the variance in intention (p = 0.0001). Perceived behavioural control emerged as the only significant predictor of physical activity behaviour and explained 3.7% of the variance (p = 0.001). Therefore, attitude and PBC successfully predicts intention towards physical activity and PBC predicts physical activity behaviour in British adolescents from lower-than-average socio-economic backgrounds.


Subject(s)
Exercise , Health Behavior , Intention , Psychological Theory , Adolescent , Female , Humans , Male , Prospective Studies , Regression Analysis , Surveys and Questionnaires , United Kingdom
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