Sample records for clinical registration studies

  1. Clinical trial registration in physical therapy journals: a cross-sectional study. (United States)

    Babu, Abraham Samuel; Veluswamy, Sundar Kumar; Rao, Pratiksha Tilak; Maiya, Arun G


    Clinical trial registration has become an important part of editorial policies of various biomedical journals, including a few physical therapy journals. However, the extent to which editorial boards enforce the need for trial registration varies across journals. The purpose of this study was to identify editorial policies and reporting of trial registration details in MEDLINE-indexed English-language physical therapy journals. This study was carried out using a cross-sectional design. Editorial policies on trial registration of MEDLINE-indexed member journals of the International Society of Physiotherapy Journal Editors (ISPJE) (Journal of Geriatric Physical Therapy, Journal of Hand Therapy, Journal of Neurologic Physical Therapy, Journal of Orthopaedic and Sports Physical Therapy, Journal of Physiotherapy [formerly Australian Journal of Physiotherapy], Journal of Science and Medicine in Sport, Manual Therapy, Physical Therapy, Physical Therapy in Sport, Physiotherapy, Physiotherapy Research International, Physiotherapy Theory and Practice, and Revista Brasileira de Fisioterapia) were reviewed in April 2013. Full texts of reports of clinical trials published in these journals between January 1, 2008, and December 31, 2012, were independently assessed for information on trial registration. Among the 13 journals, 8 recommended trial registration, and 6 emphasized prospective trial registration. As of April 2013, 4,618 articles were published between January 2008 and December 2012, of which 9% (417) were clinical trials and 29% (121/417) of these reported trial registration details. A positive trend in reporting of trial registration was observed from 2008 to 2012. The study was limited to MEDLINE-indexed ISPJE member journals. Editorial policies on trial registration of physical therapy journals and a rising trend toward reporting of trial registration details indicate a positive momentum toward trial registration. Physical therapy journal editors need to show

  2. Registration practices for observational studies on indicated low adherence. (United States)

    Boccia, Stefania; Rothman, Kenneth J; Panic, Nikola; Flacco, Maria Elena; Rosso, Annalisa; Pastorino, Roberta; Manzoli, Lamberto; La Vecchia, Carlo; Villari, Paolo; Boffetta, Paolo; Ricciardi, Walter; Ioannidis, John P A


    The study aims to assess the status of registration of observational studies. We identified studies on cancer research with prospective recruitment of participants that were registered from February 2000 to December 2011 in We recorded the dates of registration and start of recruitment, outcomes, and description of statistical method. We searched for publications corresponding to the registered studies through May 31, 2014. One thousand one hundred nine registered studies were eligible. Primary and secondary outcomes were reported in 809 (73.0%) and 464 (41.8%) of them. The date of registration preceded the month of the study start in 145 (13.8%) and coincided in 205 (19.5%). A total of 151 publications from 120 (10.8%) registered studies were identified. In 2 (33.3%) of the 6 publications where reported that the study started recruitment after registration, and in 9 (50.0%) of 18 publications where reported the same date for registration and start of recruitment, the articles showed that the study had actually started recruiting before registration. During the period reviewed, few observational studies have been registered. Registration usually occurred after the study started, and prespecification of outcomes and statistical analysis rarely occurred. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Surface-based facial scan registration in neuronavigation procedures: a clinical study. (United States)

    Shamir, Reuben R; Freiman, Moti; Joskowicz, Leo; Spektor, Sergey; Shoshan, Yigal


    Surface-based registration (SBR) with facial surface scans has been proposed as an alternative for the commonly used fiducial-based registration in image-guided neurosurgery. Recent studies comparing the accuracy of SBR and fiducial-based registration have been based on a few targets located on the head surface rather than inside the brain and have yielded contradictory conclusions. Moreover, no visual feedback is provided with either method to inform the surgeon about the estimated target registration error (TRE) at various target locations. The goals in the present study were: 1) to quantify the SBR error in a clinical setup, 2) to estimate the targeting error for many target locations inside the brain, and 3) to create a map of the estimated TRE values superimposed on a patient's head image. The authors randomly selected 12 patients (8 supine and 4 in a lateral position) who underwent neurosurgery with a commercial navigation system. Intraoperatively, scans of the patients' faces were acquired using a fast 3D surface scanner and aligned with their preoperative MR or CT head image. In the laboratory, the SBR accuracy was measured on the facial zone and estimated at various intracranial target locations. Contours related to different TREs were superimposed on the patient's head image and informed the surgeon about the expected anisotropic error distribution. The mean surface registration error in the face zone was 0.9 +/- 0.35 mm. The mean estimated TREs for targets located 60, 105, and 150 mm from the facial surface were 2.0, 3.2, and 4.5 mm, respectively. There was no difference in the estimated TRE between the lateral and supine positions. The entire registration procedure, including positioning of the scanner, surface data acquisition, and the registration computation usually required registration accuracy is better in the face and frontal zones, and error increases as the target location lies further from the face. Visualization of the anisotropic TRE

  4. Registration of randomized clinical trials

    DEFF Research Database (Denmark)

    Østervig, R M; Sonne, A; Rasmussen, L S


    BACKGROUND: Registration of interventional studies is necessary according to the Declaration of Helsinki but implementation has been a challenge for many journals. Acta Anaesthesiologica Scandinavica (Acta) requires registration for studies conducted after January 1(st) 2010. We aimed to assess...... registered when it could be verified that patient enrolment was started after registration in a trial registry. RESULTS: We identified 200 RCTs. Dates for patient enrolment were not specified in 51 (25.5%). The proportion of correctly registered trials increased significantly from 17.1% (19/111) for trials...

  5. Localization and registration accuracy in image guided neurosurgery: a clinical study. (United States)

    Shamir, Reuben R; Joskowicz, Leo; Spektor, Sergey; Shoshan, Yigal


    To measure and compare the clinical localization and registration errors in image-guided neurosurgery, with the purpose of revising current assumptions. Twelve patients who underwent brain surgeries with a navigation system were randomly selected. A neurosurgeon localized and correlated the landmarks on preoperative MRI images and on the intraoperative physical anatomy with a tracked pointer. In the laboratory, we generated 612 scenarios in which one landmark pair was defined as the target and the remaining ones were used to compute the registration transformation. Four errors were measured: (1) fiducial localization error (FLE); (2) target registration error (TRE); (3) fiducial registration error (FRE); (4) Fitzpatrick's target registration error estimation (F-TRE). We compared the different errors and computed their correlation. The image and physical FLE ranges were 0.5-2.0 and 1.6-3.0 mm, respectively. The measured TRE, FRE and F-TRE were 4.1 +/- 1.6, 3.9 +/- 1.2, and 3.7 +/- 2.2 mm, respectively. Low correlations of 0.19 and 0.37 were observed between the FRE and TRE and between the F-TRE and the TRE, respectively. The differences of the FRE and F-TRE from the TRE were 1.3 +/- 1.0 mm (max = 5.5 mm) and 1.3 +/- 1.2 mm (max = 7.3 mm), respectively. Contrary to common belief, the FLE presents significant variations. Moreover, both the FRE and the F-TRE are poor indicators of the TRE in image-to-patient registration.

  6. Construction of ethics in clinical research: clinical trials registration

    Directory of Open Access Journals (Sweden)

    C. A. Caramori


    Full Text Available Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials and scientific publications (selective, manipulated and with wrong conclusions led to an inappropriate clinical practice, favoring the involved economic aspect. In 2005, the International Committee of Medical Journal Editors (ICMJE, supported by the World Association of Medical Editors, started demanding as a requisite for publication that all clinical trials be registered at the database In 2006, the World Health Organization (WHO created the International Clinical Trial Registry Platform (ICTRP, which gathers several registry centers from all over the world, and required that all researchers and pharmaceutical industries register clinical trials. Such obligatory registration has progressed and will extend to all scientific journals indexed in all worldwide databases. Registration of clinical trials means another step of clinical research towards transparency, ethics and impartiality, resulting in real evidence to the forthcoming changes in clinical practice as well as in the health situation.

  7. Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration.

    Directory of Open Access Journals (Sweden)

    Amelia Scott

    Full Text Available To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which articles published in psychiatry journals adhering to ICMJE guidelines were correctly prospectively registered, whether there was evidence of selective outcome reporting and changes to participant numbers, and whether there was a relationship between registration status and source of funding.Any clinical trial (as defined by ICMJE published between 1 January 2009 and 31 July 2013 in the top five psychiatry journals adhering to ICMJE guidelines (The American Journal of Psychiatry, Archives of General Psychiatry/JAMA Psychiatry, Biological Psychiatry, Journal of the American Academy of Child and Adolescent Psychiatry, and The Journal of Clinical Psychiatry and conducted after July 2005 (or 2007 for two journals was included. For each identified trial, where possible we extracted trial registration information, changes to POMs between publication and registry to assess selective outcome reporting, changes to participant numbers, and funding type.Out of 3305 articles, 181 studies were identified as clinical trials requiring registration: 21 (11.6% were deemed unregistered, 61 (33.7% were retrospectively registered, 37 (20.4% had unclear POMs either in the article or the registry and 2 (1.1% were registered in an inaccessible trial registry. Only 60 (33.1% studies were prospectively registered with clearly defined POMs; 17 of these 60 (28.3% showed evidence of selective outcome reporting and 16 (26.7% demonstrated a change in participant numbers of 20% or more; only 26 (14

  8. Registration of clinical trials: Is it really needed?

    Directory of Open Access Journals (Sweden)

    Ameer Aslam


    Full Text Available Background and Aims: Withholding findings of clinical trials for publication or presentation to the regulatory authorities is a major concern. We aimed to address the importance of clinical trial registration and whether it is needed or not. Discussion: For ethical conduct of clinical trial, registration is an important but debatable issue due to proprietary interest of the pharmaceutical industry. Over the years, investigating agencies uncovered several instances of misconduct during the clinical trial. The International committee of medical journal editors requires registration of trial methodology, but does not require registration of trial results; however, the U.S. Food and Drug Administration Amendments does require researchers to register results. Conclusion: Prospective registration of clinical trial is mandatory for more transparent research and sustaining the validity of evidence based practice and availability of reliable data. Clinical trials registration has the potential to contribute substantially to improve clinical trial transparency and reducing publication bias and selective reporting.

  9. The quality of registration of clinical trials: still a problem.

    Directory of Open Access Journals (Sweden)

    Roderik F Viergever

    Full Text Available INTRODUCTION: The benefits of clinical trials registration include improved transparency on clinical trials for healthcare workers and patients, increased accountability of trialists, the potential to address publication bias and selective reporting, and possibilities for research collaboration and prioritization. However, poor quality of information in registered records of trials has been found to undermine these benefits in the past. Trialists' increasing experience with trial registration and recent developments in registration systems may have positively affected data quality. This study was conducted to investigate whether the quality of registration has improved. METHODS: We repeated a study from 2009, using the same methods and the same research team. A random sample of 400 records of clinical trials that were registered between 01/01/2012 and 01/01/2013 was taken from the International Clinical Trials Registry Platform (ICTRP and assessed for the quality of information on 1 contact details, 2 interventions and 3 primary outcomes. Results were compared to the equivalent assessments from our previous study. RESULTS: There was a small and not statistically significant increase from 81.0% to 85.5% in the percentage of records that provided a name of a contact person. There was a significant increase from 68.7% to 74.9% in the number of records that provided either an email address or a telephone number. There was a significant increase from 44.2% to 51.9% in the number of intervention arms that were complete in registering intervention specifics. There was a significant increase from 38.2% to 57.6% in the number of primary outcomes that were specific measures with a meaningful timeframe. Approximately half of all trials continued to be retrospectively registered. DISCUSSION: There have been small but significant improvements in the quality of registration since 2009. Important problems with quality remain and continue to constitute an

  10. Clinical trial registration in oral health journals. (United States)

    Smaïl-Faugeron, V; Fron-Chabouis, H; Durieux, P


    Prospective registration of randomized controlled trials (RCTs) represents the best solution to reporting bias. The extent to which oral health journals have endorsed and complied with RCT registration is unknown. We identified journals publishing RCTs in dentistry, oral surgery, and medicine in the Journal Citation Reports. We classified journals into 3 groups: journals requiring or recommending trial registration, journals referring indirectly to registration, and journals providing no reference to registration. For the 5 journals with the highest 2012 impact factors in each group, we assessed whether RCTs with results published in 2013 had been registered. Of 78 journals examined, 32 (41%) required or recommended trial registration, 19 (24%) referred indirectly to registration, and 27 (35%) provided no reference to registration. We identified 317 RCTs with results published in the 15 selected journals in 2013. Overall, 73 (23%) were registered in a trial registry. Among those, 91% were registered retrospectively and 32% did not report trial registration in the published article. The proportion of trials registered was not significantly associated with editorial policies: 29% with results in journals that required or recommended registration, 15% in those that referred indirectly to registration, and 21% in those providing no reference to registration (P = 0.05). Less than one-quarter of RCTs with results published in a sample of oral health journals were registered with a public registry. Improvements are needed with respect to how journals inform and require their authors to register their trials.

  11. Towards clinical implementation of ultrafast combined kV-MV CBCT for IGRT of lung cancer. Evaluation of registration accuracy based on phantom study

    Energy Technology Data Exchange (ETDEWEB)

    Arns, Anna; Blessing, Manuel; Fleckenstein, Jens; Stsepankou, Dzmitry; Boda-Heggemann, Judit; Simeonova-Chergou, Anna; Hesser, Juergen; Lohr, Frank; Wenz, Frederik; Wertz, Hansjoerg [University Medical Center Mannheim, University of Heidelberg, Department of Radiation Oncology, Mannheim (Germany)


    Combined kV-MV cone-beam CT (CBCT) is a promising approach to accelerate imaging for patients with lung tumors treated with deep inspiration breath-hold. During a single breath-hold (15 s), a 3D kV-MV CBCT can be acquired, thus minimizing motion artifacts and increasing patient comfort. Prior to clinical implementation, positioning accuracy was evaluated and compared to clinically established imaging techniques. An inhomogeneous thorax phantom with four tumor-mimicking inlays was imaged in 10 predefined positions and registered to a planning CT. Novel kV-MV CBCT imaging (90 arc) was compared to clinically established kV-chest CBCT (360 ) as well as nonclinical kV-CBCT and low-dose MV-CBCT (each 180 ). Manual registration, automatic registration provided by the manufacturer and an additional in-house developed manufacturer-independent framework based on the MATLAB registration toolkit were applied. Systematic setup error was reduced to 0.05 mm by high-precision phantom positioning with optical tracking. Stochastic mean displacement errors were 0.5 ± 0.3 mm in right-left, 0.4 ± 0.4 mm in anteroposterior and 0.0 ± 0.4 mm in craniocaudal directions for kV-MV CBCT with manual registration (maximum errors of no more than 1.4 mm). Clinical kV-chest CBCT resulted in mean errors of 0.2 mm (other modalities: 0.4-0.8 mm). Similar results were achieved with both automatic registration methods. The comparison study of repositioning accuracy between novel kV-MV CBCT and clinically established volume imaging demonstrated that registration accuracy is maintained below 1 mm. Since imaging time is reduced to one breath-hold, kV-MV CBCT is ideal for image guidance, e.g., in lung stereotactic ablative radiotherapy. (orig.) [German] Kombiniertes kV-MV-Cone-Beam-CT (CBCT) ist ein vielversprechender Ansatz zur Beschleunigung der Bildgebung bei Patienten mit Lungentumoren, die mit wiederholter Atemanhaltetechnik in tiefer Inspiration behandelt werden. Waehrend einer einzigen

  12. Serial volumetric registration of pulmonary CT studies (United States)

    Silva, José Silvestre; Silva, Augusto; Sousa Santos, Beatriz


    Detailed morphological analysis of pulmonary structures and tissue, provided by modern CT scanners, is of utmost importance as in the case of oncological applications both for diagnosis, treatment, and follow-up. In this case, a patient may go through several tomographic studies throughout a period of time originating volumetric sets of image data that must be appropriately registered in order to track suspicious radiological findings. The structures or regions of interest may change their position or shape in CT exams acquired at different moments, due to postural, physiologic or pathologic changes, so, the exams should be registered before any follow-up information can be extracted. Postural mismatching throughout time is practically impossible to avoid being particularly evident when imaging is performed at the limiting spatial resolution. In this paper, we propose a method for intra-patient registration of pulmonary CT studies, to assist in the management of the oncological pathology. Our method takes advantage of prior segmentation work. In the first step, the pulmonary segmentation is performed where trachea and main bronchi are identified. Then, the registration method proceeds with a longitudinal alignment based on morphological features of the lungs, such as the position of the carina, the pulmonary areas, the centers of mass and the pulmonary trans-axial principal axis. The final step corresponds to the trans-axial registration of the corresponding pulmonary masked regions. This is accomplished by a pairwise sectional registration process driven by an iterative search of the affine transformation parameters leading to optimal similarity metrics. Results with several cases of intra-patient, intra-modality registration, up to 7 time points, show that this method provides accurate registration which is needed for quantitative tracking of lesions and the development of image fusion strategies that may effectively assist the follow-up process.

  13. Construction of ethics in clinical research: clinical trials registration


    C. A. Caramori


    Scientific development that has been achieved through decades finds in clinical research a great possibility of translating findings to human health application. Evidence given by clinical trials allows everyone to have access to the best health services. However, the millionaire world of pharmaceutical industries has stained clinical research with doubt and improbability. Study results (fruits of controlled clinical trials) and scientific publications (selective, manipulated and with wrong c...

  14. Practical and conceptual issues of clinical trial registration for Brazilian researchers


    Carolina Gomes Freitas; Thomas Fernando Coelho Pesavento; Maurício Reis Pedrosa; Rachel Riera; Maria Regina Torloni


    CONTEXT AND OBJECTIVE: Clinical trial registration is a prerequisite for publication in respected scientific journals. Recent Brazilian regulations also require registration of some clinical trials in the Brazilian Clinical Trials Registry (ReBEC) but there is little information available about practical issues involved in the registration process. This article discusses the importance of clinical trial registration and the practical issues involved in this process. DESIGN AND SETTING: Desc...

  15. European registration process for Clinical Laboratory Geneticists in genetic healthcare


    Liehr, Thomas; Carreira, Isabel M.; Aktas, Dilek; Bakker, Egbert; Rodr?guez de Alba, Marta; Coviello, Domenico A; Florentin, Lina; Scheffer, Hans; Rincic, Martina


    Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine was realized. Therefore a Europe-wide recognition of the profession ?European registered Clinical Laboratory Geneticist (ErCLG)' based on a syllabus of core competences was established which allows...

  16. Automated image registration for FDOPA PET studies (United States)

    Lin, Kang-Ping; Huang, Sung-Cheng; Yu, Dan-Chu; Melega, William; Barrio, Jorge R.; Phelps, Michael E.


    In this study, various image registration methods are investigated for their suitability for registration of L-6-[18F]-fluoro-DOPA (FDOPA) PET images. Five different optimization criteria including sum of absolute difference (SAD), mean square difference (MSD), cross-correlation coefficient (CC), standard deviation of pixel ratio (SDPR), and stochastic sign change (SSC) were implemented and Powell's algorithm was used to optimize the criteria. The optimization criteria were calculated either unidirectionally (i.e. only evaluating the criteria for comparing the resliced image 1 with the original image 2) or bidirectionally (i.e. averaging the criteria for comparing the resliced image 1 with the original image 2 and those for the sliced image 2 with the original image 1). Monkey FDOPA images taken at various known orientations were used to evaluate the accuracy of different methods. A set of human FDOPA dynamic images was used to investigate the ability of the methods for correcting subject movement. It was found that a large improvement in performance resulted when bidirectional rather than unidirectional criteria were used. Overall, the SAD, MSD and SDPR methods were found to be comparable in performance and were suitable for registering FDOPA images. The MSD method gave more adequate results for frame-to-frame image registration for correcting subject movement during a dynamic FDOPA study. The utility of the registration method is further demonstrated by registering FDOPA images in monkeys before and after amphetamine injection to reveal more clearly the changes in spatial distribution of FDOPA due to the drug intervention.

  17. Is Mandatory Prospective Trial Registration Working to Prevent Publication of Unregistered Trials and Selective Outcome Reporting? An Observational Study of Five Psychiatry Journals That Mandate Prospective Clinical Trial Registration


    Amelia Scott; Julia J Rucklidge; Roger T Mulder


    Objective To address the bias occurring in the medical literature associated with selective outcome reporting, in 2005, the International Committee of Medical Journal Editors (ICMJE) introduced mandatory trial registration guidelines and member journals required prospective registration of trials prior to patient enrolment as a condition of publication. No research has examined whether these guidelines are impacting psychiatry publications. Our objectives were to determine the extent to which...

  18. The First 500 Registrations to the Research Registry(®): Advancing Registration of Under-Registered Study Types. (United States)

    Agha, Riaz; Fowler, Alexander J; Limb, Christopher; Al Omran, Yasser; Sagoo, Harkiran; Koshy, Kiron; Jafree, Daniyal J; Anwar, Mohammed Omer; McCullogh, Peter; Orgill, Dennis Paul


    The Declaration of Helsinki 2013 encourages the registration of all research studies involving human participants. However, emphasis has been placed on prospective clinical trials, and it is estimated that only 10% of observational studies are registered. In response, Research Registry(®) was launched in February 2015; a retrospectively curated registry that is free and easy to use. Research Registry(®) enables prospective or retrospective registration of studies, including those study types that cannot be registered on existing registries. In this study, we describe the first 500 registrations on Research Registry(®). Since the launch of Research Registry(®) in February 2015, data of registrations have been collected, including type of studies registered, country of origin, and data curation activity. Inappropriate registrations, such as duplicates, were identified by the data curation process. These were removed from the database or modified as required. A quality score was assigned for each registration, based on Sir Austin Bradford Hill's criteria on what research studies should convey. Changes in quality scores over time were assessed. A total of 500 studies were registered on Research Registry(®) from February 2015 to October 2015, with a total of 1.7 million patients enrolled. The most common study types were retrospective cohort studies (37.2%), case series (14.8%), and first-in-man case reports (10.4%). Registrations were received from 57 different countries; the most submissions were received from Turkey, followed by China and the United Kingdom. Retrospective data curation identified 80 studies that were initially registered as the incorrect study type, and were subsequently correct. The Kruskal-Wallis test identified a significant improvement in quality scores for registrations from February 2015 to October 2015 (p Research Registry(®) has established itself as a new registry that is free, easy to use, and enables the registration of various

  19. Quality of registration for clinical trials published in emergency medicine journals. (United States)

    Jones, Christopher W; Platts-Mills, Timothy F


    In 2005, the International Committee of Medical Journal Editors established clinical trial registration as a requirement for articles submitted to member journals, with the goal of improving the transparency of clinical research. The objective of this study is to characterize the registration of clinical trials published in emergency medicine journals. Randomized trials involving human subjects and published between June 1, 2008, and May 31, 2011 in the 5 emergency medicine journals with the highest impact factors were included. We assessed the clarity of registered primary outcomes, timing of registration relative to patient enrollment, and consistency between registered and published outcomes. Of the 123 trials included, registry entries were identified for 57 (46%). Of the 57 registered studies, 45 (79%) were registered after the initiation of subject enrollment, 9 (16%) had registered outcomes that were unclear, and 26 (46%) had discrepancies between registered and published outcomes. Only 5 studies were registered before patient enrollment with a clear primary outcome that was consistent with the published primary outcome. Annals of Emergency Medicine was the only journal in which the majority of trials were registered. Current compliance with clinical trial registration guidelines is poor among trials published in emergency medicine journals. Copyright © 2012. Published by Mosby, Inc.

  20. The impact of clinical simulation on learner self-efficacy in pre-registration nursing education. (United States)

    Pike, Tamsin; O'Donnell, Victoria


    Clinical simulation is becoming increasingly popular in pre-registration nursing education. Incorporating teaching and learning strategies that enhance learner self-efficacy will theoretically improve clinical competence (Bandura, 1986, 1997). This paper presents the findings of a study that aimed to explore the impact of clinical simulation on self-efficacy beliefs amongst pre-registration nurses. A preliminary study (Pike, 2008) used a pre- and post-test design to measure learner self-efficacy before and after a clinical simulation session. Qualitative responses to questions on the post-test questionnaire provided themes to explore in a focus group interview with a convenience sample of nine participants. Thematic content analysis of the interview highlighted two principal findings. Firstly, students described low levels of self-efficacy with regards to communication skills, an area identified as a priority within pre-registration nursing education (NMC, 2007a). Second, students highlighted the need for learning experiences within clinical simulation to be more authentic, to improve the theory to practice gap. It is argued by incorporating strategies within clinical simulation that enhance learner self-efficacy, overall clinical competence will be improved. Suggestions for how pedagogical approaches may be developed within clinical simulation are discussed, whilst acknowledging the limitations of the small scale nature of the study.

  1. Impact of registration on clinical trials on infection risk in pediatric acute myeloid leukemia. (United States)

    Dix, David; Aplenc, Richard; Bowes, Lynette; Cellot, Sonia; Ethier, Marie-Chantal; Feusner, Jim; Gillmeister, Biljana; Johnston, Donna L; Lewis, Victor; Michon, Bruno; Mitchell, David; Portwine, Carol; Price, Victoria; Silva, Mariana; Stobart, Kent; Yanofsky, Rochelle; Zelcer, Shayna; Beyene, Joseph; Sung, Lillian


    Little is known about the impact of enrollment on therapeutic clinical trials on adverse event rates. Primary objective was to describe the impact of clinical trial registration on sterile site microbiologically documented infection for children with newly diagnosed acute myeloid leukemia (AML). We conducted a multicenter cohort study that included children aged ≤18 years with de novo AML. Primary outcome was microbiologically documented sterile site infection. Infection rates were compared between those registered and not registered on clinical trials. Five hundred seventy-four children with AML were included of which 198 (34.5%) were registered on a therapeutic clinical trial. Overall, 400 (69.7%) had at least one sterile site microbiologically documented infection. In multiple regression, registration on clinical trials was independently associated with a higher risk of microbiologically documented sterile site infection [adjusted odds ratio (OR) 1.24, 95% confidence interval (CI) 1.01-1.53; p = 0.040] and viridans group streptococcal infection (OR 1.46, 95% CI 1.08-1.98; p = 0.015). Registration on trials was not associated with Gram-negative or invasive fungal infections. Children with newly diagnosed AML enrolled on clinical trials have a higher risk of microbiologically documented sterile site infection. This information may impact on supportive care practices in pediatric AML.

  2. Clinical trial registration in physiotherapy journals: recommendations from the International Society of Physiotherapy Journal Editors. (United States)

    Costa, Leonardo O P; Lin, Chung-Wei Christine; Grossi, Debora Bevilaqua; Mancini, Marisa Cota; Swisher, Anne K; Cook, Chad E; Vaughn, Daniel W; Elkins, Mark R; Sheikh, Umer; Moore, Ann; Jull, Gwendolen A; Craik, Rebecca L; Maher, Christopher G; Guirro, Rinaldo Roberto de Jesus; Marques, Amélia Pasqual; Harms, Michele; Brooks, Dina; Simoneau, Guy G; Strupstad, John Henry


    Clinical trial registration involves placing the protocol for a clinical trial on a free, publicly available, and electronically searchable register. Registration is considered to be prospective if the protocol is registered before the trial commences (ie, before the first participant is enrolled). Prospective registration has several potential advantages. It could help avoid trials being duplicated unnecessarily and it could allow people with health problems to identify trials in which they might participate. Perhaps more importantly, however, it tackles 2 big problems in clinical research: selective reporting and publication bias. Prospective clinical trial registration is of great potential value to the clinicians, consumers, and researchers who rely on clinical trial data, and that is why the International Society of Physiotherapy Journal Editors (ISPJE) is recommending that members enact a policy for prospective trial registration.

  3. European registration process for Clinical Laboratory Geneticists in genetic healthcare. (United States)

    Liehr, Thomas; Carreira, Isabel M; Aktas, Dilek; Bakker, Egbert; Rodríguez de Alba, Marta; Coviello, Domenico A; Florentin, Lina; Scheffer, Hans; Rincic, Martina


    Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine was realized. Therefore a Europe-wide recognition of the profession 'European registered Clinical Laboratory Geneticist (ErCLG)' based on a syllabus of core competences was established which allows for harmonization in professional education. The 'European Board of Medical Genetics division - Clinical Laboratory Geneticist' provides now since 3 years the possibility to register as an ErCLG. Applicants may be from all European countries and since this year also from outside of Europe. Five subtitles reflect the exact specialty of each ErCLG, who can reregister every 5 years. A previously not possible statistics based on ~300 individuals from 19 countries as holders of an ErCLG title provides interesting insights into the professionals working in human genetics. It could be substantiated that there are around twice as many females than males and that a PhD title was achieved by 80% of registered ErCLGs. Also most ErCLGs are still trained as generalists (66%), followed by such ErCLGs with focus on molecular genetics (23%); the remaining are concentrated either on clinical (6%), tumor (4%) or biochemical genetics (1%). In conclusion, besides MDs and genetic counselors/nurses an EU-wide recognition system for Clinical Laboratory Geneticist has been established, which strengthens the status of specialists working in human genetic diagnostics in Europe and worldwide.

  4. Biomechanical Role of Bone Anisotropy Estimated on Clinical CT Scans by Image Registration. (United States)

    Taghizadeh, Elham; Reyes, Mauricio; Zysset, Philippe; Latypova, Adeliya; Terrier, Alexandre; Büchler, Philippe


    Image-based modeling is a popular approach to perform patient-specific biomechanical simulations. Accurate modeling is critical for orthopedic application to evaluate implant design and surgical planning. It has been shown that bone strength can be estimated from the bone mineral density (BMD) and trabecular bone architecture. However, these findings cannot be directly and fully transferred to patient-specific modeling since only BMD can be derived from clinical CT. Therefore, the objective of this study was to propose a method to predict the trabecular bone structure using a µCT atlas and an image registration technique. The approach has been evaluated on femurs and patellae under physiological loading. The displacement and ultimate force for femurs loaded in stance position were predicted with an error of 2.5% and 3.7%, respectively, while predictions obtained with an isotropic material resulted in errors of 7.3% and 6.9%. Similar results were obtained for the patella, where the strain predicted using the registration approach resulted in an improved mean squared error compared to the isotropic model. We conclude that the registration of anisotropic information from of a single template bone enables more accurate patient-specific simulations from clinical image datasets than isotropic model.

  5. A Six Sigma approach to the rate and clinical effect of registration errors in a laboratory. (United States)

    Vanker, Naadira; van Wyk, Johan; Zemlin, Annalise E; Erasmus, Rajiv T


    Laboratory errors made during the pre-analytical phase can have an impact on clinical care. Quality management tools such as Six Sigma may help improve error rates. To use elements of a Six Sigma model to establish the error rate of test registration onto the laboratory information system (LIS), and to deduce the potential clinical impact of these errors. In this retrospective study, test request forms were compared with the tests registered onto the LIS, and all errors were noted before being rectified. The error rate was calculated. The corresponding patient records were then examined to determine the actual outcome, and to deduce the potential clinical impact of the registration errors. Of the 47 543 tests requested, 72 errors were noted, resulting in an error rate of 0.151%, equating to a sigma score of 4.46. The patient records reviewed indicated that these errors could, in various ways, have impacted on clinical care. This study highlights the clinical effect of errors made during the pre-analytical phase of the laboratory testing process. Reduction of errors may be achieved through implementation of a Six Sigma programme.

  6. 3D-2D registration of cerebral angiograms: a method and evaluation on clinical images. (United States)

    Mitrovic, Uroš; Špiclin, Žiga; Likar, Boštjan; Pernuš, Franjo


    Endovascular image-guided interventions (EIGI) involve navigation of a catheter through the vasculature followed by application of treatment at the site of anomaly using live 2D projection images for guidance. 3D images acquired prior to EIGI are used to quantify the vascular anomaly and plan the intervention. If fused with the information of live 2D images they can also facilitate navigation and treatment. For this purpose 3D-2D image registration is required. Although several 3D-2D registration methods for EIGI achieve registration accuracy below 1 mm, their clinical application is still limited by insufficient robustness or reliability. In this paper, we propose a 3D-2D registration method based on matching a 3D vasculature model to intensity gradients of live 2D images. To objectively validate 3D-2D registration methods, we acquired a clinical image database of 10 patients undergoing cerebral EIGI and established "gold standard" registrations by aligning fiducial markers in 3D and 2D images. The proposed method had mean registration accuracy below 0.65 mm, which was comparable to tested state-of-the-art methods, and execution time below 1 s. With the highest rate of successful registrations and the highest capture range the proposed method was the most robust and thus a good candidate for application in EIGI.

  7. European registration process for Clinical Laboratory Geneticists in genetic healthcare

    NARCIS (Netherlands)

    Liehr, T.; Carreira, I.M.; Aktas, D.; Bakker, E. de; Rodriguez de Alba, M.; Coviello, D.A.; Florentin, L.; Scheffer, H.; Rincic, M.


    Tremendous progress in genetics and genomics led to a wide range of healthcare providers, genetic tests, and more patients who can benefit from these developments. To guarantee and improve the quality of genetic testing, a unified European-based registration for individuals qualified in biomedicine

  8. Primary care clinical placements: The views of Australian registered nurse mentors and pre-registration nursing students (part 2). (United States)

    McInnes, Susan; Peters, Kath; Hardy, Jennifer; Halcomb, Elizabeth


    An increased burden of chronic and complex conditions treated in the community and an aging population have exacerbated the primary care workload. Predicted nursing shortages will place further stressors on this workforce. High quality clinical placements may provide a strategic pathway to introduce and recruit new nurses to this speciality. This paper is Part 2 of a two part series reporting the findings of a mixed methods project. Part 1 reported on the qualitative study and Part 2 reports on the quantitative study. Forty-five pre-registration nursing students from a single Australian tertiary institution and 22 primary care Registered Nurse (RN) mentors who supervised student learning completed an online survey. Students largely regarded their primary care placement positively and felt this to be an appropriate learning opportunity. Most RNs were satisfied with mentoring pre-registration nursing students in their setting. Furthermore, the RNs desire to mentor students and the support of general practitioners (GPs) and consumers were seen as key enablers of pre-registration nursing placements. Findings from this study provide a preliminary impression of primary care clinical placements from the perspective of pre-registration nursing students and registered nurse mentors. Further research should examine whether a broader scope of non-traditional health settings such as non-government organisations, charities, pharmacies, welfare and social services can also provide appropriate learning environments for pre-registration nursing students.

  9. Clinical characteristics and oncological outcomes of testicular cancer patients registered in 2005 and 2008: the first large-scale study from the Cancer Registration Committee of the Japanese Urological Association. (United States)

    Miki, Tsuneharu; Kamoi, Kazumi; Fujimoto, Hiroyuki; Kanayama, Hiro-omi; Ohyama, Chikara; Suzuki, Kazuhiro; Nishiyama, Hiroyuki; Eto, Masatoshi; Naito, Seiji; Fukumori, Tomoharu; Kubota, Yoshinobu; Takahashi, Satoru; Mikami, Kazuya; Homma, Yukio


    To describe the clinical and pathological characteristics and oncological outcomes of testicular cancer diagnosed in Japan, we report the results of the testicular cancer registration carried out by the Japanese Urological Association. Testicular cancer survey was conducted by the Japanese Urological Association in 2011 to register newly diagnosed testicular cancers in 2005 and 2008. The survey included details such as age, presenting symptoms, physical examination findings, tumor markers, histopathology, clinical stage, initial treatment and clinical outcomes. We analyzed 1121 cases of testicular primary germ cell tumor among 1157 registered patients. The median age was 37.0 years. Seminomas and non-seminomatous germ cell tumors accounted for 61.9% and 38.1%, respectively. Measurements of tumor markers were documented in 98.6% of the patients; however, there was an unsatisfactory uniform measurement of human chorionic gonadotropin, which made it difficult to evaluate the International Germ Cell Consensus Classification in all patients. The 1- and 3-year overall survival rates from the entire cohort were 98.3% and 96.8%, respectively. According to the International Germ Cell Consensus Classification, 3-year overall survival rates in the good, intermediate, and poor prognosis group were 99.1%, 100% and 79.9%, respectively. The present report is the first large-scale study of the characteristics and survival of testicular cancer patients in Japan based on multi-institutional registry data, and showed a good prognosis even in an advanced stage. The improved survival attributed substantially to accurate diagnosis and effective multimodal treatment. © 2014 The Japanese Urological Association.

  10. The Cardiology Audit and Registration Data Standards (CARDS), European data standards for clinical cardiology practice

    NARCIS (Netherlands)

    M.R. Flynn (Rachel); C. Barrett (Conor); F.G. Cosio (Francisco); A.K. Gitt (Anselm); L.C. Wallentin (Lars); P. Kearney (Peter); M. Lonergan (Moira); E. Shelley (Emer); M.L. Simoons (Maarten)


    textabstractAIMS: Systematic registration of data from clinical practice is important for clinical care, local, national and international registries, and audit. Data to be collected for these different purposes should be harmonized. Therefore, during Ireland's Presidency of the European Union (EU)

  11. Comparative study to evaluate the accuracy of polyether occlusal bite registration material and occlusal registration wax as a guide for occlusal reduction during tooth preparation

    Directory of Open Access Journals (Sweden)

    Niranjan Joshi


    Objective: The objective of this study was to compare and evaluate the reliability of the most commonly used occlusal registration wax that with polyether bite registration material as a guide for occlusal reduction required during tooth preparations. Materials and Methods: For the purpose of this study, 25 abutment teeth requiring tooth preparation for fixed prosthesis were selected and tooth preparations carried out. Modeling wax strips of specific dimensions were placed onto the cast of prepared tooth, which was mounted on maximum intercuspation on the articulator and the articulator was closed. The thickness of the wax registration was measured at three zones namely two functional cusps and central fossa. Similar measurements were made using the polyether bite registration material and prosthesis at the same zones. The data was tabulated and was subjected to statistical analysis using anova test and Tukey honestly significant difference test. Results: The differences in thickness between wax record and prosthesis by 0.1346 mm, whereas the difference between polyether and prosthesis was 0.02 mm with a P value of 0.042, which is statistically significant. This means that the wax record was 8.25% larger than the prosthesis while polyether was just 1.27% larger than the prosthesis. Conclusion: The clinical significance of the above analysis is that Ramitec polyether bite registration material is most suitable material when compared with commonly used modeling wax during the tooth preparation.

  12. Multislice CT brain image registration for perfusion studies (United States)

    Lin, Zhong Min; Pohlman, Scott; Chandra, Shalabh


    During the last several years perfusion CT techniques have been developed as an effective technique for clinically evaluating cerebral hemodynamics. Perfusion CT techniques are capable of measurings functional parameters such as tissue perfusion, blood flow, blood volume, and mean transit time and are commonly used to evaluate stroke patients. However, the quality of functional images of the brain frequently suffers from patient head motion. Because the time window for an effective treatment of stroke patient is narrow, a fast motion correction is required. The purpose of the paper is to present a fast and accurate registration technique for motion correction of multi-slice CT and to demonstrate the effects of the registration on perfusion calculation.

  13. Reliability of registrations : a feasibility study into registration of occupational and educational titles in hospitals

    NARCIS (Netherlands)

    Popping, R

    Some results of an investigation are presented in which answers on some basic variables (occupation and education) are registered in several ways. The variables were measured in a setting in which the registration was to occur as fast as possible. All registrations went by using a computer. The

  14. Reliability of registrations : a feasibility study into registration of occupational and educational titles in hospitals

    NARCIS (Netherlands)

    Popping, R


    Some results of an investigation are presented in which answers on some basic variables (occupation and education) are registered in several ways. The variables were measured in a setting in which the registration was to occur as fast as possible. All registrations went by using a computer. The regi

  15. Prospective multicenter registration study of colorectal cancer: significant variations in radicality and oncosurgical quality-Swiss Group for Clinical Cancer Research Protocol SAKK 40/00. (United States)

    Maurer, Christoph A; Dietrich, Daniel; Schilling, Martin K; Metzger, Urs; Laffer, Urban; Buchmann, Peter; Lerf, Bruno; Villiger, Peter; Melcher, Gian; Klaiber, Christian; Bilat, Christian; Brauchli, Peter; Terracciano, Luigi; Kessler, Katharina


    This study aimed to investigate in a multicenter cohort study the radicality of colorectal cancer resections, to assess the oncosurgical quality of colorectal specimens, and to compare the performance between centers. One German and nine Swiss hospitals agreed to prospectively register all patients with primary colorectal cancer resected between September 2001 and June 2005. The median number of eligible patients with one primary tumor included per center was 95 (range 12-204). The following variations of median values or percentages between centers were found: length of bowel specimen 20-39 cm (25.8 cm), maximum height of mesocolon 6.5-12.5 cm (9.0 cm), number of examined lymph nodes 9-24 (16), distance to nearer bowel resection margin in colon cancer 4.8-12 cm (7 cm), and in rectal cancer 2-3 cm (2.5 cm), central ligation of major artery 40-97 % (71 %), blood loss 200-500 ml (300 ml), need for perioperative blood transfusion 5-40 % (19 %), tumor opened during mobilization 0-11 % (5 %), T4-tumors not en-bloc resected 0-33 % (4 %), inadvertent perforation of mesocolon/mesorectum 0-8 % (4 %), no-touch isolation technique 36-86 % (67 %), abdominoperineal resection for rectal cancer 0-30 % (17 %), rectal cancer specimen with circumferential margin ≤1 mm 0-19 % (10 %), in-hospital mortality 0-6 % (2 %), anastomotic leak or intra-abdominal abscess 0-17 % (7 %), re-operation 0-17 % (8 %). In colorectal cancer, surgery considerable variations between different centers were found with regard to radicality and oncosurgical quality, suggesting a potential for targeted improvement of surgical technique.

  16. Pre-registration interprofessional clinical education in the workplace: a realist review. (United States)

    Kent, Fiona; Hayes, Jacinta; Glass, Sharon; Rees, Charlotte E


    The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review. Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful. In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest. © 2017 John Wiley & Sons Ltd and The Association

  17. Device and methods for "gold standard" registration of clinical 3D and 2D cerebral angiograms (United States)

    Madan, Hennadii; Likar, Boštjan; Pernuš, Franjo; Å piclin, Žiga


    Translation of any novel and existing 3D-2D image registration methods into clinical image-guidance systems is limited due to lack of their objective validation on clinical image datasets. The main reason is that, besides the calibration of the 2D imaging system, a reference or "gold standard" registration is very difficult to obtain on clinical image datasets. In the context of cerebral endovascular image-guided interventions (EIGIs), we present a calibration device in the form of a headband with integrated fiducial markers and, secondly, propose an automated pipeline comprising 3D and 2D image processing, analysis and annotation steps, the result of which is a retrospective calibration of the 2D imaging system and an optimal, i.e., "gold standard" registration of 3D and 2D images. The device and methods were used to create the "gold standard" on 15 datasets of 3D and 2D cerebral angiograms, whereas each dataset was acquired on a patient undergoing EIGI for either aneurysm coiling or embolization of arteriovenous malformation. The use of the device integrated seamlessly in the clinical workflow of EIGI. While the automated pipeline eliminated all manual input or interactive image processing, analysis or annotation. In this way, the time to obtain the "gold standard" was reduced from 30 to less than one minute and the "gold standard" of 3D-2D registration on all 15 datasets of cerebral angiograms was obtained with a sub-0.1 mm accuracy.

  18. Prospective registration and results disclosure of clinical trials in the Americas: a roadmap toward transparency. (United States)

    Krleža-Jeriç, Karmela; Lemmens, Trudo; Reveiz, Ludovic; Cuervo, Luis Gabriel; Bero, Lisa Anne


    The objective of this article is to propose a roadmap toward transparency of clinical trials in the Americas by their prospective registration and results disclosure. This will broaden access to more complete and accurate data and facilitate evidence-informed decision-making and participation in research. Consequently, it should have a positive impact on people's health and should promote trust in health research. Existing initiatives were identified, registration of trials was analyzed following the World Health Organization (WHO) standards on trial registration, and a roadmap is proposed to address the gaps in advancing transparency. The analysis shows that, in spite of numerous regional and country initiatives, clinical trials taking place in nonEnglish-speaking parts of the Americas are underregistered. A roadmap is proposed to enhance research governance and good research practice by improving the transparency of clinical trials. The proposed roadmap includes strategies for implementing WHO international standards for trial registration, for developing international standards of public disclosure of trial results, and for a potential role of the Pan American Health Organization.

  19. Using portfolios for clinical practice learning and assessment: the pre-registration nursing student's perspective. (United States)

    McMullan, Miriam


    Portfolios have been introduced to help to integrate theory and practice and thereby address the issue of the theory-practice divide. Although there has been much theoretical discussion about portfolio use in clinical placements, few studies have focused on the students' perceptions regarding their use. To obtain adult branch pre-registration nursing students' perspectives on using portfolios for their clinical practice learning and assessment, postal questionnaires were sent to 253 diploma of nursing students with a reminder to all students three weeks later. The response rate was 69% (174/253). This paper reports on the qualitative findings of the study, which employed both quantitative and qualitative methods. Although students stated that portfolios helped them in their development of self-awareness and independent learning, they indicated that portfolios do not sufficiently address the assessment of their clinical skills and the integration of theory and practice. They considered that portfolios could be greatly improved in three areas, namely in the conflict between using portfolios for both assessment and learning, the amount of support and guidance students feel they receive with their portfolio use and the portfolio design.

  20. Spatial registration of echocardiographic and positron emission tomographic heart studies

    Energy Technology Data Exchange (ETDEWEB)

    Savi, A. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Gilardi, M.C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Rizzo, G. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Pepi, M. [Centro Cardiologico, Fondazione I. Monzino, Milan (Italy); Landoni, C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Rossetti, C. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Lucignani, G. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy); Bartorelli, A. [Centro Cardiologico, Fondazione I. Monzino, Milan (Italy); Fazio, F. [INB CNR, Inst. H.S. Raffaele, Univ. of Milan (Italy)


    A method has been developed to match corresponding heart regions from functional echocardiographic (Echo) and metabolic fluorine-18-fluoro-2-deoxy-D-glucose ([18F]FDG) positron emission tomography (PET) studies in individual patients. Echo and PET images are spatially correlated by determining homologous anatomical landmarks (the two papillary muscles and the inferior junction of the right ventricle), identifiable in images obtained by both acquisition modalities. Echo-PET image registration is first performed in the plane identified by the three landmarks, using a rigid rotate-translate scale model. The registration parameters are then used to transform the whole PET volume. This allows a consistent Echo-PET regional analysis, according to a segmental subdivision of the heart. The technique was tested on patients. The overlay of Echo and PET registered images proved the reliability of realignment of the three markers and a good spatial correlation of myocardial walls. This approach to image registration could be applied to other acquisition modalities (such as magnetic resonance imaging and single-photon emission tomography), provided that the three anatomical landmarks are visualized. (orig.)

  1. 3D–2D registration in mobile radiographs: algorithm development and preliminary clinical evaluation. (United States)

    Otake, Yoshito; Wang, Adam S; Uneri, Ali; Kleinszig, Gerhard; Vogt, Sebastian; Aygun, Nafi; Lo, Sheng-fu L; Wolinsky, Jean-Paul; Gokaslan, Ziya L; Siewerdsen, Jeffrey H


    An image-based 3D-2D registration method is presented using radiographs acquired in the uncalibrated, unconstrained geometry of mobile radiography. The approach extends a previous method for six degree-of-freedom (DOF) registration in C-arm fluoroscopy (namely 'LevelCheck') to solve the 9-DOF estimate of geometry in which the position of the source and detector are unconstrained. The method was implemented using a gradient correlation similarity metric and stochastic derivative-free optimization on a GPU. Development and evaluation were conducted in three steps. First, simulation studies were performed that involved a CT scan of an anthropomorphic body phantom and 1000 randomly generated digitally reconstructed radiographs in posterior-anterior and lateral views. A median projection distance error (PDE) of 0.007 mm was achieved with 9-DOF registration compared to 0.767 mm for 6-DOF. Second, cadaver studies were conducted using mobile radiographs acquired in three anatomical regions (thorax, abdomen and pelvis) and three levels of source-detector distance (~800, ~1000 and ~1200 mm). The 9-DOF method achieved a median PDE of 0.49 mm (compared to 2.53 mm for the 6-DOF method) and demonstrated robustness in the unconstrained imaging geometry. Finally, a retrospective clinical study was conducted with intraoperative radiographs of the spine exhibiting real anatomical deformation and image content mismatch (e.g. interventional devices in the radiograph that were not in the CT), demonstrating a PDE = 1.1 mm for the 9-DOF approach. Average computation time was 48.5 s, involving 687 701 function evaluations on average, compared to 18.2 s for the 6-DOF method. Despite the greater computational load, the 9-DOF method may offer a valuable tool for target localization (e.g. decision support in level counting) as well as safety and quality assurance checks at the conclusion of a procedure (e.g. overlay of planning data on the radiograph for verification of the surgical product

  2. 3D-2D registration in mobile radiographs: algorithm development and preliminary clinical evaluation (United States)

    Otake, Yoshito; Wang, Adam S.; Uneri, Ali; Kleinszig, Gerhard; Vogt, Sebastian; Aygun, Nafi; Lo, Sheng-fu L.; Wolinsky, Jean-Paul; Gokaslan, Ziya L.; Siewerdsen, Jeffrey H.


    An image-based 3D-2D registration method is presented using radiographs acquired in the uncalibrated, unconstrained geometry of mobile radiography. The approach extends a previous method for six degree-of-freedom (DOF) registration in C-arm fluoroscopy (namely ‘LevelCheck’) to solve the 9-DOF estimate of geometry in which the position of the source and detector are unconstrained. The method was implemented using a gradient correlation similarity metric and stochastic derivative-free optimization on a GPU. Development and evaluation were conducted in three steps. First, simulation studies were performed that involved a CT scan of an anthropomorphic body phantom and 1000 randomly generated digitally reconstructed radiographs in posterior-anterior and lateral views. A median projection distance error (PDE) of 0.007 mm was achieved with 9-DOF registration compared to 0.767 mm for 6-DOF. Second, cadaver studies were conducted using mobile radiographs acquired in three anatomical regions (thorax, abdomen and pelvis) and three levels of source-detector distance (~800, ~1000 and ~1200 mm). The 9-DOF method achieved a median PDE of 0.49 mm (compared to 2.53 mm for the 6-DOF method) and demonstrated robustness in the unconstrained imaging geometry. Finally, a retrospective clinical study was conducted with intraoperative radiographs of the spine exhibiting real anatomical deformation and image content mismatch (e.g. interventional devices in the radiograph that were not in the CT), demonstrating a PDE = 1.1 mm for the 9-DOF approach. Average computation time was 48.5 s, involving 687 701 function evaluations on average, compared to 18.2 s for the 6-DOF method. Despite the greater computational load, the 9-DOF method may offer a valuable tool for target localization (e.g. decision support in level counting) as well as safety and quality assurance checks at the conclusion of a procedure (e.g. overlay of planning data on the radiograph for verification of

  3. Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology.

    Directory of Open Access Journals (Sweden)

    Marleine Azar

    Full Text Available Confidence that randomized controlled trial (RCT results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP is the primary trials journal amongst American Psychological Association (APA journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1 adequacy of primary outcome analysis definitions; (2 registration status; and, (3 among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals.Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1 adequacy of outcome analysis definitions in the published report, (2 whether the RCT was registered prior to enrolling patients, and (3 adequacy of outcome registration.Of 70 RCTs reviewed, 12 (17.1% adequately defined primary or secondary outcome analyses, whereas 58 (82.3% had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7% registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029. The proportion of registered trials in JCCP (55.7% was comparable to behavioral medicine journals (52.6%; p = 0.709.The quality of published outcome analysis definitions and trial registrations in JCCP is

  4. Transparency of Outcome Reporting and Trial Registration of Randomized Controlled Trials Published in the Journal of Consulting and Clinical Psychology. (United States)

    Azar, Marleine; Riehm, Kira E; McKay, Dean; Thombs, Brett D


    Confidence that randomized controlled trial (RCT) results accurately reflect intervention effectiveness depends on proper trial conduct and the accuracy and completeness of published trial reports. The Journal of Consulting and Clinical Psychology (JCCP) is the primary trials journal amongst American Psychological Association (APA) journals. The objectives of this study were to review RCTs recently published in JCCP to evaluate (1) adequacy of primary outcome analysis definitions; (2) registration status; and, (3) among registered trials, adequacy of outcome registrations. Additionally, we compared results from JCCP to findings from a recent study of top psychosomatic and behavioral medicine journals. Eligible RCTs were published in JCCP in 2013-2014. For each RCT, two investigators independently extracted data on (1) adequacy of outcome analysis definitions in the published report, (2) whether the RCT was registered prior to enrolling patients, and (3) adequacy of outcome registration. Of 70 RCTs reviewed, 12 (17.1%) adequately defined primary or secondary outcome analyses, whereas 58 (82.3%) had multiple primary outcome analyses without statistical adjustment or undefined outcome analyses. There were 39 (55.7%) registered trials. Only two trials registered prior to patient enrollment with a single primary outcome variable and time point of assessment. However, in one of the two trials, registered and published outcomes were discrepant. No studies were adequately registered as per Standard Protocol Items: Recommendation for Interventional Trials guidelines. Compared to psychosomatic and behavioral medicine journals, the proportion of published trials with adequate outcome analysis declarations was significantly lower in JCCP (17.1% versus 32.9%; p = 0.029). The proportion of registered trials in JCCP (55.7%) was comparable to behavioral medicine journals (52.6%; p = 0.709). The quality of published outcome analysis definitions and trial registrations in JCCP is

  5. Pre-registration nursing student's quality of practice learning: Clinical learning environment inventory (actual) questionnaire. (United States)

    Shivers, Eleanor; Hasson, Felicity; Slater, Paul


    Clinical learning is a vital component of nurse education and assessing student's experiences can provide useful insights for development. Whilst most research in this area has focused on the acute setting little attention has been given to all pre-registration nurses' experience across the clinical placements arenas. To examine of pre-registration nursing students (first, second and third year) assessment of their actual experiences of their most recent clinical learning clinical learning experience. A cross sectional survey involving a descriptive online anonymous questionnaire based on the clinical learning environment inventory tool. One higher education institution in the United Kingdom. Nursing students (n=147) enrolled in an undergraduate nursing degree. This questionnaire included demographic questions and the Clinical Learning Environment Inventory (CLEI) a 42 item tool measuring student's satisfaction with clinical placement. SPPS version 22 was employed to analyse data with descriptive and inferential statistics. Overall students were satisfied with their clinical learning experience across all placement areas. This was linked to the 6 constructs of the clinical learning environment inventory; personalization, innovation, individualization, task orientation, involvement, satisfaction. Significant differences in student experience were noted between age groups and student year but there was no difference noted between placement type, age and gender. Nursing students had a positive perception of their clinical learning experience, although there remains room for improvement. Enabling a greater understanding of students' perspective on the quality of clinical education is important for nursing education and future research. Copyright © 2017. Published by Elsevier Ltd.

  6. Augmented reality surgical navigation with ultrasound-assisted registration for pedicle screw placement: a pilot study. (United States)

    Ma, Longfei; Zhao, Zhe; Chen, Fang; Zhang, Boyu; Fu, Ligong; Liao, Hongen


    We present a novel augmented reality (AR) surgical navigation system based on ultrasound-assisted registration for pedicle screw placement. This system provides the clinically desired targeting accuracy and reduces radiation exposure. Ultrasound (US) is used to perform registration between preoperative computed tomography (CT) images and patient, and the registration is performed by least-squares fitting of these two three-dimensional (3D) point sets of anatomical landmarks taken from US and CT images. An integral videography overlay device is calibrated to accurately display naked-eye 3D images for surgical navigation. We use a 3.0-mm Kirschner wire (K-wire) instead of a pedicle screw in this study, and the K-wire is calibrated to obtain its orientation and tip location. Based on the above registration and calibration, naked-eye 3D images of the planning path and the spine are superimposed onto patient in situ using our AR navigation system. Simultaneously, a 3D image of the K-wire is overlaid accurately on the real one to guide the insertion procedure. The targeting accuracy is evaluated postoperatively by performing a CT scan. An agar phantom experiment was performed. Eight K-wires were inserted successfully after US-assisted registration, and the mean targeting error and angle error were 3.35 mm and [Formula: see text], respectively. Furthermore, an additional sheep cadaver experiment was performed. Four K-wires were inserted successfully. The mean targeting error was 3.79 mm and the mean angle error was [Formula: see text], and US-assisted registration yielded better targeting results than skin markers-based registration (targeting errors: 2.41 vs. 5.18 mm, angle errors: [Formula: see text] vs. [Formula: see text]. Experimental outcomes demonstrate that the proposed navigation system has acceptable targeting accuracy. In particular, the proposed navigation method reduces repeated radiation exposure to the patient and surgeons. Therefore, it has promising

  7. Pesticide risk production pogramme : feasibility study of the proposed pesticide registration and post-registration processes

    NARCIS (Netherlands)

    Bremmer, J.; Dhuga Chaka, K.; Dijkxhoorn, Y.; Mammo, B.


    Report on developing guidelines and procedures for the pesticide registration in Ethiopia in a scientifically underpinned way and as specific as possible for Ethiopian conditions. It covers the aspects of efficacy assessment, human health risk assessment as well as environmental risk assessment. It

  8. TU-E-BRB-00: Deformable Image Registration: Is It Right for Your Clinic

    Energy Technology Data Exchange (ETDEWEB)



    Deformable image registration (DIR) is developing rapidly and is poised to substantially improve dose fusion accuracy for adaptive and retreatment planning and motion management and PET fusion to enhance contour delineation for treatment planning. However, DIR dose warping accuracy is difficult to quantify, in general, and particularly difficult to do so on a patient-specific basis. As clinical DIR options become more widely available, there is an increased need to understand the implications of incorporating DIR into clinical workflow. Several groups have assessed DIR accuracy in clinically relevant scenarios, but no comprehensive review material is yet available. This session will also discuss aspects of the AAPM Task Group 132 on the Use of Image Registration and Data Fusion Algorithms and Techniques in Radiotherapy Treatment Planning official report, which provides recommendations for DIR clinical use. We will summarize and compare various commercial DIR software options, outline successful clinical techniques, show specific examples with discussion of appropriate and inappropriate applications of DIR, discuss the clinical implications of DIR, provide an overview of current DIR error analysis research, review QA options and research phantom development and present TG-132 recommendations. Learning Objectives: Compare/contrast commercial DIR software and QA options Overview clinical DIR workflow for retreatment To understand uncertainties introduced by DIR Review TG-132 proposed recommendations.

  9. Registration of clinical volumes to beams-eye-view images for real-time tracking

    Energy Technology Data Exchange (ETDEWEB)

    Bryant, Jonathan H.; Rottmann, Joerg; Lewis, John H.; Mishra, Pankaj; Berbeco, Ross I., E-mail: [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Keall, Paul J. [Radiation Physics Laboratory, Sydney Medical School, University of Sydney, Sydney, New South Wales 2006 (Australia)


    Purpose: The authors combine the registration of 2D beam’s eye view (BEV) images and 3D planning computed tomography (CT) images, with relative, markerless tumor tracking to provide automatic absolute tracking of physician defined volumes such as the gross tumor volume (GTV). Methods: During treatment of lung SBRT cases, BEV images were continuously acquired with an electronic portal imaging device (EPID) operating in cine mode. For absolute registration of physician-defined volumes, an intensity based 2D/3D registration to the planning CT was performed using the end-of-exhale (EoE) phase of the four dimensional computed tomography (4DCT). The volume was converted from Hounsfield units into electron density by a calibration curve and digitally reconstructed radiographs (DRRs) were generated for each beam geometry. Using normalized cross correlation between the DRR and an EoE BEV image, the best in-plane rigid transformation was found. The transformation was applied to physician-defined contours in the planning CT, mapping them into the EPID image domain. A robust multiregion method of relative markerless lung tumor tracking quantified deviations from the EoE position. Results: The success of 2D/3D registration was demonstrated at the EoE breathing phase. By registering at this phase and then employing a separate technique for relative tracking, the authors are able to successfully track target volumes in the BEV images throughout the entire treatment delivery. Conclusions: Through the combination of EPID/4DCT registration and relative tracking, a necessary step toward the clinical implementation of BEV tracking has been completed. The knowledge of tumor volumes relative to the treatment field is important for future applications like real-time motion management, adaptive radiotherapy, and delivered dose calculations.

  10. [Registration of observational studies: it is time to comply with the Declaration of Helsinki requirement]. (United States)

    Dal-Ré, Rafael; Delgado, Miguel; Bolumar, Francisco


    Publication bias is a serious deficiency in the current system of disseminating the results of human research studies. Clinical investigators know that, from an ethical standpoint, they should prospectively register clinical trials in a public registry before starting them. In addition, it is believed that this approach will help to reduce publication bias. However, most studies conducted in humans are observational rather than experimental. It is estimated that less than 2% out of 2 million concluded or ongoing observational studies have been registered. The 2013 revision of the Declaration of Helsinki requires registration of any type of research study involving humans or identifiable samples or data. It is proposed that funding agencies, such as the Fondo de Investigaciones Sanitarias, as well as private companies, require preregistration of observational studies before providing funding. It is also proposed that Research Ethics Committees which, following Spanish regulation, have been using the Declaration as the framework for assessing the ethics of clinical trials with medicines since 1990, should follow the same provisions for the assessment of health-related observational studies: therefore, they should require prospective registration of studies before granting their final approval. This would allow observational study investigators to be educated in complying with an ethical requirement recently introduced in the most important ethical code for research involving humans. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  11. Clinical trial registration was not an indicator for low risk of bias. (United States)

    Farquhar, Cynthia M; Showell, Marian G; Showell, Emily A E; Beetham, Penny; Baak, Nora; Mourad, Selma; Jordan, Vanessa M B


    To determine the prevalence of registered trials and to evaluate the risk of bias between registered and unregistered clinical trials. The Cochrane Gynecology and Fertility Group's specialized register was searched on November 5, 2015, for randomized controlled trials published from 2010 to 2014. Studies were selected if they had randomized women or men for fertility treatments, were published in full text and written in English. Two reviewers then independently assessed trial registration status for each trial, by searching the publication, trial registries, and by contacting the original authors. Of 693 eligible randomized controlled trials, only 44% were found to be registered. Unregistered clinical trials had smaller sample sizes than registered trials (P risk of bias using five of the Cochrane Risk of Bias "domains." Registered and unregistered trials differed in their risk of bias for random sequence generation (P = 0.001), allocation concealment (P = 0.003), and selective reporting (P  0.05) domains. Only 54 (43.2%) of the 125 registered trials were registered prospectively. This study has the following limitations. Only English language trials were included in this review. We were unable to obtain protocols for the unregistered trials and therefore were unable to assess the risk of bias in the selective reporting domain. All available trials should be included in systematic reviews and assessed for risk of bias as there are both registered trials with high risk of bias and unregistered trials with low risk of bias and by excluding unregistered trials more than half of the available evidence will be lost. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. Assessment of Registration Information on Methodological Design of Acupuncture RCTs: A Review of 453 Registration Records Retrieved from WHO International Clinical Trials Registry Platform. (United States)

    Gu, Jing; Wang, Qi; Wang, Xiaogang; Li, Hailong; Gu, Mei; Ming, Haixia; Dong, Xiaoli; Yang, Kehu; Wu, Hongyan


    Background. This review provides the first methodological information assessment of protocol of acupuncture RCTs registered in WHO International Clinical Trials Registry Platform (ICTRP). Methods. All records of acupuncture RCTs registered in the ICTRP have been collected. The methodological design assessment involved whether the randomization methods, allocation concealment, and blinding were adequate or not based on the information of registration records (protocols of acupuncture RCTs). Results. A total of 453 records, found in 11 registries, were examined. Methodological details were insufficient in registration records; there were 76.4%, 89.0%, and 21.4% records that did not provide information on randomization methods, allocation concealment, and blinding respectively. The proportions of adequate randomization methods, allocation concealment, and blinding were only 107 (23.6%), 48 (10.6%), and 210 (46.4%), respectively. The methodological design improved year by year, especially after 2007. Additionally, methodology of RCTs with ethics approval was clearly superior to those without ethics approval and different among registries. Conclusions. The overall methodological design based on registration records of acupuncture RCTs is not very well but improved year by year. The insufficient information on randomization methods, allocation concealment, and blinding maybe due to the relevant description is not taken seriously in acupuncture RCTs' registration.

  13. A new tool for touch-free patient registration for robot-assisted intracranial surgery: application accuracy from a phantom study and a retrospective surgical series. (United States)

    Cardinale, Francesco; Rizzi, Michele; d'Orio, Piergiorgio; Casaceli, Giuseppe; Arnulfo, Gabriele; Narizzano, Massimo; Scorza, Davide; De Momi, Elena; Nichelatti, Michele; Redaelli, Daniela; Sberna, Maurizio; Moscato, Alessio; Castana, Laura


    OBJECTIVE The purpose of this study was to compare the accuracy of Neurolocate frameless registration system and frame-based registration for robotic stereoelectroencephalography (SEEG). METHODS The authors performed a 40-trajectory phantom laboratory study and a 127-trajectory retrospective analysis of a surgical series. The laboratory study was aimed at testing the noninferiority of the Neurolocate system. The analysis of the surgical series compared Neurolocate-based SEEG implantations with a frame-based historical control group. RESULTS The mean localization errors (LE) ± standard deviations (SD) for Neurolocate-based and frame-based trajectories were 0.67 ± 0.29 mm and 0.76 ± 0.34 mm, respectively, in the phantom study (p = 0.35). The median entry point LE was 0.59 mm (interquartile range [IQR] 0.25-0.88 mm) for Neurolocate-registration-based trajectories and 0.78 mm (IQR 0.49-1.08 mm) for frame-registration-based trajectories (p = 0.00002) in the clinical study. The median target point LE was 1.49 mm (IQR 1.06-2.4 mm) for Neurolocate-registration-based trajectories and 1.77 mm (IQR 1.25-2.5 mm) for frame-registration-based trajectories in the clinical study. All the surgical procedures were successful and uneventful. CONCLUSIONS The results of the phantom study demonstrate the noninferiority of Neurolocate frameless registration. The results of the retrospective surgical series analysis suggest that Neurolocate-based procedures can be more accurate than the frame-based ones. The safety profile of Neurolocate-based registration should be similar to that of frame-based registration. The Neurolocate system is comfortable, noninvasive, easy to use, and potentially faster than other registration devices.

  14. Clinical Studies

    DEFF Research Database (Denmark)

    Pallesen, Ulla

    and repair? Have new materials improved longevity? Are there still clinical and material problems to be solved? And what has the highest impact on longevity of posterior resin restorations – the material, the dentist, the patient or the tooth? These matters will be discussed on the basis of the literature......Within the last 25 years composite resin materials have in many countries successively replaced amalgam as a restorative for posterior teeth. Resin materials and bonding systems are continuously being improved by the manufactures, adhesive procedures are now included in the curriculum of most...... universities and practicing dentists restore millions of teeth throughout the World with composite resin materials. Do we know enough about the clinical performance of these restorations over time? Numerous in vitro studies are being published on resin materials and adhesion, some of them attempting to imitate...

  15. Vision-based markerless registration using stereo vision and an augmented reality surgical navigation system: a pilot study. (United States)

    Suenaga, Hideyuki; Tran, Huy Hoang; Liao, Hongen; Masamune, Ken; Dohi, Takeyoshi; Hoshi, Kazuto; Takato, Tsuyoshi


    This study evaluated the use of an augmented reality navigation system that provides a markerless registration system using stereo vision in oral and maxillofacial surgery. A feasibility study was performed on a subject, wherein a stereo camera was used for tracking and markerless registration. The computed tomography data obtained from the volunteer was used to create an integral videography image and a 3-dimensional rapid prototype model of the jaw. The overlay of the subject's anatomic site and its 3D-IV image were displayed in real space using a 3D-AR display. Extraction of characteristic points and teeth matching were done using parallax images from two stereo cameras for patient-image registration. Accurate registration of the volunteer's anatomy with IV stereoscopic images via image matching was done using the fully automated markerless system, which recognized the incisal edges of the teeth and captured information pertaining to their position with an average target registration error of < 1 mm. These 3D-CT images were then displayed in real space with high accuracy using AR. Even when the viewing position was changed, the 3D images could be observed as if they were floating in real space without using special glasses. Teeth were successfully used for registration via 3D image (contour) matching. This system, without using references or fiducial markers, displayed 3D-CT images in real space with high accuracy. The system provided real-time markerless registration and 3D image matching via stereo vision, which, combined with AR, could have significant clinical applications.

  16. A descriptive survey investigating pre-registration student nurses' perceptions of clinical skill development in clinical placements. (United States)

    Stayt, Louise C; Merriman, Clair


    Clinical skill development is essential to nurse education. Clinical skills are frequently taught in higher education institutions using clinical simulation. It is unclear if clinical skills are subsequently consolidated and developed in clinical placements. The aim of this survey was to evaluate pre-registration student nurses perceptions of the frequency of opportunities to practise, the level of supervision and assessment of, clinical skills in their clinical placements. This was a cross-sectional survey design using an online, self-report questionnaire including a Likert-type scale and open ended comments. Four hundred and twenty one students, from all year groups, from a university in the south of England on a wide variety of clinical placements participated. Participants evaluated the frequency of opportunity to practise, level of supervision and assessment of and feedback on performance of specific clinical skills. Clinical skills evaluated were measurement of vital signs, aseptic non-touch technique, assisting with eating and drinking, and assisting with comfort and hygiene. Data were analysed utilising Statistical Package for the Social Sciences Version 19. The frequency of opportunities to practise skills in clinical placement was variable with some participants reporting that they never had opportunity to practise essential skills. Similarly the level of supervision and assessment was also inconsistent suggesting that participants frequently practised clinical skills unsupervised without being assessed as competent. Inconsistencies in clinical skill development may lead to graduates who are not work ready and as a result, insufficient clinical competence potentially leads to unsafe practice and poor patient care. This calls for stronger partnerships between educators and clinical areas and the prioritisation of mentor preparation and education as well as organisational support in terms of mentor workload planning. Copyright © 2012 Elsevier Ltd. All

  17. Trial publication after registration in ClinicalTrials.Gov: a cross-sectional analysis.

    Directory of Open Access Journals (Sweden)

    Joseph S Ross


    Full Text Available BACKGROUND: is a publicly accessible, Internet-based registry of clinical trials managed by the US National Library of Medicine that has the potential to address selective trial publication. Our objectives were to examine completeness of registration within and to determine the extent and correlates of selective publication. METHODS AND FINDINGS: We examined reporting of registration information among a cross-section of trials that had been registered at after December 31, 1999 and updated as having been completed by June 8, 2007, excluding phase I trials. We then determined publication status among a random 10% subsample by searching MEDLINE using a systematic protocol, after excluding trials completed after December 31, 2005 to allow at least 2 y for publication following completion. Among the full sample of completed trials (n = 7,515, nearly 100% reported all data elements mandated by, such as intervention and sponsorship. Optional data element reporting varied, with 53% reporting trial end date, 66% reporting primary outcome, and 87% reporting trial start date. Among the 10% subsample, less than half (311 of 677, 46% of trials were published, among which 96 (31% provided a citation within of a publication describing trial results. Trials primarily sponsored by industry (40%, 144 of 357 were less likely to be published when compared with nonindustry/nongovernment sponsored trials (56%, 110 of 198; p<0.001, but there was no significant difference when compared with government sponsored trials (47%, 57 of 122; p = 0.22. Among trials that reported an end date, 75 of 123 (61% completed prior to 2004, 50 of 96 (52% completed during 2004, and 62 of 149 (42% completed during 2005 were published (p = 0.006. CONCLUSIONS: Reporting of optional data elements varied and publication rates among completed trials registered within were low

  18. Unfolding case studies in pre-registration nursing education: lessons learned. (United States)

    West, Caryn; Usher, Kim; Delaney, Lori J


    Nursing education is undergoing radical change worldwide. There is criticism surrounding the content of education and the delivery. As a result, traditional methods of teaching and learning have been replaced by strategies that place greater emphasis on active learner interaction, critical thinking, and decision-making. Assisting pre-registration nurses to become competent and confident in clinical practice requires immersion in practice with sufficient support and coaching based on real life scenarios. Simulation via an unfolding case study approach is one way to provide interactive learning experiences where students acquire new skills that advance their clinical judgment with the aim of becoming safe, competent practitioners. Lessons learned from implementing an unfolding case study are discussed in this paper. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Review of clinical trial registration for clinical applications of acupuncture%临床试验注册在针灸临床的应用

    Institute of Scientific and Technical Information of China (English)

    严佳; 裴建


    Objective The aim of this study was to advance clinical acupuncture trials register, regulate research reports and improve the quality of clinical studies of acupuncture. Methods The domestic and international clinical trials registries and the meaning of clinical trial registration,particularly the status of acupuncture clinical trials registry were analyzed. Results There have been fourteen primary clinical trial registries of the World Health Organization Registry Network by August 2013. There are three important registries in the world,including Chinese clinical trial registry,American clinical trials registration database, and Australian and New Zealand clinical trials registry. Conclusion The clinical trials registry can increase the transparency of clinical trials,avoid selection bias and regulate ethical behavior. The acupuncture clinical researchers have an opportunity to choose a more transparent,effective and comprehensive clinical trials registry for clinical trials registry,which can promote the development of acupuncture.%目的:推进针灸临床试验注册和规范研究报告,提高针灸临床研究质量。方法收集分析国内外临床试验注册机构,对临床试验注册意义,尤其是对针灸临床试验注册现况进行分析。结果截至2013年8月,世界卫生组织一级注册机构有14个。国内外比较重要的临床试验注册机构有:中国临床试验注册中心、美国的Clinical Trials注册资料库、澳大利亚-新西兰临床试验注册中心等。结论临床试验注册增加了试验透明度、避免选择性偏倚,规范伦理行为。针灸临床研究者可选择具有良好透明度、高效、综合的临床试验注册库进行临床试验注册以促进针灸临床发展。

  20. A fast alignment method for breast MRI follow-up studies using automated breast segmentation and current-prior registration (United States)

    Wang, Lei; Strehlow, Jan; Rühaak, Jan; Weiler, Florian; Diez, Yago; Gubern-Merida, Albert; Diekmann, Susanne; Laue, Hendrik; Hahn, Horst K.


    In breast cancer screening for high-risk women, follow-up magnetic resonance images (MRI) are acquired with a time interval ranging from several months up to a few years. Prior MRI studies may provide additional clinical value when examining the current one and thus have the potential to increase sensitivity and specificity of screening. To build a spatial correlation between suspicious findings in both current and prior studies, a reliable alignment method between follow-up studies is desirable. However, long time interval, different scanners and imaging protocols, and varying breast compression can result in a large deformation, which challenges the registration process. In this work, we present a fast and robust spatial alignment framework, which combines automated breast segmentation and current-prior registration techniques in a multi-level fashion. First, fully automatic breast segmentation is applied to extract the breast masks that are used to obtain an initial affine transform. Then, a non-rigid registration algorithm using normalized gradient fields as similarity measure together with curvature regularization is applied. A total of 29 subjects and 58 breast MR images were collected for performance assessment. To evaluate the global registration accuracy, the volume overlap and boundary surface distance metrics are calculated, resulting in an average Dice Similarity Coefficient (DSC) of 0.96 and root mean square distance (RMSD) of 1.64 mm. In addition, to measure local registration accuracy, for each subject a radiologist annotated 10 pairs of markers in the current and prior studies representing corresponding anatomical locations. The average distance error of marker pairs dropped from 67.37 mm to 10.86 mm after applying registration.

  1. Automated analysis of small animal PET studies through deformable registration to an atlas

    Energy Technology Data Exchange (ETDEWEB)

    Gutierrez, Daniel F. [Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva 4 (Switzerland); Zaidi, Habib [Geneva University Hospital, Division of Nuclear Medicine and Molecular Imaging, Geneva 4 (Switzerland); Geneva University, Geneva Neuroscience Center, Geneva (Switzerland); University of Groningen, Department of Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, Groningen (Netherlands)


    This work aims to develop a methodology for automated atlas-guided analysis of small animal positron emission tomography (PET) data through deformable registration to an anatomical mouse model. A non-rigid registration technique is used to put into correspondence relevant anatomical regions of rodent CT images from combined PET/CT studies to corresponding CT images of the Digimouse anatomical mouse model. The latter provides a pre-segmented atlas consisting of 21 anatomical regions suitable for automated quantitative analysis. Image registration is performed using a package based on the Insight Toolkit allowing the implementation of various image registration algorithms. The optimal parameters obtained for deformable registration were applied to simulated and experimental mouse PET/CT studies. The accuracy of the image registration procedure was assessed by segmenting mouse CT images into seven regions: brain, lungs, heart, kidneys, bladder, skeleton and the rest of the body. This was accomplished prior to image registration using a semi-automated algorithm. Each mouse segmentation was transformed using the parameters obtained during CT to CT image registration. The resulting segmentation was compared with the original Digimouse atlas to quantify image registration accuracy using established metrics such as the Dice coefficient and Hausdorff distance. PET images were then transformed using the same technique and automated quantitative analysis of tracer uptake performed. The Dice coefficient and Hausdorff distance show fair to excellent agreement and a mean registration mismatch distance of about 6 mm. The results demonstrate good quantification accuracy in most of the regions, especially the brain, but not in the bladder, as expected. Normalized mean activity estimates were preserved between the reference and automated quantification techniques with relative errors below 10 % in most of the organs considered. The proposed automated quantification technique is

  2. A national multicenter registration study. Omalizumb in children in Denmark

    DEFF Research Database (Denmark)

    Spangberg, Katrien; Jørgensen, Inger Merete; Agertoft, Lone;

    allergic asthma according to GINA treated with Omalizumab • Total serum IgE >? • Planned and accepted off-label treatment Outcome registration: A broad panel of outcome measures is scheduled at baseline and during treatment: Outcomes: • Asthma exacerbations • Hospitalizations • Medication • Lung function...

  3. Compliance with trial registration in five core journals of clinical geriatrics: a survey of original publications on randomised controlled trials from 2008 to 2012. (United States)

    Mann, Eva; Nguyen, Natalie; Fleischer, Steffen; Meyer, Gabriele


    to assess the proportion of registered randomised controlled trials in five core clinical geriatric journals and to analyse whether registered study outcomes correspond with published outcomes. survey of original papers published 2008 to 2012. two independent reviewers retrieved the sample through search in the web-based archives of Age and Ageing, the Journal of the American Geriatric Society, the American Journal of Geriatric Psychiatry, the Journal of the American Medical Directors Association and International Psychogeriatrics. Data extraction was performed by two independent reviewers using a pre-tested 13-item checklist. Registration status was checked and information provided in registers compared with information presented in the original publication. A third reviewer was consulted if no consensus could be reached. the sample comprised 220 original publications on randomised controlled trials. A total of 140 (63.6%) were registered. Registration was in accordance with the ICMJE requirements in 54 out of 140 registered trials (38.6%). Less than one-third of registered papers (n = 40) reported on all study outcomes listed in the study register. In 74 out of the 80 non-registered trials, the missing registration was not declared in the publication. There was no consistent upward trend towards higher registration compliance throughout journals and years. our survey shows that prospective trial registration and compliance between outcomes declared in the registry and reported in the publication is poor. Concerted action of authors, editors and peer-reviewers is overdue aimed to irreversibly implement the imperative of registration of randomised controlled trials and complete outcome reporting. © The Author 2014. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@

  4. A reference dataset for deformable image registration spatial accuracy evaluation using the COPDgene study archive. (United States)

    Castillo, Richard; Castillo, Edward; Fuentes, David; Ahmad, Moiz; Wood, Abbie M; Ludwig, Michelle S; Guerrero, Thomas


    Landmark point-pairs provide a strategy to assess deformable image registration (DIR) accuracy in terms of the spatial registration of the underlying anatomy depicted in medical images. In this study, we propose to augment a publicly available database ( of medical images with large sets of manually identified anatomic feature pairs between breath-hold computed tomography (BH-CT) images for DIR spatial accuracy evaluation. Ten BH-CT image pairs were randomly selected from the COPDgene study cases. Each patient had received CT imaging of the entire thorax in the supine position at one-fourth dose normal expiration and maximum effort full dose inspiration. Using dedicated in-house software, an imaging expert manually identified large sets of anatomic feature pairs between images. Estimates of inter- and intra-observer spatial variation in feature localization were determined by repeat measurements of multiple observers over subsets of randomly selected features. 7298 anatomic landmark features were manually paired between the 10 sets of images. Quantity of feature pairs per case ranged from 447 to 1172. Average 3D Euclidean landmark displacements varied substantially among cases, ranging from 12.29 (SD: 6.39) to 30.90 (SD: 14.05) mm. Repeat registration of uniformly sampled subsets of 150 landmarks for each case yielded estimates of observer localization error, which ranged in average from 0.58 (SD: 0.87) to 1.06 (SD: 2.38) mm for each case. The additions to the online web database ( described in this work will broaden the applicability of the reference data, providing a freely available common dataset for targeted critical evaluation of DIR spatial accuracy performance in multiple clinical settings. Estimates of observer variance in feature localization suggest consistent spatial accuracy for all observers across both four-dimensional CT and COPDgene patient cohorts.

  5. Clinical translation of biomedical materials and the key factors towards product registration

    Directory of Open Access Journals (Sweden)

    Yuan Yuan


    Full Text Available Biomedical materials have been developed for facilitating tissue regeneration and healing enhancement. Although research on biomedical materials has made great progress in material innovation and preclinical testing, the bottleneck is their translation from research and development to clinical applications; that is, the current rate of product registration and industrialization is low, which directly affects their clinical applications. In this paper, we introduce the basic features of biomedical materials towards the making of medical products and the experiences of our group in research and clinical translation of biomaterials for bone-tissue regeneration in the last few years. Based on our experience, we propose that the translational medicine platform (TMP is an effective route to facilitate the progress of biomedical materials from bench to bedside. Moreover, from the viewpoints of scientific technology and management, the functions of TMP were also addressed. Relationships among TMP, research institution, enterprise, and government were also explored from the viewpoints of technological innovation, chemical engineering integration, fund raising, and management. This paper provides a theoretical and practical reference for clinical translation of biomedical materials.

  6. Rhinosinusitis in morbidity registrations in Dutch General Practice: a retro-spective case-control study



    BACKGROUND: There is only limited accurate data on the epidemiology of rhinosinusitis in primary care. This study was conducted to assess the incidence of acute and chronic rhinosinusitis by analysing data from two Dutch general practice registration projects. Several patient characteristics and diseases are related to the diagnosis rhinosinusitis. METHODS: The Continuous Morbidity Registration (CMR) and the Transitionproject (TP) are used to analyse the data on rhinosinusitis in primary prac...

  7. [Developing a harmonised system for the recognition of clinical trials for veterinary product registration]. (United States)

    Maliandi, F S


    The increase of commerce between developing countries requires a harmonised system for accepting the results of clinical trials (CT) of veterinary products, similar to those that exist in developed countries. The objective of this paper is to propose a basis for the creation of a system that harmonises CTs for approving veterinary products (VP) for registration. Such a system would be a step towards unifying the CTs of different countries, while maintaining country-specific variations that are compatible with the scientific method, international standards, and the principles of objectivity, transparency and confidentiality. Basic requirements to be fulfilled by both private institutions and public offices are described, as are professional responsibilities and possible administrative procedures that could be adapted in each country. The conclusion reached is that a harmonised system is feasible, as has been demonstrated in numerous countries throughout the world. A harmonised system will result in a more efficient product approval process, a reduction in costs, greater transparency in controls, an improvement in the reliability of the health system, and a reduction in the time the process takes. It will also contribute to animal welfare by avoiding the need to repeat trials. The author acknowledges that there are cultural, technological and economic limitations and that these problems, and others, have yet to be overcome.

  8. Nonrigid registration of myocardial perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur


    This paper describes a fully automatic registration of 10 multi-slice myocardial perfusion magnetic resonance image sequences. The registration of these sequences is crucial for the clinical interpretation, which currently is subjected to manual labour. The approach used in this study is a nonrig...

  9. SU-E-J-112: Intensity-Based Pulmonary Image Registration: An Evaluation Study

    Energy Technology Data Exchange (ETDEWEB)

    Yang, F; Meyer, J; Sandison, G [Department of Radiation Oncology, University of Washington Medical Center, Seattle, WA (United States)


    Purpose: Accurate alignment of thoracic CT images is essential for dose tracking and to safely implement adaptive radiotherapy in lung cancers. At the same time it is challenging given the highly elastic nature of lung tissue deformations. The objective of this study was to assess the performances of three state-of-art intensity-based algorithms in terms of their ability to register thoracic CT images subject to affine, barrel, and sinusoid transformation. Methods: Intensity similarity measures of the evaluated algorithms contained sum-of-squared difference (SSD), local mutual information (LMI), and residual complexity (RC). Five thoracic CT scans obtained from the EMPIRE10 challenge database were included and served as reference images. Each CT dataset was distorted by realistic affine, barrel, and sinusoid transformations. Registration performances of the three algorithms were evaluated for each distortion type in terms of intensity root mean square error (IRMSE) between the reference and registered images in the lung regions. Results: For affine distortions, the three algorithms differed significantly in registration of thoracic images both visually and nominally in terms of IRMSE with a mean of 0.011 for SSD, 0.039 for RC, and 0.026 for LMI (p<0.01; Kruskal-Wallis test). For barrel distortion, the three algorithms showed nominally no significant difference in terms of IRMSE with a mean of 0.026 for SSD, 0.086 for RC, and 0.054 for LMI (p=0.16) . A significant difference was seen for sinusoid distorted thoracic CT data with mean lung IRMSE of 0.039 for SSD, 0.092 for RC, and 0.035 for LMI (p=0.02). Conclusion: Pulmonary deformations might vary to a large extent in nature in a daily clinical setting due to factors ranging from anatomy variations to respiratory motion to image quality. It can be appreciated from the results of the present study that the suitability of application of a particular algorithm for pulmonary image registration is deformation-dependent.

  10. Evaluation of whole-body MR to CT deformable image registration

    NARCIS (Netherlands)

    Akbarzadeh, A.; Gutierrez, D.; Baskin, A.; Ay, M. R.; Ahmadian, A.; Alam, N. Riahi; Loevblad, K. O.; Zaidi, H.


    Multimodality image registration plays a crucial role in various clinical and research applications. The aim of this study is to present an optimized MR to CT whole-body deformable image registration algorithm and its validation using clinical studies. A 3D intermodality registration technique based

  11. 医疗器械注册临床评价研究%Clinical evaluation research of medical device registration

    Institute of Scientific and Technical Information of China (English)

    苑富强; 李非


    Objective: To help medical device registration applicant understand the content of clinical evaluation, guided on the clinical evaluation method, and also putted forward several suggestions of the improvement scheme for our country registered clinical assessment and review of the work. Methods:Described the Global Harmonization Task Force (GHTF) medical device registration guidance for clinical evaluation, combined with the status quo of supervision in China, and made some specific scheme on China's medical device of clinical evaluation work. Results: Introduced the contents of the clinical evaluation and the relationships between the factors, in order to help the medical device registration applicant and Chinese regulators to do clinical evaluation work of scientific and reasonable. Conclusion:The definition of medical device registration clinical evaluation should clear the clinical evaluation, and to develop guidance for clinical evaluation of the corresponding.%目的:帮助医疗器械注册申请人了解临床评价内容,指导临床评价方法,并对我国注册审查临床评价的工作提出改进方案。方法:介绍全球医疗器械协调工作组(GHTF)医疗器械注册临床评价指导原则,结合我国监管现状对医疗器械注册监管中临床评价审查工作提出具体方案。结果:介绍临床评价所涵盖的内容以及其中数个要素之间的关系,使医疗器械注册申请人和监管部门科学合理地进行临床评价工作。结论:医疗器械注册临床评价需明确临床评价的定义,并制定出相应的临床评价指导原则。

  12. Study on real-time registration in dual spectrum low level light night vision technique (United States)

    Bai, Lian-fa; Zhang, Yi; Zhang, Chuang; Chen, Qian; Gu, Guo-hua


    In low level light (LLL) color night vision technology, dual spectrum images with respective special information were acquired, and target identification probability would be effectively improved through dual spectrum image fusion. Image registration is one of the key technologies during this process. Current dual spectrum image registration methods mainly include dual imaging channel common optical axis scheme and image characteristic pixel searching scheme. In dual imaging channel common optical axis scheme, additional prismatic optical components should be used, and large amount of radiative energy was wasted. In image characteristic pixel searching scheme, complicated arithmetic made it difficult for its real time realization. In this paper, dual channel dual spectrum LLL color night vision system structure feature and dual spectrum image characteristics was studied, dual spectrum image gray scale symbiotic matrix 2-dimensional histogram was analysed, and a real time image registration method including electronic digital shifting, pixel extension and extraction was put forward. By the analysis of spatial gray-scale relativity of fusion image, registration precision is quantitatively expressed. Emulation experiments indicate that this arithmetic is fast and exact for our dual channel dual spectrum image registration. This method was realized on dual spectrum LLL color night vision experimental apparatus based on Texas Instruments digital video processing device DM642.

  13. The comparative accuracy of the ROSA stereotactic robot across a wide range of clinical applications and registration techniques. (United States)

    Brandmeir, Nicholas J; Savaliya, Sandip; Rohatgi, Pratik; Sather, Michael


    Robot-assisted stereotactic neurosurgery is an emerging technology with a growing range of applications. The ROSA system is a robotic stereotactic system that has been shown to be accurate in laboratory studies and large case series. The goal of this study was to examine the accuracy of the ROSA across different registration methods as well as different clinical applications. Sixteen patients with one hundred and seventeen stereotactic trajectories were examined. Accuracy was compared by measuring the distance between the trajectory target and the actual termination of the device as determined by imaging. Entry error and angular deviation were also measured. Variables included bone fiducials vs. laser facial scanning, the clinical indication for stereotactic surgery, and the effect of lead deflection on accuracy. Bone fiducials did not offer an accuracy benefit over laser facial scanning (mean target error 4.5-3.9 mm, p = 0.34) in these clinical scenarios. Laser interstitial thermal therapy, responsive neurostimulation, and stereo electroencephalography were equally accurate when placed by the ROSA (mean target error 4.4-4.3-4.0 mm, respectively, p = 0.69). Deflection did not affect lead accuracy (mean target error 4.4-3.9 mm, p = 0.11). Similar results are seen for entry error and angular deviation. ROSA is a highly accurate stereotactic system. Laser facial scanning provides the same accuracy as bone fiducials in these stereotactic applications. The ROSA is equally accurate across a wide spectrum of applications. The ROSA is effective at limiting lead deflection, and when it does occur, it does not impact target accuracy in a significant way.

  14. Taken-for-granted assumptions about the clinical experience of newly graduated registered nurses from their pre-registration paid employment: A narrative inquiry. (United States)

    Law, Yee-Shui Bernice; Chan, E Angela


    Paid employment within clinical setting, such as externships for undergraduate student, are used locally and globally to better prepare and retain new graduates for actual practice and facilitate their transition into becoming registered nurses. However, the influence of paid employment on the post-registration experience of such nurses remains unclear. Through the use of narrative inquiry, this study explores how the experience of pre-registration paid employment shapes the post-registration experience of newly graduated registered nurses. Repeated individual interviews were conducted with 18 new graduates, and focus group interviews were conducted with 11 preceptors and 10 stakeholders recruited from 8 public hospitals in Hong Kong. The data were subjected to narrative and paradigmatic analyses. Taken-for-granted assumptions about the knowledge and performance of graduates who worked in the same unit for their undergraduate paid work experience were uncovered. These assumptions affected the quantity and quality of support and time that other senior nurses provided to these graduates for their further development into competent nurses and patient advocates, which could have implications for patient safety. It is our hope that this narrative inquiry will heighten awareness of taken-for-granted assumptions, so as to help graduates transition to their new role and provide quality patient care.

  15. Emotional intelligence increases over time: A longitudinal study of Australian pre-registration nursing students. (United States)

    Foster, Kim; Fethney, Judith; McKenzie, Heather; Fisher, Murray; Harkness, Emily; Kozlowski, Desirée


    Emotional intelligence (EI) has been associated with positive outcomes for nursing students. Higher EI is associated with personal wellbeing and stress management, higher academic performance, stronger nursing leadership and practice performance, and greater patient safety. While there is an increasing body of evidence on nursing students' EI, there is minimal evidence on EI over time during pre-registration programs. To measure EI in pre-registration nursing students from program commencement to conclusion to ascertain EI over time and examine the relationship between EI and academic performance. Longitudinal repeated measures study between March 2010-February 2013 at a metropolitan university in Australia. 111 nursing students (74.8% female) contributed data on at least two occasions. Participants were enrolled in a pre-registration Master of Nursing degree. Half the cohort (55.0%) comprised Graduate Entry students who completed the course in two years full time. The other 45% were enrolled in an undergraduate degree in arts, science or health science, combined with the same pre-registration Master of Nursing Degree. These students completed their Combined Degree program in four years full time. Participants had a mean age of 24.7years (SD=7.36). EI was measured for commencing students (T1) using the Assessing Emotions Scale (AES), then a further three times: end of first year (T2; 9 months follow up); beginning of second year (12 months follow up; T3) and end of the program (T4; 24/36 months follow up). Students' EI was found to increase across the program; one subscale of EI (managing others' emotions) was related to higher academic performance; and there was a significant increase in the Utilising Emotions subscale scores over time. Pre-registration nurse education contributes to strengthening students' EI over time. Specific EI education scaffolded throughout programs is recommended in pre-registration curricula. Copyright © 2017. Published by Elsevier Ltd.

  16. Study on requirements of bioequivalence for registration of pharmaceutical products in USA, Europe and Canada


    Galgatte, Upendra C.; Jamdade, Vijay R.; Aute, Pravin P.; Chaudhari, Pravin D.


    The present study was aimed to study the requirements of bioequivalence for the registration of pharmaceutical products in the USA, Europe and Canada. Before going into bioequivalence studies it is essential for the pharmaceutical industry to study the guidelines of bioequivalence for the respective country where the industry wants to market its products and thus enter into generic market. This study reviews the requirements of bioequivalence with study parameters such as study design, fastin...

  17. Rhinosinusitis in morbidity registrations in Dutch General Practice: a retro-spective case-control study

    NARCIS (Netherlands)

    Hoffmans, R.; Schermer, T.R.; Linde, K. van der; Bor, H.; Boven, K. van; Weel, C. van; Fokkens, W.


    BACKGROUND: There is only limited accurate data on the epidemiology of rhinosinusitis in primary care. This study was conducted to assess the incidence of acute and chronic rhinosinusitis by analysing data from two Dutch general practice registration projects. Several patient characteristics and dis

  18. Towards optimal clinical and epidemiological registration of haematological malignancies: Guidelines for recording progressions, transformations and multiple diagnoses. (United States)

    Gavin, Anna; Rous, Brian; Marcos-Gragera, Rafael; Middleton, Richard; Steliarova-Foucher, Eva; Maynadie, Marc; Zanetti, Roberto; Visser, Otto


    Haematological malignancies (HM) represent over 6% of the total cancer incidence in Europe and affect all ages, ranging between 45% of all cancers in children and 7% in the elderly. Thirty per cent of childhood cancer deaths are due to HM, 8% in the elderly. Their registration presents specific challenges, mainly because HM may transform or progress in the course of the disease into other types of HM. In the context of cancer registration decisions have to be made about classifying subsequent notifications on the same patient as the same tumour (progression), a transformation or a new tumour registration. Allocation of incidence date and method of diagnosis must also be standardised. We developed European Network of Cancer Registries (ENCR) recommendations providing specific advice for cancer registries to use haematology and molecular laboratories as data sources, conserve the original date of incidence in case of change of diagnosis, make provision for recording both the original as well as transformed tumour and to apply precise rules for recording and counting multiple diagnoses. A reference table advising on codes which reflect a potential transformation or a new tumour is included. This work will help to improve comparability of data produced by population-based cancer registries, which are indispensable for aetiological research, health care planning and clinical research, an increasing important area with the application of targeted therapies.

  19. A transformation similarity constraint for groupwise nonlinear registration in longitudinal neuroimaging studies (United States)

    Fleishman, Greg M.; Gutman, Boris A.; Fletcher, P. Thomas; Thompson, Paul


    Patients with Alzheimer's disease and other brain disorders often show a similar spatial distribution of volume change throughout the brain over time, but this information is not yet used in registration algorithms to refine the quantification of change. Here, we develop a mathematical basis to incorporate that prior information into a longitudinal structural neuroimaging study. We modify the canonical minimization problem for non-linear registration to include a term that couples a collection of registrations together to enforce group similarity. More specifically, throughout the computation we maintain a group-level representation of the transformations and constrain updates to individual transformations to be similar to this representation. The derivations necessary to produce the Euler-Lagrange equations for the coupling term are presented and a gradient descent algorithm based on the formulation was implemented. We demonstrate using 57 longitudinal image pairs from the Alzheimer's Disease Neuroimaging Initiative (ADNI) that longitudinal registration with such a groupwise coupling prior is more robust to noise in estimating change, suggesting such change maps may have several important applications.

  20. Enhancing the Multivariate Signal of 15O water PET Studies With a New Non-Linear Neuroanatomical Registration Algorithm

    DEFF Research Database (Denmark)

    Kjems, Ulrik; Storther, Stephen C.; Anderson, Jon


    This paper addresses the problem of neuro-anatomical registration across individuals for functional [15O]water PET activation studies. A new algorithm for 3D non-linear structural registration (warping) of MR scans is presented. The method performs a hierarchically scaled search for a displacement...

  1. Enhancing the Multivariate Signal of 15O water PET Studies With a New Non-Linear Neuroanatomical Registration Algorithm

    DEFF Research Database (Denmark)

    Kjems, Ulrik; Storther, Stephen C.; Anderson, Jon


    This paper addresses the problem of neuro-anatomical registration across individuals for functional [15O]water PET activation studies. A new algorithm for 3D non-linear structural registration (warping) of MR scans is presented. The method performs a hierarchically scaled search for a displacemen...

  2. Real-time bladder lesion registration and navigation: a phantom study.

    Directory of Open Access Journals (Sweden)

    Michelle Agenant

    Full Text Available BACKGROUND: Bladder cancer is the fourth most common malignancy in men, with a recurrence rate of 33-64%. Tumor documentation during cystoscopy of the bladder is suboptimal and might play a role in these high recurrence rates. OBJECTIVE: In this project, a bladder registration and navigation system was developed to improve bladder tumor documentation and consequently increase reproducibility of the cystoscopy. MATERIALS/METHODS: The bladder registration and navigation system consists of a stereo-tracker that tracks the location of a newly developed target, which is attached to the endoscope during cystoscopy. With this information the urology registration and navigation software is able to register the 3D position of a lesion of interest. Simultaneously, the endoscopic image is captured in order to combine it with this 3D position. To enable navigation, navigational cues are displayed on the monitor, which subsequently direct the cystoscopist to the previously registered lesion. To test the system, a rigid and a flexible bladder phantom was developed. The system's robustness was tested by measuring the accuracy of registering and navigating the lesions. Different calibration procedures were compared. It was also tested whether system accuracy is limited by using a previously saved calibration, to avoid surgical delay due to calibration. Urological application was tested by comparing a rotational camera (fixed to the rotating endoscope to a non-rotational camera (dangling by gravity used in standard urologic practice. Finally, the influence of volume differences on registering and navigating was tested. RESULTS/CONCLUSION: The bladder registration and navigation system has an acceptable accuracy for bladder lesion registration and navigation. Limitations for patient determinants included changes in bladder volume and bladder deformation. In vivo studies are required to measure the effect of these limitations and functionality in urological

  3. Explaining the experiences of nurses about post-registration nursing education context: A qualitative study

    Directory of Open Access Journals (Sweden)

    A. A Vaezi


    Full Text Available Introduction: One of the ways that can improve scientifically the nursing care behaviors is Post-Registration Nursing Education and sttaf development process. To achieve this objective appropriate context Post-Registration Education must be provided for nurses. Currently, despite the legal requirement for continuing education for nurses, this goal has not been achieved as desired. To achieve this goal, the underlying cause should be investigated. Therefore, the aim of this study was to explore nurses' experiences of nursing continuing education context by a qualitative study.  Methods: The study with a qualitative approach was conducted in 2011, 23 people from the Educational Supervisors, nurse managers and nurses with a purposeful sampling participated in the study . The data collected by unstructured interviews and field notes and were analyzed using conventional content analysis .  Results: During the process of content analysis, participants explained three themes includeing: 1 insufficient attitude to the required training 2 inadequate support 3 Passive training monitoring and the main theme of the study was inadequate perception of their legal education.  Conclusion: Currently, due to lack of motivation, support and effective supervision of Post-Registration Nursing Education nurses involved inactively in the learning process and continuing education is limited to the statutory approvals and business benefits of training for nurses and their organizations. So To improve this situation is required attention and good infrastructure Includeing adequate support and effective supervision.

  4. Studying primate carpal kinematics in three dimensions using a computed-tomography-based markerless registration method. (United States)

    Orr, Caley M; Leventhal, Evan L; Chivers, Spencer F; Marzke, Mary W; Wolfe, Scott W; Crisco, Joseph J


    The functional morphology of the wrist pertains to a number of important questions in primate evolutionary biology, including that of hominins. Reconstructing locomotor and manipulative capabilities of the wrist in extinct species requires a detailed understanding of wrist biomechanics in extant primates and the relationship between carpal form and function. The kinematics of carpal movement, and the role individual joints play in providing mobility and stability of the wrist, is central to such efforts. However, there have been few detailed biomechanical studies of the nonhuman primate wrist. This is largely because of the complexity of wrist morphology and the considerable technical challenges involved in tracking the movements of the many small bones that compose the carpus. The purpose of this article is to introduce and outline a method adapted from human clinical studies of three-dimensional (3D) carpal kinematics for use in a comparative context. The method employs computed tomography of primate cadaver forelimbs in increments throughout the wrist's range of motion, coupled with markerless registration of 3D polygon models based on inertial properties of each bone. The 3D kinematic principles involved in extracting motion axis parameters that describe bone movement are reviewed. In addition, a set of anatomically based coordinate systems embedded in the radius, capitate, hamate, lunate, and scaphoid is presented for the benefit of other primate functional morphologists interested in studying carpal kinematics. Finally, a brief demonstration of how the application of these methods can elucidate the mechanics of the wrist in primates illustrates the closer-packing of carpals in chimpanzees than in orangutans, which may help to stabilize the midcarpus and produce a more rigid wrist beneficial for efficient hand posturing during knuckle-walking locomotion.

  5. Registration of symptoms and diagnoses in patients of a Belarussian-Dutch outpatient clinic in Gomel, October 1991 - September 1993

    Energy Technology Data Exchange (ETDEWEB)

    Van Oostrum, I.E.A.; Svalkoul, T.J.F. [National Poison Control Centre, RIVM, Bilthoven (Netherlands); Joore, J.C.A. [Department of Intensive Care and Clinical Toxicology, AZU, Utrecht (Netherlands); Volkova, G.V.; Savkova, M.I.; Derzhitski, V.E. [Gomel Regional Specialized Dispensary, Gomel (Belarus); Bootsma, P.A. [Bureau for International Cooperation, RIVM, Bilthoven (Netherlands)


    The results of a survey of the medical consumption of 4,500 patients at the Belarussian-Dutch Outpatient Clinic in Gomel during 1991-1993 are presented and discussed. Analysis of the patient registration data was focused on complaints related to possible enhanced radiation exposure of the patients since the reactor incident at Chernobyl in 1986. The pattern of complaints and diagnoses was comparable to the situation in a Dutch outpatient clinic, except for a higher number of goitre, gastritis, gastric and duodenal ulcers. Diagnoses that could be attributed to increased radiation exposure were not enhanced compared to the pattern in a Dutch population of similar size, except for a higher number of thyroid disease. 19 refs.

  6. SU-E-J-76: CBCT Reconstruction of a Full Couch Using Rigid Registration and Pre-Scanned Couch Image and Its Clinical Application

    Energy Technology Data Exchange (ETDEWEB)

    Hu, E; Lasio, G; Lee, M; Chen, S; Yi, B [Univ. of Maryland School Of Medicine, Baltimore, MD (United States)


    Purpose: Only a part of a treatment couch is reconstructed in CBCT due to the limited field of view (FOV). This often generates inaccurate results in the delivered dose evaluation with CBCT and more noise in the CBCT reconstruction. Full reconstruction of the couch at treatment setup can be used for more accurate exit beam dosimetry. The goal of this study is to develop a method to reconstruct a full treatment couch using a pre-scanned couch image and rigid registration. Methods: A full couch (Exact Couch, Varian) model image was reconstructed by rigidly registering and combining two sets of partial CBCT images. The full couch model includes three parts: two side rails and a couch top. A patient CBCT was reconstructed with reconstruction grid size larger than the physical field of view to include the full couch. The image quality of the couch is not good due to data truncation, but good enough to allow rigid registration of the couch. A composite CBCT image of the patient plus couch has been generated from the original reconstruction by replacing couch portion with the pre-acquired model couch, rigidly registered to the original scan. We evaluated the clinical usefulness of this method by comparing treatment plans generated on the original and on the modified scans. Results: The full couch model could be attached to a patient CBCT image set via rigid image registration. Plan DVHs showed 1∼2% difference between plans with and without full couch modeling. Conclusion: The proposed method generated a full treatment couch CBCT model, which can be successfully registered to the original patient image. This method was also shown to be useful in generating more accurate dose distributions, by lowering 1∼2% dose in PTV and a few other critical organs. Part of this study is supported by NIH R01CA133539.

  7. Registration Service

    CERN Multimedia

    GS Department


    Following a reorganization in Building 55, please note that the Registration Service is now organised as follows :  Ground floor: access cards (76903). 1st floor : registration of external firms’ personnel (76611 / 76622); car access stickers (76633); biometric registration (79710). Opening hours: 07-30 to 16-00 non-stop. GS-SEM Group General Infrastructure Services Department

  8. Rethinking theory and practice: pre-registration student nurses experiences of simulation teaching and learning in the acquisition of clinical skills in preparation for practice. (United States)

    Hope, Angela; Garside, Joanne; Prescott, Stephen


    In the United Kingdom (UK) simulation learning has been recognised in the form of a regulatory agreement that may replace hours from clinical practice. This integration has become an embedded feature of the pre-registration nursing programme at a University in the North of England, along with strategic investment in staff and simulation suites developed to underpin this curriculum change albeit in the absence of sparse empirical evidence, hence the rationale for the study which was designed to explore the relationship between simulation, theory and practice. The study features a thematic analysis of evaluation questionnaires from pre-registration student nurses (n=>500) collected over a 2 year period which informed subsequent focus group interviews to explore the themes in more detail. Consistent data findings were the students' positive response to simulation as a learning approach facilitating the application of theory in a safe controlled environment. Students reported that they felt prepared for practice, recognising that simulated learning improved their humanistic and problem solving abilities as well as the development of psychomotor, technical skills, and overall confidence. The theory-practice gap is a recurring narrative in the nursing literature, the findings of this study recognises that simulation offers an opportunity to enact the integration of theory and practice illuminating this relationship in a controlled environment thus, reinforcing the theory-practice relationship for nursing students.

  9. Sensitivity study of voxel-based PET image comparison to image registration algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Yip, Stephen, E-mail:; Chen, Aileen B.; Berbeco, Ross [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 (United States); Aerts, Hugo J. W. L. [Department of Radiation Oncology, Brigham and Women’s Hospital, Dana-Farber Cancer Institute and Harvard Medical School, Boston, Massachusetts 02115 and Department of Radiology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts 02115 (United States)


    Purpose: Accurate deformable registration is essential for voxel-based comparison of sequential positron emission tomography (PET) images for proper adaptation of treatment plan and treatment response assessment. The comparison may be sensitive to the method of deformable registration as the optimal algorithm is unknown. This study investigated the impact of registration algorithm choice on therapy response evaluation. Methods: Sixteen patients with 20 lung tumors underwent a pre- and post-treatment computed tomography (CT) and 4D FDG-PET scans before and after chemoradiotherapy. All CT images were coregistered using a rigid and ten deformable registration algorithms. The resulting transformations were then applied to the respective PET images. Moreover, the tumor region defined by a physician on the registered PET images was classified into progressor, stable-disease, and responder subvolumes. Particularly, voxels with standardized uptake value (SUV) decreases >30% were classified as responder, while voxels with SUV increases >30% were progressor. All other voxels were considered stable-disease. The agreement of the subvolumes resulting from difference registration algorithms was assessed by Dice similarity index (DSI). Coefficient of variation (CV) was computed to assess variability of DSI between individual tumors. Root mean square difference (RMS{sub rigid}) of the rigidly registered CT images was used to measure the degree of tumor deformation. RMS{sub rigid} and DSI were correlated by Spearman correlation coefficient (R) to investigate the effect of tumor deformation on DSI. Results: Median DSI{sub rigid} was found to be 72%, 66%, and 80%, for progressor, stable-disease, and responder, respectively. Median DSI{sub deformable} was 63%–84%, 65%–81%, and 82%–89%. Variability of DSI was substantial and similar for both rigid and deformable algorithms with CV > 10% for all subvolumes. Tumor deformation had moderate to significant impact on DSI for progressor

  10. A fast and robust patient specific Finite Element mesh registration technique: application to 60 clinical cases

    CERN Document Server

    Bucki, Marek; Payan, Yohan; 10.1016/


    Finite Element mesh generation remains an important issue for patient specific biomechanical modeling. While some techniques make automatic mesh generation possible, in most cases, manual mesh generation is preferred for better control over the sub-domain representation, element type, layout and refinement that it provides. Yet, this option is time consuming and not suited for intraoperative situations where model generation and computation time is critical. To overcome this problem we propose a fast and automatic mesh generation technique based on the elastic registration of a generic mesh to the specific target organ in conjunction with element regularity and quality correction. This Mesh-Match-and-Repair (MMRep) approach combines control over the mesh structure along with fast and robust meshing capabilities, even in situations where only partial organ geometry is available. The technique was successfully tested on a database of 5 pre-operatively acquired complete femora CT scans, 5 femoral heads partially...

  11. GLP principles and their role in supporting pharmacokinetic and residue depletion studies for drug registration and licensing. (United States)

    Croubels, Siska; De Backer, Patrick; Devreese, Mathias


    Good Laboratory Practice (GLP) is a quality system concerned with the organizational process and the conditions under which non-clinical health and environmental safety studies are planned, performed, monitored, recorded, archived, and reported. This paper focuses on the GLP principles applicable for veterinary drug registration and licensing purposes. First, a general overview of the GLP requirements is given, followed by a more specific comparison and discussion of the analytical method validation parameters and acceptance criteria of different international guidelines applied in the context of veterinary drug pharmacokinetic and residue depletion studies. Finally, some needs with respect to method validation and new developments in pharmacokinetic and residue depletion studies are highlighted. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  12. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Children & Clinical Studies NHLBI Trials Clinical Trial Websites Children and Clinical Studies Learn more about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to ...

  13. Ten Years after the International Committee of Medical Journal Editors' Clinical Trial Registration Initiative, One Quarter of Phase 3 Pediatric Epilepsy Clinical Trials Still Remain Unpublished: A Cross Sectional Analysis.

    Directory of Open Access Journals (Sweden)

    Anette Lampert

    Full Text Available Although selective reporting of clinical trial results introduces bias into evidence based clinical decision making, publication bias in pediatric epilepsy is unknown today. Since there is a considerable ambiguity in the treatment of an important and common clinical problem, pediatric seizures, we assessed the public availability of results of phase 3 clinical trials that evaluated treatments of seizures in children and adolescents as a surrogate for the extent of publication bias in pediatric epilepsy.We determined the proportion of published and unpublished study results of phase 3 clinical trials that were registered as completed on We searched, PubMed, and Google Scholar for publications and contacted principal investigators or sponsors. The analysis was performed according to STROBE criteria.Considering studies that were completed before 2014 (N = 99, 75 (76% pediatric phase 3 clinical trials were published but 24 (24% remained unpublished. The unpublished studies concealed evidence from 4,437 patients. Mean time-to-publication was 25 SD ± 15.6 months, more than twice as long as mandated.Ten years after the ICMJE's clinical trials registration initiative there is still a considerable amount of selective reporting and delay of publication that potentially distorts the body of evidence in the treatment of pediatric seizures.

  14. How Commonly Used Inclusion and Exclusion Criteria in Antidepressant Registration Trials Affect Study Enrollment. (United States)

    Preskorn, Sheldon H; Macaluso, Matthew; Trivedi, Madhukar


    In clinical trials, each specific inclusion and exclusion criterion eliminates a percentage of the potentially eligible population from trial participation and thus increases the time and effort needed for enrollment in a study. Drug developers often do not have data on how these criteria affect the pool of potentially eligible subjects for their trials and, hence, they cannot factor in the impact of these criteria when designing a study and planning the time needed to complete it. Consequently, drug developers often have ambitious timelines that are unrealistic and can lead to actions that may interfere with the ability to separate the efficacy of drug versus placebo. To investigate the effects of inclusion and exclusion criteria on study enrollment, the authors quantified the effects of the inclusion and exclusion criteria commonly used in antidepressant registration trials (ARTs) by applying these criteria to the population treated in the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study. In essence, the STAR*D study population was used as a surrogate for the general population of individuals with major depressive disorder. The effect of each criterion commonly used in ARTs was assessed in terms of the percentage of the STAR*D population that would have been excluded individually and collectively (i.e., when all criteria were applied at once). For continuous criteria such as age and severity of depression, the resulting effects have been presented graphically. Collectively, the typical inclusion and exclusion criteria used in ARTs would have eliminated at least 82% of the STAR*D population. This result means that more than 5 times the number of subjects would have to be screened to find a population that would meet the typical inclusion and exclusion criteria for an ART, directly determining the screening effort required in terms of both resources and time. Thus, developers of antidepressant drugs can use the data from this study to plan the

  15. Clinical trial registration, reporting, publication and FDAAA compliance: a cross-sectional analysis and ranking of new drugs approved by the FDA in 2012


    Miller, Jennifer E.; Korn, David; Ross, Joseph S


    Objective: To evaluate clinical trial registration, reporting and publication rates for new drugs by: (1) legal requirements and (2) the ethical standard that all human subjects research should be publicly accessible to contribute to generalisable knowledge. Design: Cross-sectional analysis of all clinical trials submitted to the Food and Drug Administration (FDA) for drugs approved in 2012, sponsored by large biopharmaceutical companies. Data sources Information from Drugs@FDA, ClinicalTrial...

  16. Considerations for clinical pharmacology studies for biologics in emerging markets. (United States)

    Damle, Bharat; White, Robert; Wang, Huifen Faye


    Registration of innovative biologics in Emerging Markets (EMs) poses many opportunities and challenges. The BRIC-MT countries (Brazil, Russia, India, China, Mexico, and Turkey) that are the fastest growing markets and regulators in these countries have imposed certain requirements, including the need for local clinical studies, for registration of biologics. The regulatory landscape in these countries is rapidly evolving, which necessitates an up-to-date understanding of such requirements. There is growing evidence which suggests that race, after accounting for body weight differences, may not influence the pharmacokinetics of biologics to the same extent that it does for small molecules. Thus, the requirements for clinical pharmacology trials in EMs are driven mainly by regulatory needs set forth by local Ministry of Health. In addition to the clinical Phase I to III studies done in the global program that supports registration in large geographies, countries such as China require local single and multiple dose Phase I studies. Participating in global studies with clinical sites within their country may be sufficient for some markets, while other regulators may be satisfied with a Certificate of Pharmaceutical Product. This paper discusses the current requirements for registration of innovative biologics in key EMs.

  17. Geometry-based vs. intensity-based medical image registration: A comparative study on 3D CT data. (United States)

    Savva, Antonis D; Economopoulos, Theodore L; Matsopoulos, George K


    Spatial alignment of Computed Tomography (CT) data sets is often required in numerous medical applications and it is usually achieved by applying conventional exhaustive registration techniques, which are mainly based on the intensity of the subject data sets. Those techniques consider the full range of data points composing the data, thus negatively affecting the required processing time. Alternatively, alignment can be performed using the correspondence of extracted data points from both sets. Moreover, various geometrical characteristics of those data points can be used, instead of their chromatic properties, for uniquely characterizing each point, by forming a specific geometrical descriptor. This paper presents a comparative study reviewing variations of geometry-based, descriptor-oriented registration techniques, as well as conventional, exhaustive, intensity-based methods for aligning three-dimensional (3D) CT data pairs. In this context, three general image registration frameworks were examined: a geometry-based methodology featuring three distinct geometrical descriptors, an intensity-based methodology using three different similarity metrics, as well as the commonly used Iterative Closest Point algorithm. All techniques were applied on a total of thirty 3D CT data pairs with both known and unknown initial spatial differences. After an extensive qualitative and quantitative assessment, it was concluded that the proposed geometry-based registration framework performed similarly to the examined exhaustive registration techniques. In addition, geometry-based methods dramatically improved processing time over conventional exhaustive registration.

  18. Responsible Translation of Stem Cell Research: An Assessment of Clinical Trial Registration and Publications

    Directory of Open Access Journals (Sweden)

    Moses Fung


    Full Text Available We assessed the extent to which the publication of clinical trial results of innovative cell-based interventions reflects International Society for Stem Cell Research best practice guidelines. We assessed: (1 characteristics and time to publication of completed trials; (2 quality of reported trials; and (3 results of published trials. We identified and analyzed publications from 1,052 novel stem cell clinical trials: 179 (45.4% of 393 completed trials had published results; 48 trials were registered by known stem cell tourism clinics, none of which reported results. Completed non-industry-sponsored trials initially published more rapidly, but differences with industry-sponsored trials decreased over time. Most publications reported safety, and 67.3% (mainly early-stage trials reported positive outcomes. A higher proportion of industry trials reported positive efficacy. Heightened patient expectations for stem cell therapies give rise to ethical obligations for the transparent conduct of clinical trials. Reporting guidelines need to be developed that are specific to early-phase clinical trials.

  19. Subjectivity and the valid assessment of pre-registration student nurse clinical learning outcomes: implications for mentors. (United States)

    Cassidy, Simon


    This discussion, supported by the author's personal reflections as a mentor and teacher, examines the issue of subjectivity when assessing the competence of pre-registration nursing students during their clinical placements. A difference is highlighted between valid and invalid subjectivity affecting the quality of mentors' assessments. Valid subjectivity refers to situations where students and mentors enter into a contract of trust and commitment from the outset of placement learning, enabling the 'substantiated' opinion of mentors to become a credible part of proficiency assessment. Invalid subjectivity presupposes that there has been limited investment in the student/mentor relationship and that assessment is therefore more reliant on the 'unconfirmed' views of mentors. Humanistic approaches to evaluating student learning are explored and a question is posed as to whether the trustworthiness of subjective assessment is improved when there is a sense of mutual reciprocity between students and mentors. Particular reference is made to reflective practice in adding meaning to this connection. Finally, an example of holistic assessment during 'live' clinical supervision involving a student and this author is offered (Table 1), in order to illustrate the implications for mentors attempting to enhance subjective evaluation of student learning.

  20. Posterior open occlusion management by registration of overlay removable partial denture: A clinical report

    Directory of Open Access Journals (Sweden)

    Saeid Nosouhian


    Full Text Available This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.

  1. Posterior open occlusion management by registration of overlay removable partial denture: A clinical report. (United States)

    Nosouhian, Saeid; Davoudi, Amin; Derhami, Mohammad


    This clinical report describes prosthetic rehabilitation of posterior open bite relationship in a patient with several missing teeth and skeletal Class III malocclusion. Primary diagnostic esthetic evaluations were performed by mounting casts in centric relation and estimating lost vertical dimension of occlusion. Exclusive treatments were designated by applying overlay removable partial denture with external attachment systems for higher retentions.

  2. Radiographic aluminum equivalent value of bone : the development of a registration method and some clinical applications

    NARCIS (Netherlands)

    W.T. Trouerbach (Willem)


    textabstractThe aim of this thesis is to establish and develop a method suitable for obtaining an objective analysis of bone as registered on a radiographic image. This analysis concerns determination of the quantity of bone mineral present. The system has been tested in-vitro and in a clinical stud

  3. NCI-CPTAC DREAM Proteogenomics Challenge (Registration Now Open) | Office of Cancer Clinical Proteomics Research (United States)

    Proteogenomics, integration of proteomics, genomics, and transcriptomics, is an emerging approach that promises to advance basic, translational and clinical research.  By combining genomic and proteomic information, leading scientists are gaining new insights due to a more complete and unified understanding of complex biological processes.

  4. Registration of 3D and Multispectral Data for the Study of Cultural Heritage Surfaces

    Directory of Open Access Journals (Sweden)

    Frank Boochs


    Full Text Available We present a technique for the multi-sensor registration of featureless datasets based on the photogrammetric tracking of the acquisition systems in use. This method is developed for the in situ study of cultural heritage objects and is tested by digitizing a small canvas successively with a 3D digitization system and a multispectral camera while simultaneously tracking the acquisition systems with four cameras and using a cubic target frame with a side length of 500 mm. The achieved tracking accuracy is better than 0.03 mm spatially and 0.150 mrad angularly. This allows us to seamlessly register the 3D acquisitions and to project the multispectral acquisitions on the 3D model.

  5. 79 original article clinical studies on seroprevalence of rubella virus ...

    African Journals Online (AJOL)

    Dr Oboro VO

    AFRICAN JOURNAL OF CLINICAL AND EXPERIMENTAL MICROBIOLOGY MAY ... Immunology, Biochemistry and Biotechnology Laboratory, Medical & ..... registration of each participant and records ..... information system: global summary,.

  6. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen


    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  7. Prolactinomas : clinical studies

    NARCIS (Netherlands)

    Kars, Marleen


    Prolactinoma are treated with dopamine agonists, which are effective in reducing prolactin and tumor size. Studies reporting clinical and radiological outcome are scarce. The study described in chapter 2, assesses long-term outcome in patients treated with dopamine agonists for macroprolactinoma. An

  8. Study on requirements of bioequivalence for registration of pharmaceutical products in USA, Europe and Canada. (United States)

    Galgatte, Upendra C; Jamdade, Vijay R; Aute, Pravin P; Chaudhari, Pravin D


    The present study was aimed to study the requirements of bioequivalence for the registration of pharmaceutical products in the USA, Europe and Canada. Before going into bioequivalence studies it is essential for the pharmaceutical industry to study the guidelines of bioequivalence for the respective country where the industry wants to market its products and thus enter into generic market. This study reviews the requirements of bioequivalence with study parameters such as study design, fasting or fed state studies, volunteers recruitment, study dose, sampling points, analytical method validation parameters, moieties to be measured in plasma, pharmacokinetic parameters, criteria for bioequivalence, GCP requirements etc, which are needed for the pharmaceutical industry to carry out bioequivalence studies and to file ANDA. Test products and reference products are needed for this study. Test products are usually manufactured by a sponsor and reference products are provided by the government laboratories of the respective countries. Sampling points also vary with respect to the regulatory guidelines of these countries. All these countries follow ICH GCP guidelines. The criterion of bioequivalence for these countries is 90% CI 80-125% for C max, AUC t , AUC0-∞.

  9. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... Guidelines Resources Continuing Education Researchers Funding Training & Career Development Division of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & Clinical Studies NHLBI Trials Clinical Trial Websites News & ...

  10. 3D-2D ultrasound feature-based registration for navigated prostate biopsy: A feasibility study


    Selmi, Sonia,; Promayon, Emmanuel; Troccaz, Jocelyne


    International audience; The aim of this paper is to describe a 3D-2D ultrasound feature-based registration method for navigated prostate biopsy and its first results obtained on patient data. A system combining a low-cost tracking system and a 3D-2D registration algorithm was designed. The proposed 3D-2D registration method combines geometric and image-based distances. After extracting features from ultrasound images, 3D and 2D features within a defined distance are matched using an intensity...

  11. 3D-2D ultrasound feature-based registration for navigated prostate biopsy: a feasibility study. (United States)

    Selmi, Sonia Y; Promayon, Emmanuel; Troccaz, Jocelyne


    The aim of this paper is to describe a 3D-2D ultrasound feature-based registration method for navigated prostate biopsy and its first results obtained on patient data. A system combining a low-cost tracking system and a 3D-2D registration algorithm was designed. The proposed 3D-2D registration method combines geometric and image-based distances. After extracting features from ultrasound images, 3D and 2D features within a defined distance are matched using an intensity-based function. The results are encouraging and show acceptable errors with simulated transforms applied on ultrasound volumes from real patients.

  12. Toward adaptive radiotherapy for head and neck patients: Feasibility study on using CT-to-CBCT deformable registration for “dose of the day” calculations

    Energy Technology Data Exchange (ETDEWEB)

    Veiga, Catarina, E-mail:; Lourenço, Ana; Ricketts, Kate; Annkah, James; Royle, Gary [Radiation Physics Group, Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom); McClelland, Jamie; Modat, Marc; Ourselin, Sébastien [Centre for Medical Image Computing, Department of Medical Physics and Bioengineering, University College London, London WC1E 6BT (United Kingdom); Moinuddin, Syed [Department of Radiotherapy, University College London Hospital, London NW1 2BU (United Kingdom); D’Souza, Derek [Department of Radiotherapy Physics, University College London Hospital, London NW1 2PG (United Kingdom)


    Purpose: The aim of this study was to evaluate the appropriateness of using computed tomography (CT) to cone-beam CT (CBCT) deformable image registration (DIR) for the application of calculating the “dose of the day” received by a head and neck patient. Methods: NiftyReg is an open-source registration package implemented in our institution. The affine registration uses a Block Matching-based approach, while the deformable registration is a GPU implementation of the popular B-spline Free Form Deformation algorithm. Two independent tests were performed to assess the suitability of our registrations methodology for “dose of the day” calculations in a deformed CT. A geometric evaluation was performed to assess the ability of the DIR method to map identical structures between the CT and CBCT datasets. Features delineated in the planning CT were warped and compared with features manually drawn on the CBCT. The authors computed the dice similarity coefficient (DSC), distance transformation, and centre of mass distance between features. A dosimetric evaluation was performed to evaluate the clinical significance of the registrations errors in the application proposed and to identify the limitations of the approximations used. Dose calculations for the same intensity-modulated radiation therapy plan on the deformed CT and replan CT were compared. Dose distributions were compared in terms of dose differences (DD), gamma analysis, target coverage, and dose volume histograms (DVHs). Doses calculated in a rigidly aligned CT and directly in an extended CBCT were also evaluated. Results: A mean value of 0.850 in DSC was achieved in overlap between manually delineated and warped features, with the distance between surfaces being less than 2 mm on over 90% of the pixels. Deformable registration was clearly superior to rigid registration in mapping identical structures between the two datasets. The dose recalculated in the deformed CT is a good match to the dose calculated on


    Directory of Open Access Journals (Sweden)

    Mwafag Ghanma


    Full Text Available Registration activities combine data from different sources in order to attain higher accuracy and derive more information than available from one source. The increasing availability of a wide variety of sensors capable of capturing high quality and complementary data requires parallel efforts for developing accurate and robust registration techniques. Currently, photogrammetric and LIDAR systems are being incorporated in a wide spectrum of mapping applica¬tions such as city modeling, surface reconstruction, and object recognition. Photogrammetric processing of overlapping imagery provides accurate information regarding object space break-lines in addition to an explicit semantic description of the photographed objects. On the other hand, LIDAR systems supply dense geometric surface information in the form of non-selective points. Considering the properties of photogrammetric and LIDAR data, it is clear that the two technologies provide complementary information. However, the synergic characteristics of both systems can be fully utilized only after successful registration of the photogrammetric and LIDAR data relative to a common reference frame. The registration methodology has to deal with three issues: registration primitives, transformation function, and similarity measure. This paper presents two methodologies for utilizing straight-line features derived from both datasets as the registration primitives. The first methodology directly incorporates the LIDAR lines as control information in the photogrammetric triangulation. The second methodology starts by generating a photogrammetric model relative to an arbitrary datum. Then, LIDAR features are used as control information for the absolute orientation of the photogram¬metric model. In addition to the registration methodologies, the paper presents a comparative analysis between two approaches for extracting linear features from raw and processed/interpolated LIDAR data. Also, a comparative

  14. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... about Children and Clinical Studies Importance of Children in Clinical Studies Children have often had to accept ... treatments based on what is known to work in adults. To improve clinical care of children, more ...

  15. Complications related to bone augmentation procedures of localized defects in the alveolar ridge. A retrospective clinical study

    DEFF Research Database (Denmark)

    Jensen, Anders Torp; Jensen, Simon Storgård; Worsaae, Nils


    PURPOSE: This retrospective clinical study aims to evaluate complications after augmentation of localized bone defects of the alveolar ridge. METHODS: From standardized registrations, the following complications related to bone augmentation procedures were recorded: soft tissue dehiscence, infect...

  16. Image registration

    CERN Document Server

    Goshtasby, A Ardeshir


    This book presents a thorough and detailed guide to image registration, outlining the principles and reviewing state-of-the-art tools and methods. The book begins by identifying the components of a general image registration system, and then describes the design of each component using various image analysis tools. The text reviews a vast array of tools and methods, not only describing the principles behind each tool and method, but also measuring and comparing their performances using synthetic and real data. Features: discusses similarity/dissimilarity measures, point detectors, feature extr

  17. A comparison of registration errors with imageless computer navigation during MIS total knee arthroplasty versus standard incision total knee arthroplasty: a cadaveric study. (United States)

    Davis, Edward T; Pagkalos, Joseph; Gallie, Price A M; Macgroarty, Kelly; Waddell, James P; Schemitsch, Emil H


    Optimal component alignment in total knee arthroplasty has been associated with better functional outcome as well as improved implant longevity. The ability to align components optimally during minimally invasive (MIS) total knee replacement (TKR) has been a cause of concern. Computer navigation is a useful aid in achieving the desired alignment although it is limited by the error during the manual registration of landmarks. Our study aims to compare the registration process error between a standard and a MIS surgical approach. We hypothesized that performing the registration error via an MIS approach would increase the registration process error. Five fresh frozen lower limbs were routinely prepared and draped. The registration process was performed through an MIS approach. This was then extended to the standard approach and the registration was performed again. Two surgeons performed the registration process five times with each approach. Performing the registration process through the MIS approach was not associated with higher error compared to the standard approach in the alignment parameters of interest. This rejects our hypothesis. Image-free navigated MIS TKR does not appear to carry higher risk of component malalignment due to the registration process error. Navigation can be used during MIS TKR to improve alignment without reduced accuracy due to the approach.

  18. SU-E-I-23: Design and Clinical Application of External Marking Body in Multi- Mode Medical Images Registration and Fusion

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Z; Gong, G [Shandong Cancer Hospital, Jinan, Shandong (China)


    Purpose: To design an external marking body (EMB) that could be visible on computed tomography (CT), magnetic resonance (MR), positron emission tomography (PET) and single-photon emission computed tomography (SPECT) images and to investigate the use of the EMB for multiple medical images registration and fusion in the clinic. Methods: We generated a solution containing paramagnetic metal ions and iodide ions (CT'MR dual-visible solution) that could be viewed on CT and MR images and multi-mode image visible solution (MIVS) that could be obtained by mixing radioactive nuclear material. A globular plastic theca (diameter: 3–6 mm) that mothball the MIVS and the EMB was brought by filling MIVS. The EMBs were fixed on the patient surface and CT, MR, PET and SPECT scans were obtained. The feasibility of clinical application and the display and registration error of EMB among different image modalities were investigated. Results: The dual-visible solution was highly dense on CT images (HU>700). A high signal was also found in all MR scanning (T1, T2, STIR and FLAIR) images, and the signal was higher than subcutaneous fat. EMB with radioactive nuclear material caused a radionuclide concentration area on PET and SPECT images, and the signal of EMB was similar to or higher than tumor signals. The theca with MIVS was clearly visible on all the images without artifact, and the shape was round or oval with a sharp edge. The maximum diameter display error was 0.3 ± 0.2mm on CT and MRI images, and 1.0 ± 0.3mm on PET and SPECT images. In addition, the registration accuracy of the theca center among multi-mode images was less than 1mm. Conclusion: The application of EMB with MIVS improves the registration and fusion accuracy of multi-mode medical images. Furthermore, it has the potential to ameliorate disease diagnosis and treatment outcome.

  19. Identifying clinical learning needs using structured group feedback: first year evaluation of pre-registration nursing and midwifery degree programmes. (United States)

    Frazer, Kate; Connolly, Michael; Naughton, Corina; Kow, Veronica


    Facilitating and supporting clinical learning for student nurses and midwives are essential within their practice environments. Clinical placements provide unique opportunities in preparation for future roles. Understanding the experiences of first year student nurses and midwives following clinical exposures and examining the clinical facilitators and barriers can assist in maintaining and developing clinical supports. The study used a structured group feedback approach with a convenience sample of 223 first year nursing and midwifery students in one Irish university in April 2011 to ascertain feedback on the clinical aspects of their degree programme. Approximately 200 students participated in the process. Two key clinical issues were identified by students: facilitating clinical learning and learning experiences and needs. Positive learning environments, supportive staff and increased opportunities for reflection were important issues for first year students. The role of supportive mentoring staff in clinical practice is essential to enhance student learning. Students value reflection in practice and require more opportunities to engage during placements. More collaborative approaches are required to ensure evolving and adapting practice environments can accommodate student learning. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Children and Clinical Studies: Why Clinical Studies Are Important

    Medline Plus

    Full Text Available ... of Intramural Research Research Resources Research Meeting Summaries Technology Transfer Clinical Trials What Are Clinical Trials? Children & ... Clinical Studies Children have often had to accept medicines and treatments based on what is known to ...

  1. A global CT to US registration of the lumbar spine (United States)

    Nagpal, Simrin; Hacihaliloglu, Ilker; Ungi, Tamas; Rasoulian, Abtin; Osborn, Jill; Lessoway, Victoria A.; Rohling, Robert N.; Borschneck, Daniel P.; Abolmaesumi, Purang; Mousavi, Parvin


    During percutaneous lumbar spine needle interventions, alignment of the preoperative computed tomography (CT) with intraoperative ultrasound (US) can augment anatomical visualization for the clinician. We propose an approach to rigidly align CT and US data of the lumbar spine. The approach involves an intensity-based volume registration step, followed by a surface segmentation and a point-based registration of the entire lumbar spine volume. A clinical feasibility study resulted in mean registration error of approximately 3 mm between CT and US data.

  2. Enhanced ICP for the Registration of Large-Scale 3D Environment Models: An Experimental Study. (United States)

    Han, Jianda; Yin, Peng; He, Yuqing; Gu, Feng


    One of the main applications of mobile robots is the large-scale perception of the outdoor environment. One of the main challenges of this application is fusing environmental data obtained by multiple robots, especially heterogeneous robots. This paper proposes an enhanced iterative closest point (ICP) method for the fast and accurate registration of 3D environmental models. First, a hierarchical searching scheme is combined with the octree-based ICP algorithm. Second, an early-warning mechanism is used to perceive the local minimum problem. Third, a heuristic escape scheme based on sampled potential transformation vectors is used to avoid local minima and achieve optimal registration. Experiments involving one unmanned aerial vehicle and one unmanned surface vehicle were conducted to verify the proposed technique. The experimental results were compared with those of normal ICP registration algorithms to demonstrate the superior performance of the proposed method.

  3. Enhanced ICP for the Registration of Large-Scale 3D Environment Models: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Jianda Han


    Full Text Available One of the main applications of mobile robots is the large-scale perception of the outdoor environment. One of the main challenges of this application is fusing environmental data obtained by multiple robots, especially heterogeneous robots. This paper proposes an enhanced iterative closest point (ICP method for the fast and accurate registration of 3D environmental models. First, a hierarchical searching scheme is combined with the octree-based ICP algorithm. Second, an early-warning mechanism is used to perceive the local minimum problem. Third, a heuristic escape scheme based on sampled potential transformation vectors is used to avoid local minima and achieve optimal registration. Experiments involving one unmanned aerial vehicle and one unmanned surface vehicle were conducted to verify the proposed technique. The experimental results were compared with those of normal ICP registration algorithms to demonstrate the superior performance of the proposed method.

  4. Project Management Series Case Study: The Office of Registration and Records (United States)

    Burgher, Karl E.; Snyder, Michael


    This is the third in a series of eight articles on project management (PM) in the academy. In this article, the authors describe the step-by-step implementation of a structural change to Indiana State University's (ISU's) Office of Registration and Records (ORR). The process described may vary as it is implemented elsewhere, but the authors…

  5. Project Management Series Case Study: The Office of Registration and Records (United States)

    Burgher, Karl E.; Snyder, Michael


    This is the third in a series of eight articles on project management (PM) in the academy. In this article, the authors describe the step-by-step implementation of a structural change to Indiana State University's (ISU's) Office of Registration and Records (ORR). The process described may vary as it is implemented elsewhere, but the authors…

  6. Preliminary studies for a CBCT imaging protocol for offline organ motion analysis: registration software validation and CTDI measurements. (United States)

    Falco, Maria Daniela; Fontanarosa, Davide; Miceli, Roberto; Carosi, Alessandra; Santoni, Riccardo; D'Andrea, Marco


    Cone-beam X-ray volumetric imaging in the treatment room, allows online correction of set-up errors and offline assessment of residual set-up errors and organ motion. In this study the registration algorithm of the X-ray volume imaging software (XVI, Elekta, Crawley, United Kingdom), which manages a commercial cone-beam computed tomography (CBCT)-based positioning system, has been tested using a homemade and an anthropomorphic phantom to: (1) assess its performance in detecting known translational and rotational set-up errors and (2) transfer the transformation matrix of its registrations into a commercial treatment planning system (TPS) for offline organ motion analysis. Furthermore, CBCT dose index has been measured for a particular site (prostate: 120 kV, 1028.8 mAs, approximately 640 frames) using a standard Perspex cylindrical body phantom (diameter 32 cm, length 15 cm) and a 10-cm-long pencil ionization chamber. We have found that known displacements were correctly calculated by the registration software to within 1.3 mm and 0.4°. For the anthropomorphic phantom, only translational displacements have been considered. Both studies have shown errors within the intrinsic uncertainty of our system for translational displacements (estimated as 0.87 mm) and rotational displacements (estimated as 0.22°). The resulting table translations proposed by the system to correct the displacements were also checked with portal images and found to place the isocenter of the plan on the linac isocenter within an error of 1 mm, which is the dimension of the spherical lead marker inserted at the center of the homemade phantom. The registration matrix translated into the TPS image fusion module correctly reproduced the alignment between planning CT scans and CBCT scans. Finally, measurements on the CBCT dose index indicate that CBCT acquisition delivers less dose than conventional CT scans and electronic portal imaging device portals. The registration software was found to be

  7. A mathematical framework for the registration and analysis of multi-fascicle models for population studies of the brain microstructure. (United States)

    Taquet, Maxime; Scherrer, Benoit; Commowick, Olivier; Peters, Jurriaan M; Sahin, Mustafa; Macq, Benoit; Warfield, Simon K


    Diffusion tensor imaging (DTI) is unable to represent the diffusion signal arising from multiple crossing fascicles and freely diffusing water molecules. Generative models of the diffusion signal, such as multi-fascicle models, overcome this limitation by providing a parametric representation for the signal contribution of each population of water molecules. These models are of great interest in population studies to characterize and compare the brain microstructural properties. Central to population studies is the construction of an atlas and the registration of all subjects to it. However, the appropriate definition of registration and atlasing methods for multi-fascicle models have proven challenging. This paper proposes a mathematical framework to register and analyze multi-fascicle models. Specifically, we define novel operators to achieve interpolation, smoothing and averaging of multi-fascicle models. We also define a novel similarity metric to spatially align multi-fascicle models. Our framework enables simultaneous comparisons of different microstructural properties that are confounded in conventional DTI. The framework is validated on multi-fascicle models from 24 healthy subjects and 38 patients with tuberous sclerosis complex, 10 of whom have autism. We demonstrate the use of the multi-fascicle models registration and analysis framework in a population study of autism spectrum disorder.

  8. Improving the image quality of contrast-enhanced MR angiography by automated image registration: A prospective study in peripheral arterial disease of the lower extremities

    Energy Technology Data Exchange (ETDEWEB)

    Menke, Jan, E-mail: Menke-J@T-Online.d [Department of Diagnostic Radiology, University Hospital, Robert-Koch-Strasse 40, 37075 Goettingen (Germany)


    Objective: If a patient has moved during digital subtraction angiography (DSA), manual pixel shift can improve the image quality. This study investigated whether such image registration can also improve the quality of contrast-enhanced magnetic resonance angiography (MRA) in patients with peripheral arterial disease of the lower extremities. Materials and methods: 404 leg MRAs of patients likely to have peripheral artery disease were included in this prospective study. The standard non-registered MRAs were compared to automatically linear, affine and warp registered MRAs by four image quality parameters, including the vessel detection probability (VDP) in maximum intensity projection (MIP) images and contrast-to-noise ratios (CNR). The different registration types were compared by analysis of variance. Results: All studied image quality parameters showed similar trends. Generally, registration improved the leg MRA quality significantly (P < 0.05). The 12% of lower legs with a body shift of 1 mm or more showed the highest gain in image quality when using linear registration instead of no registration, with an average VDP gain of 20-49%. Warp registration improved the image quality slightly further. Conclusion: Automated image registration can improve the MRA image quality especially in the lower legs, which is comparable to the effect of pixel shift in DSA.

  9. Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at a systematic review of registration details (United States)

    Buffel du Vaure, Céline; Dechartres, Agnès; Battin, Constance; Ravaud, Philippe; Boutron, Isabelle


    Objectives To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions. Design Systematic review of trial registration records. Data sources register. Study selection All ongoing RCTs registered from 1 January 2014 to 31 January 2015 that assessed an intervention targeting adults with coronary heart disease (CHD), hypertension, heart failure, stroke/transient ischaemic attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, painful condition, depression and dementia with a target sample size ≥100. Data extraction From the trial registration records, 2 researchers independently recorded the trial characteristics and the number of exclusion criteria and determined whether patients with concomitant chronic conditions were excluded or specifically targeted. Results Among 319 ongoing RCTs, despite the high prevalence of the concomitant chronic conditions, patients with these conditions were excluded in 251 trials (79%). For example, although 91% of patients with CHD had a concomitant chronic condition, 69% of trials targeting such patients excluded patients with concomitant chronic condition(s). When considering the co-occurrence of 2 chronic conditions, 31% of patients with chronic pain also had depression, but 58% of the trials targeting patients with chronic pain excluded patients with depression. Only 37 trials (12%) assessed interventions specifically targeting patients with concomitant chronic conditions; 31 (84%) excluded patients with concomitant chronic condition(s). Conclusions Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions

  10. A Comparative Study of Registration Methods for RGB-D Video of Static Scenes

    Directory of Open Access Journals (Sweden)

    Vicente Morell-Gimenez


    Full Text Available The use of RGB-D sensors for mapping and recognition tasks in robotics or, in general, for virtual reconstruction has increased in recent years. The key aspect of these kinds of sensors is that they provide both depth and color information using the same device. In this paper, we present a comparative analysis of the most important methods used in the literature for the registration of subsequent RGB-D video frames in static scenarios. The analysis begins by explaining the characteristics of the registration problem, dividing it into two representative applications: scene modeling and object reconstruction. Then, a detailed experimentation is carried out to determine the behavior of the different methods depending on the application. For both applications, we used standard datasets and a new one built for object reconstruction.

  11. Developing information literacy skills in pre-registration nurses: an experimental study of teaching methods. (United States)

    Brettle, Alison; Raynor, Michael


    To compare the effectiveness of an online information literacy tutorial with a face-to-face session for teaching information literacy skills to nurses. Randomised control trial. Seventy-seven first year undergraduate pre-registration diploma nursing students. Online in-house information literacy tutorial One hour face-to-face session, covering the same material as the intervention, delivered by the nursing subject librarian. Search histories were scored using a validated checklist covering keyword selection, boolean operators, truncation and synonyms. Skills retention was measured at 1 month using the same checklist. Inferential statistics were used to compare search skills within and between groups pre and post-session. The searching skills of first year pre-registration nursing students improve following information literacy sessions (pInformation literacy skills improve after both face-to-face and online instruction. There is no skills degradation at 1 month post-intervention for either method. Copyright © 2011. Published by Elsevier Ltd.

  12. Methodology for Registration of Shrinkage Tumors in Head-and-Neck CT Studies

    Directory of Open Access Journals (Sweden)

    Jianhua Wang


    Full Text Available Tumor shrinkage occurs in many patients undergoing radiotherapy for head-and-neck (H&N cancer. However, one-to-one correspondence is not always available between voxels of two image sets. This makes intensity-based deformable registration difficult and inaccurate. In this paper, we describe a novel method to increase the performance of the registration in presence of tumor shrinkage. The method combines an image modification procedure and a fast symmetric Demons algorithm to register CT images acquired at planning and posttreatment fractions. The image modification procedure modifies the image intensities of the primary tumor by calculating tumor cell survival rate using the linear quadratic (LQ model according to the dose delivered to the tumor. A scale operation is used to deal with uncertainties in biological parameters. The method was tested in 10 patients with nasopharyngeal cancer (NPC. Registration accuracy was improved compared with that achieved using the symmetric Demons algorithm. The average Dice similarity coefficient (DSC increased by 21%. This novel method is suitable for H&N adaptive radiation therapy.

  13. Feasibility of Multimodal Deformable Registration for Head and Neck Tumor Treatment Planning

    Energy Technology Data Exchange (ETDEWEB)

    Fortunati, Valerio, E-mail: [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Verhaart, René F. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Angeloni, Francesco [Istituto di Ricovero e Cura a Carattere Scientifico Foundation SDN for Research and High Education in Nuclear Diagnostics, Naples (Italy); Lugt, Aad van der [Department of Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Niessen, Wiro J. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Faculty of Applied Sciences, Delft University of Technology, Delft (Netherlands); Veenland, Jifke F. [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands); Paulides, Margarethus M. [Hyperthermia Unit, Department of Radiation Oncology, Erasmus MC University Medical Center Cancer Institute, Rotterdam (Netherlands); Walsum, Theo van [Biomedical Imaging Group Rotterdam, Department of Medical Informatics and Radiology, Erasmus MC University Medical Center, Rotterdam (Netherlands)


    Purpose: To investigate the feasibility of using deformable registration in clinical practice to fuse MR and CT images of the head and neck for treatment planning. Method and Materials: A state-of-the-art deformable registration algorithm was optimized, evaluated, and compared with rigid registration. The evaluation was based on manually annotated anatomic landmarks and regions of interest in both modalities. We also developed a multiparametric registration approach, which simultaneously aligns T1- and T2-weighted MR sequences to CT. This was evaluated and compared with single-parametric approaches. Results: Our results show that deformable registration yielded a better accuracy than rigid registration, without introducing unrealistic deformations. For deformable registration, an average landmark alignment of approximatively 1.7 mm was obtained. For all the regions of interest excluding the cerebellum and the parotids, deformable registration provided a median modified Hausdorff distance of approximatively 1 mm. Similar accuracies were obtained for the single-parameter and multiparameter approaches. Conclusions: This study demonstrates that deformable registration of head-and-neck CT and MR images is feasible, with overall a significanlty higher accuracy than for rigid registration.

  14. Clinical studies involving probiotics


    Degnan, Fred H


    Researchers from a diverse array of scientific disciplines have focused and continue to focus on opportunities and areas for responsible clinical research involving the possible beneficial health effects of “probiotics.” Investigators and researchers should be aware that not all clinical research involving probiotics reasonably falls within the requirements of the “investigational new drug” (IND) rubric administered and enforced by the US Food and Drug Administration. In determining whether a...

  15. Clinical Nursing Records Study (United States)


    for Sam Houston, Texas MAJ Joanne Burton , AN, Clinical Head Nurse, Psychiatry MAJ Shelby Christian, AN, Clinical Head Nurse, OB/GYN MAJ Melissa Opio...Specify Level) Parenting, Potential Alteration In Decubitus Ulcer Self-Care Deficit, Total (Specify Level) Social Isolation Fluid Volume Deficit. Potential...METABOLIC PATTERN Self-Care Dieficit. Total (Specify Level) SiX alizaticni Alterations ifl Decubitus ulcer S-If-Batingrla.v~qene Oeticit 601?Cif Levet

  16. Geometrical analysis of registration errors in point-based rigid-body registration using invariants. (United States)

    Shamir, Reuben R; Joskowicz, Leo


    Point-based rigid registration is the method of choice for aligning medical datasets in diagnostic and image-guided surgery systems. The most clinically relevant localization error measure is the Target Registration Error (TRE), which is the distance between the image-defined target and the corresponding target defined on another image or on the physical anatomy after registration. The TRE directly depends on the Fiducial Localization Error (FLE), which is the discrepancy between the selected and the actual (unknown) fiducial locations. Since the actual locations of targets usually cannot be measured after registration, the TRE is often estimated by the Fiducial Registration Error (FRE), which is the RMS distance between the fiducials in both datasets after registration, or with Fitzpatrick's TRE (FTRE) formula. However, low FRE-TRE and FTRE-TRE correlations have been reported in clinical practice and in theoretical studies. In this article, we show that for realistic FLE classes, the TRE and the FRE are uncorrelated, regardless of the target location and the number of fiducials and their configuration, and regardless of the FLE magnitude distribution. We use a geometrical approach and classical invariant theory to model the FLE and derive its relation to the TRE and FRE values. We show that, for these FLE classes, the FTRE and TRE are also uncorrelated. Finally, we show with simulations on clinical data that the FRE-TRE correlation is low also in the neighborhood of the FLE-FRE invariant classes. Consequently, and contrary to common practice, the FRE and FTRE may not always be used as surrogates for the TRE.

  17. Time spent studying on a pre-registration nursing programme module: an exploratory study and implications for regulation. (United States)

    Snelling, Paul C; Lipscomb, Martin; Lockyer, Lesley; Yates, Sue; Young, Pat


    European Union (EU) regulations require that university programmes are of specified duration. Additional EU regulations apply specifically to university based nurse education, enacted in the UK by the Nursing and Midwifery Council (NMC). However, little is known about how much time student nurses spend on their studies. In this exploratory study, students undertaking a single module in the pre-registration diploma programme at an English university were asked to keep a log of learning activity for the duration of the module. Twenty-six students completed the log. These students achieved higher grades and attended more lectures than the average for the module. The mean study time was 128.4 h against a regulatory assumption that the module should take 200 h. More than half of the 26 students undertook paid work during the module run, though this work was not associated with poorer performance. Problems in regulation for course duration are discussed and it is suggested that undertaking a 4600 h course in 3 years is problematic. More research is required so that patterns of study can be better understood and student centred programmes meeting regulatory requirements developed.

  18. Civil Society Organizations and medicines policy change: a case study of registration, procurement, distribution and use of misoprostol in Uganda. (United States)

    Atukunda, Esther Cathyln; Brhlikova, Petra; Agaba, Amon Ganafa; Pollock, Allyson M


    Misoprostol use for postpartum haemorrhage (PPH) has been promoted by Civil Society Organizations (CSOs) since the early 2000s. Yet, CSOs' role in improving access to misoprostol and shaping health policy at global and national levels is not well understood. We document the introduction of misoprostol in Uganda in 2008 from its registration, addition to treatment guidelines and national Essential Medicines List (EML), to its distribution and use. We then analyse the contribution of CSOs to this health policy change and service provision. Policy documents, procurement data and 82 key informant interviews with government officials, healthcare providers, and CSOs in four Ugandan districts of Kampala, Mbarara, Apac, Bundibugyo were collected between 2010 and 2013. Five key CSOs promoted and accelerated the rollout of misoprostol in Uganda. They supported the registration of misoprostol with the National Drug Authority, the development of clinical guidelines, and the piloting and training of health care providers. CSOs and National Medical Stores were procuring and distributing misoprostol country-wide to health centres two years before it was added to the clinical guidelines and EML of Uganda and in the absence of good evidence. The evidence suggests an increasing trend of misoprostol procurement and availability over the medicine of choice, oxytocin. This shift in national priorities has serious ramifications for maternal health care that need urgent evaluation. The absence of clinical guidelines in health centres and the lack of training preclude rational use of misoprostol. CSOs shifted their focus from the public to the private sector, where some of them continue to promote its use for off-label indications including induction of labour and abortion. There is an urgent need to build capacity to improve the robustness of the national and local institutions in assessing the safety and effectiveness of all medicines and their indications in Uganda.

  19. The use of simulation to address the acute care skills deficit in pre-registration nursing students: a clinical skill perspective. (United States)

    Nickless, Lesley J


    The increase in patient acuity in primary and secondary settings is continuing, with a corresponding increase in the need for technological competence in these areas. Evidence, however, both nationally and internationally, suggests that these expectations are not being met. This paper offers a review of the literature on acute care, with a specific focus on pre-registration nursing students and the development of acute care skills. Three themes are discussed: factors contributing to the acute care skills deficit, the knowledge and skills required to work in acute care and strategies used to support the acquisition of acute care skills. In response to the review, and based upon the evidence-based solutions identified, the clinical skills team at Bournemouth University designed and developed two teaching sessions, using simulation and role play to support the acquisition of acute care skills in pre-registration students. Student evaluations identify that their knowledge, competence and confidence in this area have increased following the teaching sessions, although caution remains regarding transferability of these skills into the practice environment.

  20. An Empirical Study on Employees Provident Fund (EPF Response towards the Initiative of Hajj Registration through Account 1

    Directory of Open Access Journals (Sweden)

    Siti Aminah Mainal


    Full Text Available The study intends to measure the contributors’ response from the initiative launched by EPF that permits the hajj registration through savings in EPF. The study incorporates questionnaire 5 Likert scale format which distributed to 350 EPF contributors within the Klang Valley region of which 174 were filled and returned. It is consistent with Roscoe (1975 who suggests to have a sample sizes of larger than 30 and less than 500 to minimize committing Type II errors. Klang Valley was chosen due to availability of significant white collar workers which displays a significant presence of middle and high income families which associates with private sector workers since they are the main contributors’ for EPF. All variables display meaningful relationship with each other but as shown in the regression analysis, the main variable that really influences one’s attitude towards the hajj withdrawal scheme is the perceived convenience of the program itself. The contradictory issue in this study is on the permission of hajj registration itself; whereby the permission is only for registration and not to the extent of withdrawal the money for the hajj except if the contributor has reached the age of 55. In other word, the authors view it as a non holistic approach. The findings are useful for the EPF to enhance its initiative by allowing physical withdrawal of money from the account 1 once the depositor gets the hajj call-up even though the person has not meet the age of 55. The limitation of the study can arise from the demographic influence pertinent to other areas in the country. It is recommended to expand the pool of respondents and covering other nation’s region as well; Southern part, Northern part, the East Coast etc. Better representation of the findings is expected by incorporating the EPF management in future research.

  1. Isolated rural general practice as the focus for teaching core clinical rotations to pre-registration medical students

    Directory of Open Access Journals (Sweden)

    Davies Llewellyn M


    Full Text Available Abstract Background Earlier studies have successfully demonstrated that medical students can achieve success in core clinical rotations with long term attachments in small groups to rural general / family practices. Methods In this study, three students from a class of 226 volunteered for this 1-year pilot program, conducted by the University of Queensland in 2004, for medical students in the 3rd year of a 4-year graduate entry medical course. Each student was based with a private solo general practitioner in a different rural town between 170 and 270 km from the nearest teaching hospital. Each was in a relatively isolated rural setting, rated 5 or 6 on the RRMA scale (Rural, Remote, Metropolitan Classification: capital city = 1, other metropolitan = 2, large regional city = 3, most remote community = 7. The rural towns had populations respectively of 500, 2000 and 10,000. One practice also had a General Practice registrar. Only one of the locations had doctors in the same town but outside the teaching practice, while all had other doctors within the same area. All 3 supervisors had hospital admitting rights to a hospital within their town. The core clinical rotations of medicine, surgery, mental health, general practice and rural health were primarily conducted within these rural communities, with the student based in their own consulting room at the general practitioner (GP supervisor's surgery. The primary teacher was the GP supervisor, with additional learning opportunities provided by visiting specialists, teleconferences and university websites. At times, especially during medicine and surgery terms, each student would return to the teaching hospital for additional learning opportunities. Results All students successfully completed the year. There were no statistical differences in marks at summative assessment in each of the five core rotations between the students in this pilot and their peers at the metropolitan or rural hospital based

  2. Earth Science Imagery Registration (United States)

    LeMoigne, Jacqueline; Morisette, Jeffrey; Cole-Rhodes, Arlene; Johnson, Kisha; Netanyahu, Nathan S.; Eastman, Roger; Stone, Harold; Zavorin, Ilya


    The study of global environmental changes involves the comparison, fusion, and integration of multiple types of remotely-sensed data at various temporal, radiometric, and spatial resolutions. Results of this integration may be utilized for global change analysis, as well as for the validation of new instruments or for new data analysis. Furthermore, future multiple satellite missions will include many different sensors carried on separate platforms, and the amount of remote sensing data to be combined is increasing tremendously. For all of these applications, the first required step is fast and automatic image registration, and as this need for automating registration techniques is being recognized, it becomes necessary to survey all the registration methods which may be applicable to Earth and space science problems and to evaluate their performances on a large variety of existing remote sensing data as well as on simulated data of soon-to-be-flown instruments. In this paper we present one of the first steps toward such an exhaustive quantitative evaluation. First, the different components of image registration algorithms are reviewed, and different choices for each of these components are described. Then, the results of the evaluation of the corresponding algorithms combining these components are presented o n several datasets. The algorithms are based on gray levels or wavelet features and compute rigid transformations (including scale, rotation, and shifts). Test datasets include synthetic data as well as data acquired over several EOS Land Validation Core Sites with the IKONOS and the Landsat-7 sensors.

  3. 77 FR 30016 - Clinical Study Design and Performance of Hospital Glucose Sensors (United States)


    ... interested in viewing the Web cast must register online by 4 p.m., June 15, 2012. Early registration is..., but to view using one connection per location. Web cast participants will be sent technical system... laboratories, and other stakeholders regarding clinical validation studies and performance criteria for...

  4. Formal security analysis of registration protocols for interactive systems: a methodology and a case of study

    CERN Document Server

    Diaz, Jesus; Rodriguez, Francisco B


    In this work we present and formally analyze CHAT-SRP (CHAos based Tickets-Secure Registration Protocol), a protocol to provide interactive and collaborative platforms with a cryptographically robust solution to classical security issues. Namely, we focus on the secrecy and authenticity properties while keeping a high usability. Indeed, most interactive platforms currently base their security properties almost exclusively on the correct implementation and configuration of the systems. In this sense, users are forced to blindly trust the system administrators and developers. Moreover, as far as we know, there is a lack of formal methodologies for the verification of security properties for interactive applications. We propose here a methodology to fill this gap, i.e., to analyse both the security of the proposed protocol and the pertinence of the underlying premises. In this concern, we propose the definition and formal evaluation of a protocol for the distribution of digital identities. Once distributed, thes...

  5. A survey of medical image registration - under review. (United States)

    Viergever, Max A; Maintz, J B Antoine; Klein, Stefan; Murphy, Keelin; Staring, Marius; Pluim, Josien P W


    A retrospective view on the past two decades of the field of medical image registration is presented, guided by the article "A survey of medical image registration" (Maintz and Viergever, 1998). It shows that the classification of the field introduced in that article is still usable, although some modifications to do justice to advances in the field would be due. The main changes over the last twenty years are the shift from extrinsic to intrinsic registration, the primacy of intensity-based registration, the breakthrough of nonlinear registration, the progress of inter-subject registration, and the availability of generic image registration software packages. Two problems that were called urgent already 20 years ago, are even more urgent nowadays: Validation of registration methods, and translation of results of image registration research to clinical practice. It may be concluded that the field of medical image registration has evolved, but still is in need of further development in various aspects.

  6. Mass preserving image registration

    DEFF Research Database (Denmark)

    Gorbunova, Vladlena; Sporring, Jon; Lo, Pechin Chien Pau


    The paper presents results the mass preserving image registration method in the Evaluation of Methods for Pulmonary Image Registration 2010 (EMPIRE10) Challenge. The mass preserving image registration algorithm was applied to the 20 image pairs. Registration was evaluated using four different...

  7. Learn about Clinical Studies (United States)

    ... is to make sure that the study is ethical and that the rights and welfare of participants ... trials provide the basis for the development and marketing of new drugs, biological products, and medical devices. ...

  8. How psychiatry journals support the unbiased translation of clinical research. A cross-sectional study of editorial policies.

    Directory of Open Access Journals (Sweden)

    Hannes Knüppel

    Full Text Available INTRODUCTION: Reporting guidelines (e.g. CONSORT have been developed as tools to improve quality and reduce bias in reporting research findings. Trial registration has been recommended for countering selective publication. The International Committee of Medical Journal Editors (ICMJE encourages the implementation of reporting guidelines and trial registration as uniform requirements (URM. For the last two decades, however, biased reporting and insufficient registration of clinical trials has been identified in several literature reviews and other investigations. No study has so far investigated the extent to which author instructions in psychiatry journals encourage following reporting guidelines and trial registration. METHOD: Psychiatry Journals were identified from the 2011 Journal Citation Report. Information given in the author instructions and during the submission procedure of all journals was assessed on whether major reporting guidelines, trial registration and the ICMJE's URM in general were mentioned and adherence recommended. RESULTS: We included 123 psychiatry journals (English and German language in our analysis. A minority recommend or require 1 following the URM (21%, 2 adherence to reporting guidelines such as CONSORT, PRISMA, STROBE (23%, 7%, 4%, or 3 registration of clinical trials (34%. The subsample of the top-10 psychiatry journals (ranked by impact factor provided much better but still improvable rates. For example, 70% of the top-10 psychiatry journals do not ask for the specific trial registration number. DISCUSSION: Under the assumption that better reported and better registered clinical research that does not lack substantial information will improve the understanding, credibility, and unbiased translation of clinical research findings, several stakeholders including readers (physicians, patients, authors, reviewers, and editors might benefit from improved author instructions in psychiatry journals. A first step of

  9. 3D Assessment of Mandibular Growth Based on Image Registration: A Feasibility Study in a Rabbit Model

    Directory of Open Access Journals (Sweden)

    I. Kim


    Full Text Available Background. Our knowledge of mandibular growth mostly derives from cephalometric radiography, which has inherent limitations due to the two-dimensional (2D nature of measurement. Objective. To assess 3D morphological changes occurring during growth in a rabbit mandible. Methods. Serial cone-beam computerised tomographic (CBCT images were made of two New Zealand white rabbits, at baseline and eight weeks after surgical implantation of 1 mm diameter metallic spheres as fiducial markers. A third animal acted as an unoperated (no implant control. CBCT images were segmented and registered in 3D (Implant Superimposition and Procrustes Method, and the remodelling pattern described used color maps. Registration accuracy was quantified by the maximal of the mean minimum distances and by the Hausdorff distance. Results. The mean error for image registration was 0.37 mm and never exceeded 1 mm. The implant-based superimposition showed most remodelling occurred at the mandibular ramus, with bone apposition posteriorly and vertical growth at the condyle. Conclusion. We propose a method to quantitatively describe bone remodelling in three dimensions, based on the use of bone implants as fiducial markers and CBCT as imaging modality. The method is feasible and represents a promising approach for experimental studies by comparing baseline growth patterns and testing the effects of growth-modification treatments.

  10. Keyhole历史影像配准方法研究%Study on Registration of Keyhole Historical Declassified Image

    Institute of Scientific and Technical Information of China (English)

    邢哲; 冯仲科; 龚威平; 侯碧屿; 叶影


    According to the basic characteristics of historical declassified image, this article studied the method and existing problems of image registration based on Keyhole image. . After half a century of change, to find the corresponding point in the historical image, not only need artificial identify, more importantly , one also need analysis of the objects based on historical events to determine the previous corresponding surface features now found on the point. Tto recognize the same objects with historical basis, image registration can be guaranteed.%根据历史影像的特点,研究对于Keyhole为例的历史影像进行配准的方法和存在的问题.经过半个世纪的变迁,如果要在以前的影像图上找到现在的相应地物点,不仅需要人工识别,更重要的是根据历史事件分析哪些才是肯定不变的地物,有了历史的依据,判断同名地物点才有根据,配准起来才能有保证.

  11. Prospective registration, bias risk and outcome-reporting bias in randomised clinical trials of traditional Chinese medicine

    DEFF Research Database (Denmark)

    Liu, Jian-Ping; Han, Mei; Li, Xin-Xue;


    Clinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in registries with their subsequent publications.......Clinical trials on Traditional Chinese Medicine (TCM) should be registered in a publicly accessible international trial register and report on all outcomes. We systematically assessed and evaluated TCM trials in registries with their subsequent publications....

  12. Study of Automatic Image Rectification and Registration of Scanned Historical Aerial Photographs (United States)

    Chen, H. R.; Tseng, Y. H.


    Historical aerial photographs directly provide good evidences of past times. The Research Center for Humanities and Social Sciences (RCHSS) of Taiwan Academia Sinica has collected and scanned numerous historical maps and aerial images of Taiwan and China. Some maps or images have been geo-referenced manually, but most of historical aerial images have not been registered since there are no GPS or IMU data for orientation assisting in the past. In our research, we developed an automatic process of matching historical aerial images by SIFT (Scale Invariant Feature Transform) for handling the great quantity of images by computer vision. SIFT is one of the most popular method of image feature extracting and matching. This algorithm extracts extreme values in scale space into invariant image features, which are robust to changing in rotation scale, noise, and illumination. We also use RANSAC (Random sample consensus) to remove outliers, and obtain good conjugated points between photographs. Finally, we manually add control points for registration through least square adjustment based on collinear equation. In the future, we can use image feature points of more photographs to build control image database. Every new image will be treated as query image. If feature points of query image match the features in database, it means that the query image probably is overlapped with control images.With the updating of database, more and more query image can be matched and aligned automatically. Other research about multi-time period environmental changes can be investigated with those geo-referenced temporal spatial data.

  13. Respiratory motion compensation for simultaneous PET/MR based on a 3D-2D registration of strongly undersampled radial MR data: a simulation study (United States)

    Rank, Christopher M.; Heußer, Thorsten; Flach, Barbara; Brehm, Marcus; Kachelrieß, Marc


    We propose a new method for PET/MR respiratory motion compensation, which is based on a 3D-2D registration of strongly undersampled MR data and a) runs in parallel with the PET acquisition, b) can be interlaced with clinical MR sequences, and c) requires less than one minute of the total MR acquisition time per bed position. In our simulation study, we applied a 3D encoded radial stack-of-stars sampling scheme with 160 radial spokes per slice and an acquisition time of 38 s. Gated 4D MR images were reconstructed using a 4D iterative reconstruction algorithm. Based on these images, motion vector fields were estimated using our newly-developed 3D-2D registration framework. A 4D PET volume of a patient with eight hot lesions in the lungs and upper abdomen was simulated and MoCo 4D PET images were reconstructed based on the motion vector fields derived from MR. For evaluation, average SUVmean values of the artificial lesions were determined for a 3D, a gated 4D, a MoCo 4D and a reference (with ten-fold measurement time) gated 4D reconstruction. Compared to the reference, 3D reconstructions yielded an underestimation of SUVmean values due to motion blurring. In contrast, gated 4D reconstructions showed the highest variation of SUVmean due to low statistics. MoCo 4D reconstructions were only slightly affected by these two sources of uncertainty resulting in a significant visual and quantitative improvement in terms of SUVmean values. Whereas temporal resolution was comparable to the gated 4D images, signal-to-noise ratio and contrast-to-noise ratio were close to the 3D reconstructions.

  14. Registration of acute stroke

    DEFF Research Database (Denmark)

    Wildenschild, Cathrine; Mehnert, Frank; Thomsen, Reimar Wernich


    BACKGROUND: The validity of the registration of patients in stroke-specific registries has seldom been investigated, nor compared with administrative hospital discharge registries. The objective of this study was to examine the validity of the registration of patients in a stroke-specific registry...... (The Danish Stroke Registry [DSR]) and a hospital discharge registry (The Danish National Patient Registry [DNRP]). METHODS: Assuming that all patients with stroke were registered in either the DSR, DNRP or both, we first identified a sample of 75 patients registered with stroke in 2009; 25 patients...... in the DSR, 25 patients in the DNRP, and 25 patients registered in both data sources. Using the medical record as a gold standard, we then estimated the sensitivity and positive predictive value of a stroke diagnosis in the DSR and the DNRP. Secondly, we reviewed 160 medical records for all potential stroke...


    Directory of Open Access Journals (Sweden)

    H. R. Chen


    Full Text Available Historical aerial photographs directly provide good evidences of past times. The Research Center for Humanities and Social Sciences (RCHSS of Taiwan Academia Sinica has collected and scanned numerous historical maps and aerial images of Taiwan and China. Some maps or images have been geo-referenced manually, but most of historical aerial images have not been registered since there are no GPS or IMU data for orientation assisting in the past. In our research, we developed an automatic process of matching historical aerial images by SIFT (Scale Invariant Feature Transform for handling the great quantity of images by computer vision. SIFT is one of the most popular method of image feature extracting and matching. This algorithm extracts extreme values in scale space into invariant image features, which are robust to changing in rotation scale, noise, and illumination. We also use RANSAC (Random sample consensus to remove outliers, and obtain good conjugated points between photographs. Finally, we manually add control points for registration through least square adjustment based on collinear equation. In the future, we can use image feature points of more photographs to build control image database. Every new image will be treated as query image. If feature points of query image match the features in database, it means that the query image probably is overlapped with control images.With the updating of database, more and more query image can be matched and aligned automatically. Other research about multi-time period environmental changes can be investigated with those geo-referenced temporal spatial data.

  16. Summary of recommendations for the design of clinical trials and the registration of drugs used in the treatment of asthma

    DEFF Research Database (Denmark)

    Holgate, S T; Bousquet, J; Chung, K F


    With new drugs being introduced to treat asthma it is timely to review criteria that can be used to assess efficacy in clinical trials. Anti-asthma drugs are classified into symptoms-modifying, symptom preventers and disease modifying agents. Attention is drawn to the types of experimental eviden...

  17. Manifold-based feature point matching for multi-modal image registration. (United States)

    Hu, Liang; Wang, Manning; Song, Zhijian


    Images captured using different modalities usually have significant variations in their intensities, which makes it difficult to reveal their internal structural similarities and achieve accurate registration. Most conventional feature-based image registration techniques are fast and efficient, but they cannot be used directly for the registration of multi-modal images because of these intensity variations. This paper introduces the theory of manifold learning to transform the original images into mono-modal modalities, which is a feature-based method that is applicable to multi-modal image registration. Subsequently, scale-invariant feature transform is used to detect highly distinctive local descriptors and matches between corresponding images, and a point-based registration is executed. The algorithm was tested with T1- and T2-weighted magnetic resonance (MR) images obtained from BrainWeb. Both qualitative and quantitative evaluations of the method were performed and the results compared with those produced previously. The experiments showed that feature point matching after manifold learning achieved more accurate results than did the similarity measure for multi-modal image registration. This study provides a new manifold-based feature point matching method for multi-modal medical image registration, especially for MR images. The proposed method performs better than do conventional intensity-based techniques in terms of its registration accuracy and is suitable for clinical procedures. Copyright © 2012 John Wiley & Sons, Ltd.

  18. [Review of the 2008 revision of the ethical guidelines for clinical studies]. (United States)

    Imoto, Masakatsu


    The ethical guidelines for clinical studies were revised in 2008 and enforced in April 2009. This was the second revision but first regular revision and largely reviewed. In particular, articles under the purview of the Institutional Review Board (IRB) for clinical studies are reviewed and enhanced. This additional role further increases the authority of the IRB, and those who fix the IRB must exhibit the activity of the IRB to the public and report to the MHLW annually. The provision of compensation for clinical studies on the evaluation of drugs and medical devices has been added to this version of the ethical guidelines. The compensation for interventional clinical studies using drugs and medical devices has not yet been decided, similar to "chiken," which is defined in pharmaceutical affairs laws (PAL). Since April 2009, some insurance offices have started offering special insurance covers for clinical studies. New registration rules have been established for clinical studies. Moreover, there is now a database for clinical study registration called "Japan Primary Registries Network (JPRN)," which is certified by WHO. This database comprises 3 open databases, which were originally independent, related to clinical trials in Japan. They are however under the purview of the National Institute of Public Health. This institution works in collaboration with the "International Clinical Trials Registry Platform (ICTRP)" of WHO.

  19. Accuracy Validation for Medical Image Registration Algorithms: a Review

    Institute of Scientific and Technical Information of China (English)

    Zhe Liu; Xiang Deng; Guang-zhi Wang


    Accuracy validation is essential to clinical application of medical image registration techniques.Registration validation remains a challenging problem in practice mainly due to lack of 'ground truth'.In this paper,an overview of current validation methods for medical image registration is presented with detailed discussion of their benefits and drawbacks.Special focus is on non-rigid registration validation.Promising solution is also discussed.

  20. SU-E-J-102: Performance Variations Among Clinically Available Deformable Image Registration Tools in Adaptive Radiotherapy: How Should We Evaluate and Interpret the Result?

    Energy Technology Data Exchange (ETDEWEB)

    Nie, K [Rutgers Cancer Institute of New Jersey, New Brunswick, NJ (United States); Pouliot, J; Smith, E; Chuang, C [University of California, San Francisco, San Francisco, CA (United States)


    Purpose: To evaluate the performance variations in commercial deformable image registration (DIR) tools for adaptive radiation therapy. Methods: Representative plans from three different anatomical sites, prostate, head-and-neck (HN) and cranial spinal irradiation (CSI) with L-spine boost, were included. Computerized deformed CT images were first generated using virtual DIR QA software (ImSimQA) for each case. The corresponding transformations served as the “reference”. Three commercial software packages MIMVista v5.5 and MIMMaestro v6.0, VelocityAI v2.6.2, and OnQ rts v2.1.15 were tested. The warped contours and doses were compared with the “reference” and among each other. Results: The performance in transferring contours was comparable among all three tools with an average DICE coefficient of 0.81 for all the organs. However, the performance of dose warping accuracy appeared to rely on the evaluation end points. Volume based DVH comparisons were not sensitive enough to illustrate all the detailed variations while isodose assessment on a slice-by-slice basis could be tedious. Point-based evaluation was over-sensitive by having up to 30% hot/cold-spot differences. If adapting the 3mm/3% gamma analysis into the evaluation of dose warping, all three algorithms presented a reasonable level of equivalency. One algorithm had over 10% of the voxels not meeting this criterion for the HN case while another showed disagreement for the CSI case. Conclusion: Overall, our results demonstrated that evaluation based only on the performance of contour transformation could not guarantee the accuracy in dose warping. However, the performance of dose warping accuracy relied on the evaluation methodologies. Nevertheless, as more DIR tools are available for clinical use, the performance could vary at certain degrees. A standard quality assurance criterion with clinical meaning should be established for DIR QA, similar to the gamma index concept, in the near future.

  1. [Clinical studies on pramipexol retard]. (United States)

    Klivényi, Péter; Vécsei, László


    Pramipexol retard is the newest drug for the treatment of Parkinson's disease. The prolonged release of the agent in this preparation allows a more continuous dopaminergic stimulation than previous preparations, without reducing the agent's already known and proven clinical efficiency. In addition, it has a more favourable adverse effect profile than previous preparations, and patient compliance can also be better as it needs to be taken only once daily. These benefits have been proven in recent clinical studies, of which the most important ones are reviewed here.

  2. Configurable automatic detection and registration of fiducial frames for device-to-image registration in MRI-guided prostate interventions. (United States)

    Tokuda, Junichi; Song, Sang-Eun; Tuncali, Kemal; Tempany, Clare; Hata, Nobuhiko


    We propose a novel automatic fiducial frame detection and registration method for device-to-image registration in MRI-guided prostate interventions. The proposed method does not require any manual selection of markers, and can be applied to a variety of fiducial frames, which consist of multiple cylindrical MR-visible markers placed in different orientations. The key idea is that automatic extraction of linear features using a line filter is more robust than that of bright spots by thresholding; by applying a line set registration algorithm to the detected markers, the frame can be registered to the MRI. The method was capable of registering the fiducial frame to the MRI with an accuracy of 1.00 +/- 0.73 mm and 1.41 +/- 1.06 degrees in a phantom study, and was sufficiently robust to detect the fiducial frame in 98% of images acquired in clinical cases despite the existence of anatomical structures in the field of view.

  3. Phantom study and accuracy evaluation of an image-to-world registration approach used with electro-magnetic tracking system for neurosurgery (United States)

    Li, Senhu; Sarment, David


    Minimally invasive neurosurgery needs intraoperative imaging updates and high efficient image guide system to facilitate the procedure. An automatic image guided system utilized with a compact and mobile intraoperative CT imager was introduced in this work. A tracking frame that can be easily attached onto the commercially available skull clamp was designed. With known geometry of fiducial and tracking sensor arranged on this rigid frame that was fabricated through high precision 3D printing, not only was an accurate, fully automatic registration method developed in a simple and less-costly approach, but also it helped in estimating the errors from fiducial localization in image space through image processing, and in patient space through the calibration of tracking frame. Our phantom study shows the fiducial registration error as 0.348+/-0.028mm, comparing the manual registration error as 1.976+/-0.778mm. The system in this study provided a robust and accurate image-to-patient registration without interruption of routine surgical workflow and any user interactions involved through the neurosurgery.

  4. [Progress of research in retinal image registration]. (United States)

    Yu, Lun; Wei, Lifang; Pan, Lin


    The retinal image registration has important applications in the processes of auxiliary diagnosis and treatment for a variety of diseases. The retinal image registration can be used to measure the disease process and the therapeutic effect. A variety of retinal image registration techniques have been studied extensively in recent years. However, there are still many problems existing and there are numerous research possibilities. Based on extensive investigation of existing literatures, the present paper analyzes the feature of retinal image and current challenges of retinal image registration, and reviews the transformation models of the retinal image registration technology and the main research algorithms in current retinal image registration, and analyzes the advantages and disadvantages of various types of algorithms. Some research challenges and future developing trends are also discussed.

  5. Deformable image registration based automatic CT-to-CT contour propagation for head and neck adaptive radiotherapy in the routine clinical setting

    Energy Technology Data Exchange (ETDEWEB)

    Kumarasiri, Akila, E-mail:; Siddiqui, Farzan; Liu, Chang; Yechieli, Raphael; Shah, Mira; Pradhan, Deepak; Zhong, Hualiang; Chetty, Indrin J.; Kim, Jinkoo [Department of Radiation Oncology, Henry Ford Health System, Detroit, Michigan 48202 (United States)


    Purpose: To evaluate the clinical potential of deformable image registration (DIR)-based automatic propagation of physician-drawn contours from a planning CT to midtreatment CT images for head and neck (H and N) adaptive radiotherapy. Methods: Ten H and N patients, each with a planning CT (CT1) and a subsequent CT (CT2) taken approximately 3–4 week into treatment, were considered retrospectively. Clinically relevant organs and targets were manually delineated by a radiation oncologist on both sets of images. Four commercial DIR algorithms, two B-spline-based and two Demons-based, were used to deform CT1 and the relevant contour sets onto corresponding CT2 images. Agreement of the propagated contours with manually drawn contours on CT2 was visually rated by four radiation oncologists in a scale from 1 to 5, the volume overlap was quantified using Dice coefficients, and a distance analysis was done using center of mass (CoM) displacements and Hausdorff distances (HDs). Performance of these four commercial algorithms was validated using a parameter-optimized Elastix DIR algorithm. Results: All algorithms attained Dice coefficients of >0.85 for organs with clear boundaries and those with volumes >9 cm{sup 3}. Organs with volumes <3 cm{sup 3} and/or those with poorly defined boundaries showed Dice coefficients of ∼0.5–0.6. For the propagation of small organs (<3 cm{sup 3}), the B-spline-based algorithms showed higher mean Dice values (Dice = 0.60) than the Demons-based algorithms (Dice = 0.54). For the gross and planning target volumes, the respective mean Dice coefficients were 0.8 and 0.9. There was no statistically significant difference in the Dice coefficients, CoM, or HD among investigated DIR algorithms. The mean radiation oncologist visual scores of the four algorithms ranged from 3.2 to 3.8, which indicated that the quality of transferred contours was “clinically acceptable with minor modification or major modification in a small number of contours

  6. Deformable image registration based automatic CT-to-CT contour propagation for head and neck adaptive radiotherapy in the routine clinical setting. (United States)

    Kumarasiri, Akila; Siddiqui, Farzan; Liu, Chang; Yechieli, Raphael; Shah, Mira; Pradhan, Deepak; Zhong, Hualiang; Chetty, Indrin J; Kim, Jinkoo


    To evaluate the clinical potential of deformable image registration (DIR)-based automatic propagation of physician-drawn contours from a planning CT to midtreatment CT images for head and neck (H&N) adaptive radiotherapy. Ten H&N patients, each with a planning CT (CT1) and a subsequent CT (CT2) taken approximately 3-4 week into treatment, were considered retrospectively. Clinically relevant organs and targets were manually delineated by a radiation oncologist on both sets of images. Four commercial DIR algorithms, two B-spline-based and two Demons-based, were used to deform CT1 and the relevant contour sets onto corresponding CT2 images. Agreement of the propagated contours with manually drawn contours on CT2 was visually rated by four radiation oncologists in a scale from 1 to 5, the volume overlap was quantified using Dice coefficients, and a distance analysis was done using center of mass (CoM) displacements and Hausdorff distances (HDs). Performance of these four commercial algorithms was validated using a parameter-optimized Elastix DIR algorithm. All algorithms attained Dice coefficients of >0.85 for organs with clear boundaries and those with volumes >9 cm(3). Organs with volumes <3 cm(3) and/or those with poorly defined boundaries showed Dice coefficients of ∼ 0.5-0.6. For the propagation of small organs (<3 cm(3)), the B-spline-based algorithms showed higher mean Dice values (Dice = 0.60) than the Demons-based algorithms (Dice = 0.54). For the gross and planning target volumes, the respective mean Dice coefficients were 0.8 and 0.9. There was no statistically significant difference in the Dice coefficients, CoM, or HD among investigated DIR algorithms. The mean radiation oncologist visual scores of the four algorithms ranged from 3.2 to 3.8, which indicated that the quality of transferred contours was "clinically acceptable with minor modification or major modification in a small number of contours." Use of DIR-based contour propagation in the routine

  7. MIND Demons for MR-to-CT deformable image registration in image-guided spine surgery (United States)

    Reaungamornrat, S.; De Silva, T.; Uneri, A.; Wolinsky, J.-P.; Khanna, A. J.; Kleinszig, G.; Vogt, S.; Prince, J. L.; Siewerdsen, J. H.


    Purpose: Localization of target anatomy and critical structures defined in preoperative MR images can be achieved by means of multi-modality deformable registration to intraoperative CT. We propose a symmetric diffeomorphic deformable registration algorithm incorporating a modality independent neighborhood descriptor (MIND) and a robust Huber metric for MR-to-CT registration. Method: The method, called MIND Demons, solves for the deformation field between two images by optimizing an energy functional that incorporates both the forward and inverse deformations, smoothness on the velocity fields and the diffeomorphisms, a modality-insensitive similarity function suitable to multi-modality images, and constraints on geodesics in Lagrangian coordinates. Direct optimization (without relying on an exponential map of stationary velocity fields used in conventional diffeomorphic Demons) is carried out using a Gauss-Newton method for fast convergence. Registration performance and sensitivity to registration parameters were analyzed in simulation, in phantom experiments, and clinical studies emulating application in image-guided spine surgery, and results were compared to conventional mutual information (MI) free-form deformation (FFD), local MI (LMI) FFD, and normalized MI (NMI) Demons. Result: The method yielded sub-voxel invertibility (0.006 mm) and nonsingular spatial Jacobians with capability to preserve local orientation and topology. It demonstrated improved registration accuracy in comparison to the reference methods, with mean target registration error (TRE) of 1.5 mm compared to 10.9, 2.3, and 4.6 mm for MI FFD, LMI FFD, and NMI Demons methods, respectively. Validation in clinical studies demonstrated realistic deformation with sub-voxel TRE in cases of cervical, thoracic, and lumbar spine. Conclusions: A modality-independent deformable registration method has been developed to estimate a viscoelastic diffeomorphic map between preoperative MR and intraoperative CT

  8. Nurses' motivations for studying third level post-registration nursing programmes and the effects of studying on their personal and work lives. (United States)

    Cooley, Mary Clodagh


    Internationally nurses' motivations for post-registration education and the effects of studying are important concerns for the profession. This paper describes Irish nurses' motivations for studying post-registration nursing programmes and the effects of studying on their personal and work lives. Eighteen nurses participated in this qualitative study. Data were collected using three focus groups and a one-to-one interview. Data were analysed using the qualitative data analysis method Framework [Ritchie, J., Spencer, L., 1994. Qualitative data analysis for applied policy research. In: Bryman, A., Burgess, R. (Eds.), Analyzing Qualitative Data. Routledge, London, pp. 173-194]. Three themes were identified: "I want to keep up and I want to keep in there," "It's about juggling and getting the balance" and "I'm looking at things differently." Findings revealed that nurses studied to aid their professional development. Contextual factors influenced their motivations including a free fees initiative and Irish nursing developing into an all graduate profession. The impact of studying on their personal and work lives was broader in scope than their motivations.

  9. Image Registration for Targeted MRI-guided Transperineal Prostate Biopsy (United States)

    Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Tokuda, Junichi; Hata, Nobuhiko; Wells, William M.; Kikinis, Ron; Tempany, Clare M.


    Purpose To develop and evaluate image registration methodology for automated re-identification of tumor-suspicious foci from pre-procedural MR exams during MR-guided transperineal prostate core biopsy. Materials and Methods A hierarchical approach for automated registration between planning and intra-procedural T2-weighted prostate MRI was developed and evaluated on the images acquired during 10 consecutive MR-guided biopsies. Registration accuracy was quantified at image-based landmarks and by evaluating spatial overlap for the manually segmented prostate and sub-structures. Registration reliability was evaluated by simulating initial mis-registration and analyzing the convergence behavior. Registration precision was characterized at the planned biopsy targets. Results The total computation time was compatible with a clinical setting, being at most 2 minutes. Deformable registration led to a significant improvement in spatial overlap of the prostate and peripheral zone contours compared to both rigid and affine registration. Average in-slice landmark registration error was 1.3±0.5 mm. Experiments simulating initial mis-registration resulted in an estimated average capture range of 6 mm and an average in-slice registration precision of ±0.3 mm. Conclusion Our registration approach requires minimum user interaction and is compatible with the time constraints of our interventional clinical workflow. The initial evaluation shows acceptable accuracy, reliability and consistency of the method. PMID:22645031

  10. Feasibility study for image-guided kidney surgery: Assessment of required intraoperative surface for accurate physical to image space registrations (United States)

    Benincasa, Anne B.; Clements, Logan W.; Herrell, S. Duke; Galloway, Robert L.


    A notable complication of applying current image-guided surgery techniques of soft tissue to kidney resections (nephrectomies) is the limited field of view of the intraoperative kidney surface. This limited view constrains the ability to obtain a sufficiently geometrically descriptive surface for accurate surface-based registrations. The authors examined the effects of the limited view by using two orientations of a kidney phantom to model typical laparoscopic and open partial nephrectomy views. Point-based registrations, using either rigidly attached markers or anatomical landmarks as fiducials, served as initial alignments for surface-based registrations. Laser range scanner (LRS) obtained surfaces were registered to the phantom’s image surface using a rigid iterative closest point algorithm. Subsets of each orientation’s LRS surface were used in a robustness test to determine which parts of the surface yield the most accurate registrations. Results suggest that obtaining accurate registrations is a function of the percentage of the total surface and of geometric surface properties, such as curvature. Approximately 28% of the total surface is required regardless of the location of that surface subset. However, that percentage decreases when the surface subset contains information from opposite ends of the surface and∕or unique anatomical features, such as the renal artery and vein. PMID:18841875


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    Full Text Available BACKGROUND AND OBJECTIVE: Acute poisoning is an important medical emergency. Studies of this nature will be useful tool in planning, early diagnosis and management of acute poisoning cases. The objective of the study are to study the clinical features, diagnosis and management, morbidity and mortality of various acute poisoning. METHODOLOGY: This study comprises of 350 patients of acute poisoning admitted to Chigateri General Hospital and Bapuji Hospital attached to J. J. M. Medical College, Davangere, between 1st March 2011 to 31st October 2011. REUSLTS: Out of 350 cases of acute poisoning studied, there were 268 males and 82 females. Males comprised 76.57%and females 23.42% of the total, in this series, Organophosphorous compounds were the commonest (30%, majority of the patients hailed from rural area 70%. Mortality is 10.57%.

  12. Feasibility study for image guided kidney surgery: assessment of required intraoperative surface for accurate image to physical space registrations (United States)

    Benincasa, Anne B.; Clements, Logan W.; Herrell, S. Duke; Chang, Sam S.; Cookson, Michael S.; Galloway, Robert L.


    Currently, the removal of kidney tumor masses uses only direct or laparoscopic visualizations, resulting in prolonged procedure and recovery times and reduced clear margin. Applying current image guided surgery (IGS) techniques, as those used in liver cases, to kidney resections (nephrectomies) presents a number of complications. Most notably is the limited field of view of the intraoperative kidney surface, which constrains the ability to obtain a surface delineation that is geometrically descriptive enough to drive a surface-based registration. Two different phantom orientations were used to model the laparoscopic and traditional partial nephrectomy views. For the laparoscopic view, fiducial point sets were compiled from a CT image volume using anatomical features such as the renal artery and vein. For the traditional view, markers attached to the phantom set-up were used for fiducials and targets. The fiducial points were used to perform a point-based registration, which then served as a guide for the surface-based registration. Laser range scanner (LRS) obtained surfaces were registered to each phantom surface using a rigid iterative closest point algorithm. Subsets of each phantom's LRS surface were used in a robustness test to determine the predictability of their registrations to transform the entire surface. Results from both orientations suggest that about half of the kidney's surface needs to be obtained intraoperatively for accurate registrations between the image surface and the LRS surface, suggesting the obtained kidney surfaces were geometrically descriptive enough to perform accurate registrations. This preliminary work paves the way for further development of kidney IGS systems.

  13. Comparing distance education and conventional education: observations from a comparative study of post-registration nurses

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    Tim Duffy


    Full Text Available This retrospective study presents a comparison of assessment results achieved by distancelearning students and classroom-based students undertaking the same module in a degree course. The purpose of the comparison is to provide some objective measurement of the quality of distance education in relation to conventional classroom-based education. The authors have selected three groups of students, who have all undertaken the same module in the B. Sc Health Studies degree programme offered by the University of Paisley. One group (in Paisley undertook their studies by means of conventional classroom-based education, the second (in Hong Kong by supported distance learning with face-to-face contact in the form of tutorials, and the third (in a geographically dispersed group in the United Kingdom and other countries by supported distance learning with no face-to-face contact. The results obtained by these three groups of students were analysed. Because of the differences in the size of the groups, the Kruskal- Wallis 1- Way Anova test was applied to validate the face value findings. The authors include findings from the literature comparing distance education with conventional education and from cross-cultural studies to present their data in context. Analysis of the assessment results showed that students from all three groups were successful in their studies, but the students studying by distance learning obtained significantly higher end-of-module results than their classroom-based colleagues. This latter finding reflects the conclusion that other investigators have reached In their discussion the authors identify educational, cultural and personal factors that may help to explain their findings. A limitation in the study is that it concerns only one module in the degree programme. The research now moves on to comparing students who have undertaken the whole degree programme by the means described

  14. A qualitative study of the perceptions and experiences of Pre-Registration House Officers on teamwork and support

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    Cochrane Mac


    Full Text Available Abstract Background Following the implementation of a new final Year 5 curriculum in one medical school we carried out a study to explore the experience of the transition from final student year to Pre-Registration House Officer (PRHO. This study looks at the experiences of two successive cohorts of PRHOs in relation to team work, support and shared responsibility in their transition from final year students to qualified doctors. The involvement of PRHOs in teams is likely to change in the development of Foundation programmes. Methods A qualitative study with semi-structured interviews with 33 PRHOs, stratified by gender, ethnicity and maturity, from two study cohorts, qualifying in 2001 and 2002, from one medical school in the UK, in their first three months following medical graduation. Results Most PRHOs reported positive experiences for their inclusion as a full member of their first ward teams. This contributed to their increasing confidence and competence in this early period of career transition. However, a number of organisational barriers were identified, e.g. incomplete teams, shift work, which produced problems in their integration for one third of newly qualified doctors. Conclusion Recently introduced policies, intended to improve the working lives of newly qualified doctors have produced both benefits and unintended adverse impacts on PRHOs. The changes of the new PRHO Foundation programme will have further impact. Foundation doctors may need to relate to wider teams with more interaction and less protection. Such changes will need to be managed carefully to protect the PRHO at a vulnerable time.

  15. Age-specific incidence and prevalence of keratoconus : a nationwide registration study

    NARCIS (Netherlands)

    Godefrooij, Daniel A; de Wit, G Ardine; Uiterwaal, Cuno S; Imhof, Saskia M; Wisse, Robert P L

    PURPOSE: To determine the age-specific incidence and prevalence of keratoconus in the modern era of diagnostics. DESIGN: Epidemiologic study. PARTICIPANTS: 4.4 million patients from a mandatory health insurance database. METHODS: Data were extracted from the largest health insurance provider in the

  16. Age-specific incidence and prevalence of keratoconus : a nationwide registration study

    NARCIS (Netherlands)

    Godefrooij, Daniel A; de Wit, G Ardine; Uiterwaal, Cuno S; Imhof, Saskia M; Wisse, Robert P L


    PURPOSE: To determine the age-specific incidence and prevalence of keratoconus in the modern era of diagnostics. DESIGN: Epidemiologic study. PARTICIPANTS: 4.4 million patients from a mandatory health insurance database. METHODS: Data were extracted from the largest health insurance provider in the

  17. Acute hamstring injuries in Danish elite football: a 12-month prospective registration study among 374 players

    DEFF Research Database (Denmark)

    Petersen, Jesper; Thorborg, Kristian; Nielsen, Michael Bachmann;


    The purpose of the present study was to examine the incidence rates of acute hamstring injuries in Danish elite football sustained during training or match play. Furthermore, it was our intention to document details about the recurrence, severity and the injury seasonal distribution. Hamstring in...

  18. Numerical methods for image registration

    CERN Document Server

    Modersitzki, Jan


    Based on the author's lecture notes and research, this well-illustrated and comprehensive text is one of the first to provide an introduction to image registration with particular emphasis on numerical methods in medical imaging. Ideal for researchers in industry and academia, it is also a suitable study guide for graduate mathematicians, computer scientists, engineers, medical physicists, and radiologists.Image registration is utilised whenever information obtained from different viewpoints needs to be combined or compared and unwanted distortion needs to be eliminated. For example, CCTV imag

  19. Optimization of megavoltage CT scan registration settings for brain cancer treatments on tomotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Woodford, Curtis; Yartsev, Slav; Van Dyk, Jake [London Regional Cancer Program, London Health Sciences Centre, 790 Commissioners Road East, London, Ontario (Canada)


    This study aims to determine the settings that provide the optimal clinical accuracy and consistency for the registration of megavoltage CT (MVCT) with planning kilovoltage CT image sets on the Hi-ART tomotherapy system. The systematic offset between the MVCT and the planning kVCT was determined by registration of multiple MVCT scans of a head phantom aligned with the planning isocentre. Residual error vector lengths and components were used to quantify the alignment quality for the phantom shifted by 5 mm in different directions obtained by all 27 possible combinations of MVCT inter-slice spacing, registration techniques and resolution. MVCT scans with normal slices are superior to coarse slices for registration of shifts in the superior-inferior, lateral and anterior-posterior directions. Decreasing the scan length has no detrimental effect on registration accuracy as long as the scan lengths are larger than 24 mm. In the case of bone technique and fine resolution, normal and fine MVCT scan slice spacing options give similar accuracy, so normal mode is preferable due to shorter procedure and less delivered dose required for patient set-up. A superior-inferior field length of 24-30 mm, normal slice spacing, bone technique, and fine resolution is the optimum set of registration settings for MVCT scans of a Rando head phantom acquired with the Hi-ART tomotherapy system, provided the registration shifts are less than 5 mm. (note)

  20. Regulation of stability studies to enhance the efficiency of drug registrations to regulatory authorities

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    Mohammad Sajjad Khan


    Full Text Available Stability testing is an important tool to assess the quality of drug substances and products which may vary with time under influence of variety of factors such as temperature, humidity, and light. Stability studies of drugs are designed according to the climatic zones to establish a retest period for active drug substance or a shelf life for the finished product as well as to recommend the storage conditions. The strict regulatory requirements on designing, performing evaluating stability study to claim the expiry date, and shelf life of drug products are based on a series of regulatory requirements and advisory guidelines that have been developed by regulatory authorities of US, Europe, and Japan which; were harmonized through the development of the International Conference on Harmonization (ICH procedures. To assess the stability of drug substances and products, the design and conduct of stability studies, defining relevant thresholds for impurities testing is required with a current good manufacturing practice-based risk management approach to achieve a robust stability of pharmaceutical dosage forms. There are relevant requirements that cover new drug substances and products as well as new dosage forms containing existing active ingredients and vice versa.


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    Full Text Available An ectopic pregnancy is one in which fertilized ovum is implanted at the site other than normal uterine cavity.[1] Incidence of ectopic pregnancy is 1:160 deliveries.[2] Clinical presentation is variable from acute to chronic type. Due to its varied clinical presentation ectopic pregnancy poses great diagnostic difficulty both to obstetrician, physician and surgeons.[3] OBJECTIVE: To find out incidence in our study population and to evaluate symptomatically and clinical presentation in these patients. MATERIALS AND METHODS: Retrospective study of 34 ectopic pregnancies admitted and treated in Medical College hospital, Ujjain from 2010 to 2015 are included in the study. RESULTS: The incidence of ectopic pregnancy is more between the age group of 21-30years (73.52% and in Multigravida 64.71%. Infertility and previous tubal surgery are the high risk factors for tubal pregnancy. Pain in abdomen was present in all 34 cases, amenorrhea in 97.05% and bleeding per vagina in 76.47% cases. Syncopal attacks, vomiting were detected in 14.70% cases. Acute ectopic pregnancy was detected in 14.71% and chronic in 85.29% cases. 82.35% cases presented with adnexal mass, 79.41% with cervical motion tenderness, 50% with pallor, 32.35% with abdominal lump and tenderness and 11.76% with fullness in POD. CONCLUSION: Ectopic pregnancy is leading cause of maternal mortality in first trimester. In spite of advanced diagnostic techniques. It poses great diagnostic difficulties due to varied signs and symptoms. Previous tubal surgery pelvic inflammatory disease and infertility are the risk factors of tubal pregnancy.

  2. Study of Hospital Records Registration in Teaching Hospitals of Hamadan University of Medical Sciences in 2009

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    M. Shokouhee Solgi


    Full Text Available Introduction & Objectives: Hospital records are representative evidences of medical team activities. In this study, we analyzed hospital records in Hamadan teaching hospitals to find out the problem extent and possible solutions for the problem.Materials & Methods: In a cross-sectional study, hospital records from teaching hospitals were gathered and put in check lists. We used convenient sampling from all departments, so that by referring to hospital achieve, all new discharged cases from different wards were extracted. We used a 16 item check list which targeted some basic questions like: admission order, discharge order, early and final diagnosis and so on. In each case perfect answer was registered in yes or no boxes. Collected data were analyzed by SPSS16 hardware.Results: We achieved the following results after analyzing 457 records from 4 teaching hospitals; there were admission note in 94% of the patients' files. 93% of physicians and residents had signed the orders. 88% of the history sheets were being singed by medical students and/or residents. Differential diagnoses were present in only 75% of cases. Final diagnoses were found in 90% and discharge notes in 84% of the files. 86% of physicians had recorded therapeutic and/or surgical procedures. Paraclinical procedure recordings were present in 83% of the files. Only 63% of residents and/or interns had signed their progress notes. And nursing papers were signed in 99% of records. There was exact counseling information in 83% of the files which needed to be consulted; meanwhile 82% of the consulted files had been signed by physicians. Conclusion: This study shows that, there are important defects in hospital records. It seems that there are multiple factors contributing to the problem, such as overcrowding of the hospitals, careless medical students and the most important factors is insufficient training about the problem.

  3. Age-specific Incidence and Prevalence of Keratoconus: A Nationwide Registration Study. (United States)

    Godefrooij, Daniel A; de Wit, G Ardine; Uiterwaal, Cuno S; Imhof, Saskia M; Wisse, Robert P L


    To determine the age-specific incidence and prevalence of keratoconus in the modern era of diagnostics. Epidemiologic study. Total of 4.4 million patients from a mandatory health insurance database. Data were extracted from the largest health insurance provider in the Netherlands. Patients aged 10-40 years were defined as the relevant age category for newly diagnosed keratoconus and the annual incidence of newly diagnosed keratoconus was determined. The prevalence of keratoconus was estimated based on the annual incidence, mean age at diagnosis, and average life expectancy. Main outcome measure was the annual incidence and prevalence of keratoconus. The annual incidence of keratoconus was 1:7500 in the relevant age category (13.3 cases per 100 000, 95% confidence interval [CI]: 11.6-15.2) and the estimated prevalence of keratoconus in the general population was 1:375 (265 cases per 100 000, 95% CI: 260-270). These values are 5-fold to 10-fold higher than previously reported values in population studies. The mean age at diagnosis was 28.3 years and 60.6% of diagnosed patients were male. Both the annual incidence and the prevalence of keratoconus were 5-fold to 10-fold higher than previously reported. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Warping-based co-registration of thermal infrared images: Study of factors influencing its applicability (United States)

    Cardone, D.; Pinti, P.; Di Donato, L.; Merla, A.


    A relevant issue for processing biomedical thermal imaging data is the availability of tools for objective and quantitative comparison of images across different conditions or subjects. To this goal, a solution can be offered by projecting the thermal distribution data onto a fictitious template to obtain a common reference for comparison across cases or subjects. In this preliminary study, we tested the feasibility of applying a warping procedure on infrared thermal images. Fifteen thermal images of checkerboard were recorded at three different distances and five different angles in order to evaluate which factor mostly influences the warping accuracy. The accuracy of three different warping transformation models (local weighted mean (LWM), polynomial, affine) was tested by comparing the positioning error between users' selected fiduciary points on each thermal image and their corresponding reference position assigned on the template image. Fifteen users, divided into three groups upon on their experience in thermal imaging processing, participated in this study in order to evaluate the effect of experience in applying a warping procedure to the analysis of thermal infrared images. The most relevant factor influencing the positioning and thermal errors is the acquisition distance, while the users' level of experience and the inclination angle do not seem to play the same importance. Comparing the three transformations, the LWM seems to be the best in terms of minimizing the two categories of errors. This preliminary work helps to understand the limits and the possibilities of applying warping techniques for objective, quantitative and automatic thermal image comparisons.

  5. Performance of clinical mammography: a nationwide study from Denmark

    DEFF Research Database (Denmark)

    Jensen, Allan; Vejborg, Ilse; Severinsen, Niels;


    in Denmark in the year 2000 were collected and linked to cancer outcome. Use of the National Institute of Radiation Hygiene register for identification of radiology clinics ensured comprehensive nationwide registration. We used the final mammographic assessment at the end of the imaging work-up to determine...

  6. Acute hamstring injuries in Danish elite football: a 12-month prospective registration study among 374 players

    DEFF Research Database (Denmark)

    Petersen, Jesper; Nielsen, Michael Bachmann; Hølmich, Per


    The purpose of the present study was to examine the incidence rates of acute hamstring injuries in Danish elite football sustained during training or match play. Furthermore, it was our intention to document details about the recurrence, severity and the injury seasonal distribution. Hamstring...... injuries among 374 elite football players were registered prospectively during a 12-month period. A total of 46 first-time and eight recurrent hamstring injuries were registered. The incidence rates for incurring a first-time hamstring injury showed a significantly (P28 days from injury to injury free......). Each team sustained a mean of 3.4 hamstring injuries per season, with a mean of 21.5 days missed per injury (range 3-136; median 16 days per injury). The seasonal distribution showed an accumulation of injuries in the first 2 months after a 3.5-month mid-season winter break....

  7. Objective assessment of deformable image registration in radiotherapy: A multi-institution study

    Energy Technology Data Exchange (ETDEWEB)

    Kashani, Rojano; Hub, Martina; Balter, James M.; Kessler, Marc L.; Dong Lei; Zhang Lifei; Xing Lei; Xie Yaoqin; Hawkes, David; Schnabel, Julia A.; McClelland, Jamie; Joshi, Sarang; Chen Quan; Lu Weiguo [Department of Radiation Oncology, University of Michigan, 1500 E. Medical Center Drive, Ann Arbor, Michigan 48109-0010 (United States); Department of Radiation Oncology, Deutsches Krebsforschungszentrum, Heidelberg (Germany); Department of Radiation Oncology, University of Michigan, Ann Arbor, Michigan 48109 (United States); Department of Radiation Oncology, UT MD Anderson Cancer Center, Houston, Texas 77030 (United States); Department of Radiation Oncology, Stanford University School of Medicine, Stanford, California 94305 (United States); Centre for Medical Image Computing, University College London, London (United Kingdom); Scientific Computing and Imaging Institute, University of Utah, Salt Lake City, Utah 84112 (United States); TomoTherapy Inc., Madison, Wisconsin 53717 (United States)


    The looming potential of deformable alignment tools to play an integral role in adaptive radiotherapy suggests a need for objective assessment of these complex algorithms. Previous studies in this area are based on the ability of alignment to reproduce analytically generated deformations applied to sample image data, or use of contours or bifurcations as ground truth for evaluation of alignment accuracy. In this study, a deformable phantom was embedded with 48 small plastic markers, placed in regions varying from high contrast to roughly uniform regional intensity, and small to large regional discontinuities in movement. CT volumes of this phantom were acquired at different deformation states. After manual localization of marker coordinates, images were edited to remove the markers. The resulting image volumes were sent to five collaborating institutions, each of which has developed previously published deformable alignment tools routinely in use. Alignments were done, and applied to the list of reference coordinates at the inhale state. The transformed coordinates were compared to the actual marker locations at exhale. A total of eight alignment techniques were tested from the six institutions. All algorithms performed generally well, as compared to previous publications. Average errors in predicted location ranged from 1.5 to 3.9 mm, depending on technique. No algorithm was uniformly accurate across all regions of the phantom, with maximum errors ranging from 5.1 to 15.4 mm. Larger errors were seen in regions near significant shape changes, as well as areas with uniform contrast but large local motion discontinuity. Although reasonable accuracy was achieved overall, the variation of error in different regions suggests caution in globally accepting the results from deformable alignment.

  8. Masters swimming competitions – A study on applying a registration fee

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    Marcel RĂSĂDEAN


    Full Text Available At the conceptual level, masters swimming is systematically practiced in an organized environment, by adults as amateurs. According to the level of personal motivation, practicing swimming by adults can be conducted as: a recreational activity (leisure swimming; an activity for maintaining physical capacity (fitness; a therapeutic activity; a socializing activity; an initiation activity for adults; a competitive activity. The competitive activity values the sportive dimension of masters swimming. At a worldwide level, there are many masters swimming competitions, and the vast majority of them are organized by the masters swimming clubs. Taking into account that the financing of masters swimming events is mainly based on income from the participation fees, the choice of the participation fee is an important factor in the financial success of such an event. The purpose of this study is to analyse the financial impact determined by applying the two most common types of participation fees both on the organizing club and on the participants themselves. Furthermore, we aim to find a way of taxing participation so that one may take part in as many competitions as possible, but also to ensure the budgetary balance of the event.

  9. Registration error study of digital watt-hour meters under distorted conditions (United States)

    Reta-Hernandez, Manuel

    The increasing application of non-linear loads based on the use of converters, uninterruptible power supplies, and other solid-state switching devices has increased the harmonic content in voltage and current at metering points. One of many problems caused by the voltage and current distortion is the effect on the watt-hour meter performance. The digital watt-hour meter is replacing the old induction meter for measuring electric energy, obtaining additional flexibility and functionality. However, the digital meter performance can be deeply affected when a dc current component is added to the distorted conditions. This dissertation presents a study of the digital watt-hour meter's performance under different nonsinusoidal conditions, including a dc current component. The work is divided into two sections: experimental and analytical. The experimental section consists of accuracy testing on several models of digital meters, both single-phase and three-phase units, subjected to computer-controlled distortion. The system setup used for the measurements was designed by using 12-bits data acquisition hardware (DAQ) and virtual-instrument software (VI) installed in a personal computer. Additional testing on electromechanical watt-hour meters is included for comparison purposes.

  10. Development and evaluation of an articulated registration algorithm for human skeleton registration (United States)

    Yip, Stephen; Perk, Timothy; Jeraj, Robert


    Accurate registration over multiple scans is necessary to assess treatment response of bone diseases (e.g. metastatic bone lesions). This study aimed to develop and evaluate an articulated registration algorithm for the whole-body skeleton registration in human patients. In articulated registration, whole-body skeletons are registered by auto-segmenting into individual bones using atlas-based segmentation, and then rigidly aligning them. Sixteen patients (weight = 80-117 kg, height = 168-191 cm) with advanced prostate cancer underwent the pre- and mid-treatment PET/CT scans over a course of cancer therapy. Skeletons were extracted from the CT images by thresholding (HU>150). Skeletons were registered using the articulated, rigid, and deformable registration algorithms to account for position and postural variability between scans. The inter-observers agreement in the atlas creation, the agreement between the manually and atlas-based segmented bones, and the registration performances of all three registration algorithms were all assessed using the Dice similarity index—DSIobserved, DSIatlas, and DSIregister. Hausdorff distance (dHausdorff) of the registered skeletons was also used for registration evaluation. Nearly negligible inter-observers variability was found in the bone atlases creation as the DSIobserver was 96 ± 2%. Atlas-based and manual segmented bones were in excellent agreement with DSIatlas of 90 ± 3%. Articulated (DSIregsiter = 75 ± 2%, dHausdorff = 0.37 ± 0.08 cm) and deformable registration algorithms (DSIregister = 77 ± 3%, dHausdorff = 0.34 ± 0.08 cm) considerably outperformed the rigid registration algorithm (DSIregsiter = 59 ± 9%, dHausdorff = 0.69 ± 0.20 cm) in the skeleton registration as the rigid registration algorithm failed to capture the skeleton flexibility in the joints. Despite superior skeleton registration performance, deformable registration algorithm failed to preserve the local rigidity of bones as over 60% of the


    Directory of Open Access Journals (Sweden)

    Suhaib Rehaman


    Full Text Available INTRODUCTION : Early diagnosis and severity evaluation on patients with acute pancreatitis are very important due to its potential morbidity and mortality. Given the wide spectrum of disease seen, the care of patients with pancreatitis must be highly individualized. Sev eral clinical, laboratory and radiologic factors and many scoring systems have been proposed for outcome prediction. AIMS AND OBJECTIVES: To study the symptomatology, clinical presentation and management in pancreatitis . To study the severity of acute panc reatitis according to Glasgow Scale . METHODS: Present study includes consecutive 38 patients hospitalized in CSI Holdsworth Memorial Hospital over the period of 2 years. All patients were thoroughly investigated and were stratified according to the Glasgow criteria. Data was collected on complications, investigations and interventions undertaken, outcome, duration of stay in hospital and ICU. STATISTICAL ANALYSIS USED: Descriptive, Chi square tests, Crosstabs (Contingency coefficient analysis . RESULTS : Mean age of presentation in our study was 43.1 years. There was a male predominance accounting for 68.4% compared to 31.6% females. Alcohol was the main etiological factor in about 50% of the patients. Sensitivity to S. amylase was about 100%. Accuracy of USG abdomen in diagnosing pancreatitis was about 88.5%. Ascitis was the commonest complication seen in 13.2%. Mean duration of hospital stay was 6.2 days. The patient were stratified according to Glasgow scoring system into mild (0 - 3 and severe (>3 panc reatitis. In our study 32 people were graded with mild pancreatitis, all improved and in 6 people who were graded with severe pancreatitis, 83.3 % improved and 2.6% expired because of complications. Test statistics showed Contingency coefficient 0.355 and P 0.019 (NS. CONCLUSION : Glasgow scoring system remains a valid predicting system for the outcome in patients with acute pancreatitis. It is simple easy to apply with

  12. GPU-accelerated Block Matching Algorithm for Deformable Registration of Lung CT Images. (United States)

    Li, Min; Xiang, Zhikang; Xiao, Liang; Castillo, Edward; Castillo, Richard; Guerrero, Thomas


    Deformable registration (DR) is a key technology in the medical field. However, many of the existing DR methods are time-consuming and the registration accuracy needs to be improved, which prevents their clinical applications. In this study, we propose a parallel block matching algorithm for lung CT image registration, in which the sum of squared difference metric is modified as the cost function and the moving least squares approach is used to generate the full displacement field. The algorithm is implemented on Graphic Processing Unit (GPU) with the Compute Unified Device Architecture (CUDA). Results show that the proposed parallel block matching method achieves a fast runtime while maintaining an average registration error (standard deviation) of 1.08 (0.69) mm.

  13. Empyema thoracis: A clinical study

    Directory of Open Access Journals (Sweden)

    Acharya Preetam


    Full Text Available Background: Empyema thoracis is a disease that, despite centuries of study, still causes significant morbidity and mortality. Aim: The present study was undertaken to study the age-sex profile, symptomatology, microbiologic findings, etiology and the management and treatment outcome in a tertiary care hospital. Settings and Design: A prospective study of empyema thoracis was conducted on 40 consecutive patients with empyema thoracis admitted to the tuberculosis and chest diseases ward of a teaching hospital. Materials and Methods: The demographic data, clinical presentation, microbiological findings, etiology, the clinical course and management were recorded as per a planned pro forma and analyzed. Results: The peak age was in the range of 21-40 years, the male-to-female ratio was 3.4:1.0 and the left pleura was more commonly affected than the right pleura. Risk factors include pulmonary tuberculosis, chronic obstructive pulmonary diseases, smoking, diabetes mellitus and pneumonia. Etiology of empyema was tubercular in 65% cases and nontubercular in 35% cases. Gram-negative organisms were cultured in 11 cases (27.5%. Two patients received antibiotics with repeated thoracentesis only, intercostal chest tube drainage was required in 38 cases (95% and more aggressive surgery was performed on 2 patients. The average duration for which the chest tube was kept in the complete expansion cases was 22.3 days. Conclusion: It was concluded that all cases of simple empyema with thin pus and only those cases of simple empyema with thick pus where size of empyema is small should be managed by aspiration/s. Cases failed by the above method, all cases of simple empyema with thick pus and with moderate to large size of empyema and all cases of empyema with bronchopleural fistula should be managed by intercostal drainage tube connected to water seal. It was also observed that all cases of empyema complicated by bronchopleural fistula were difficult to manage and

  14. Locally Orderless Registration Code

    DEFF Research Database (Denmark)


    This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows.......This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows....

  15. Locally orderless registration code

    DEFF Research Database (Denmark)


    This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows.......This is code for the TPAMI paper "Locally Orderless Registration". The code requires intel threadding building blocks installed and is provided for 64 bit on mac, linux and windows....

  16. MO-F-BRA-04: Voxel-Based Statistical Analysis of Deformable Image Registration Error via a Finite Element Method. (United States)

    Li, S; Lu, M; Kim, J; Glide-Hurst, C; Chetty, I; Zhong, H


    Purpose Clinical implementation of adaptive treatment planning is limited by the lack of quantitative tools to assess deformable image registration errors (R-ERR). The purpose of this study was to develop a method, using finite element modeling (FEM), to estimate registration errors based on mechanical changes resulting from them. Methods An experimental platform to quantify the correlation between registration errors and their mechanical consequences was developed as follows: diaphragm deformation was simulated on the CT images in patients with lung cancer using a finite element method (FEM). The simulated displacement vector fields (F-DVF) were used to warp each CT image to generate a FEM image. B-Spline based (Elastix) registrations were performed from reference to FEM images to generate a registration DVF (R-DVF). The F- DVF was subtracted from R-DVF. The magnitude of the difference vector was defined as the registration error, which is a consequence of mechanically unbalanced energy (UE), computed using 'in-house-developed' FEM software. A nonlinear regression model was used based on imaging voxel data and the analysis considered clustered voxel data within images. Results A regression model analysis showed that UE was significantly correlated with registration error, DVF and the product of registration error and DVF respectively with R̂2=0.73 (R=0.854). The association was verified independently using 40 tracked landmarks. A linear function between the means of UE values and R- DVF*R-ERR has been established. The mean registration error (N=8) was 0.9 mm. 85.4% of voxels fit this model within one standard deviation. Conclusions An encouraging relationship between UE and registration error has been found. These experimental results suggest the feasibility of UE as a valuable tool for evaluating registration errors, thus supporting 4D and adaptive radiotherapy. The research was supported by NIH/NCI R01CA140341. © 2012 American Association of Physicists in

  17. WE-AB-BRA-08: Results of a Multi-Institutional Study for the Evaluation of Deformable Image Registration Algorithms for Structure Delineation Via Computational Phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Loi, G; Fusella, M [University Hospital “Maggiore della Carita”, Novara (Italy); Fiandra, C [University of Torino, Turin (Italy); Lanzi, E [G. Mazzini Hospital, Teramo (Italy); Rosica, A [Regina Elena National Cancer Institute, Rome (Italy); Strigari, L [Centro Oncologico Fiorentino, Florence (Italy); Orlandini, L [A.O. Ordine Mauriziano di Torino, Turin (Italy); Gino, E [Istituto Oncologico Veneto IOV, Padova (Italy); Roggio, A [Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori (IRST) IRCCS, Meldola (Italy); Marcocci, F [ARNAS Civico - Di Cristina - Benfratelli, Palermo (Italy); Iacovello, G; Miceli, R [Tor Vergata University General Hospital, Rome (Italy)


    Purpose: To investigate the accuracy of various algorithms for deformable image registration (DIR), to propagate regions of interest (ROIs) in computational phantoms based on patient images using different commercial systems. This work is part of an Italian multi-institutional study to test on common datasets the accuracy, reproducibility and safety of DIR applications in Adaptive Radiotherapy. Methods: Eleven institutions with three available commercial solutions provided data to assess the agreement of DIR-propagated ROIs with automatically drown ROIs considered as ground-truth for the comparison. The DIR algorithms were tested on real patient data from three different anatomical districts: head and neck, thorax and pelvis. For every dataset two specific Deformation Vector Fields (DVFs) provided by ImSimQA software were applied to the reference data set. Three different commercial software were used in this study: RayStation, Velocity and Mirada. The DIR-mapped ROIs were then compared with the reference ROIs using the Jaccard Conformity Index (JCI). Results: More than 600 DIR-mapped ROIs were analyzed. Putting together all JCI data of all institutions for the first DVF, the mean JCI was 0.87 ± 0.7 (1 SD) while for the second DVF JCI was 0.8 ± 0.13 (1 SD). Several considerations on different structures are available from collected data: the standard deviation among different institutions on specific structure raise as the larger is the applied DVF. The higher value is 10% for bladder. Conclusion: Although the complexity of deformation of human body is very difficult to model, this work illustrates some clinical scenarios with well-known DVFs provided by specific software. CI parameter gives the inter-user variability and may put in evidence the need of improving the working protocol in order to reduce the inter-institution JCI variability.

  18. Children and Clinical Studies: Why Clinical Studies Are Important

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    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND: A norectal malformations are relatively encountered anomalies. Presentations may vary from mild to severe and bowel control is t he main concern. AIM: To study the modes of presentation , types of anomalies , associated anomalies , reliability of clinical signs and radiological investigations in the diagnosis and the prognosis and continence in the post - operative in relation to type of anomaly and associated anomaly (s. MATERIAL AND METHODS: 50 cases of anorectal malformations admit ted to Department of Paediatric Surgery , in Medical Coll ege and Research Institute , were included in the study. Data related to the objectives of the study were collected. RESULTS: Commonest mode of presentation was failure to pass meconium 50%. 59% of mal es had high anomalies , while 53% females had intermediate anomalies. The diagnosis of low anomaly was made clinically , while high and intermediate anomalies needed further investigations. Associated anomalies were noted in 46.6% of the cases. 71.42% of the se patients had either a high or intermediate ARM. All patients with high anomalies underwent a 3 stage procedure , while low anomalies underwent a single stage procedure followed by anal dilatations. Rectal mucosal prolapse (2 cases , wound infection (4 ca ses , stenosis (3 cases , retraction of neo anus (1 case was seen. All the patients with low anomalies had a good functional result post operatively , while 57% and 28% of patients with intermediate and high anomalies had good results. CONCLUSION : Anorectal malformations are common congenital anomalies. Males are more commonly affected (1.3:1. Low anomalies are the commonest lesions noted in both the sexes (36.67%. High anomalies are more frequent in males. Invertogram offer an accurate diagnosis for planning management in patients with anorectal malformations. