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Supplemental material, sj-docx-1-tct-10.1177_15330338231189593 for X-ray and MR Contrast Bearing Nanoparticles Enhance the Therapeutic Response of Image-Guided Radiation Therapy for Oral Cancer by Gayatri Sharma, Mir Hadi Razeghi Kondelaji and Guru P. Sharma, Christopher Hansen, Abdul K. Parchur, Shayan Shafiee, Jaidip M. Jagtap, Brian Fish, Carmen Bergom, Eric Paulson, William A. Hall, Heather A. Himburg, Amit Joshi in Technology in Cancer Research & Treatment

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231189463 for Rapid, selective and homogeneous brain cooling with transnasal flow of ambient air for pediatric resuscitation by Raymond C Koehler, Michael Reyes, C Danielle Hopkins, Jillian S Armstrong, Suyi Cao, Ewa Kulikowicz, Jennifer K Lee and Harikrishna Tandri in Journal of Cerebral Blood Flow & Metabolism

Supplemental material, sj-docx-2-tct-10.1177_15330338231167249 for DOT1L Epigenetically Regulates Autophagy and Mitochondria Fusion in Cell Lines of Renal Cancer by Yanguang Hou, Jiachen Liu, Shiyu Huang, Lei Wang, Juncheng Hu and Xiuheng Liu in Technology in Cancer Research & Treatment

Supplemental material, sj-docx-1-tct-10.1177_15330338231167249 for DOT1L Epigenetically Regulates Autophagy and Mitochondria Fusion in Cell Lines of Renal Cancer by Yanguang Hou, Jiachen Liu, Shiyu Huang, Lei Wang, Juncheng Hu and Xiuheng Liu in Technology in Cancer Research & Treatment

Supplemental material, sj-docx-1-tct-10.1177_15330338231189593 for X-ray and MR Contrast Bearing Nanoparticles Enhance the Therapeutic Response of Image-Guided Radiation Therapy for Oral Cancer by Gayatri Sharma, Mir Hadi Razeghi Kondelaji and Guru P. Sharma, Christopher Hansen, Abdul K. Parchur, Shayan Shafiee, Jaidip M. Jagtap, Brian Fish, Carmen Bergom, Eric Paulson, William A. Hall, Heather A. Himburg, Amit Joshi in Technology in Cancer Research & Treatment

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231184365 for A new framework for metabolic connectivity mapping using bolus [18F]FDG PET and kinetic modeling by Tommaso Volpi, Giulia Vallini, Erica Silvestri, Mattia De Francisci, Tony Durbin, Maurizio Corbetta, John J Lee, Andrei G Vlassenko, Manu S Goyal and Alessandra Bertoldo in Journal of Cerebral Blood Flow & Metabolism

Supplemental Material for Recommendations for the Management of Incidental Musculoskeletal Findings on MRI and CT by Gina Di Primio, Gordon J. Boyd, Christopher I. Fung, Casey Hurrell, Gary L. Brahm, Jeffery R. Bird, Steven J. Co and Iain D. C. Kirkpatrick in Canadian Association of Radiologists Journal

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231184365 for A new framework for metabolic connectivity mapping using bolus [18F]FDG PET and kinetic modeling by Tommaso Volpi, Giulia Vallini, Erica Silvestri, Mattia De Francisci, Tony Durbin, Maurizio Corbetta, John J Lee, Andrei G Vlassenko, Manu S Goyal and Alessandra Bertoldo in Journal of Cerebral Blood Flow & Metabolism

Supplemental material, sj-docx-1-acr-10.1177_02841851231187373 for Pectoralis muscle predicts distant metastases in breast cancer by deep learning radiomics by Shidi Miao, Yunfei An, Pingping Liu, Shikai Mu, Wenjin Zhou, Haobo Jia, Wenjuan Huang, Jing Li and Ruitao Wang in Acta Radiologica

Supplemental material, sj-pdf-2-tct-10.1177_15330338231183937 for The Impact of a History of Different Other Cancers on the Long-Term Outcomes of Patients with Gallbladder Cancer: A Propensity Score–Adjusted, Population-Based Study by Jing Wang, Chan Zhang and Dong Yan in Technology in Cancer Research & Treatment

