Pulse sequence extrapolation with MR image synthesis

Previous reports have presented validation studies of magnetic resonance (MR) image synthesis in which multiple spin-echo (MSE) source data were used to generate spin-echo images for various echo times and repetition times (TRs). A new method-"pulse sequence extrapolation" -synthesizes images for pulse sequences different from that of the acquisition. MSE data acquired in a time equivalent to a TR of 2,000 msec can be used to generate inversion-recovery (IR) images for arbitrarily chosen TI inversion times. Other combinations of pulse sequences were also studied, and synthetic images were compared visually and quantitatively to directly acquired images with corresponding parameters. Synthetic IR signals of the brain parenchyma consistently matched directly acquired signals to within 6%, with respect to the full magnetization signal. The noise level of synthetic signals was generally no more than twice that of direct acquisition signals, as predicted. This method can achieve selective fat suppression and enhancement in IR imaging.     

A dialectical analysis of an art of dental hygiene practice

Abstract: Objective: There has been little in the literature to date that speaks of an art of dental hygiene compared to science. Yet, science, conceived as the findings from research, does not apply itself; it is the knowledge, judgement and skill of practitioners to apply these findings in a particular setting that, at its highest level, informs artful dental hygiene practice. The purpose of this paper is to question whether an art of dental hygiene exists, if it is important, and how it relates to science. Methods: The method used in the analysis contained in this paper is a dialectical approach used to examine contrary positions, i.e. whether art exists or does not exist, by outlining the structure of each position and clarifying explicit and implicit similarities and dissimilarities. A framework of conceptualizations of art from nursing has been used to examine dental hygiene literature for evidence of art. Results: A preliminary conceptualization, substantiated within dental hygiene, sees the art of dental hygiene as abilities to grasp meaning in client encounters, establish meaningful connections with clients, perform dental hygiene actions skillfully and proficiently, rationally determine courses of dental hygiene action, and conduct dental hygiene practice morally and ethically. Conclusions: That an art of dental hygiene exists is not in doubt and the analysis is presented. To understand better how dental hygienists make practice decisions to develop this process to its optimum – the pursuit of perfection and excellence in dental hygiene practice, we must pursue understanding the art of dental hygiene practice.     

The roles of the first‐line nurse manager: perceptions from four perspectives

Aim To study the perception of the first‐line nurse managers (FLNMs), registered nurses (RNs), assistant nurses (ANs) and head of departments (HDs) on the FLNM's current and desired roles. Background In the process of decentralization, the role of FLNM has changed from having overall responsibility for patients to having responsibility for the management of the ward. Method Interviews with five FLNMs, five RNs, five ANs, and one HD were used. Qualitative content analysis was used to analyse the transcribed text. Results When describing the current roles, the FLNMs, RNs and ANs focused on the coordination of activities that contributed to a well‐functioning service and care of patients as well as on the recruitment of, support to and development of the personnel. The HD focused on the FLNM's responsibilities towards the personnel, especially regarding empowerment and staff well‐being. When describing desired roles, the FLNMs, RNs and ANs emphasized service on the ward while the HD underlined the development of services and co‐operation with other nurse managers. Conclusion The perception of the current and desired roles of the FLNM varied among the groups. The FLNMs, RNs and ANs reported a similar understanding which in turn differed from that of the HD who described fewer roles and focused on other areas.     

Axillary and subclavian vein stenosis: percutaneous angioplasty

Twenty-nine percutaneous balloon dilations of the axillary and subclavian veins were performed in 19 patients. Stenoses occurred in typical locations of anatomic narrowing or at sites of previous trauma. The initial success rate was 76%, with a 1-year patency rate of 35% and a 2-year patency rate of 6%. Angioplasty can be performed on an outpatient basis with a very low rate of significant complications and can be repeated numerous times to keep a vein patent for many years. This procedure is especially valuable in dialysis patients who have limited access sites.     

Red cell alterations associated with virucidal methylene blue phototreatment

Several red cell storage properties were evaluated following phototreatment with methylene blue (MB) under conditions that inactivated > or = 6 log10 of added vesicular stomatitis virus. Red cell 2,3 DPG levels were similar to untreated controls throughout conventional 42-day storage at 4 degrees C. Plasma hemoglobin levels were elevated approximately twofold in MB-phototreated samples, and morphology scores were 5 percent lower after 42-day storage. ATP levels declined 30 percent in phototreated samples and in a control sample containing MB and not exposed to light. Lipid peroxidation was not observed in treated or control cells, nor were differences observed in sodium dodecyl sulfate-polyacrylamide gel electrophoresis of ghost membranes derived from phototreated and control samples. Phototreated cells exhibited enhanced ion permeability; sodium and potassium levels approached equilibrium with the suspending medium within 4 to 7 days after treatment. Direct agglutination tests using rabbit anti-human IgG or rabbit anti-human serum albumin on MB-phototreated cells indicated that serum proteins had absorbed to the surface of treated red cells. Plasma depletion by washing red cells prior to phototreatment did not prevent protein binding upon subsequent addition of untreated autologous or group AB plasma. To a much smaller extent, phototreatment of plasma resulted in IgG association with untreated red cells. The addition of glutathione to red cell suspensions prevented IgG binding to phototreated red cells but did not prevent enhanced ion permeability. Taken together, these data suggest that the red cell surface is altered by virucidal MB phototreatment of vesicular stomatitis virus.