Tribological performance of electrically conductive and self-lubricating polypropylene-ionic-liquid composites.

In this work, self-lubricating and electrically conductive polymers on a polypropylene (PP) matrix were prepared and investigated. These properties were obtained by additivating PP with carbon black (CB) and multi-walled carbon nanotubes (MWCNTs), in combination with a surface active ionic liquid (IL, trihexyltetradecylphosphonium docusate [P66614][DOC]). These polymeric composites are expected to achieve coefficients of friction (COFs) comparable to lubricated systems. Combined with electrical conductivity, these materials could be applied in electrically loaded tribosystems. The COF was reduced by up to 25% compared to that of plain PP, and high electrical conductivity and self-lubrication were achieved. Fundamental differences between the carbon-based fillers in their interaction with IL were investigated with high-resolution surface analysis (TEM, AFM) and Raman and ATR-FTIR spectroscopy. By varying the tribological test parameters, the application limits of self-lubrication were identified. It was demonstrated that the contact pressure has a strong influence on the COF. Therefore, this work points to potential applications in (e.g. 3D-printed) bearings and electrically loaded bearings where electrical conductivity and relatively low COFs are required.

Development of High Temperature Resistant Stereocomplex PLA for Injection Moulding.

In this study, the production of stereocomplex PLA formulations (sc-PLA) by compounding and subsequent injection moulding at different mould temperatures was investigated. Several selective nucleating agents were identified and compounded with different poly(L-lactide)/poly(D-lactide) (PLLA/PDLA) ratios on a co-rotating twin screw extruder. The effect of nucleating agents (NA) on the crystallisation behaviour of the compound was systematically investigated by DSC analysis. The crystallisation behaviour of NA-21 (aluminium complex of a phosphoric ester), also in combination with talc, under cooling rates of up to 70 K/min was analysed. The wide-angle X-ray diffraction (WAXD) results showed a complete stereocomplex (sc) crystal formation on all specimens containing NA-21 even at the highest cooling rates. The thermo-mechanical testing of sc-PLA shows a Young's modulus of approx. 3 GPa, yield stress of 30-40 MPa, elongation of 1%, and a heat deflection temperature (HDT-B) up to 180 °C. Processing sc-PLA exclusively via the processing route of compounding and injection moulding will open new areas of application for PLA at higher temperatures.

Pacemaker Lead Placement via Transmural Approach in an Adult With Palliated Single Ventricle Heart Disease.

Given the lack of systemic venous return to the heart, palliated single ventricle patients frequently require epicardial pacemaker implantation for management of dysrhythmias including sinus node dysfunction, atrial arrhythmias, and heart block. Repeated device hardware replacement, frequently required due to high lead thresholds or other device failure, is a challenging and significant problem for this population. 3-dimensional imaging can assist in delineating the cardiac anatomy allowing for novel approaches to intervention. We review a patient with extracardiac Fontan circulation who underwent placement of an endocardial atrial pacemaker lead via a transmural approach with a 3D-printed model used for procedural guidance.

Volumetric brain analysis in neurosurgery: Part 3. Volumetric CT analysis as a predictor of seizure outcome following temporal lobectomy.

OBJECT: The incidence of temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (MTS) can be high in developing countries. Current diagnosis of MTS relies on structural MRI, which is generally unavailable in developing world settings. Given widespread effects on temporal lobe structure beyond hippocampal atrophy in TLE, the authors propose that CT volumetric analysis can be used in patient selection to help predict outcomes following resection. METHODS: Ten pediatric patients received preoperative CT scans and temporal resections at the CURE Children's Hospital of Uganda. Engel classification of seizure control was determined 12 months postoperatively. Temporal lobe volumes were measured from CT and from normative MR images using the Cavalieri method. Whole brain and fluid volumes were measured using particle filter segmentation. Linear discrimination analysis (LDA) was used to classify seizure outcome by temporal lobe volumes and normalized brain volume. RESULTS: Epilepsy patients showed normal to small brain volumes and small temporal lobes bilaterally. A multivariate measure of the volume of each temporal lobe separated patients who were seizure free (Engel Class IA) from those with incomplete seizure control (Engel Class IB/IIB) with LDA (p<0.01). Temporal lobe volumes also separate normal subjects, patients with Engel Class IA outcomes, and patients with Class IB/IIB outcomes (p<0.01). Additionally, the authors demonstrated that age-normalized whole brain volume, in combination with temporal lobe volumes, may further improve outcome prediction (p<0.01). CONCLUSIONS: This study shows strong evidence that temporal lobe and brain volume can be predictive of seizure outcome following temporal lobe resection, and that volumetric CT analysis of the temporal lobe may be feasible in lieu of structural MRI when the latter is unavailable. Furthermore, since the authors' methods are modality independent, these findings suggest that temporal lobe and normative brain volumes may further be useful in the selection of patients for temporal lobe resection when structural MRI is available.

