scholarly journals Does MRI Increase the Diagnostic Confidence of Physicians in an Outpatient Memory Clinic

2016 ◽  
Vol 6 (2) ◽  
pp. 242-251 ◽  
Author(s):  
Leo Boelaarts ◽  
Philip Scheltens ◽  
Jos de Jonghe
Keyword(s):  
Diagnostic Tool ◽  
Cognitive Disorders ◽  
Added Value ◽  
Everyday Practice ◽  
Diagnostic Process ◽  
Unexpected Finding ◽  
Mr Images ◽  
Diagnostic Confidence ◽  
Tertiary Referral ◽  
Before And After

Background and Aim: Data showing the usefulness of MRI to improve the accuracy of the diagnostic process in cognitive disorders were derived from studies in tertiary referral centers. MRI is widely used as a diagnostic tool in everyday practice, but it is unknown what the actual added value of MRI is. We studied the usefulness of MRI in the diagnostic process by measuring the change of confidence of the physician. Methods: Physicians indicated confidence in their diagnosis before and after presentation of MR images using a visual analogue scale from 0-100%. Results: Use of MRI increased the level of confidence by 3% in experienced clinicians and by 9% in inexperienced physicians. In 2/125 cases, MRI showed an unexpected finding. Conclusion: MRI is a useful diagnostic tool in everyday practice of diagnosing cognitive disorders.

Normal cerebral ventricular volume growth in childhood

2020 ◽  
Vol 26 (5) ◽  
pp. 517-524
Author(s):  
Noah S. Cutler ◽  
Sudharsan Srinivasan ◽  
Bryan L. Aaron ◽  
Sharath Kumar Anand ◽  
Michael S. Kang ◽  
...  
Keyword(s):  
Brain Mri ◽  
Volume Growth ◽  
Ventricular Volume ◽  
Growth Patterns ◽  
Diagnostic Process ◽  
Growth Charts ◽  
Normal Brain ◽  
Mr Images ◽  
Ventricular Volumes ◽  
Brain Mr Images

OBJECTIVENormal percentile growth charts for head circumference, length, and weight are well-established tools for clinicians to detect abnormal growth patterns. Currently, no standard exists for evaluating normal size or growth of cerebral ventricular volume. The current standard practice relies on clinical experience for a subjective assessment of cerebral ventricular size to determine whether a patient is outside the normal volume range. An improved definition of normal ventricular volumes would facilitate a more data-driven diagnostic process. The authors sought to develop a growth curve of cerebral ventricular volumes using a large number of normal pediatric brain MR images.METHODSThe authors performed a retrospective analysis of patients aged 0 to 18 years, who were evaluated at their institution between 2009 and 2016 with brain MRI performed for headaches, convulsions, or head injury. Patients were excluded for diagnoses of hydrocephalus, congenital brain malformations, intracranial hemorrhage, meningitis, or intracranial mass lesions established at any time during a 3- to 10-year follow-up. The volume of the cerebral ventricles for each T2-weighted MRI sequence was calculated with a custom semiautomated segmentation program written in MATLAB. Normal percentile curves were calculated using the lambda-mu-sigma smoothing method.RESULTSVentricular volume was calculated for 687 normal brain MR images obtained in 617 different patients. A chart with standardized growth curves was developed from this set of normal ventricular volumes representing the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles. The charted data were binned by age at scan date by 3-month intervals for ages 0–1 year, 6-month intervals for ages 1–3 years, and 12-month intervals for ages 3–18 years. Additional percentile values were calculated for boys only and girls only.CONCLUSIONSThe authors developed centile estimation growth charts of normal 3D ventricular volumes measured on brain MRI for pediatric patients. These charts may serve as a quantitative clinical reference to help discern normal variance from pathologic ventriculomegaly.

scholarly journals Paediatric attendances of the emergency department in a major Irish tertiary referral centre before and after expansion of free GP care to children under 6: a retrospective observational study

