Prevalence and factors associated with professional burnout in Polish oncologists-results of a nationwide survey.

BACKGROUND: High rates of burnout are observed among health care professionals worldwide, which could have negative consequences on personal and organizational levels. We aimed to evaluate the burnout prevalence and factors associated with burnout among oncologists in Poland. MATERIALS AND METHODS: An online survey was conducted using the validated Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and additional work/lifestyle questions. Descriptive statistics, parametric and nonparametric tests, and multivariate logistic regression were used to identify factors associated with burnout. RESULTS: A total of 228 physicians participated in the survey, including 168 medical oncologists, 43 radiation oncologists, and 17 from other specialties. Data collected from 211 medical and radiation oncologists were included in the final analyses. Most participants were female (71.6%) and ≤40 years of age (70.1%). A self-reported feeling of burnout was present in 65.9% of participants. Based on the MBI-HSS, 74.9% showed evidence of burnout with burnout subdomains as follows: depersonalization 37.0%; emotional exhaustion 64.5%; low accomplishment 43.1%. There were no differences in burnout rates based on specialization (oncology/haematology-75.6%, radiotherapy-72.1%), career stage, gender, or age groups. Lack of work-life balance was the only significant factor associated with the risk of burnout in the logistic regression (relative risk 2.6, 95% confidence interval 1.3-5.4). Only 20.9% of physicians had access to psychological support in their workplace; however, 70.1% desired such support. Three main factors impacting burnout in cancer care workers were: bureaucracy and administrative duties overload, admissions of many patients, and poor work culture. CONCLUSIONS: Burnout is common among medical and radiation oncologists in Poland. There is a high demand for psychological support and organizational changes in the workplace to reduce risk and mitigate the adverse effects of burnout among health care professionals.

Antagonist activation exercises elicit similar post-activation performance enhancement as agonist activities on throwing performance.

BACKGROUND: This study aimed to determine the acute effect of agonist and antagonist conditioning activities (CA) on medicine ball throw performance among female softball players. METHODS: Thirteen national-level female softball players (age 22.2 ± 3.1 years; body mass 68.3 ± 11.3 kg; softball experience 7.3 ± 2.4 years) performed 3 medicine ball chest throws before conditioning activity (CA) and after CA respectively in 3rd, 6th, and 9th minute. CA was the bench press and bent-over barbell row with 2 sets of 4 repetitions at 60% and 80% of one-repetition maximum, and 2 sets of 4 repetition bodyweight push up. RESULTS: Two-way ANOVA revealed an increase in throwing distance (p < 0.001) after bent over barbell row and push-up exercise, and an increase in throwing speed (p < 0.001) after bench press and push-up. All performance increases were in moderate effect size (Cohen d 0.33-0.41), and no differences were found between the experimental CA. CONCLUSIONS: We conclude that upper body throwing performance is similar after antagonist exercise and agonist CA, both agonist and antagonist CA increase muscle power. In the resistance training practice, we recommend the interchange of agonist and antagonist CA using bodyweight push-up or submaximal intensity (80% of 1RM) bench press and bent over barbell row to succeed post-activation performance enhancement in upper limbs.

Hydrothermal carbonization of the wet fraction from mixed municipal solid waste: Hydrochar characteristics and energy balance.

Mixed municipal solid waste (MSW) may be pre-treated in a mechanical-biological treatment (MBT) plant to produce an exiting stream with improved combustible characteristics. The process also produces a second waste stream, which is generally separated on a size basis by industrial sieving equipment. It contains fractions with a high moisture content such as residual food waste, soiled paper and cardboard, and small fragments of other materials. Samples of this stream, collected at an existing plant, were characterized and processed by hydrothermal carbonization (HTC) at laboratory scale, at various temperatures (180, 200 and 220 °C), reaction times (1, 4 and 8 h) and solid to water ratios (0.15 and 0.07). The primary energy balance, on a hypothetical industrial scale, was performed. In brief, the results confirmed that the produced hydrochar was a brittle, hydrophobic, solid carbonaceous product which gave a better combustion performance as the residence time of the HTC process was increased. Moreover, the dewaterability of the carbonized waste was greatly improved when compared to raw, wet samples. The results of the primary energy balance confirmed that the energy contained in the produced hydrochar was higher than the energy consumption for the process itself, under all the HTC working conditions. The energy consumed in the process was in the range of 40-70 % of the energy content of the produced hydrochar.

