Predictive value of electrocardiographic patterns in localizing left ventricular asynergy in coronary artery disease.

Transmural myocardial infarction by ECG (ECG-MI) was correlated with left ventricular asynergy by biplane left cineventriculography in 200 patients with coronary artery disease. The ability of individual ECG-MI patterns to predict and correctly localize asynergy was: anterior--98 per cent (43 of 44), inferior--82 per cent (36 of 44), true posterior--73 per cent (11 of 15). Of various combinations of criteria for true posterior ECG-MI, the pattern of an R wave and upright T wave in Lead V1 was most predictive of posterior asynergy--80 per cent (8 of 10). The LAO projection demonstrated a wall motion abnormality not appreciated in the RAO in 8 per cent (10 of 122) of cases of inferoposterior asynergy and enhanced assessment of asynergy in 30 per cent (36 of 122) of cases. It is concluded that: (1) ECG-MI has a high predictive accuracy for left ventricular asynergy, (2) an R-wave and upright T wave in Lead V1 is the best ECG predictor of posterior asynergy, and (3) the LAO projection makes an important contribution to the assessment of regional asynergy in coronary artery dieseas.     

Mechanical and Tribological Behavior of Mechanically Alloyed Ni-TiC Composites Processed via Spark Plasma Sintering

Titanium carbide (TiC) reinforced nickel (Ni) matrix composites were processed via mechanical alloying (MA) followed by spark plasma sintering (SPS) process. Mechanical alloying has gained special attention as a powerful non-equilibrium process for fabricating amorphous and nanocrystalline materials, whereas spark plasma sintering (SPS) is a unique technique for processing dense and near net shape bulk alloys with homogenous microstructure. TiC reinforcement varied from 5 to 50 wt.% into nickel matrix to investigate its effect on the microstructure and mechanical behavior of Ni-TiC composites. All Ni-TiC composites powder was mechanically alloyed using planetary high energy ball mill with 400 rpm and ball to powder ratio (BPR) 15:1 for 24 h. Bulk Ni-TiC composites were then sintered via SPS process at 50 MPa pressure and 900–1200 °C temperature. All Ni-TiC composites exhibited higher microhardness and compressive strength than pure nickel due to the presence of homogeneously distributed TiC particles within the nickel matrix, matrix grain refinement, and excellent interfacial bonding between nickel and TiC reinforcement. There is an increase in Ni-TiC composites microhardness with an increase in TiC reinforcement from 5 to 50 wt.%, and it reaches the maximum value of 900 HV for Ni-50TiC composites.     

A Road Map to Foster Wellness and Engagement in Our Workplace—A Report of the 2018 Summer Intersociety Meeting

The 2018 radiology Intersociety Committee reviewed the current state of stress and burnout in our workplaces and identified approaches for fostering engagement, wellness, and job satisfaction. In addition to emphasizing the importance of personal wellness (the fourth aim of health care), the major focus of the meeting was to identify strategies and themes to mitigate the frequency, manifestations, and impact of stress. Strategies include reducing the stigma of burnout, minimizing isolation through community building and fostering connectivity, utilizing data and benchmarking to guide effectiveness of improvement efforts, resourcing and training “wellness” committees, acknowledging value contributions of team members, and improving efficiency in the workplace. Four themes were identified to prioritize organizational efforts: (1) collecting, analyzing, and benchmarking data; (2) developing effective leadership; (3) building high-functioning teams; and (4) amplifying our voice to increase our influence.     

Temporal Trends in Imaging Utilization for Suspected Substance Use Disorder in an Academic Emergency Radiology Department

PurposeTo assess temporal trends and utilization patterns of diagnostic imaging performed for substance use disorder (SUD)-related indications in an academic radiology emergency department (ED).MethodsRetrospective analyses of ED imaging examinations acquired from 2005 to 2015 were performed. Imaging examinations performed for suspected SUD-related indications, based on the order history, were compared with those without a SUD-related indication. Unadjusted analyses comparing demographic and imaging characteristics between SUD-related versus non-SUD-related indications used Wilcoxon and Pearson’s χ² tests. Multivariable logistic regression models, within each imaging modality subgroup and combined, were employed to examine the odds of imaging examinations having an SUD-related indication as a function of demographic and imaging characteristics.ResultsAmong 938,245 examinations, 0.17% had an SUD-related indication. Patients with SUD-related indications were younger (mean 37.2 ± 11.1 versus 53.5 ± 22.4, P < .001) and more commonly male (65% versus 52%, P < .001). The proportions of MR (17%), spine (17%), and extremities (33%) studies performed for SUD-related indications were larger among SUD than non-SUD indications (6%, 8%, 26%, respectively, all P < .001). Regression analysis demonstrated the odds of acquiring an ED imaging examination with an SUD-related indication significantly increased over time (P < .001, adjusted odds ratio [aOR] = 1.06), which was most pronounced among MR (P < .001, aOR = 1.23). For all regression models, younger age, male gender, and body part being imaged were identified as independent predictors of an SUD-related indication for ED imaging.ConclusionImaging performed for an SUD-related indication represented a small but increasing subset of overall ED imaging. Utilization of MR for SUD-related indications significantly outpaced growth of MR without SUD-related indications.     

大蒜素体外抗猴甲型轮状病毒的研究

目的  研究大蒜素体外抗猴甲型轮状病毒（SA11）的作用。方法  通过病毒滴度测定来确定大蒜素能否抗SA11以及最佳浓度。结果  大蒜素对MA104细胞的最大无毒浓度为100 mg/ml,病毒滴度测定可以得出,50 mg/ml的大蒜素可以抑制SA11感染的MA104细胞出现细胞病变效应（CPE）。结论  一定浓度的大蒜素在体外有抗SA11的作用。

     

Validity of Birth Certificate and Hospital Discharge Data Reporting of Labor Induction

Purpose

To examine the concordance of labor induction measures derived from birth certificate and hospital discharge data with each other and with maternal report.

The Association Between Social Engagement,Mild Cognitive Impairment,and Falls Among Older Primary Care Patients

ObjectivesTo examine associations between mild cognitive impairment (MCI) and falls among primary care patients, and to investigate whether social engagement (SE) modifies these associations.DesignCross sectional analysis using baseline data from an observational cohort study.SettingPrimary care.ParticipantsCommunity-dwelling older adults (N=430) at risk of mobility decline with a mean age of 76.6 years (range 65-96y).Main Outcome MeasuresThe number of falls in the past year was reported at the baseline interview. MCI was identified using a cutoff of 1.5 SD below the age-adjusted mean on at least 2 of the standardized cognitive performance tests. SE (eg, keeping in touch with friends and family, volunteering, participating social activities…) was assessed with the Late Life Function and Disability Instrument, and required a score above the median value 49.5 out of 100.ResultsMCI was present among 42% of participants and 42% reported at least 1 fall in the preceding year. Using generalized estimating equations, MCI was associated with a 77% greater rate of falls (P<.05). There was a statistically significant interaction between SE and MCI on the rate of falls (P<.01), such that at a high level of SE, MCI was not statistically associated with falls (P=.83). In participants with lower levels of SE, MCI is associated with 1.3 times greater rate of falls (P<.01).ConclusionsWhile MCI is associated with a greater risk for falls, higher levels of SE may play a protective role.