Miracle-dz/UniFAR-FTUs huggingface dataset:
In vivo lactate signal enhancement using binomial spectral‐selective pulses in selective MQ coherence (SS‐SelMQC) spectroscopy

Tumor vasculature and tissue oxygen pressure can influence tumor growth, metastases, and patient survival. Elevated levels of lactate may be observed during the process of aggressive tumor development accompanied by angiogenesis (the evolution of the microenvironment). The noninvasive MR detection of lactate in tumor tissues as a potential biomarker is difficult due to the presence of co‐resonating lipids that are present at high concentrations. Methods were previously reported for lactate editing using the SELective Multiple Quantum Coherence (SelMQC) method. Here we report a sequence “SS‐SelMQC,” Spectral‐Selective SelMQC, which is a modified version of SelMQC using binomial pulses. Binomial pulses were employed in this editing sequence for frequency excitation or inversion of selective lactate resonances. Lactate detection has been demonstrated using SS‐SelMQC, both in vitro (30 mM lactate/H2O doped with 25 μM Gd‐DTPA) and in vivo (Dunning R3337‐AT prostate tumors), and compared to similar measurements made with SelMQC. Lactate areas were measured from nonlocalized spectra, one‐dimensional (1D) localized spectra, and two‐dimensional chemical shift images (CSI) of the localized slice. In data from whole phantoms, the modified pulse sequence yielded enhancement of the lactate signal of 2.4 ± 0.40 times compared to SelMQC. Similar in vivo lactate signal enhancement of 2.3 ± 0.24 times was observed in 1D slice‐localized experiment. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
In vivo detection of serine in the human brain by proton magnetic resonance spectroscopy (1H‐MRS) at 7 Tesla

A single‐voxel proton magnetic resonance spectroscopy (1H‐MRS) filtering strategy for in vivo detection of serine (Ser) in human brain at 7T is proposed. Spectral difference of coupled resonances arising from different subecho times of triple refocusing at a constant total echo time (TE) was utilized to detect the Ser multiplet and cancel the overlapping creatine (Cr) 3.92‐ppm singlet via difference editing. Dependence of the Ser signal on subecho times was investigated using density‐matrix simulation incorporating the slice‐selective radio frequency (RF) pulses. The simulation indicated that the difference‐edited Ser CH2 multiplet at ∼3.96 ppm is maximized with (TE1, TE2, TE3) = (54, 78, 78) and (36, 152, 22) ms. The edited Ser peak amplitude was estimated, with both numerical and phantom analyses of the performance, as 83% with respect to 90° acquisition for a localized volume, ignoring relaxation effects. From the area ratio of the edited Ser and unedited Cr 3.03‐ppm peaks, assuming identical T1 and T2 between Ser and Cr, the Ser‐to‐Cr concentration ratio for the frontal cortex of healthy adults was estimated to be 0.8 ± 0.2 (mean ± SD; N = 6). Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
ACUTE PAIN & PERIOPERATIVE PAIN SECTION Original Research Articles Acute Pain Evaluation with Algoplus ® Scale in Cambodian Patients

Objective. Evaluation of acute pain in patients with language barriers is often difficult during humanitarian missions. Algoplus ® , a behavioral scale validated for acute pain evaluation in Caucasians with verbal communication difficulties, was tested during a clinical mission in Cambodia in patients admitted to hospital for acute pain. Methods. Patients (N = 33, 19 men and 14 women [38 ± 3 years old]) suffering from acute pain were admitted to Calmette Hospital, Phnom Penh, Cambodia during June 2010. Patients spoke Khmer only; a medical trainee who did no speak Khmer performed the Algoplus scale, and a bilingual Khmer pain specialist doctor asked the patient to score pain intensity on a numerical scale (0–10). The relevance of the scale and of each item (facial expression, complaints, look, body position, and atypical behavior yes/no) was studied. Internal consistency was assessed by Cronbach alpha analysis and convergent validity by correlation coefficient. The relationship between Algoplus items and pain intensity was analysed. Results. Pain intensity (6.3 ± 2.2) and Algoplus scores (2.1 ± 1.2) are correlated ( r = 0.61, P < 0.001): increases in Algoplus are correlated to increases in pain intensity. Internal consistency is 0.51, and scales comparison per item is signiﬁcant for facial expression ( P = 0.028) and complaints ( P = 0.005), but not for the other items. Conclusion. This feasibility study shows that despite a correlation with pain intensity, Algoplus may underestimate acute pain in this population. It is, however, an interesting tool for future studies to explore facial expression and complaints as proxies of pain in non-communicative patients.
Ex situ endorectal MRI probe for prostate imaging