Tritium dynamics in soils and plants grown under three irrigation regimes at a tritium processing facility in Canada.

The dynamics of tritium released from nuclear facilities as tritiated water (HTO) have been studied extensively with results incorporated into regulatory assessment models. These models typically estimate organically bound tritium (OBT) for calculating public dose as OBT itself is rarely measured. Higher than expected OBT/HTO ratios in plants and soils are an emerging issue that is not well understood. To support the improvement of models, an experimental garden was set up in 2012 at a tritium processing facility in Pembroke, Ontario to characterize the circumstances under which high OBT/HTO ratios may arise. Soils and plants were sampled weekly to coincide with detailed air and stack monitoring. The design included a plot of native grass/soil, contrasted with sod and vegetables grown in barrels with commercial topsoil under natural rain and either low or high tritium irrigation water. Air monitoring indicated that the plume was present infrequently at concentrations of up to about 100 Bq/m(3) (the garden was not in a major wind sector). Mean air concentrations during the day on workdays (HTO 10.3 Bq/m(3), HT 5.8 Bq/m(3)) were higher than at other times (0.7-2.6 Bq/m(3)). Mean Tissue Free Water Tritium (TFWT) in plants and soils and OBT/HTO ratios were only very weakly or not at all correlated with releases on a weekly basis. TFWT was equal in soils and plants and in above and below ground parts of vegetables. OBT/HTO ratios in above ground parts of vegetables were above one when the main source of tritium was from high tritium irrigation water (1.5-1.8). Ratios were below one in below ground parts of vegetables when irrigated with high tritium water (0.4-0.6) and above one in vegetables rain-fed or irrigated with low tritium water (1.3-2.8). In contrast, OBT/HTO ratios were very high (9.0-13.5) when the source of tritium was mainly from the atmosphere. TFWT varied considerably through time as a result of SRBT's operations; OBT/HTO ratios showed no clear temporal pattern in above or below ground plant parts. Native soil after ∼20 years of operations at SRBT had high initial OBT that persisted through the growing season; little OBT formed in garden plot soil during experiments. High OBT in native soil appeared to be a signature of higher past releases at SRBT. This phenomenon was confirmed in soils obtained at another processing facility in Canada with a similar history. The insights into variation in OBT/HTO ratios found here are of regulatory interest and should be incorporated in assessment models to aid in the design of relevant environmental monitoring programs for OBT.

Modelling analysis and prediction of women javelin throw results in the years 1946 - 2013.

The main goals of our study of the women's javelin throw were twofold:. first, to analyse the dynamics of female javelin throw results variability as a function of time (time period 1946-2014), second, to create a predictive model of the results during the upcoming 4 years. The study material consisted of databases covering the female track and field events obtained from the International Association of Athletics Federations. Prior to predicting the magnitude of results change dynamics in the time to follow, the adjustment of trend function to empirical data was tested using the coefficients of convergence. Phase II of the investigation consisted of the construction of predictive models. The greatest decreases in result indexes were noted in 2000 (9.4%), 2005-2006 (8.7%) and 2009 (7.4%). The trend increase was only noted in the years 2006-2008. In general, until 1998 the mean result improved by 54.6% (100% - results of 1946) whereas from 1999 through 2011 the result only increased by 1.3%. Based on data and results variability analysis it might be presumed that, in the nearest future (2015-2018), results variability will increase by approximately 9.7%. Percent improvement of javelin throw distance calculated on the basis of the 1999 raw input data is 1.4% (end of 2014).

Levels of tritium in soils and vegetation near Canadian nuclear facilities releasing tritium to the atmosphere: implications for environmental models.

