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K-edge subtraction computed tomography (KES-CT) allows simultaneous imaging of both structural features and regional distribution of contrast elements inside an organ. Using this technique, regional lung ventilation and blood volume distributions can be measured experimentally in vivo. In order for this imaging technology to be applicable in humans, it is crucial to minimize exposure to ionizing radiation with little compromise in image quality. The goal of this study was to assess the changes in signal-to-noise ratio (SNR) of KES-CT lung images as a function of radiation dose. The experiments were performed in anesthetized and ventilated rabbits using inhaled xenon gas in O2 at two concentrations: 20% and 70%. Radiation dose, defined as air kerma (Ka), was measured free-in-air and in a 16 cm polymethyl methacrylate phantom with a cylindrical ionization chamber. The dose free-in-air was varied from 2.7 mGy to 8.0 Gy. SNR in the images of xenon in air spaces was above the Rose criterion (SNR > 5) when Ka was over 400 mGy with 20% xenon, and over 40 mGy with 70% xenon. Although in human thorax attenuation is higher, based on these findings it is estimated that, by optimizing the imaging sequence and reconstruction algorithms, the radiation dose could be further reduced to clinically acceptable levels. [ABSTRACT FROM AUTHOR]

BackgroundOutdoor mobility is an important aspect of older adults’ functional status. GPS has been used to create indicators reflecting the spatiotemporal dimensions of outdoor mobility for applications in health and aging. However, outdoor mobility is a multidimensional construct. There is, as of yet, no classification algorithm that groups and characterizes older adults’ outdoor mobility based on its semantic aspects (ie, mobility intentions and motivations) by integrating geographic and domain knowledge. ObjectiveThis study assesses the feasibility of using GPS to determine semantic dimensions of older adults’ outdoor mobility, including destinations and activity types. MethodsA total of 5 healthy individuals, aged 65 years or older, carried a GPS device when traveling outside their homes for 4 weeks. The participants were also given a travel diary to record details of all excursions from their homes, including date, time, and destination information. We first designed and implemented an algorithm to extract destinations and infer activity types (eg, food, shopping, and sport) from the GPS data. We then evaluated the performance of the GPS-derived destination and activity information against the traditional diary method. ResultsOur results detected the stop locations of older adults from their GPS data with an F1 score of 87%. On average, the extracted home locations were within a 40.18-meter (SD 1.18) distance of the actual home locations. For the activity-inference algorithm, our results reached an F1 score of 86% for all participants, suggesting a reasonable accuracy against the travel diary recordings. Our results also suggest that the activity inference’s accuracy measure differed by neighborhood characteristics (ie, Walk Score). ConclusionsWe conclude that GPS technology is accurate for determining semantic dimensions of outdoor mobility. However, further improvements may be needed to develop a robust application of this system that can be adopted in clinical practice.

Background and Aim: Cerebral palsy (CP) is the most common motor impairment in childhood and affects 2 in 1000 live births, in which postural and motor control involved. In hemiplegic type, two sides of the body have differences in postural tone that cause weight shift to the intact side. In these children postural disorders appear as postural stability disorder. The aim of this study is to assess the effect of lateral wedge insole on postural control in cerebral palsy children. Materials and Methods: Sixteen hemiplegic children attended in this program and stood in two conditions on the force plate with and without lateral wedge on the hard plate. Center of pressure displacement measured for medio-lateral and antro-posterio directions. Every test took 20 seconds. It was repeated 3 times. Results: Range of sideways decreased significantly with use of 5º wedge. Also a shoe wedge of 5º provided symmetrical weight distribution. Conclusion: The results represent that a 5º lateral wedge applied to the unaffected limb, can improve factors of postural control and gain the symmetry in hemiplegic children. [ABSTRACT FROM AUTHOR]