A unique ex situ MRI probe, which examines samples external to its geometry, is presented. The probe is intended to be used for imaging the prostate gland via an endorectal pathway. It has a semicylindrical shape with a length of 6 cm and typical diameter of ∼3 cm. The probe's imaging field of view spans almost along its entire length and up to a distance of 2 cm away from its surface, with an angular sector of ∼90°. The detailed design of the probe is presented, followed by a set of representative results obtained by the current bench prototype of this system. Magn Reson Med, 2009. © 2009 Wiley‐Liss, Inc.
Nurses and Families: A Guide to Family Assessment and Intervention

-- Completely new to this edition and to family practice: how to do 15-minute family interviews in a variety of clinical settings-- The only practical and detailed "how-to" guide for the nursing of families-- Excellent in-depth clinical guide to nursing assessment and intervention with families, with clinical examples-- Updated and expanded Calgary Family Assessment Model-- Updated and revised Calgary Family Intervention Model-- Emphasizes diversity issues such as ethnicity, race, culture, sexual orientation, gender, and socioeconomic class in numerous clinical examples-- Supplies detailed clinical guidelines of how to prepare, conduct, and document a family interview
High‐resolution spiral imaging on a whole‐body 7T scanner with minimized image blurring

High‐resolution (∼0.22 mm) images are preferably acquired on whole‐body 7T scanners to visualize minianatomic structures in human brain. They usually need long acquisition time (∼12 min) in three‐dimensional scans, even with both parallel imaging and partial Fourier samplings. The combined use of both fast imaging techniques, however, leads to occasionally visible undersampling artifacts. Spiral imaging has an advantage in acquisition efficiency over rectangular sampling, but its implementations are limited due to image blurring caused by a strong off‐resonance effect at 7T. This study proposes a solution for minimizing image blurring while keeping spiral efficient. Image blurring at 7T was, first, quantitatively investigated using computer simulations and point‐spread functions. A combined use of multishot spirals and ultrashort echo time acquisitions was then employed to minimize off‐resonance‐induced image blurring. Experiments on phantoms and healthy subjects were performed on a whole‐body 7T scanner to show the performance of the proposed method. The three‐dimensional brain images of human subjects were obtained at echo time = 1.18 ms, resolution = 0.22mm (field of view = 220mm, matrix size = 1024), and in‐plane spiral shots = 128, using a home‐developed ultrashort echo time sequence (acquisition‐weighted stack of spirals). The total acquisition time for 60 partitions at pulse repetition time = 100 ms was 12.8 min without use of parallel imaging and partial Fourier sampling. The blurring in these spiral images was minimized to a level comparable to that in gradient‐echo images with rectangular acquisitions, while the spiral acquisition efficiency was maintained at eight. These images showed that spiral imaging at 7T was feasible. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Improved arterial spin labeling after myocardial infarction in mice using cardiac and respiratory gated look‐locker imaging with fuzzy C‐means clustering

Experimental myocardial infarction (MI) in mice is an important disease model, in part due to the ability to study genetic manipulations. MRI has been used to assess cardiac structural and functional changes after MI in mice, but changes in myocardial perfusion after acute MI have not previously been examined. Arterial spin labeling noninvasively measures perfusion but is sensitive to respiratory motion and heart rate variability and is difficult to apply after acute MI in mice. To account for these factors, a cardiorespiratory‐gated arterial spin labeling sequence using a fuzzy C‐means algorithm to retrospectively reconstruct images was developed. Using this method, myocardial perfusion was measured in remote and infarcted regions at 1, 7, 14, and 28 days post‐MI. Baseline perfusion was 4.9 ± 0.5 mL/g·min and 1 day post‐MI decreased to 0.9 ± 0.8 mL/g·min in infarcted myocardium (P < 0.05 versus baseline) while remaining at 5.2 ± 0.8 mL/g·min in remote myocardium. During the subsequent 28 days, perfusion in the remote zone remained unchanged, while a partial recovery of perfusion in the infarct zone was seen. This technique, when applied to genetically engineered mice, will allow for the investigation of the roles of specific genes in myocardial perfusion during infarct healing. Magn Reson Med 63:648–657, 2010. © 2010 Wiley‐Liss, Inc.
Susceptibility mapping in the human brain using threshold‐based k‐space division