Concentrations of organically bound tritium (OBT) and tritiated water (HTO) were measured over two growing seasons in vegetation and soil samples obtained in the vicinity of four nuclear facilities and two background locations in Canada. At the background locations, with few exceptions, OBT concentrations were higher than HTO concentrations: OBT/HTO ratios in vegetation varied between 0.3 and 20 and values in soil varied between 2.7 and 15. In the vicinity of the four nuclear facilities OBT/HTO ratios in vegetation and soils deviated from the expected mean value of 0.7, which is used as a default value in environmental transfer models. Ratios of the OBT activity concentration in plants ([OBT]plant) to the OBT activity concentration in soils ([OBT]soil) appear to be a good indicator of the long-term behaviour of tritium in soil and vegetation. In general, OBT activity concentrations in soils were nearly equal to OBT activity concentrations in plants in the vicinity of the two nuclear power plants. [OBT]plant/[OBT]soil ratios considerably below unity observed at one nuclear processing facility represents historically higher levels of tritium in the environment. The results of our study reflect the dynamic nature of HTO retention and OBT formation in vegetation and soil during the growing season. Our data support the mounting evidence suggesting that some parameters used in environmental transfer models approved for regulatory assessments should be revisited to better account for the behavior of HTO and OBT in the environment and to ensure that modelled estimates (e.g., plant OBT) are appropriately conservative.

Mesenchymal stem cell therapy promotes corneal allograft survival in rats by local and systemic immunomodulation.

Mesenchymal stem cells (MSCs) are being investigated extensively due to their ability to dampen immune responses. Here, we tested the ability of MSCs from three distinct sources to prolong rat corneal allograft survival. A fully allogeneic rat cornea transplant model (DA to LEW) was used. Recipient rats received 1 × 10(6) MSCs (syn [LEW], allo [DA] or third-party [Wistar Furth]) intravenously 7 days before transplantation and again on the day of transplantation (day 0). A high percentage of untreated and syn-MSC treated allografts were rejected (80% and 100%, respectively). Preactivation of syn-MSCs with interferon gamma also failed to prolong allograft survival. Conversely, corneal allograft survival was significantly prolonged in allo-MSC treated (90%) and third-party MSC treated (80%) allograft recipients. Flow cytometric analysis revealed less infiltrating natural killer T cells in corneas of both allo- and third-party MSC treated animals, coupled with a higher proportion of splenic CD4+Foxp3+ regulatory T cells, compared to controls. In the case of allo- and third-party MSCs, results from a delayed-type hypersensitivity assay clearly showed that hypo-responsiveness was specific for corneal donor-associated allo-antigens. Thus, allo- and third-party MSC treatment prolongs corneal allograft survival by suppressing peripheral immune responses and promoting an intragraft immunoregulatory milieu.

Fungal Planet description sheets: 154-213.