Drinking games, tailgating, and pregaming: precollege predictors of risky college drinking.

BACKGROUND: The transition from high school to college is a critical period for developing college drinking habits. Hazardous alcohol consumption increases during this period, as well as participation in drinking games, pregaming, and tailgating. All of these risky drinking practices are associated with higher levels of intoxication as well as an increased risk of alcohol-related problems. OBJECTIVE: The current study aimed to evaluate pre-college predictors (personality, social norms, and beliefs reflecting the internalization of the college drinking culture [ICDC]) of estimated peak BAC (pBAC) reached during drinking games, pregaming, and tailgating, as well as pBAC and alcohol-related problems during the first 30 days of college. METHODS: Participants (n = 936) were incoming freshmen at a large university who completed a baseline assessment prior to college matriculation and a follow-up assessment after they had been on campus for 30 days. RESULTS: Using path analysis, ICDC was significantly associated with pBAC reached during the three risky drinking practices. ICDC had an indirect effect on both pBAC and alcohol-related problems via pBAC from drinking games, pregaming, and tailgating. Hopelessness and sensation seeking were significantly related to alcohol use outcomes. CONCLUSION: Precollege perceptions of the college drinking culture are a stronger predictor of subsequent alcohol use than social norms. Interventions that target these beliefs may reduce peak intoxication and associated harms experienced during the first 30 days of college.

Single injection, inspiratory/expiratory high-pitch dual-source CT angiography for median arcuate ligament syndrome: novel technique for a classic diagnosis.

This article discusses a novel technique for dynamic imaging of median arcuate ligament syndrome utilizing low dose CT technology and a single contrast injection.

Defining natural history: assessment of the ability of college students to aid in characterizing clinical progression of Niemann-Pick disease, type C.

Niemann-Pick Disease, type C (NPC) is a fatal, neurodegenerative, lysosomal storage disorder. It is a rare disease with broad phenotypic spectrum and variable age of onset. These issues make it difficult to develop a universally accepted clinical outcome measure to assess urgently needed therapies. To this end, clinical investigators have defined emerging, disease severity scales. The average time from initial symptom to diagnosis is approximately 4 years. Further, some patients may not travel to specialized clinical centers even after diagnosis. We were therefore interested in investigating whether appropriately trained, community-based assessment of patient records could assist in defining disease progression using clinical severity scores. In this study we evolved a secure, step wise process to show that pre-existing medical records may be correctly assessed by non-clinical practitioners trained to quantify disease progression. Sixty-four undergraduate students at the University of Notre Dame were expertly trained in clinical disease assessment and recognition of major and minor symptoms of NPC. Seven clinical records, randomly selected from a total of thirty seven used to establish a leading clinical severity scale, were correctly assessed to show expected characteristics of linear disease progression. Student assessment of two new records donated by NPC families to our study also revealed linear progression of disease, but both showed accelerated disease progression, relative to the current severity scale, especially at the later stages. Together, these data suggest that college students may be trained in assessment of patient records, and thus provide insight into the natural history of a disease.

Optimization of patient dose and image quality with z-axis dose modulation for computed tomography (CT) head in acute head trauma and stroke.

The purpose of this study is to retrospectively analyze the effect of z-axis modulation for CT head protocols on patient dose and image quality in patients with acute head trauma and stroke. The study was approved by the Institutional Review Board. We retrospectively evaluated the effect of dose modulation on unenhanced CT head examinations in patients with acute head trauma and stroke. Two series of 100 consecutive studies were reviewed: 100 studies performed without dose modulation, 100 studies performed with z-axis dose modulation. Multidetector 16-section CT was performed sequentially and axial 5-mm-thick slices were obtained from base of skull to vertex. With z-axis dose modulation, the same tube current range was maintained, but a computer algorithm altered the tube current applied to each CT section. For each examination, the weighted volume CT dose index (CTDI (vol)) and dose-length product (DLP) were recorded and noise was measured. Each study was also reviewed for image quality by two independent, blinded readers. The variables (CTDI (vol) and DLP, image quality, and noise) in the two groups were compared by using student t test and Wilcoxon rank-sum test. For unenhanced CT head examinations, the CTDI (vol) and DLP, respectively, were reduced by 35.8% and 35.2%, respectively, by using z-axis dose modulation. Image quality and noise were unaffected by the use of this dose modulation technique (P < 0.004). Utilization of z-axis modulation technique for CT head examination in patients with acute head trauma and stroke offers significant radiation dose reduction while image quality is optimally maintained.

