Comparison between N13NH3-PET and 99mTc-Tetrofosmin-CZT SPECT in the evaluation of absolute myocardial blood flow and flow reserve.

BACKGROUND: PET/CT is the standard for quantitative assessments of myocardial blood flow (MBF), but it requires short-lived-tracers, costly, and not widely available. SPECT with Cadmium Zinc Telluride (CZT) detectors allows dynamic acquisition and quantitation of MBF. The study aims were to compare MBF measurements by 99mTc-tetrofosmin-CZT to N13NH3 PET/CT after regadenoson-induced coronary hyperemia and to evaluate the effect of attenuation correction (AC). METHODS: 54 patients were evaluated at rest and during vasodilation by 99mTc-tetrofosmin-CZT and N13NH3 PET/CT within 2 weeks. MBF and MBF reserve (MFR) were measured by CZT with or without AC (NAC). RESULTS: The global rest MBF was 0.76 ± 0.19 mL/min/gr by PET and 0.76 ± 0.24 by AC-CZT (P = NS) and 1.14 ± 0.4 by NAC-CZT (P < 0.001 vs PET and AC-CZT). Stress MBF was higher when measured by PET than AC-CZT (1.87 ± 0.45 vs 1.62 ± 0.68 mL/min/gr, P < 0.0008), but lower than NAC-CZT (2.36 ± 1.1, P < 0.0003). The MBF reserve ratio (MFR) was higher by PET than AC-CZT (2.52 ± 0.56 vs 2.22 ± 1 (P < 0.009) and NAC-CZT (2.18 ± 1.0, P < 0.004). Linear regression was better between PET (MFR and stress MBF) and AC-CZT than between PET and NAC-CZT. ROC curve analysis showed the significant ability of AC-CZT to predict MFR < 2 and stress MBF < 1.7 (AUC = 0.75 and 0.82 respectively) and to differentiate between normal and CAD patients (AUC = 0.747 and 0.892 for MFR and stress MBF, respectively). CONCLUSIONS: Our data show a reasonable correlation between MBF and MFR measured by N13NH3-PET and 99mTc-Tetrofosmin-CZT SPECT. NAC-CZT overestimates MBF. AC is recommended when using CZT for measuring MBF.

Feasibility study of a novel general purpose CZT-based digital SPECT camera: initial clinical results.

BACKGROUND: The performance of a prototype novel digital single-photon emission computed tomography (SPECT) camera with multiple pixelated CZT detectors and high sensitivity collimators (Digital SPECT; Valiance X12 prototype, Molecular Dynamics) was evaluated in various clinical settings. Images obtained in the prototype system were compared to images from an analog camera fitted with high-resolution collimators. Clinical feasibility, image quality, and diagnostic performance of the prototype were evaluated in 36 SPECT studies in 35 patients including bone (n = 21), brain (n = 5), lung perfusion (n = 3), and parathyroid (n = 3) and one study each of sentinel node and labeled white blood cells. Images were graded on a scale of 1-4 for sharpness, contrast, overall quality, and diagnostic confidence. RESULTS: Digital CZT SPECT provided a statistically significant improvement in sharpness and contrast in clinical cases (mean score of 3.79 ± 0.61 vs. 3.26 ± 0.50 and 3.92 ± 0.29 vs. 3.34 ± 0.47 respectively, p < 0.001 for both). Overall image quality was slightly higher for the digital SPECT but not statistically significant (3.74 vs. 3.66). CONCLUSION: CZT SPECT provided significantly improved image sharpness and contrast compared to the analog system in the clinical settings evaluated. Further studies will evaluate the diagnostic performance of the system in large patient cohorts in additional clinical settings.

Pollutant Ground Concentrations of Nonneutrally Buoyant Particles.

A methodology is suggested for the estimation of the mass density and the cumulative ground deposition of a nonvolatile, nonneutrally buoyant, air pollutant (liquid or solid) released from a polluted column (following an explosion caused during routine operation in, e.g., the chemical industry or due to any kind of hostile act) and deposited on the ground via gravitational settling. In many cases, the deposited mass due to gravitational settling constitutes a significant fraction of the original inventory released from the source. Implementation of the methodology in preliminary risk assessments can serve as an efficient tool for emergency planning for both immediate and long-term measures such as evacuation and decontamination. The methodology considers, inter alia, an estimation of the critical particle diameter, particle size, and mass distributions along the polluted column. This methodology was developed to apply in rural regions since proper application of relevant meteorological input data can be accomplished mainly for such areas.

Indirect estimation of emission factors for phosphate surface mining using air dispersion modeling.

To date, phosphate surface mining suffers from lack of reliable emission factors. Due to complete absence of data to derive emissions factors, we developed a methodology for estimating them indirectly by studying a range of possible emission factors for surface phosphate mining operations and comparing AERMOD calculated concentrations to concentrations measured around the mine. We applied this approach for the Khneifiss phosphate mine, Syria, and the Al-Hassa and Al-Abyad phosphate mines, Jordan. The work accounts for numerous model unknowns and parameter uncertainties by applying prudent assumptions concerning the parameter values. Our results suggest that the net mining operations (bulldozing, grading and dragline) contribute rather little to ambient TSP concentrations in comparison to phosphate processing and transport. Based on our results, the common practice of deriving the emission rates for phosphate mining operations from the US EPA emission factors for surface coal mining or from the default emission factor of the EEA seems to be reasonable. Yet, since multiple factors affect dispersion from surface phosphate mines, a range of emission factors, rather than only a single value, was found to satisfy the model performance.