Novel species of microfungi described in the present study include the following from South Africa: Camarosporium aloes, Phaeococcomyces aloes and Phoma aloes from Aloe, C. psoraleae, Diaporthe psoraleae and D. psoraleae-pinnatae from Psoralea, Colletotrichum euphorbiae from Euphorbia, Coniothyrium prosopidis and Peyronellaea prosopidis from Prosopis, Diaporthe cassines from Cassine, D. diospyricola from Diospyros, Diaporthe maytenicola from Maytenus, Harknessia proteae from Protea, Neofusicoccum ursorum and N. cryptoaustrale from Eucalyptus, Ochrocladosporium adansoniae from Adansonia, Pilidium pseudoconcavum from Greyia radlkoferi, Stagonospora pseudopaludosa from Phragmites and Toxicocladosporium ficiniae from Ficinia. Several species were also described from Thailand, namely: Chaetopsina pini and C. pinicola from Pinus spp., Myrmecridium thailandicum from reed litter, Passalora pseudotithoniae from Tithonia, Pallidocercospora ventilago from Ventilago, Pyricularia bothriochloae from Bothriochloa and Sphaerulina rhododendricola from Rhododendron. Novelties from Spain include Cladophialophora multiseptata, Knufia tsunedae and Pleuroascus rectipilus from soil and Cyphellophora catalaunica from river sediments. Species from the USA include Bipolaris drechsleri from Microstegium, Calonectria blephiliae from Blephilia, Kellermania macrospora (epitype) and K. pseudoyuccigena from Yucca. Three new species are described from Mexico, namely Neophaeosphaeria agaves and K. agaves from Agave and Phytophthora ipomoeae from Ipomoea. Other African species include Calonectria mossambicensis from Eucalyptus (Mozambique), Harzia cameroonensis from an unknown creeper (Cameroon), Mastigosporella anisophylleae from Anisophyllea (Zambia) and Teratosphaeria terminaliae from Terminalia (Zimbabwe). Species from Europe include Auxarthron longisporum from forest soil (Portugal), Discosia pseudoartocreas from Tilia (Austria), Paraconiothyrium polonense and P. lycopodinum from Lycopodium (Poland) and Stachybotrys oleronensis from Iris (France). Two species of Chrysosporium are described from Antarctica, namely C. magnasporum and C. oceanitesii. Finally, Licea xanthospora is described from Australia, Hypochnicium huinayensis from Chile and Custingophora blanchettei from Uruguay. Novel genera of Ascomycetes include Neomycosphaerella from Pseudopentameris macrantha (South Africa), and Paramycosphaerella from Brachystegia sp. (Zimbabwe). Novel hyphomycete genera include Pseudocatenomycopsis from Rothmannia (Zambia), Neopseudocercospora from Terminalia (Zambia) and Neodeightoniella from Phragmites (South Africa), while Dimorphiopsis from Brachystegia (Zambia) represents a novel coelomycetous genus. Furthermore, Alanphillipsia is introduced as a new genus in the Botryosphaeriaceae with four species, A. aloes, A. aloeigena and A. aloetica from Aloe spp. and A. euphorbiae from Euphorbia sp. (South Africa). A new combination is also proposed for Brachysporium torulosum (Deightoniella black tip of banana) as Corynespora torulosa. Morphological and culture characteristics along with ITS DNA barcodes are provided for all taxa.

Role of lentivirus-mediated overexpression of programmed death-ligand 1 on corneal allograft survival.

To investigate the role of lentivirus-mediated overexpression of programmed death-ligand 1 (PD-L1) on rat corneal allograft survival. A fully allogeneic rat cornea transplant model was used for in vivo studies. Lentiviral (LV) vectors are efficient tools for ex vivo genetic modification of cultured corneas. LV vector encoding for PD-L1 (LV.PD-L1) and LV vector encoding for eGFP (LV.eGFP, as control) were constructed and tested. PD-L1 or eGFP expression was increased on corneal cells upon LV.PD-L1 and LV.eGFP transduction, respectively. Both allogeneic controls and allogeneic LV.eGFP transduced corneas were uniformly rejected (MST: 13.8 ± 1.7 days and 12.3 ± 1.9 days, respectively). In contrast, allogeneic LV.PD-L1 transduced corneas showed a high percentage (83%) of graft survival (MST > 30 days, n = 5, 15 days, n = 1). Graft opacity of PD-L1 transduced corneas was present but was significantly reduced compared to control or eGFP expressing corneas. Flow cytometric analysis revealed that percentages of CD3(+) CD8(+) CD161(+) and CD3(+) CD8(+) CD161(-) lymphocytes were decreased in animals receiving LV.PD-L1 transduced corneas compared to animals grafted with LV.eGFP transduced corneas. Moreover, reduced expression of proinflammatory cytokines (IFN-γ and IL-6) in PD-L1 transduced corneas compared to allogeneic controls was also observed. Local PD-L1 gene transfer in cultured corneas is a promising approach for the prolongation of corneal allograft survival and attenuation of graft rejection.

[Systemic sclerosis with renal involvement in a 15-year old girl diagnosed with lichen sclerosus]. / Twardzina ukladowa z zajeciem nerek u 15-letniej dziewczynki z rozpoznanym liszajem twardzinowym.