Background and Aim: in hemiplegic children Postural tone of the two sides of body is different. Once, asymmetric stance is a typical state in individuals' with unilateral pain and/or paresis and standing is with weight bearing on the stronger side. Obviously, an asymmetric stance with majority of weight bearing on the affected side can counter faces individual with the falling risk and causes instability. It seems coordinating of the two sides of body is the most vitally important therapeutic exercises in hemiplegic patients. Although stable stance is a simple postural task but it's controlled semi-automatically by cortical and spinal centers. It is established that stable standing, also demands cognition resources. So, postural control demands the interaction between musculoskeletal and nervous systems. Material and method: In this clinical trial (before-after) 17 children 5-12 years old with spastic hemiplegia were participated. The subjects stayed in the center of force plate with the most stable standing position while using /not-using lateral wedge and in each state with/without doing cognition task. Short- memory test of digit span used as dual task condition. The mean range of fore-after and mediolateral sway and velocity and area as postural control independent variables and error measures in recalling of randomized digit chain as cognition task independent variables were registered. Results: The wedge affected Rsw (P=0.015), Area (P=0.007) and Vm (P=0.005) significantly. Dual task also had significant effect on Rfa (P=0.014), Rsw (P=0.014), Area (P=0.002) and Vm (P=0.002). But the wedge declines its effect properly. Conclusion: : The results represent that a 5° lateral wedge applied to the unaffected limb, can improve factors of postural control even in Dual tasking; thus The wedge can be used with a good effect on the posture of hemiplegic children. [ABSTRACT FROM AUTHOR]

Copyright of Annals of 'Constantin Brancusi' University of Targu-Jiu. Engineering Series / Analele Universităţii Constantin Brâncuşi din Târgu-Jiu. Seria Inginerie is the property of Universitatea Constantin Brancusi din Targu-Jiu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

1. There is an increasing demand in diagnostic radiology for extracting additional morphological and functional quantitative parameters from three-dimensional computed tomography (CT) images. Synchrotron radiation computed tomography (SRCT) is the state-of-the-art method in preclinical X-ray CT, because its performance is close to the theoretical limits in terms of accuracy and precision. 2. The SRCT method with monochromatic X-ray beams yields absolute high-Z element contrast agent concentrations, without errors arising from beam hardening or scatter artefacts, by using digital subtraction techniques of the sinograms. Each pixel of the reconstructed difference images provides a quantitative concentration versus time curve of inhaled or injected high-Z contrast agents (xenon or iodine) with a high sensitivity. This is the key point of two functional imaging techniques that were developed at the European Synchrotron Radiation Facility: brain perfusion and lung function (ventilation and perfusion). 3. These two imaging techniques provide parametric images expressed in absolute perfusion parameters (blood volume, blood flow, mean transit time and capillary permeability) or ventilation parameters (lung volume, regional lung ventilation, bronchial lumen size, regional airway and lung compliance) with a high accuracy and precision. 4. The aim of the present brief review is to give a snapshot of the status and perspectives of these two imaging techniques, with emphasis on the performances and interests for functional imaging. Two separate sections will then describe the results obtained so far using SRCT as an in vivo functional imaging tool for measuring changes in haemodynamics and ventilation, in the investigation of experimental pathophysiology and in the effects of therapeutic intervention. [ABSTRACT FROM AUTHOR]

Abstract: Micro-tomographic imaging of bone micro-architecture is increasingly used on wild and transgenic mice to follow effects of diseases or therapeutics. Synchrotron radiation micro-tomography (SR micro-CT) provides quantitative images at very high spatial resolution but has mainly been used in vitro. The aim of this work was to show the feasibility of SR micro-CT for assessing bone mineral density and micro-architecture in vivo in mice. Imaging with a pixel size of 10μm was performed on beam line ID19 at the ESRF using a special mouse holder. Two strains of mice (C3H/HeJ and C57BL/6J) were used for the experiment. First tests were performed in order to optimize the imaging conditions with respect to dose. Then, six mice of each group were imaged at doses of 7 and 13Gy (total scan time <5min). A similar volume of interest was selected in each image to perform quantitative analysis. The first results on bone volume and mineralization revealed significant differences between the strains as expected. Although there was no apparent damage, the imaged femurs will be further investigated by histology to evaluate the effect of irradiation on bone cells. In conclusion, SR micro-CT provides in vivo images with high signal-to-noise ratio (SNR), very short scan time and may be used in longitudinal studies. [Copyright &y& Elsevier]

