Function biomedical informatics research network recommendations for prospective multicenter functional MRI studies

This report provides practical recommendations for the design and execution of multicenter functional MRI (MC-fMRI) studies based on the collective experience of the Function Biomedical Informatics Research Network (FBIRN). The study was inspired by many requests from the fMRI community to FBIRN group members for advice on how to conduct MC-fMRI studies. The introduction briefly discusses the advantages and complexities of MC-fMRI studies. Prerequisites for MC-fMRI studies are addressed before delving into the practical aspects of carefully and efficiently setting up a MC-fMRI study. Practical multisite aspects include: (i) establishing and verifying scan parameters including scanner types and magnetic fields, (ii) establishing and monitoring of a scanner quality program, (iii) developing task paradigms and scan session documentation, (iv) establishing clinical and scanner training to ensure consistency over time, (v) developing means for uploading, storing, and monitoring of imaging and other data, (vi) the use of a traveling fMRI expert, and (vii) collectively analyzing imaging data and disseminating results. We conclude that when MC-fMRI studies are organized well with careful attention to unification of hardware, software and procedural aspects, the process can be a highly effective means for accessing a desired participant demographics while accelerating scientific discovery.     

Image informatics at a national research center.

Image informatics at the Communications Engineering Branch of the Lister Hill National Center for Biomedical Communications (LHNCBC), an R&D division of the National Library of Medicine (NLM), includes document and biomedical images. In both domains, research into computer-assisted methods for information extraction, and the implementation of prototype systems incorporating such methods, is central to our mission. Current document image research focuses on extracting bibliographic data from scanned journal articles. Current biomedical imaging work focuses on content-based image retrieval (CBIR) and related problems in segmentation, indexing, and classifying collections of images of the spine and of the uterine cervix.     

Transcranial oximetry as a new monitoring method for HEMS

Introduction: Transcranial oximetry (TCO) is a new method to measure continuous changes in brain blood oxygen saturation (rSO₂) by using near-infrared spectroscopy (NIRS). To our knowledge, no studies about TCO in air medical transport have been published.Methods: Twenty healthy volunteers (HEMS medical crew) were investigated during flight missions without patients. We measured oxygen saturation (SpO₂), cardiac rate, and rSO₂ with an INVOS 4100 Cerebral Oximeter^® at sea level and at each 1000 feet until we reached a flight level of 5000 feet.Results: The oximeter did not produce any interference with medical or aeronautical equipment. Subjects' SpO₂ showed a slight decrease with altitude (P<0.010), but rSO₂ remained constant (P=0.28), with little delay in the physiological correction of SpO₂ and rSO₂ values.Conclusion: TCO may play an important role in the development of new monitoring methods for critical patients in air medical transport. Further studies with large sample sizes and patients are necessary to generalize findings.     

Drop jumping as a training method for jumping ability

Vertical jumping ability is of importance for good performance in sports such as basketball and volleyball. Coaches are in need of exercises that consume only little time and still help to improve their players' jumping ability, without involving a high risk of injury. Drop jumping is assumed to satisfy these requirements. This assumption is supported by a review of results of training studies. However, it appears that regular jumping exercises can be just as helpful. The same holds for exercises with weights, provided the subjects have no weight-training history. In fact, for unskilled jumpers who have no weight-training history, the effects of training programmes utilising these different exercises are additive. The most effective, efficient and safe way for a coach to improve the jumping achievement of his athletes may well be to submit them first to a training programme utilising regular jumps, then to a weight-training programme and finally to a drop jump training programme. In drop jump training programmes themselves, the improvement in jumping height varies greatly among studies. This variation cannot be explained satisfactorily with the information available on subjects and training programmes. Given the current state of knowledge, coaches seem to have no other option than to strictly copy a programme which has proved to be very effective. Obviously there is a need for more systematic research of the relationship between design and effect of drop jump training programmes. The most important variable to be controlled is drop jumping technique. From a review of biomechanical studies of drop jumping, it becomes clear that jumping technique strongly affects the mechanical output of muscles. The biomechanics of 2 techniques are discussed. In the bounce drop jump the downward movement after the drop is reversed as soon as possible into an upward push-off, while in the countermovement drop jump this is done more gradually by increasing the amplitude of the downward movement after landing. It is speculated that the bounce drop jump might trigger improvement of the power output capacity of muscles, whereas the repetition of the countermovement drop jump may help to improve coordination. Future training studies are needed to determine whether drop jumping technique really affects the outcome of the training, and if so, which technique should be preferred. Also, further biomechanical research is needed to determine kinematics and kinetics of other drop jumping techniques, and to trace potential dangers. The author urges for a close cooperation between coaches and scientists in future research.     