In 15-year-old girl with lichen sclerosus diagnosed 4 years ago described nephritis development in systemic sclerosis without skin manifestations of scleroderma (sclerodermia sine sclerodermia). Raynaud's phenomenon, typical microcirculatory abnormalities in capilaroscopy and positive antinuclear antibodies were observed.

[Misoprostol and oxytocin in induction of labour in women with prolonged pregnancy--safety and effectiveness comparison]. / Mizoprostol a oksytocyna w indukcji porodu po terminie--porównanie bezpieczenstwa i skutecznosci dzialania.

16 women with prolonged pregnancy and indications to induction of labour were involved into prospective analysis. Sixty of them were given 50 micrograms of Mizoprostol straight into posterior vaginal fornix (only once). In 56 women the labour was induced by intravenous administration of 5 IU Oxytocin. Effectiveness and safety of both preparations used in labour induction were compared. Non-significant higher effectiveness and significant faster induction of uterine contractions by Oxytocin was found. Mizoprostol administration significantly shortens duration of the first labour period. Eventually, time from the medicine administration until the labour in both groups was comparative.

[Predicting the risk of poor pregnancy outcome by ultrasound examination of yolk sac diameter]. / Ultrasonograficzna ocena pecherzyka zóltkowego w prognozowaniu ryzyka poronienia.

Ultrasound examination with 7.0 MHz transvaginal transducer was performed in 136 pregnant women between 5 and 12 weeks of pregnancy. Yolk Sac diameter and Crown-Rump Length were measured. It was observed that absence of YS or its diameter greater than 7 mm was usually associated with poor pregnancy outcome.

[Spirometry parameters of women in various positions of delivery]. / Ocena parametrów spirometrycznych u rodzacych w róznych pozycjach.

UNLABELLED: Position in labour depends mostly on women's preferences, and is chosen instinctively in order to reduce labour pain. Between two different positions: vertical and horizontal, the first of them seems to guarantee more convenient gas exchange in maternal lungs. DESIGN: To prove that the vertical position in labour increase spirometry parameters in comparison with horizontal one. METHODS: Women were divided into two groups according to position in labour and spirometry examination were performed in second period of labour. Group I were composed of 17 women in vertical position whereas group II--19 women in horizontal one. RESULTS: Whole of analysed spirometral parameters had higher values in group I (8.2%-17.1%), but the increase wasn't statistically significant (p < 0.05).

[Analysis of fear structure and intensity at women in prolonged pregnancy]. / Analiza struktury i natezenia leku u kobiet w ciazy po terminie porodu.

41 women in prolonged pregnancy were involved into anonymous researches. By the use of survey created in IVth Obstetrics and Gynaecological Department of Silesian Medical School and STAI Spielberger questionnaire and AS Cattell questionnaire and K test MPI Eyseneck Scale--the structure, level of intensity and crystallisation fear was examined. The expectation and wishes of women were known. The general psychological characteristic was done and dominant strategies of coping with difficult situations were isolated. Higher fear levels, mostly of reactive genesis and crystallised mainly on the pregnancy, higher level of ergic tension and suspicion and high level of psychic integration and strong ego were observed.

Gamma camera-mounted anatomical X-ray tomography: technology, system characteristics and first images.

Scintigraphic diagnosis, based on functional image interpretation, becomes more accurate and meaningful when supported by corresponding anatomical data. In order to produce anatomical images that are inherently registered with images of emission computerised tomography acquired with a gamma camera, an X-ray transmission system was mounted on the slip-ring gantry of a GEMS Millennium VG gamma camera. The X-ray imaging system is composed of an X-ray tube and a set of detectors located on opposite sides of the gantry rotor that moves around the patient along with the nuclear detectors. A cross-sectional anatomical transmission map is acquired as the system rotates around the patient in a manner similar to a third-generation computerised tomography (CT) system. Following transmission, single-photon emission tomography (SPET) or positron emission tomography (PET) coincidence detection images are acquired and the resultant emission images are thus inherently registered to the anatomical maps. Attenuation correction of the emission images is performed with the same anatomical maps to generate transmission maps. Phantom experiments of system performance and examples of first SPET and coincidence detection patient images are presented. Despite limitations of the system when compared with a state of the art CT scanner, the transmission anatomical maps allow for precise anatomical localisation and for attenuation correction of the emission images.