Background: Faced with an abrupt surge of severe COVID patients in March and April 2020, intensive care units (ICU) from four French regions transferred around 660 patients towards six other regions and four neighbouring countries. The intensity and the diversity of the vectors used (plane, helicopter, train, ambulance), during this wave of medical evacuations make it an unprecedented event. The aim of TRANSCOV is to examine the impact of long distance transfers on patient’s health and to understand how actors collaborated to overcome clinical and logistical challenges. Methods: TRANSCOV is made of three disciplinary components: 1) interviews with clinicians and health authorities staff involved in the organisation and realisation of the transfers as part of the qualitative component; 2) a retrospective cohort collecting clinical parameters and pathway details before during and after transfer; 3) a collection of data regarding human and logistical resources mobilised during transfers as part of an economical evaluation. Results: Preliminary results indicate that prior experience in medical evacuations proved useful to collaborate effectively in the exceptional circumstances prevailing in spring 2020. Clinicians had to establish quickly eligibility criteria for transfer. Actors’ opinions may vary on the appropriateness of vectors to transfer isolated (e.g. via helicopter) or grouped (train) patients. Early epidemiological data suggest that transferred patients were younger and experienced comparable, if not lower, in-hospital mortality compared to other patients. The economic evaluation is in progress. Conclusions: Initial results indicate that effective collaborations led to the selection of clinically eligible patients and the realisation of safe distant transfers. Key messages: • Healthcare organisations have been able to adapt and create organizational innovations to respond to COVID-19. • Multidisciplinary approaches are appropriate to evaluate such complex innovations. [ABSTRACT FROM AUTHOR]

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Néphrologie & Thérapeutique is the property of John Libbey Eurotext Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Introduction L’objectif de l’étude était d’analyser les variations géographiques de l’accès à la greffe rénale en France en utilisant trois évènements d’intérêts différents : 1) accès à la liste d’attente ; 2) accès à la greffe rénale après inscription sur la liste et 3) accès à la greffe rénale après le démarrage de la dialyse. Patients/Matériels et méthodes Tous les cas incidents adultes ayant démarré la dialyse en 2012 en France métropolitaine et DOM-TOM ont été inclus (registre REIN). Les associations entre les caractéristiques biocliniques des patients, les caractéristiques régionales et les évènements d’intérêts (inscription, greffe) ont été étudiés en utilisant le modèle de Cox multiniveau incluant les données au niveau individuel ainsi qu’au niveau régional. Observation/Résultats Parmi les 9312 patients inclus à la date du 31 décembre 2015, 26,3 % ont été inscrits sur la liste d’attente et 15,1 % ont été greffés. Les patients résidant en Île-de-France avaient la plus grande probabilité d’être inscrits sur la liste en comparaison aux patients résidant dans les autres régions mais moins d’accès à la greffe. Le sexe féminin et la présence de comorbidités étaient associés avec une faible probabilité d’inscription sur la liste d’attente et de greffe après le démarrage de la dialyse. Au niveau régional, un taux d’incidence de l’insuffisance rénale chronique terminale moins élevé et une activité de greffe préemptive plus élevée étaient associés avec une forte probabilité d’inscription sur la liste et de greffe après le démarrage de la dialyse. Discussion/Conclusion L’étude des disparités dans l’accès à la greffe doit regarder différents marqueurs comme l’accès à la liste mais aussi l’accès à la greffe de façon indépendante. L’utilisation de différents évènements d’intérêt dans l’étude de l’accès à la greffe rénale pourrait aider les responsables politiques de santé à sélectionner les interventions les plus appropriées pour chaque région française, ceci afin de réduire les disparités régionales dans l’accès à la greffe. [ABSTRACT FROM AUTHOR]