A method for calculating quantitative three‐dimensional susceptibility maps from field measurements acquired using gradient echo imaging at high field is presented. This method is based on division of the three‐dimensional Fourier transforms of high‐pass‐filtered field maps by a simple function that is the Fourier transform of the convolution kernel linking field and susceptibility, and uses k‐space masking to avoid noise enhancement in regions where this function is small. Simulations were used to show that the method can be applied to data acquired from objects that are oriented at one angle or multiple angles with respect to the applied field and that the use of multiple orientations improves the quality of the calculated susceptibility maps. As part of this work, we developed an improved approach for high‐pass filtering of field maps, based on using an arrangement of dipoles to model the fields generated by external structures. This approach was tested on simulated field maps from the substantia nigra and red nuclei. Susceptibility mapping was successfully applied to experimental measurements on a structured phantom and then used to make measurements of the susceptibility of the red nuclei and substantia nigra in healthy subjects at 3 and 7 T. Magn Reson Med 63:1292–1304, 2010. © 2010 Wiley‐Liss, Inc.
The effect of cognitive load and patient race on physicians' decisions to prescribe opioids for chronic low back pain: a randomized trial.

OBJECTIVE To test the hypothesis that racial biases in opioid prescribing would be more likely under high levels of cognitive load, defined as the amount of mental activity imposed on working memory, which may come from environmental factors such as stressful conditions, chaotic workplace, staffing insufficiency, and competing demands, one's own psychological or physiological state, as well as from demands inherent in the task at hand. DESIGN Two (patient race: White vs Black) by two (cognitive load: low vs high) between-subjects factorial design. SETTING AND PARTICIPANTS Ninety-eight primary care physicians from the Veterans Affairs Healthcare System. METHODS Web-based experimental study. Physicians were randomly assigned to read vignettes about either a Black or White patient, under low vs high cognitive load, and to indicate their likelihood of prescribing opioids. High cognitive load was induced by having physicians perform a concurrent task under time pressure. RESULTS There was a three-way interaction between patient race, cognitive load, and physician gender on prescribing decisions (P = 0.034). Hypotheses were partially confirmed. Male physicians were less likely to prescribe opioids for Black than White patients under high cognitive load (12.5% vs 30.0%) and were more likely to prescribe opioids for Black than White patients under low cognitive load (30.8% vs 10.5%). By contrast, female physicians were more likely to prescribe opioids for Black than White patients in both conditions, with greater racial differences under high (39.1% vs 15.8%) vs low cognitive load (28.6% vs 21.7%). CONCLUSIONS Physician gender affected the way in which patient race and cognitive load influenced decisions to prescribe opioids for chronic pain. Future research is needed to further explore the potential effects of physician gender on racial biases in pain treatment, and the effects of physician cognitive load on pain treatment.
Impact of Question Content on e-Consultation Outcomes.