Vestibular pneumolabyrinth: why assessment with temporal bone computed tomography utilizing dynamic focal spot mode is important for the diagnosis.

We present an interesting and relatively uncommon case of vestibular pneumolabyrinth in a young child post-trauma. His initial clinical exam and imaging studies of the head and cervical spine were negative. He subsequently developed nystagmus and a dedicated temporal bone study demonstrated a subtle fracture and vestibular pneumolabyrinth. Temporal bone fractures can be difficult to appreciate, and therefore, associated findings of fluid in the middle ear, stapes dislocation, or vestibular pneumolabyrinth must be carefully evaluated. Temporal bone computed tomography is a high resolution study, utilizing dynamic focal spot mode which leads to increased sampling and resolution, thereby reducing aliasing artifacts but a longer scan time and increased radiation dose. CT head and cervical spine normally obtained without using this technique leads to aliasing artifacts where even the normal endolymph in the inner ear structures appear hypodense mimicking pneumolabyrinth, thereby obscuring true pneumolabyrinth. It is important to be aware of this finding and technique-related artifact, if a temporal bone injury is suspected, to ensure an earlier diagnosis and optimum management.

Reconstruction of rapidly acquired Germanium-68 transmission scans for cardiac PET attenuation correction.

BACKGROUND: Transmission (TX) scan time by use of radionuclide sources for cardiac positron emission tomography prolong imaging and increase the likelihood of patient motion artifacts. A reconstruction algorithm combining ordered-subsets expectation maximization with a Bayesian prior was developed and applied to rapid Germanium-68 (Ge-68) TX scans. METHODS AND RESULTS: A cardiac phantom with Fluorine-18 (Fl-18) was used to determine a minimal count threshold for Ge-68 TX scanning. Images were acquired over a count range from 2.5 x 10(6) to 8 x 10(7) and for a high-count scan of 1.6 x 10(9) counts to study reconstruction parameters and to determine the minimum TX count threshold. The method was compared against clinical 4-minute TX scans in ten Rubidium-82 (Rb-82) rest/stress myocardial perfusion studies (body mass index, 30 +/- 4 kg/m(2)). The minimal count threshold was 20 x 10(6), and the mean scan time for the Rb-82 studies was 70.5 +/- 3.4 seconds. More than 90% of the segmental scores computed from images acquired via rapid TX scans differed by less than 5% from those obtained with 4-minute TX scans. The mean differences in perfusion scores between the rapid and 4-minute TX scans were 0.46% (95% confidence interval, -1.84% to 0.93%) at rest and 0.39% (95% confidence interval, -1.84% to 1.07%) at stress, demonstrating equivalency of the rapid and 4-minute scans. CONCLUSIONS: Ordered-subsets expectation maximization with a Bayesian prior accurately and efficiently reconstructs rapidly acquired Ge-68 TX scans for Rb-82 myocardial perfusion positron emission tomography studies.

Clinical utility of coronary calcium scoring after nonischemic myocardial perfusion imaging.

BACKGROUND: Coronary artery calcium (CAC) scoring is increasingly being used after myocardial perfusion imaging (MPI) to detect preclinical coronary artery disease (CAD). However, there are few data to support this approach. METHODS AND RESULTS: We reviewed 200 consecutive patients without known CAD who were referred for CAC scoring shortly after nonischemic MPI. Of these, 13 (6.5%) had CAC scores greater than 400, indicating significant CAD; 22 (11%) had CAC scores of 101 to 400; 27 had CAC scores of 11 to 100; and the remainder (n = 138) has CAC scores of 1 to 10. Traditional risk factors and patient characteristics were not significant predictors of CAC scores of 101 or greater. However, age and the Framingham risk score were predictors of CAC scores greater than 0. At follow-up, significantly more patients with CAC scores of 101 or greater had been given the advice to take lipid-lowering medication and aspirin compared with those with CAC scores of 0. CONCLUSIONS: Of patients referred for CAC scoring after nonischemic MPI, 17.5% were identified as having CAD based on a CAC score greater than 100, allowing intervention with aggressive medical therapy. Patients who were reclassified were not easily identifiable by traditional risk factors, but Framingham risk score did predict the presence of CAC. Clinicians modified medical therapy based on the results of CAC scoring.

Interscan variability of coronary artery calcium quantification using an electrocardiographically pulsed spiral computed tomographic protocol.