Purpose: To employ deep learning for suppression of the artifact-generating T1-relaxation echo in cine displacement encoding with stimulated echoes (DENSE) for the purpose of reducing the scan time. Methods: A U-Net was trained to suppress the artifact-generating T1-relaxation echo using complementary phase-cycled data as the ground truth. A data augmentation method was developed that generates synthetic DENSE images with arbitrary displacement encoding frequencies to suppress the T1-relaxation echo modulated for a range of frequencies. The resulting U-Net (DAS- Net) was compared to a k-space zero-filling as an alternative method. Non-phase-cycled DENSE images acquired in shorter breath-holds were processed by DAS-Net and compared to DENSE images acquired with phase-cycling for the quantification of myocardial strain. Results: DAS-Net effectively suppressed the T1-relaxation echo and its artifacts, and achieved root mean square error (RMSE) = 5.5±0.8 and structural similarity index (SSIM) = 0.85±0.02 for DENSE images acquired with a displacement encoding frequency of 0.10 cycles/mm. DAS-Net outperformed zero-filling (RMSE = 5.8±1.5 vs 13.5±1.5, DAS-Net vs zero-filling, pConclusion: DAS-Net provides an effective alternative approach for suppression of the artifact- generating T1-relaxation echo in DENSE MRI, enabling a 42% reduction in scan time compared to DENSE with phase-cycling.

Sarcopenia is defined as the progressive, systematic loss of skeletal muscle mass, function and quality that is associated with aging or atrophy. There are multiple methods for diagnosing sarcopenia, with body composition tools being increasingly utilised. The presence of sarcopenia has been shown to be associated with poorer outcomes for patients with malignancy. This thesis describes an initial study investigating the use of body composition software in identifying sarcopenia in a population of patients with upper gastrointestinal (UGI) malignancies undergoing surgical resection at a single institution. The impact of sarcopenia on outcomes will also be investigated.

Purpose: To employ deep learning for suppression of the artifact-generating T1-relaxation echo in cine displacement encoding with stimulated echoes (DENSE) for the purpose of reducing the scan time. Methods: A U-Net was trained to suppress the artifact-generating T1-relaxation echo using complementary phase-cycled data as the ground truth. A data augmentation method was developed that generates synthetic DENSE images with arbitrary displacement encoding frequencies to suppress the T1-relaxation echo modulated for a range of frequencies. The resulting U-Net (DAS- Net) was compared to a k-space zero-filling as an alternative method. Non-phase-cycled DENSE images acquired in shorter breath-holds were processed by DAS-Net and compared to DENSE images acquired with phase-cycling for the quantification of myocardial strain. Results: DAS-Net effectively suppressed the T1-relaxation echo and its artifacts, and achieved root mean square error (RMSE) = 5.5±0.8 and structural similarity index (SSIM) = 0.85±0.02 for DENSE images acquired with a displacement encoding frequency of 0.10 cycles/mm. DAS-Net outperformed zero-filling (RMSE = 5.8±1.5 vs 13.5±1.5, DAS-Net vs zero-filling, pConclusion: DAS-Net provides an effective alternative approach for suppression of the artifact- generating T1-relaxation echo in DENSE MRI, enabling a 42% reduction in scan time compared to DENSE with phase-cycling.

Supplemental material, sj-docx-1-tct-10.1177_15330338231184995 for Plasma Thioredoxin Reductase as a Potential Biomarker for Gynecologic Cancer by Yinxing Zhu, MS, Yixuan Hu, MS, Junfeng Shi, MD, Xiaowei Wei, MD, Yaqi Song, MD, Cuiju Tang, MD, PhD, and Wenwen Zhang, MD, PhD in Technology in Cancer Research & Treatment

Supplemental material, sj-pdf-1-tct-10.1177_15330338231184990 for Clinical Features and Prognosis of Uncommon Metastatic Breast Cancer: A Retrospective Analysis of 82 Cases by Yusi Zhang, MD, Chenyu Sun, MD, Vicky Yau, MD, Shuanglong Chen, MD, Qingmo Yang, MD, Wenlin Chen, MD, Scott Lowe, MD, Rachel Bentley, MD, and Zhong Ouyang, MD in Technology in Cancer Research & Treatment

Supplemental material, sj-docx-1-acr-10.1177_02841851231187065 for Left atrium volume and ventricular volume ratio algorithm as indication of pulmonary hypertension etiology by Yoav Granot, Tomer Ziv-Baran, Shlomo Berliner, Yan Topilsky and Galit Aviram in Acta Radiologica