2021 ◽  
Vol 5 (1) ◽  
pp. e000862
Author(s):  
Irina Korotchikova ◽  
Sukainah Al Khalaf ◽  
Ewa Sheridan ◽  
Rory O'Brien ◽  
Colin P Bradley ◽  
...  
Keyword(s):  
Emergency Department ◽  
Health Service ◽  
Observational Study ◽  
Referral Centre ◽  
Tertiary Referral ◽  
Tertiary Referral Centre ◽  
Period 2 ◽  
Time Period ◽  
Before And After ◽  
Gp Care

ObjectivesTo examine the characteristics of paediatric attendances to the emergency department (ED) in Cork University Hospital (CUH) before and after the expansion of free general practitioner (GP) care to children under the age of 6 years.DesignThis is a retrospective observational study that used a large administrative dataset.SettingThe study was conducted in major Irish tertiary referral centre that serves a total population of over 1.1 million. It is a public hospital, owned and managed by the health service executive.ParticipantsChildren aged 0–15 years who attended CUH ED during the study period of 6 years (2012–2018) were included in this study (n=76 831).InterventionsFree GP care was expanded to all children aged 0–5 years in July 2015.Main outcome measuresPaediatric attendances to CUH ED were examined before (Time Period 1: July 2012–June 2015) and after (Time Period 2: July 2015–June 2018) the expansion of free GP care to children under 6. Changes in GP referral rates and inpatient hospital admissions were investigated.ResultsPaediatric presentations to CUH ED increased from 35 819 during the Time Period 1 to 41 012 during the Time Period 2 (14.5%). The proportion of the CUH ED attendances through GP referrals by children under 6 increased by over 8% in the Time Period 2 (from 10 148 to 14 028). Although the number of all children who attended CUH ED and were admitted to hospital increased in Time Period 2 (from 8704 to 9320); the proportion of children in the 0–5 years group who attended the CUH ED through GP referral and were subsequently admitted to hospital, decreased by over 3%.ConclusionThe expansion of free GP care has upstream health service utilisation implications, such as increased attendances at ED, and should be considered and costed by policy-makers.

Dysprosium-enhanced MR imaging for tumor tissue characterization

1997 ◽  
Vol 38 (2) ◽  
pp. 281-286 ◽  
Author(s):  
C. Wang ◽  
A. Sundin ◽  
A. Ericsson ◽  
T. Bach-Gansmo ◽  
A. Hemmingsson ◽  
...  
Keyword(s):  
Mr Imaging ◽  
Tissue Characterization ◽  
Tumor Tissue ◽  
Tumor Model ◽  
Human Colon ◽  
Mr Images ◽  
Histological Sections ◽  
Necrotic Tumor ◽  
Before And After ◽  
Weighted Sequences

Purpose: to evaluate dysprosium-enhanced MR imaging for differentiation between morphologically intact and necrotic tumor tissue in a tumor model. Material and Methods: A human colon carcinoma was transplanted subcutaneously into 9 nude (immunodeprived) rats. MR imaging was performed before and after injection of the dysprosium agent Dy-DTPA-BMA. T1-, T2- and T2*-weighted sequences were acquired. the tumors were dissected, histological sections were prepared, and compared with corresponding MR images. Results: in intact tissue, the MR signal intensity in the T2- and T2*-weighted images decreased after Dy injection and the delineation of the intact regions were sharp and corresponded well to the gross histological sections. Conclusion: Dy-enhanced MR imaging facilitated the differentiation between intact and necrotic tumor tissue.