The use of an electrocardiographically pulsed spiral computed tomographic protocol significantly reduced the radiation dose to patients who underwent coronary calcium screening. For Agatston scores <10, the interscan variability of such a protocol was significantly lower than that for a sequential acquisition protocol. At higher Agatston scores, the 2 protocols had similar variability characteristics.

Extraction and validation of correlation lengths from interstitial velocity fields using diffusion-weighted MRI.

Magnetic Resonance Imaging methods sensitive to individual molecular displacements (q-space MRI) provide a convenient means of measuring dispersion in complex interstitial spaces. Pressure-driven flow experiments through a water-saturated packed bed phantom have been conducted to prove the feasibility of using q-space MRI to measure the coherence length associated with the interstitial velocity field. The method involves measuring the dependence of the apparent dispersion coefficient on the distance along the mean flow by repeating a small number of pulsed-gradient stimulated-echo experiments with increasing gradient pulse separation times. Assuming homogeneous interstitial flow statistics inside the averaging volume, an integral spatial scale characterizing the Eulerian velocity auto-correlation coefficient is extracted via a stochastic convective model. The validity of the a priori statistical description of interstitial flow is verified by comparing with an independent MRI measurement of the Eulerian velocity field using phase contrast methods in the same phantom with pore-level resolution. The integral length scale obtained via q-space MRI agrees with the mean pore size in the present as well as in similar phantoms found in the literature. This method has direct applicability in the quantification of the interstitial morphology of fluid-saturated porous media with resolution independent of voxel size, assuming "perfectly reflecting pore walls" (no surface relaxation) and no contribution to the MR signal from outside the pore space.

Coronary calcium screening in asymptomatic patients as a guide to risk factor modification and stress myocardial perfusion imaging.

BACKGROUND: Previous studies have demonstrated a correlation between the extent of coronary artery calcification (CAC) and atherosclerotic plaque. As a result, CAC screening could be useful in predicting cardiovascular risk in individuals in whom atherosclerosis is developing. One possible method of detecting and quantifying CAC is by x-ray computed tomography, which potentially allows one to stratify patients into groups requiring risk factor modification or follow-up testing such as myocardial perfusion single photon emission computed tomography (SPECT). METHODS AND RESULTS: This study was designed to evaluate the clinical utility of multidetector computed tomography (MDCT) in a cardiology practice setting. A retrospective analysis was performed on data from 794 asymptomatic patients who underwent CAC screening over an 8-month period. On the basis of the CAC score and physician consultation, 102 patients underwent subsequent myocardial perfusion SPECT imaging. A substudy was also conducted in 306 patients to measure the interscan variability of MDCT across different CAC score ranges. CAC was detected in 422 of 794 patients. Of these, the CAC was moderate (Agatston score = 101-400) in 14% and severe (>400) in 9%. Patients with 3 or more cardiac risk factors were most likely to exhibit moderate to severe CAC. In myocardial perfusion SPECT testing, no patient with an Agatston score lower than 100 had an abnormal study. In contrast, 41% of patients with severe CAC had an abnormal SPECT study. In the reproducibility substudy the minimal CAC group had the largest variability (86.0%) whereas the severe CAC group had the lowest variability (9.5%). CONCLUSION: CAC screening with MDCT is justified for asymptomatic patients with 3 or more cardiac risk factors. However, risk factor assessment is poor at predicting which individuals will have CAC if fewer risk factors are present. In terms of the interscan variability, MDCT is capable of following changes in CAC for patients with Agatston scores greater than 100. Finally, this study demonstrated that an Agatston score of 400 is a logical threshold to initiate follow-up myocardial perfusion SPECT testing.

Synchronized EPI phase contrast velocimetry in a mixing reactor.

Notwithstanding its widespread use in cardiovascular and functional MRI studies, Echo Planar Imaging (EPI) has only recently been subjected to systematic validation studies. Most velocity measurement studies employing such ultrafast MRI methods involve the use of phantoms characterized by rigid or deformable solid motion. The current implementation involves a rotating phantom (angular velocity up to 10.5 rpm) with a superimposed swirling liquid flow (with axial velocities ranging between 0.145 and 0.27 cm/s) of water doped with copper sulfate. The standard implementation of single-shot EPI with phase contrast velocity encoding allows the complete mapping of the Eulerian velocity field in slices perpendicular to the rotation axis following a subtractive procedure requiring the synchronized acquisition of each velocity component on each selected transverse slice during two revolutions of the rotor. The image acquisition time is 100 ms (per velocity component) at each 64 x 64 slice. In addition to acquiring full-field velocity data for future direct comparisons with other techniques, EPI is employed here for the first time to reconstruct the three-dimensional flow field between the blades of a partitioned pipe mixer.