BACKGROUND By facilitating direct communication of primary care providers (PCPs) with specialists for advice, electronic consult (e-consult) services can reduce the need for patients to wait for and travel to face-to-face consultations with specialists. An association between avoiding face-to-face referrals using an e-consult service and specific content within each e-consult has not been rigorously explored. MATERIALS AND METHODS Cases submitted to the Champlain Building Access to Specialists through eConsultation service between April 2011 to May 2013 were evaluated. Factors analyzed include question type (e.g., diagnosis or management), formulation (if interventions or outcomes were specified), and the addressed specialty. An avoided referral was present if the PCP indicated so in a mandatory close-out survey. A discrepancy was present if the PCP made a referral when the specialist did not indicate one was necessary, or if the PCP did not request a referral despite the specialist recommending one. RESULTS There were 426 (40%) avoided referrals among 1,055 cases analyzed. Questions associated with the highest avoided referral rates included ones pertaining to diagnosis (44%), nonspecific requests for direction (44%), questions without specified interventions or outcomes (47%), and dermatology cases (49.5%). Specialists agreed on the need for a referral in 82% of cases, with most discrepancies due to the PCP making a referral without the specialist recommending one. CONCLUSIONS Referral outcomes are associated with the type of question being asked, the formulation of each question, and the specialty being addressed. Discrepancies among PCPs and specialists regarding which patients require face-to-face referrals may help identify knowledge gaps and guide professional development.
Intracellular bimodal nanoparticles based on quantum dots for high‐field MRI at 21.1 T

Multimodal, biocompatible contrast agents for high magnetic field applications represent a new class of nanomaterials with significant potential for tracking of fluorescence and MR in vitro and vivo. Optimized for high‐field MR applications—including biomedical imaging at 21.1 T, the highest magnetic field available for MRI—these nanoparticles capitalize on the improved performance of chelated Dy3+ with increasing magnetic field coupled to a noncytotoxic Indium Phosphide/Zinc Sulfide (InP/ZnS) quantum dot that provides fluorescence detection, MR responsiveness, and payload delivery. By surface modifying the quantum dot with a cell‐penetrating peptide sequence coupled to an MR contrast agent, the bimodal nanomaterial functions as a self‐transfecting high‐field MR/optical contrast agent for nonspecific intracellular labeling. Fluorescent images confirm sequestration in perinuclear vesicles of labeled cells, with no apparent cytotoxicity. These techniques can be extended to impart cell selectivity or act as a delivery vehicle for genetic or pharmaceutical interventions. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
A graph‐based approach for automatic cardiac tractography

A new automatic algorithm for assessing fiber‐bundle organization in the human heart using diffusion‐tensor magnetic resonance imaging is presented. The proposed approach distinguishes from the locally “greedy” paradigm, which uses voxel‐wise seed initialization intrinsic to conventional tracking algorithms. It formulates the fiber tracking problem as the global problem of computing paths in a boolean‐weighted undirected graph, where each voxel is a vertex and each pair of neighboring voxels is connected with an edge. This leads to a global optimization task that can be solved by iterated conditional modes‐like algorithms or Metropolis‐type annealing. A new deterministic optimization strategy, namely iterated conditional modes with α‐relaxation using (t2)‐ and (t4)‐moves, is also proposed; it has similar performance to annealing but offers a substantial computational gain. This approach offers some important benefits. The global nature of our tractography method reduces sensitivity to noise and modeling errors. The discrete framework allows an optimal balance between the density of fiber bundles and the amount of available data. Besides, seed points are no longer needed; fibers are predicted in one shot for the whole diffusion‐tensor magnetic resonance imaging volume, in a completely automatic way. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Answering engineers' questions using semantic annotations

Question–answering (QA) systems have proven to be helpful, especially to those who feel uncomfortable entering keywords, sometimes extended with search symbols such as +, *, and so forth. In developing such systems, the main focus has been on the enhanced retrieval performance of searches, and recent trends in QA systems center on the extraction of exact answers. However, when their usability was evaluated, some users indicated that they found it difficult to accept the answers because of the absence of supporting context and rationale. Current approaches to address this problem include providing answers with linking paragraphs or with summarizing extensions. Both methods are believed to be sufficient to answer questions seeking the names of objects or quantities that have only a single answer. However, neither method addresses the situation when an answer requires the comparison and integration of information appearing in multiple documents or in several places in a single document. This paper argues that coherent answer generation is crucial for such questions, and that the key to this coherence is to analyze texts to a level beyond sentence annotations. To demonstrate this idea, a prototype has been developed based on rhetorical structure theory, and a preliminary evaluation has been carried out. The evaluation indicates that users prefer to see the extended answers that can be generated using such semantic annotations, provided that additional context and rationale information are made available.
Echo planar correlated spectroscopic imaging: Implementation and pilot evaluation in human calf in vivo