Rural radiographers draw upon informally, experientially acquired knowledge in order to navigate dilemmas and activities that demonstrate complex ethical and social dimensions in their practice. Through an exploration of the social and historical world of the rural radiographer, this thesis generates a substantive theoretical insight into rural radiographers' participation in radiographic interpretation, communication with referrers and disclosure of their radiographic opinion to patients, with a specific focus on plain film radiography. A two phase, exploratory interpretive study was undertaken. The first phase employed a paper based questionnaire and elicited information from Australian rural radiographers that included demographic profile, context and patterns of service delivery. The purpose of the questionnaire was not to draw statistical conclusions about the rural radiographic population, but rather to gather a demographic snapshot of rural radiographers and to determine radiographers' involvement in radiographic interpretation, communication and disclosure of their radiographic opinion. To this end the quantitative component of the questionnaire data was analysed using frequency analysis. Consistent with field literature, the questionnaire data demonstrated that radiographers are engaged in radiographic interpretation, communication with referrers and disclosure of their radiographic opinion to their patients. Emerging findings from the questionnaire provided the foundation for the second stage of the study, interviews with radiographers again providing radiographic services in rural Australia. The thematic analysis of the interview data revealed that, without a clear picture of where they stand medico-legally, rural radiographers draw on an experiential collective of radiographic perception and radiographic interpretation skills as the basis for the complex decisions they make about communication and disclosure of their radiographic opinion. Furthermore, the findings show that the level and method of disclosure chosen by radiographers is governed by the diagnostic, therapeutic and emotional impact this disclosure may have on the patient. Rural radiography transcends the technical image that dominates the field literature and extends to a more humanistic endeavour: patient welfare is central to the practice world of the rural radiographer. Utilising a social constructionist framework, theoretical explanations of radiographic practices in relation to radiographic interpretation, communication and disclosure were generated. This study shows that rural radiographers' construct of their role in patient care extends beyond image acquisition into radiographic image reading, communication and disclosure of their radiographic opinion. A key finding from this study is that rural radiographers, guided by an ethic of care, navigate a complex interplay of variables as they decide the way in which to convey their radiographic opinion. Radiographers' communication of their radiographic opinion with referrers is mediated by the radiographer/referrer game and tends to diagnostic accuracy, but with patients, disclosure is diagnostically vague and may be understood as filtered truth. The way in which rural radiographers convey their radiographic opinion is contextual and informed by experiential knowledge that has evolved through their shared experience of clinical practice in rural settings. This knowledge contributes as equally to an effective outcome for the patient to a radiographic examination as the radiographer's technical expertise in image acquisition; it is however not well described in the radiographic literature nor does it seem to be commonly discussed amongst radiographers and their health care colleagues. The findings from this study indicate that a mismatch in educational preparation, compounded by a lack of professional guidelines and legislative clarity, has led to the ways in which radiographers choose to convey their radiographic opinion. It is important that this implicit and tacit dimension to rural radiographic practice is understood so that it can inform professional, educational and policy decisions relating to radiographers' contemporary scope of practice.

Supplemental material, sj-pdf-1-tct-10.1177_15330338231184990 for Clinical Features and Prognosis of Uncommon Metastatic Breast Cancer: A Retrospective Analysis of 82 Cases by Yusi Zhang, MD, Chenyu Sun, MD, Vicky Yau, MD, Shuanglong Chen, MD, Qingmo Yang, MD, Wenlin Chen, MD, Scott Lowe, MD, Rachel Bentley, MD, and Zhong Ouyang, MD in Technology in Cancer Research & Treatment

Preeclampsia and other hypertensive disorders of pregnancy impact 2-8% of pregnancies with often devastating results. Current treatment methods resort to birth, which forces the fetus into the world before they are fully developed but can save the mother’s life. Preeclampsia is broadly considered to be of placental origin and current etiologic understanding focuses on systemic endothelial dysfunction triggered by an imbalance of vasoregulatory factors released by this maternal/fetal organ. This imbalance explains many early-term cases but fails to adequately address later cases where this imbalance is not always seen. Conversely, ischemia-reperfusion of the kidney is known to correlate with endothelial dysfunction, and preeclamptic women are known to have a stenosis in their left renal vein (LRV) in the supine position (on their back). Herein, we suggest that extrinsic compression of the LRV by the gravid uterus, without collaterals, produces a renal injury which can induce systemic endothelial cell dysfunction. We theorize this compression is position dependent and produces renal ischemia through an unchecked cycle of increased intrarenal pressure, subsequent afferent arteriole constriction and decreased glomerular perfusion, and activation of the renin-angiotensin-aldosterone system. We aim to elucidate this through murine studies of a surgically induced LRV stenosis and a retrospective clinical study where the maternal renal veins are measured from magnetic resonance images. Findings from this work suggest partial renal venous outflow obstruction leads to renal injury but could be moderated through alternative maternal resting positions. This potential alternative pathologic mechanism has significant clinical implications for future therapies targeting this condition.