Dispersion of TSP and PM(10) emissions from quarries in complex terrain.

This study evaluates AERMOD and CALPUFF dispersion calculations of particulate matter emissions from stone quarries in two mountainous regions against TSP and PM10 measurements, using both observational and WRF-modeled meteorological data. Due to different model parameterization, AERMOD dispersion predictions were in better agreement with the measured concentrations than those obtained by CALPUFF. As expected, the smaller the distance between the meteorological station, the source (quarry) and the receptors, the better the predictions of both AERMOD and CALPUFF. In contrast, using in-situ wind field obtained by runs of the WRF meteorological model for the complex terrain study area provided, in general, less accurate dispersion estimates than when using (even remote) meteorological observations. In particular, using the three-dimensional WRF-modeled wind field within CALPUFF did not provide any advantage over using the two-dimensional wind field, which is the common procedure of AERMOD and CALPUFF. Dry deposition was more significant for ambient concentration estimation in AERMOD than in CALPUFF.

The possible association between exposure to air pollution and the risk for congenital malformations.

BACKGROUND: Over the last decade, there is growing evidence that exposure to air pollution may be associated with increased risk for congenital malformations. OBJECTIVES: To evaluate the possible association between exposures to air pollution during pregnancy and congenital malformations among infants born following spontaneously conceived (SC) pregnancies and assisted reproductive technology (ART) pregnancies. METHODS: This is an historical cohort study comprising 216,730 infants: 207,825 SC infants and 8905 ART conceived infants, during the periods 1997-2004. Air pollution data including sulfur dioxide (SO2), particulate matter <10 µm (PM10), nitrogen oxides (NOx) and ozone (O3) were obtained from air monitoring stations database for the study period. Using a geographic information system (GIS) and the Kriging procedure, exposure to air pollution during the first trimester and the entire pregnancy was assessed for each woman according to her residential location. Logistic regression models with generalized estimating equation (GEE) approach were used to evaluate the adjusted risk for congenital malformations. RESULTS: In the study cohort increased concentrations of PM10 and NOx pollutants in the entire pregnancy were associated with slightly increased risk for congenital malformations: OR 1.06(95% CI, 1.01-1.11) for 10 µg/m(3) increase in PM10 and OR 1.03(95% CI, 1.01-1.04) for 10 ppb increase in NOx. Specific malformations were evident in the circulatory system (for PM10 and NOx exposure) and genital organs (for NOx exposure). SO2 and O3 pollutants were not significantly associated with increased risk for congenital malformations. In the ART group higher concentrations of SO2 and O3 in entire pregnancy were associated (although not significantly) with an increased risk for congenital malformations: OR 1.06(95% CI, 0.96-1.17) for 1 ppb increase in SO2 and OR 1.15(95% CI, 0.69-1.91) for 10 ppb increase in O3. CONCLUSIONS: Exposure to higher levels of PM10 and NOx during pregnancy was associated with an increased risk for congenital malformations. Specific malformations were evident in the circulatory system and genital organs. Among ART pregnancies possible adverse association of SO2 and O3 exposure was also observed. Further studies are warranted, including more accurate exposure assessment and a larger sample size for ART pregnancies, in order to confirm these findings.

Evaluation of AERMOD and CALPUFF for predicting ambient concentrations of total suspended particulate matter (TSP) emissions from a quarry in complex terrain.

Concentrations of particulate emissions from a quarry located in hilly terrain were calculated by two common atmospheric dispersion models, AERMOD and CALPUFF. Evaluation of these models for emissions from quarries/open pit mines that are located in complex topography is missing from the literature. Due to severe uncertainties in the input parameters, numerous scenarios were simulated and model sensitivity was studied. Model results were compared among themselves, and to measured total suspended particulate (TSP). For a wide range of meteorological and topographical conditions studied, AERMOD predictions were in a better agreement with the measurements than those obtained by CALPUFF. The use of AERMOD's "Open pit" tool seems unnecessary when accurate digital topographic data are available. Onsite meteorological data are shown to be crucial for reliable dispersion calculations in complex terrain.

[Mathematical models as tools for studying and developing strategies in the case of a pandemic influenza outbreak].

The current spread of swine flu H1N1 raises serious concerns for public health worldwide. Mathematical modelling has proved to be an essential tool for both developing strategies in preparation for an outbreak and for predicting and evaluating the effectiveness of control policies during an outbreak. Given its growing importance, this article outlines some of the fundamental contributions of mathematical modelling in the study of infectious diseases. The authors review the classical SIR model which has become central to epidemiology, demonstrating basic concepts such as outbreak threshold, the reproductive number Ro and herd immunity. The authors show how the model can be expanded to include different intervention and mitigation strategies, and discuss other biological and social complexities that may be introduced. Finally, the paper illustrates different scenarios for the spread of swine flu in Israel and provides estimates for Reproductive rate (Ro).