Exploiting the speed benefits of echo‐planar imaging (EPI), the echo‐planar spectroscopic imaging (EPSI) sequence facilitates recording of one spectral and two to three spatial dimensions faster than the conventional magnetic resonance spectroscopic imaging (MRSI). A novel four dimensional (4D) echo‐planar correlated spectroscopic imaging (EP‐COSI) was implemented on a whole body 3 T MRI scanner combining two spectral with two spatial encodings. Similar to EPSI, the EP‐COSI sequence used a bipolar spatial read‐out train facilitating simultaneous spatial and spectral encoding, and the conventional phase and spectral encodings for the other spatial and indirect spectral dimensions, respectively. Multiple 2D correlated spectroscopy (COSY) spectra were recorded over the spatially resolved volume of interest (VOI) localized by a train of three slice‐selective radiofrequency (RF) pulses (90°–180°–90°). After the initial optimization using phantom solutions, the EP‐COSI data were recorded from the lower leg of eight healthy volunteers including one endurance trained volunteer. Pilot results showed acceptable spatial and spectral quality achievable using the EP‐COSI sequence. There was a detectable separation of cross peaks arising from the skeletal muscle intramyocellular lipids (IMCLs) and extramyocellular lipids (EMCLs) saturated and unsaturated pools. Residual dipolar interaction between the N‐methylene and N‐methyl protons of creatine/phosphocreatine (Cr/PCr) was also observed in the tibialis anterior region. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
In vivo observation of intracellular oximetry in perfluorocarbon‐labeled glioma cells and chemotherapeutic response in the CNS using fluorine‐19 MRI

Preclinical development of therapeutic agents against cancer could greatly benefit from noninvasive markers of tumor killing. Potentially, the intracellular partial pressure of oxygen (pO2) can be used as an early marker of antitumor efficacy. Here, the feasibility of measuring intracellular pO2 of central nervous system glioma cells in vivo using 19F magnetic resonance techniques is examined. Rat 9L glioma cells were labeled with perfluoro‐15‐crown‐5‐ether ex vivo and then implanted into the rat striatum. 19F MRI was used to visualize tumor location in vivo. The mean 19F T1 of the implanted cells was measured using localized, single‐voxel spectroscopy. The intracellular pO2 in tumor cells was determined from an in vitro calibration curve. The basal pO2 of 9L cells (day 3) was determined to be 45.3 ± 5 mmHg (n = 6). Rats were then treated with a 1× LD10 dose of bischloroethylnitrosourea intravenously and changes in intracellular pO2 were monitored. The pO2 increased significantly (P = 0.042, paired T‐test) to 141.8 ± 3 mmHg within 18 h after bischloroethylnitrosourea treatment (day 4) and remained elevated (165 ± 24 mmHg) for at least 72 h (day 6). Intracellular localization of the perfluoro‐15‐crown‐5‐ether emulsion in 9L cells before and after bischloroethylnitrosourea treatment was confirmed by histological examination and fluorescence microscopy. Overall, noninvasive 19F magnetic resonance techniques may provide a valuable preclinical tool for monitoring therapeutic response against central nervous system or other deep‐seated tumors. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.
Sweep MRI with algebraic reconstruction

In the recently proposed technique Sweep Imaging with Fourier Transform (SWIFT), frequency‐modulated radiofrequency pulses are used in concert with simultaneous acquisition to facilitate MRI of samples with very short transverse relaxation time. In the present work, sweep MRI is reviewed from a reconstruction perspective and several extensions and modifications of the current methodology are proposed. An algorithm for algebraic image reconstruction is derived from a comprehensive description of signal formation, including interleaved radiofrequency transmission and acquisition of arbitrary timing as well as the relevant filtering and decimation steps along the receiver chain. The new reconstruction approach readily permits several measures of optimising the signal sampling strategy as demonstrated in simulations and imaging experiments. Employing a variety of radiofrequency pulse envelopes, water and rubber phantoms as well as bone samples with transverse relaxation time in the order of 500 μsec were imaged at signal bandwidths of up to 96 kHz. Magn Reson Med, 2010. © 2010 Wiley‐Liss, Inc.