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231189463 for Rapid, selective and homogeneous brain cooling with transnasal flow of ambient air for pediatric resuscitation by Raymond C Koehler, Michael Reyes, C Danielle Hopkins, Jillian S Armstrong, Suyi Cao, Ewa Kulikowicz, Jennifer K Lee and Harikrishna Tandri in Journal of Cerebral Blood Flow & Metabolism

Supplemental Material for Gene Signatures for Latent Radiation-Induced Lung Injury Post X-ray Exposure in Mouse by Tongtong Zhang, Zhaoming Zhou, Lei Wen, Changguo Shan, Mingyao Lai, Jing Liao, Xin Zeng, Gang Yan, Linbo Cai, Meijuan Zhou, and Minghua Wang in Dose-Response

Supplemental material, sj-docx-2-tct-10.1177_15330338231167249 for DOT1L Epigenetically Regulates Autophagy and Mitochondria Fusion in Cell Lines of Renal Cancer by Yanguang Hou, Jiachen Liu, Shiyu Huang, Lei Wang, Juncheng Hu and Xiuheng Liu in Technology in Cancer Research & Treatment

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231185507 for Intermittent hypoxia protects against hypoxic-ischemic brain damage by inducing functional angiogenesis by Yuying Guan, Yakun Gu, Haitao Shao, Wei Ma, Gaifen Li, Mengyuan Guo, Qianqian Shao, Yuning Li, Yingxia Liu, Chaoyu Wang, Zhengming Tian, Jia Liu and Xunming Ji in Journal of Cerebral Blood Flow & Metabolism

Delayed enhancement (DE) MRI is an important tool in diagnosis of cardiovascular disease as it can reveal different characteristics of the myocardium scars including infarction and no-reflow. Automatic segmentation of different regions has the advantage of improved accuracy and reduced inter-observer variability in quantifying key imaging biomarkers such as percentage of scars. In recent years deep learning has led to drastic performance improvement in automatic segmentation tasks using the UNet architecture. Cardiac MRI segmentation is a challenging task due to the high variability in imaging contrast, orientation and signal-to-noise ratio; specifically, for short-axis views, as they are double-oblique slices, due to the different orientations of the heart and operator choice, the overall appearance of the image can vary significantly, which poses a challenge to the neural networks as they cannot learn a consistent global anatomy. In this paper we developed a rotation-based augmentation to address this issue in both training and testing steps by eliminating the variance in orientations and demonstrated its effectiveness. 2D dilated UNet was used as the backbone network structure. On the test dataset, Dice scores of 0.933 for LV blood pool, 0.824 for myocardium, 0.578 for infarction and 0.697 for no re-flow regions were archived using the proposed framework.

Supplemental Material for Machine Learning Classification of Body Part, Imaging Axis, and Intravenous Contrast Enhancement on CT Imaging by Wuqi Li, Hui-Ming Lin, Amy Lin, Marc Napoleone, Robert Moreland, Alexis Murari, Maxim Stepanov, Eric Ivanov, Abhinav Sanjeeva Prasad, George Shih, Zixuan Hu, Suvd Zulbayar, Ervin Sejdić, and Errol Colak in Canadian Association of Radiologists Journal

Supplemental material, sj-docx-1-tct-10.1177_15330338231185285 for Comprehensive Mutation Profiling of Colorectal Cancer Patients With Lung or Liver Metastasis by Targeted Next-Generation Sequencing by Chun-Ting Hu, Jing-Long Wang, Ting Hou, Zhao-Wen Yan, Li-Dong Zu, Guo-Hui Fu and Wei-Wei Shen in Technology in Cancer Research & Treatment