L'utilisation d'un score permettant de prédire la mortalité, est très utile dans la prise de décision entre le démarrage de la dialyse ou d'un traitement conservateur chez les patients poly-pathologiques. L'objectif était d'étudier l'intérêt de l'utilisation des données médico-administratives, en plus des données REIN dans la construction d'un score de comorbidités, prédictif de la mortalité toutes causes à 1 an, chez les patients en insuffisance rénale chronique terminale (IRCT). Les données REIN ont été appariées aux données du système national des données de santé (SNDS). Notre score de comorbidités a été construit à partir de la population incidente en dialyse en 2015, préalablement divisée en 2 pour respectivement construire et valider le score. Plusieurs modèles ont été testés et comparés avant d'identifier le score le plus performant : Rennes score. Enfin, le Rennes score a été comparé aux scores de Wright et de Charlson. La performance pronostique du score construit à partir des données REIN appariées aux données SNDS n'est pas supérieure à celle du score issue uniquement des données REIN (Rennes score). Le Rennes score inclut : albumine < 30 g/dL, cancer actif, maladie hépatique, troubles de la marche et pathologie cardiovasculaire. Pour chaque décennie ≥ 50 ans, 1 point était additionné au score. Au sein de la population de validation, le Rennes score (c-statistic = 0,777 ; IC 95 % : 0,764–0,790) était plus performant que le score de Wright (c-statistic = 0,631 ; p < 0,001) et celui de Charlson (c-statistic = 0,703 ; p < 0,001). Notre étude a permis de montrer que les données de REIN seules étaient suffisantes pour développer un score présentant une bonne capacité de prédiction de la mortalité à 1 an au sein de la population en IRCT. Le Rennes score, simple à construire, pourrait intéresser la communauté de néphrologues dans l'aide à la décision d'un démarrage de la dialyse ou d'un traitement conservateur. [ABSTRACT FROM AUTHOR]

En France, d'après le registre REIN, environ 30 % des patients atteints d'IRCT démarrent l'hémodialyse en urgence. Un tel démarrage augmente le risque de morbidité et de mortalité et diminue la qualité de vie. L'objectif était de comparer le parcours de soins pré-dialyse de ces patients avec celui des patients ayant bénéficié d'une 1re dialyse programmée. Les patients ≥ 18 ans ayant démarré la dialyse en 2015 en France ont été inclus. Les données du REIN ont été appariées à celles du Système national des données de santé (SNDS). Les caractéristiques individuelles, les hospitalisations (nombre, durée et diagnostic principal) et le recours aux généralistes et aux néphrologues durant l'année précédant la 1re dialyse ont été comparés entre les deux groupes (démarrage en urgence vs. programmé). Parmi les 8964 patients inclus, 30,6 % avaient démarré la dialyse en urgence. Durant l'année précédant la 1re dialyse, le nombre médian de séjours était inférieur chez ces patients (1 vs. 2, p = 0,001) mais la durée moyenne d'un séjour était plus longue (8,1 jours vs. 5,8 jours, p < 0,001). Le nombre moyen de consultations avec un néphrologue était moindre chez les patients démarrant en urgence (2,5 vs. 4,5, p < 0,001) mais pas différent pour les consultations avec un généraliste (9,7 vs. 9,3, p = 0,064). Cette étude inédite du parcours de soins, grâce à l'appariement du registre REIN et du SNDS, a permis de montrer que les patients démarrant la dialyse de manière programmée étaient plus fréquemment suivis par des néphrologues et préparés à la dialyse. Cependant, dans les 2 groupes, beaucoup de patients avaient un suivi rapproché avec les généralistes. La comparaison du parcours de ces patients avec celui recommandé par la Haute Autorité de santé est en cours. Une étude qualitative impliquant patients, néphrologues et généralistes, approfondira la question d'adressage et les raisons médicales de ce suivi. [ABSTRACT FROM AUTHOR]

Background and Aim:Since the study of images quality taken with dental portable radiographic devices is not carried out, the aim of this study was to compare the quality of radiographs taken with Diox 602 portable device and Min Ray fixed device with each other. Materials and Methods: This experimental study was performed on 10 patients with request of more than 10 intraoral radiographs were almost symmetrically from both sides of the jaws. Half of radiographs per patient were performed using a portable device and the other half using fixed device by Kodak intraoral films. Then they were developed and fixed by automatic processing in the same condition. After coding, radiographs were examined by three oral and maxillofacial radiologists by four defined criteria in terms of density, contrast, resolution and noise. To each of the qualitative criteria was given a rating of acceptable or unacceptable. The weighted kappa coefficient was 90% for inter-observer reproducibility. The results were analyzed using Chisquare test. Result:From a total of 109 radiographs, 58 radiographs were taken by portable device (Diox 602) and 51 radiographs by fixed device (Min Ray). Most of the radiographs were evaluated at an acceptable level in terms of ranking in each of the qualitative parameters and no significant difference was noted between two groups in any parameter (P<0.9). Conclusion: Quality of the images taken by the portable X-ray machine (Diox 602) showed no significant difference compared with fixed X-ray machine (Min Ray). [ABSTRACT FROM AUTHOR]

Background and Aim: Considering the importance of detecting the secondary proximal caries and known effects of false positive and false negative diagnosis and regarding the lack of information about this issue, the purpose of this study was to compare the ability of CCD and PSP sensor in detection of secondary proximal caries in permanent premolar teeth with the gold standard method. Materials and Methods: In this diagnostic study, 40 normal extracted premolar teeth were used. Class ǁ cavities were prepared and filled with amalgam and digital radiographs were taken .Then, the secondary caries were made artificially by acid solution and digital images were obtained with the above condition. Evaluation of all radiographs was performed by 5 observers. Detections were performed and results were analyzed with statistical tests. Result: The unacceptable detection for CCD was 30% and for PSP was 37.5%. This difference was not statistically significant (p<0.4). Conclusion:There is no superior for the clinical use of CCD and PSP receptors in detection of proximal caries in permanent premolars. [ABSTRACT FROM AUTHOR]

The management of pemphigus vulgaris (PV) is challenging. This study aimed to evaluate the immunomodulating effects of metformin on PV. The study was conducted in two phases: in the first phase, patients received routine first‐line treatment (prednisolone plus azathioprine) for 2 months, then in the second phase, metformin was added to this regimen for another 2 months. After addition of metformin to the first‐line medications, significant reductions were seen in serum IgG1 (reduced from 534.92 ± 134.83 mg/dL to 481.58 ± 130.46 mg/dL, P < 0.001), IgG4 (51.83 ± 27.26 mg/dL to 44.50 ± 26.05 mg/dL, P < 0.001) and interferon‐γ (277.99 ± 108.71 pg/mL to 45.05 ± 17.080 pg/mL, P = 0.03) concentrations. The suppressant effect of metformin was greatest on IgG4 (coefficient of variation 1.28), the dominant subclass of IgG involved in PV. Metformin could have immunomodulating effects on PV with controlling effects on steroid complications. [ABSTRACT FROM AUTHOR]

This paper describes the development of an approach for trajectory planning of cable-suspended parallel robots using optimal control approach. A prototype has been built, and tests have been carried out to verify the theoretical results. This paper briefly illustrates this device and presents some initial tests. The final dynamic equations are organized in a closed form similar to serial manipulator equations. Dynamic load-carrying capacity problem is converted into a trajectory optimization problem which is fundamentally a constrained nonlinear optimization problem. The problem is formulated using optimal control theory, and the ideas are analyzed using Pontryagin's minimum principle. The optimal solutions are found by solving the corresponding nonlinear two-point boundary value problems. The main objective is to find the manipulator load-carrying capacity in point-to-point task by considering actuator torque while cable forces are positive. [ABSTRACT FROM AUTHOR]