How to write an original article for a biomedical journal

Writing a scientific article is difficult, but skillful writing does not depend only on talent. This skill can be learned, and writing requires discipline and dedication. This article discusses the basic characteristics of the IMRaD (Introduction, Material and methods, Results, and Discussion) format and the contents of each section, as well as the characteristics of the title, abstract, and bibliographical references. It also provides a list of five characteristics that are essential for an original article published in a scientific journal: objective, permission of the ethics committee, a structured material and methods section, results that follow appropriately from the material and methods section, and a structured discussion. Furthermore, we provide a basic outline for the discussion section consisting of stating the most important results, developing a critical discussion of the results, stating and discussing the strengths and limitations of the study, and elaborating the final synthesis.     

A prospective approach to correct for inter-image head rotation in FMRI

Global head motion occurring between successive image acquisitions during a functional MRI time series can corrupt the signal of physiologic brain activation, potentially invalidating interpretation of the final activation map from that particular fMRI time series. By approximating the head as a rigid body, multiaxial global head motion can be decomposed into orthogonal linear and rotational components. This paper describes a method using orbital navigator echoes to provide prospective correction for both through–plane and in–plane inter–image head rotation in functional MRI. The dynamic detection and correction of rotation can be performed in <100 ms. Phantom experiments demonstrate accurate correction of rotational motion over a range of ±0.36° to ±12°. Imaging studies in volunteers document the feasibility of real–time prospective correction of rotational motion in vivo. Using a modified receiver operating characteristic method, motion–corrected functional MRI sensorimotor studies incorporating deliberate head rotations are shown to be superior to functional MRI time series acquired under similar conditions but without motion correction.     

Exploring tapelifts as a method for dual workflow STR amplification

Although a version of direct PCR is implemented in forensic laboratories for reference material, its incorporation into workflow for the analysis of touch DNA, as a form of latent DNA, from casework exhibits is not. In addition to concerns about increased sensitivity causing more complex mixtures or the generation of more genetic data implicating an individual superfluous to the context of the alleged event, the complete use of the collected sample in the PCR as template has meant that there is no possibility for data reproducibility when needed. Here it is proposed that the use of tapelifts in touch DNA collection can facilitate replicate direct PCR analysis from a single sample allowing the sample to be re-tested. If all portions of the tapelift result in profiles with allelic and likelihood ratio concordance, these sub-samples may be accepted as technical replicates, thus meeting any accreditation guideline requirements. Furthermore, we assess the use of a single tapelift for both direct PCR and extraction-based PCR workflows to illustrate the potential for benefits of both systems to be facilitated. DNA was deposited by three donors onto six substrates with five sample replicates of each condition. Separation of each tapelift into three portions for three direct PCRs ensued using VeriFiler™ Plus. Separation of single tapelifts into three direct PCRs showed no statistical difference in donor allele calls or RFU, or subsequent LRs associated with their profiles. Comparison of profiles within the single tapelift showed more similarity, with high mixture-to-mixture match likelihoods, than when these sub-samples were compared with profiles generated from other samples. This allows each sub-sample taken from the tapelift to be considered as technical replicates. For dual workflow facilitation assessment, one donor deposited DNA through touch onto six substrates with five research replicates of each. Separation of single tapelifts into two portions, one for direct PCR and the retention and use of the remaining portion for extraction and subsequent PCR, showed no significant difference in allelic yield and subsequent donor comparison LRs. Comparison of deconvoluted profiles produced from a single tapelift showed high mixture-to-mixture match likelihoods, supporting DNA donor concordance. This indicates that removing a portion of a tapelift for direct PCR amplification, while processing the remainder through standard processes, allows increased sensitivity through direct PCR while offering the preparation of an eluate suitable for repeated analyses.     

Thermography as a quantitative imaging method for assessing postoperative inflammation

Objective

To assess differences in skin temperature between the operated and control side of the face after mandibular third molar surgery using thermography.