Delayed enhancement (DE) MRI is an important tool in diagnosis of cardiovascular disease as it can reveal different characteristics of the myocardium scars including infarction and no-reflow. Automatic segmentation of different regions has the advantage of improved accuracy and reduced inter-observer variability in quantifying key imaging biomarkers such as percentage of scars. In recent years deep learning has led to drastic performance improvement in automatic segmentation tasks using the UNet architecture. Cardiac MRI segmentation is a challenging task due to the high variability in imaging contrast, orientation and signal-to-noise ratio; specifically, for short-axis views, as they are double-oblique slices, due to the different orientations of the heart and operator choice, the overall appearance of the image can vary significantly, which poses a challenge to the neural networks as they cannot learn a consistent global anatomy. In this paper we developed a rotation-based augmentation to address this issue in both training and testing steps by eliminating the variance in orientations and demonstrated its effectiveness. 2D dilated UNet was used as the backbone network structure. On the test dataset, Dice scores of 0.933 for LV blood pool, 0.824 for myocardium, 0.578 for infarction and 0.697 for no re-flow regions were archived using the proposed framework.

No abstract available.

Supplemental Material, sj-pdf-1-dos-10.1177_15593258231187357 for Pharmacological Activities and In-Silico Studies of Bioactive Compounds Identified in Organic Fractions of the Methanolic Extract of Citrullus Colocynthis by Haseeb Akram Sindhu, Muhammad Afzal, and Izzah Shahid in Dose-Response

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231185507 for Intermittent hypoxia protects against hypoxic-ischemic brain damage by inducing functional angiogenesis by Yuying Guan, Yakun Gu, Haitao Shao, Wei Ma, Gaifen Li, Mengyuan Guo, Qianqian Shao, Yuning Li, Yingxia Liu, Chaoyu Wang, Zhengming Tian, Jia Liu and Xunming Ji in Journal of Cerebral Blood Flow & Metabolism

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231185658 for Association between time-dependent changes in cerebrovascular autoregulation after cardiac arrest and outcomes: A prospective cohort study by Jotaro Tachino, Yuta Nonomiya, Satsuki Taniuchi, Ayumi Shintani, Shunichiro Nakao, Ryosuke Takegawa, Tomoya Hirose, Tomohiko Sakai, Mitsuo Ohnishi, Takeshi Shimazu and Tadahiko Shiozaki in Journal of Cerebral Blood Flow & Metabolism

Supplemental material, sj-docx-1-tct-10.1177_15330338231184995 for Plasma Thioredoxin Reductase as a Potential Biomarker for Gynecologic Cancer by Yinxing Zhu, MS, Yixuan Hu, MS, Junfeng Shi, MD, Xiaowei Wei, MD, Yaqi Song, MD, Cuiju Tang, MD, PhD, and Wenwen Zhang, MD, PhD in Technology in Cancer Research & Treatment

Supplemental material, sj-pdf-1-jcb-10.1177_0271678X231185658 for Association between time-dependent changes in cerebrovascular autoregulation after cardiac arrest and outcomes: A prospective cohort study by Jotaro Tachino, Yuta Nonomiya, Satsuki Taniuchi, Ayumi Shintani, Shunichiro Nakao, Ryosuke Takegawa, Tomoya Hirose, Tomohiko Sakai, Mitsuo Ohnishi, Takeshi Shimazu and Tadahiko Shiozaki in Journal of Cerebral Blood Flow & Metabolism

Herein, the development, optimization, and evaluation of quantitative techniques are presented for dynamic PET studies in cancer imaging applications. Dynamic PET image analysis techniques are first applied to 18F-fluoroethyltyrosine (FET) PET imaging of glioma and brain metastasis patients. In a second application, dynamic PET image analysis techniques are applied to 68Ga-PSMA-11 PET imaging for primary prostate cancer patients. Overall, the application of dynamic PET imaging techniques supports improved clinical outcomes and enhanced clinician confidence for treatment modifications.

Supplemental material, sj-docx-1-tct-10.1177_15330338231167249 for DOT1L Epigenetically Regulates Autophagy and Mitochondria Fusion in Cell Lines of Renal Cancer by Yanguang Hou, Jiachen Liu, Shiyu Huang, Lei Wang, Juncheng Hu and Xiuheng Liu in Technology in Cancer Research & Treatment

Cranial ultrasound is used routinely to examine the brains of prematurely born infants. Our novel study indicates that diagnostic levels of ultrasound are capable of inducing inflammation in the brain without sufficient knowledge by operators on strategies to reduce such potentially adverse effects. The critical factor in determining the likelihood of inducing a bioeffect is the overall duration of exposure. Yet, this is not recognised by governing bodies or operators. These findings call for urgent further research in order to establish safety protocols for neonatal cranial scans.