Effect of unweighting on skeletal muscle use during exercise

1995 ◽  
Vol 79 (1) ◽  
pp. 168-175 ◽  
Author(s):  
L. L. Ploutz-Snyder ◽  
P. A. Tesch ◽  
D. J. Crittenden ◽  
G. A. Dudley
Keyword(s):  
Lower Limb ◽  
Weight Bearing ◽  
Muscle Group ◽  
Mr Images ◽  
Cross Sectional ◽  
Quadriceps Femoris Muscle ◽  
Before And After ◽  
Exercise Induced ◽  
The Right ◽  
Femoris Muscle

Exercise-induced spin-spin relaxation time (T2) shifts in magnetic resonance (MR) images were used to test the hypothesis that more muscle would be used to perform a given submaximal task after 5 wk of unweighting. Before and after unilateral lower limb suspension (ULLS), 7 subjects performed 5 sets of 10 unilateral concentric actions with the quadriceps femoris muscle group (QF) at each of 4 loads: 25, 40, 55, and 70% of maximum. T2-weighted MR images of the thigh were collected at rest and after each relative load. ULLS elicited a 20% decrease in strength of the left unweighted QF and a 14% decrease in average cross-sectional area (CSA) with no changes in the right weight-bearing QF. Average CSA of the left or right QF showing exercise-induced T2 shift increased as a function of exercise intensity both before and after ULLS. On average, 12 +/- 1, 15 +/- 2, 18 +/- 2, and 22 +/- 1 cm2 of either QF showed elevated T2 for the 25, 40, 55, and 70% loads, respectively, before ULLS. Average CSA of the left but not the right QF, showing elevated T2 after ULLS, was increased to 16 +/- 2, 23 +/- 3, 31 +/- 7, and 39 +/- 5 cm2, respectively. The results indicated that unweighting increased exercise-induced T2 shift in MR images, presumably due to greater muscle mass involvement in exercise after than before unweighting, suggesting a change in motor control.

scholarly journals A Modificatory Screening Protocol for ARDS in Patients with Respiratory Support Based on SpO2 and FiO2

2021 ◽  
Author(s):  
Yan Xia ◽  
Qiancheng Xu ◽  
Zhiyuan Guo ◽  
Huijuan Zhang ◽  
Yingya Cao ◽  
...  
Keyword(s):  
Diagnostic Tool ◽  
Significant Negative Correlation ◽  
Diagnostic Value ◽  
Respiratory Support ◽  
Diagnostic Process ◽  
Observation Data ◽  
Roc Curve Analysis ◽  
Potential Value ◽  
New Diagnosis ◽  
Hypoxic Group

Abstract Background: A large number of recent studies have confirmed that the pulse oximetric saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (SFR) correlate well with PaO2/FiO2 ratio (PFR). However, whether SFR can replace PFR for the diagnosis and evaluate the severity of ARDS patients with advanced respiratory support is unclearly. The purpose of this study is to explore potential value of SFR ratio as a new diagnostic tool for ARDS by establishing new processes in patients who require high levels of oxygen support.Methods: 341 patients were included in this study, SFR and PFR values were recorded in the same time. 161 patients were used to establish the model, and 180 patients were used to verify the validity of the model. 161 groups of data were divide into hypoxic group (group H) and non-hypoxic group (group N) according to whether SpO2 was greater than 97%. For group H, the regression equation was established to describe the relationship between SFR and PFR. and calculated the value of SFR when PFR is 300. For group N, the correlation between each observation data andPFR were analyzed. Receiver operating characteristic (ROC) curve analysis was used to determine the diagnostic value of the index. Finally, a new diagnostic process was established for ARDS based on these results, and the reliability was verified with Berlin definition set as the gold standard for diagnosis and classification. Results: For group H, the diagnostic linear equation is PFR = 0.9162*SFR-21.39 ( R2=0.66 , P<0.0001 ). After calculation, when PFR is 300, SFR is 352. For group N, There is a significant negative correlation between FiO2 and PFR((R= -0.521,P<0.0001)). The AUC of using FiO2 to diagnose ARDS was 0.694 (95%CI 0.571~0.817, P ＜ 0.005). When the cutoff value of FiO2 was 39%, the sensitivity was 0.838 and the specificity was 0.545. Therefore, in this new diagnosis progress, when SpO2≤97%, if SFR≤352, ARDS may exist; when SpO2>97%, if FiO2min>39%, there may be ARDS. The sensitivity, specificity, NPV, PPV, and accuracy of the new diagnosis progress for ARDS were 91.1%, 76.7%, 89.6%, 79.6%, and 83.9%, respectively. Conclusion: There are potential value of SpO2 and FiO2 as a noninvasive diagnostic tool for ARDS by new processes in patients who are already receiving high levels of oxygen support.

scholarly journals Impact of mineral and organic absorbent during the discoloration of avocado oil by comparing with olive oil

2021 ◽  
Vol 16 (2) ◽  
pp. 113-121
Author(s):  
Orléans Ngomo ◽  
Joseph Sieliechi ◽  
Etienne Dongo
Keyword(s):  
Activated Carbon ◽  
Shelf Life ◽  
Olive Oil ◽  
Nutritional Quality ◽  
The Other ◽  
Added Value ◽  
Avocado Oil ◽  
Before And After ◽  
Valuable Product ◽  
Cie Lab

Avocado is a versatile and valuable product. Its oil is comparable to olive oil in terms of nutritional quality. It can also be used in cosmetics, in particular, in soaps, shampoos and lotions. Despite all these important attributes that avocado has, it is highly perishable and coupled with the lack of farm-to-market roads, a lot of it is lost after harvest during the peak season. The introduction of methods that will transform avocado to products with a long shelf life and added value will go a long way to solving the problem of post-harvest losses and poverty. One of these methods is the production of avocado oil. In addition, in order to reduce the colour of the pigments without altering their quality, discoloration tests were carried out by adsorption on bleaching grounds (a montmorillonite, a kaolinite and activated carbon). The colour intensities of the oils before and after adsorption were determined using two complementary methods: a UV-Vis spectrophotometer and a Konica Minolta spectrophotometer CM-5. The UV-Vis spectrophotometer show that the activated carbon has a best fixing capacity of the pigments; According to the Colorimetric parameters (CIE-Lab) the coordinates L* a* b* that showed brightness (L*) of the avocado oil was half of the olive oil (41.13±0.02 vs 84.85±0.02). The activated carbon was better in fixing the red (a*) (4.99±0.01vs 15.73±0.01 before adsorption) and yellow (b*) (63.71±0.09 vs 70.07±0.09 before adsorption) pigments, while the other two adsorbents have very little influence on the red colour of avocado oil. RésuméL’avocat est un produit versatile et de grande valeur. Son huile est comparable à huile d’olive en terme de qualité nutritionnelle ; elle peut également être utilisée en cosmétique en occurrence dans les savons, champoings et lotions. En pleine saison, l’on fait face à une abondance des avocats dans les zones de production qui sont très souvent enclavées ; c’est ainsi que face aux difficultés de transport et les routes peu praticables pour l’importation, l’on se retrouve en train de perdre de très importantes quantités d’avocats après les récoltes. Or la production d’huile d’avocats permettrait de réduire les pertes post récolte, réduirait le chômage et permettrait de lutter contre la pauvreté après la vente des huiles extraites. De plus, dans le but de réduire les pigments colorés, des tests de décolorations effectués par adsorption sur des terres décolorantes (une montmorillonite en provenance de Maroua, une kaolinite en provenance de Douala et le charbon actif) sont effectués. Les couleurs des huiles mesurées avant et après adsorption à l’aide deux appareils complémentaires : Le spectrophotomètre UV-Vis et du Konica Minolta spectrophotomètre CM-5 montrent. Les analyses spectrophotométriques UV-Vis montrent que c’est le charbon activé qui présente la meilleure adsorption des pigments ; D’après les coordonnées L*a*b*, la clarté de l’huile d’avocat est pratiquement la moitié de celle de l’huile d’olive (41,13±0,02 contre 84,85±0,02), le charbon activé fixe mieux les pigments rouges (a*) (4,99±0,01 contre 15,73±0,01 avant adsorption) et jaunes (b*) (63,71±0,09 contre 70,07±0,09 après adsorption), tandis que les deux autres adsorbants influencent très peu sur la coloration des huiles.