Methods

127 patients had 1 mandibular third molar removed. Before the surgery, standardized thermograms were taken of both sides of the patient''s face using a Flir ThermaCam™ E320 (Precisions Teknik AB, Halmstad, Sweden). The imaging procedure was repeated 2 days and 7 days after surgery. A region of interest including the third molar region was marked on each image. The mean temperature within each region of interest was calculated. The difference between sides and over time were assessed using paired t-tests.

Results

No significant difference was found between the operated side and the control side either before or 7 days after surgery (p > 0.3). The temperature of the operated side (mean: 32.39 °C, range: 28.9–35.3 °C) was higher than that of the control side (mean: 32.06 °C, range: 28.5–35.0 °C) 2 days after surgery [0.33 °C, 95% confidence interval (CI): 0.22–0.44 °C, p < 0.001]. No significant difference was found between the pre-operative and the 7-day post-operative temperature (p > 0.1). After 2 days, the operated side was not significantly different from the temperature pre-operatively (p = 0.12), whereas the control side had a lower temperature (0.57 °C, 95% CI: 0.29–0.86 °C, p < 0.001).

Conclusions

Thermography seems useful for quantitative assessment of inflammation between the intervention side and the control side after surgical removal of mandibular third molars. However, thermography cannot be used to assess absolute temperature changes due to normal variations in skin temperature over time.     

慧星电泳用于肿瘤细胞辐射敏感性检测的研究

目的：探讨彗星电泳方法检测肿瘤细胞对γ射线的辐射敏感性的可行性。方法：以自行设计的图像分析系统，用彗星电泳方法检测4种人肿瘤细胞受γ射线照射后细胞初始DNA损伤，以及细胞径30min修复时DNA损伤残余率；用细胞集落存活法检测2Gy γ射线照射后细胞存活率。结果：4种肿瘤细胞初始DNA损伤与辐射敏感性无关，2Gyγ射线照射后4种细胞存活率（SF2）与细胞经30min修复后的DNA损伤残余率相关明显（r=-0.87)，结论：本实验方法有可能成为一种快速、准确检测肿瘤细胞内在辐射敏感性的方法。     

Interdepartmental problem-solving as a method for teaching and learning systems-based practice

RATIONALE AND OBJECTIVES: Systems-based practice (SBP) has been the most difficult competency to implement in radiology residency programs, and methods for teaching and learning SBP concepts are needed. Because systems problems are usually multifactorial, a multidisciplinary approach is required. In our institution, survey data indicated patient dissatisfaction with emergency care. Prolonged wait times for radiology procedures were identified as a systems problem. When hospital administration asked the emergency medicine and radiology departments to work together to improve patient care, residents had a "real-world" opportunity to achieve the SBP competency. MATERIALS AND METHODS: Systems problems were identified and categorized. Data on patient transport were collected. Accurate time logs documenting when studies were ordered, performed, and interpreted were maintained. Data were analyzed at interdepartmental meetings and three improvements were planned and implemented. RESULTS: A direct line of communication was established between radiology and emergency medicine via a dedicated cellular telephone. A joint emergency medicine/radiology teaching conference was established. Additional transport personnel were employed. Residents in both departments increased their understanding of their role in the health care system, demonstrated an ability to identify systems problems and appropriately implement improvements, and enhanced their professional relationships. CONCLUSION: This innovative method integrated educational goals with patient care goals, was grounded in "real-life" experience, and held residents accountable for results. Competence in SBP, patient care, professionalism, and interpersonal and communication skills were demonstrated. We recommend this approach as an efficient and effective way to integrate SBP into everyday clinical practice.     

Supraselective embolization as a method for the management of renal vascular injuries

BACKGROUND: Renal injuries are most often caused by traumatic injuries, but they can also be induced iatrogenically, during renal biopsy, percutaneous nephrostomy or lithotripsy. Vascular renal injuries may be treated by embolization, non-surgical or surgical methods. CASE REPORT: In this paper we presented a high-risk patient with poor outcome of an open surgery threatment and a prior attempt of embolization, with gross haematuria caused by traumatic renal arterio-venous (AV) fistula and pyelocalical injury who was managed by supraselective embolization of the irrigating arterial vessel. CONCLUSION: Supraselective embolization is a first choice method for the treatment of low grade renal vessel injuries. Even patients with the most severe renovascular lesions and major renal destruction (a grade IV injury) can be treated nonsurgically with supraselective embolization, with an excellent chance to preserve the maximal amount of functional renal parenchyma. This method is rapid, effective, tissue preserving, and likely to reduce morbidity and mortality.