Vocal fold vibration results in voice production. Optimal hydration levels contribute to self-sustained vocal fold vibration and preservation of voice quality. Adequate hydration is implicated as a factor in maintaining voice and preventing voice problems. Voice problems affect up to one third of adults during their lifetime. But whether altered hydration state adversely affects vocal fold biology and biomechanics is still unclear. To untangle the effects of systemic dehydration on vocal fold biology, we developed a water restriction protocol on lab animals that can translate to humans. Our results showed that dehydration induced by restricted water access downregulated the gene expression of IL-1α and desmoglein-1, upregulated the gene expression level of hyaluronidase-2, and downregulated hyaluronic acid (HA). Clinically, hydration treatments are hypothesized to maintain the viscoelastic properties of vocal folds. However, our understanding of the relationship between vocal fold tissue hydration level and biomechanical properties is still evolving. To investigate the effects of dehydration on biomechanical properties we used an ex vivo experimental design. We hypothesized that the optimal stiffness of vocal folds would be impacted after dehydration via losing both water and HA, but that the stiffness properties would recover through rehydration. To test this hypothesis, we experimentally treated porcine vocal fold samples using two different approaches: 1) immersion in hypertonic solution (15% NaCl in ddH2O) and PBS sequentially to mimic dehydration and rehydration, and 2) incubation with hyaluronidase (Hyal) to mimic HA loss during dehydration. Our results showed that loss of water increased tissue stiffness and could be recovered through rehydration in a certain degree. In addition, loss of HA increased tissue stiffness. In While dehydration decreases total body blood volume, different tissues and organs of the body may be impacted in different ways from dehydration. Therefore, it is important to investigate the hemodynamic alterations during changes to hydration status. Magnetic resonance angiography (MRA) and ultrasound imaging were employed to identify the delicate vascular geometry and hemodynamics of the laryngeal blood supply. Animals underwent both MRA and ultrasound imaging at baseline, dehydration and rehydration time points. Our results showed that dehydration impacted the blood supply to larynx. This blood supply was restored through rehydration treatment. Overall, this research has been successful in establishing a mild dehydration animal model, providing evidence from gene and protein levels that dehydration affects cytokine production and extracellular matrix components (ECM) in vocal fold, demonstrating the vocal fold tissue biomechanical behavior after dehydration and loss of HA, and offering a combination application of MRA and ultrasound imaging to study vascular geometry and hemodynamics of the blood supply to the vocal fold region.

Ultrasound is extensively used in continental Europe and the United States in the prompt assessment of patients after trauma, or acute abdominal emergencies. The capacity of non-radiology specialists to perform focused point-of-care ultrasound relevant to their field of expertise is gaining acceptability, and it is considered a technological third hand, or even the modern-day stethoscope. Ireland has been slow to adopt this technique, mainly it would seem for medico-legal reasons, and has hitherto pursued a more conservative approach. This work aims to demonstrate that surgeon-performed point-of-care ultrasound can be successfully implemented in Irish hospitals, with a tailored approach, to the advantage of the Irish Health Service.The first study in this thesis is focused on surgeon-performed ultrasound in acute biliary disease. Acute cholecystitis is one of the commonest presentations to the on-call general surgeon, be it in Irish hospitals or worldwide. Ultrasound is the mainstay of diagnostic imaging but there can often be delays before an ultrasound can be performed in the radiology department. It would make sense to have the diagnosis made at the bedside along with clinical examination, as is happening in many parts of Europe and in the United States. This can be confirmed in the imaging department if there is any doubt, or if intervention is required. The second study is aimed at surgeon-performed ultrasound in acute diverticulitis, which can be thought of as a more advanced procedure. Most of patients with acute diverticulitis can be conservatively managed. Computerized tomography (CT) scanning changes management in a very few instances. It is thus intuitive that ultrasound can diminish the number of unnecessary CTs and subsequent radiation exposure, costs and length of hospital stay.

The thesis investigates the diffuse noxious inhibitory control of cough and the urge-to-cough via the use of functional magnetic resonance imaging to identify brain regions associated with the reduction in cough-related processing of airway inputs.