scholarly journals Monitoring of the Project to Convert Cereal Production into Olive Plantations in the Province of Tetouan (Northern Morocco)

2020 ◽  
pp. 1-16
Author(s):  
Ettakifi Hajar ◽  
Barbara Hicham ◽  
El Bouzdoudi Brahim ◽  
Errabii Tomader ◽  
El Kbiach Mohammed L’bachir
Keyword(s):  
Agricultural Sector ◽  
Olive Tree ◽  
Ecological Impacts ◽  
Tree Planting ◽  
Added Value ◽  
Social Constraints ◽  
Cereal Crops ◽  
High Productivity ◽  
Before And After ◽  
Productivity And Competitiveness

The agricultural sector occupies an important economic and social position in Morocco. In this sense, in recent years our country has adopted a new strategy for the agricultural sector called the "Green Morocco Plan". This plan is based on two pillars, the first is that which provides agriculture with high added value, high productivity, and competitiveness, the second is that which offers solidarity-based agriculture, based on the fight against poverty, increasing the income of small farmers, particularly in disadvantaged areas (such as unfavourable stock areas, mountains or oases, plains and plateaus in semi-arid regions). In our present study, we are particularly interested in the project to convert 760 ha of cereal crops into olive groves in the province of Tetouan. On the one hand, all stages of olive tree planting in cereal crops were monitored, as well as a comparison of yields, area, income, productivity and employment before and after the project was carried out. And on the other hand, an analysis of the various positive (social, economic and environmental) and negative (ecological) impacts of the project on the rural population in the province of Tetouan and on the environment in general. On the contrary, this project encountered several constraints, including natural, economic and social constraints.

scholarly journals Pemanfaatan bahan baku lokal dalam pengembangan wisata Pulau Cinta di Desa Teluk Kenidai Kecamatan Tambang Kabupaten Kampar Provinsi Riau

2020 ◽  
Vol 2 ◽  
pp. 38-43
Author(s):  
Trisla Warningsih ◽  
Kusai Kusai ◽  
Lamun Bathara ◽  
Andarini Diharmi ◽  
Deviasari Deviasari
Keyword(s):  
Natural Resources ◽  
Community Service ◽  
Added Value ◽  
Tourist Destinations ◽  
The People ◽  
Hands On ◽  
Before And After ◽  
Opening Up ◽  
Additional Income ◽  
Very High

Teluk Kenidai Village is located in Tambang District, Kampar Regency, Riau Province. Teluk Kenidai Village has the potential for natural tourism in the form of beaches, which are one of the alternative tourist destinations for the community. The activities carried out are playing various kinds of rides and swimming on the banks of the Kampar River. The visitors to the island of love in Kenidai Bay are the largest visitors of all tourist objects in Kampar Regency. The existence of the island of love tourism can develop the community's economy by providing special foods as souvenirs and drinks for tourist visitors. Alternative foods that can be done are processed crispy monitor fish and lime syrup drinks because these two things have very high potential in Kampar Regency, and can provide added value to people's lives. The purpose of the activity is to empower the people of Teluk Kenidai Village, to process various crispy monitoring fish and to increase the attractiveness of the island of love for visiting tourists. The benefits of the activity are opening up people's insights in increasing the potential of natural resources, gaining skills and abilities in making crispy monitor fish and lime syrup to improve the economy. The method is carried out by demonstration and hands-on practice in the manufacture of crispy monitoring fish and lime syrup. The target communities are the people living in Teluk Kenidai Village and village customary leaders and the Tourism Awareness Group (Pokdarwis) totaling 15 people. Evaluation is carried out by giving questionnaires to all participats before and after the delivery of counseling materials and practices. The results of the evaluation of the community service activities that have been carried out show that the increasing desire of the community in practicing extension activities to earn additional income by opening this bussines, especially in the tourist area of Pulau Cinta in Teluk Kenidai Village.

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