[The use of Misoprostol preparation (Cytotec) in induction of labor at prolonged pregnancy]. / Indukcja porodu u kobiet w ciazy przenoszonej z zastosowaniem preparatu Mizoprostol.

OBJECTIVES: Safety and effectiveness testing of Misoprostol use at prolonged pregnancies. DESIGN: Prospective, clinical study. MATERIAL AND METHODS: 50 pregnant women with prolonged pregnancy, monocyesis, cephalic longitudinal foetus lie, existing foetal membranes and lack of spontaneous delivery action. Women were given 50 micrograms Misoprostol (Cytotec) to posterior vaginal fornix in case to provoke delivery. Effectiveness of inducing, delivery lasting, way of its finishing and infant condition at birth were controlled. Results were matched with control group of 35 patients with physiological pregnancy, who delivered in spontaneous partus. RESULTS: Effective provocation was observed at 38 pregnant. Natural way delivery was observed at 40 patients. In 10 cases caesarean section was done. Lasting time of birth, way of finishing, infant condition at birth and number of complication do not differ statistically between examined and control group. CONCLUSION: Misoprostol can be effective and save of delivery induction in prolonged pregnancy.

Beneficial effect of short-term endurance training on glucose metabolism during rehabilitation after coronary bypass surgery.

AIMS: Our study was aimed at determining whether beneficial modification of carbohydrate metabolism can be obtained after a short-term training program and whether it is associated with an increase in binding and degradation of (125)I-insulin by erythrocyte receptors that suggests a decrease in insulin resistance. METHODS: The study was conducted in a group of 20 patients aged 56 +/- 1.9 years (mean +/- SEM), within 1 to 6 months after coronary bypass surgery. All patients completed 15 training sessions based on 30 min of cycling with a constant load. Before and after a 3-week training program, glucose, insulin, and C-peptide blood levels, as well as binding and degradation of (125)I-insulin by erythrocyte receptors, were determined. RESULTS: A statistically significant decrease was found in the blood glucose level, from 111.2 +/- 4.2 to 97.8 +/- 3.5 mg/dL (p < 0.01); this decrease was not accompanied by significant insulin concentration changes. There was also a significant increase in insulin binding, from 0.535 +/- 0.059 to 0.668 +/- 0.042 pg (125)I/10(11) RBCs (p < 0.01), and degradation from 7.64 +/- 0.54 to 9.49 +/- 0.58 pg (125)I/10(11) RBCs (p < 0.05). CONCLUSION: The results indicated that even short-term endurance training in patients rehabilitated after coronary bypass surgery induced favorable modification of glucose metabolism, presumably caused by a decrease in insulin resistance.

Capillary electrophoretic separation of N-acetylcysteine and its impurities as a method for quality control of pharmaceuticals.

Capillary electrophoresis has been applied to separate and determine N-acetylcysteine (NAC) and related impurities. Determination conditions were found to be optimum with 100 mmol/l borate as the buffer, pH 8.40. The limit of detection was established for each substance examined. The method has been validated by examining linearity ranges, precision and repeatability. The method was used to determine the content of NAC in, and purity of, pharmaceutical preparations. The major impurities (N,N-diacetylcystine, N,S-diacetylcysteine and cystine) were determined at levels of 0.1%.

The influence of short-term endurance training on the insulin blood level, binding, and degradation of 125I-insulin by erythrocyte receptors in patients after myocardial infarction.

PURPOSE: This study was directed toward establishing whether and to what extent, short-term endurance training influences the insulin blood level, and the binding and degradation of 125I-insulin by erythrocyte receptors in patients undergoing rehabilitation after myocardial infarction. METHODS: The study was conducted in a group of 60 patients who had had myocardial infarction within the past 1.5 to 3 months and who did not have arterial hypertension and diabetes mellitus. All the patients took a symptom-limited cardiopulmonary exercise test. Before and after the test, venous blood was collected to determine lactic acid and insulin blood levels as well as the binding and degradation of 125I-insulin. The study group was randomized into two subgroups. One subgroup entered into a 3-week in-patient rehabilitation course. The control group was discharged from the hospital and was given no recommendations for physical exercise. The same investigation was repeated 3 weeks later. RESULTS: In the patients (50%) with hyperinsulinemia (insulin resistance index, > 10 microIU/mL), which was detected during the first investigation, insulin blood level decreased from 23.9 +/- 4.4 to 15.0 +/- 1.9 microIU/mL (P < 0.05) after rehabilitation, whereas insulin binding increased from 0.67 +/- 0.05 to 0.85 +/- 0.08 pg 125I/10(11) erythrocytes (P < 0.05). In the control group, which included normal subjects and those with hyperinsulinemia, the results obtained during the first and second investigations showed no statistically significant changes when compared. CONCLUSIONS: The results suggest that a 3-week endurance training period during rehabilitation after myocardial infarction reduces insulin resistance in patients with hyperinsulinemia.

Evaluation of an attenuation correction method for thallium-201 myocardial perfusion tomographic imaging of patients with low likelihood of coronary artery disease.

BACKGROUND: Image artifacts caused by nonuniform photon attenuation are a source of error in interpretation of images during myocardial perfusion single photon emission computed tomography (SPECT). A newly introduced attenuation correction method was evaluated for improvement in image homogeneity during 201Tl SPECT. The method was assessed with a cardiac phantom and in examinations of 42 patients (29 men) with a low likelihood of coronary disease. METHODS AND RESULTS: Simultaneous transmission-emission SPECT was performed with a moving collimated 153Gd line source synchronized with a moving electronic acquisition window for transmission imaging and a novel variable-width electronic exclusion window for emission imaging designed to avoid transmission-to-emission cross talk. The resulting uncorrected and corrected polar maps were analyzed visually and divided into 31 segments for quantitative analysis. Visual analysis of the color-coded mean polar maps showed clear improvement in homogeneity after correction among the phantom, male patients, female patients, and 42 patients combined at stress and redistribution. The male and female mean polar maps showed very little differences in regional count distribution after correction. Quantitative analysis of the mean polar maps showed the following mean segmental counts (%SD) before and after attenuation correction: phantom 88 (9) to 90 (7.5), P = .00005; men at stress 83 (10) to 88 (6), P = .0007, and at redistribution 84 (8) to 88 (6), P = .01; women at stress 86 (7) to 90 (5), P = .0002, and at redistribution 87 (5) to 88 (7), P = .3; patients combined at stress 84 (8) to 88 (6), P = .0004, and at redistribution 85 (7) to 87 (7), P = .03. Inferior/anterior count ratio for men at stress increased after correction from 0.82 to 0.99 and septal/lateral count ratio from 0.94 to 1.02. Inferior/anterior count ratio for men at redistribution increased from 0.86 to 1.06 and septal/lateral count ratio from 0.97 to 1.04. Inferior/anterior count ratio for women at stress increased from 0.95 to 1.03 and septal/lateral count ratio from 0.93 to 1.00. Inferior/anterior count ratio for women at redistribution increased from 1.04 to 1.10, and septal/lateral count ratio decreased from 1.02 to 1.00. CONCLUSION: Improvement in image homogeneity was demonstrated with this attenuation correction method with a cardiac phantom and for patients with low likelihood of coronary artery disease. The slight relative increase in inferior wall counts at redistribution was most likely caused by scatter from the relatively higher liver activity compared with the situation during stress and emphasizes the need for scatter correction. The close similarity in count distribution for the mean male and female polar maps supports use of a sex-independent normal database for quantitative analysis. The reduced variation in corrected images from patient to patient implies increased accuracy for detection of myocardial defects.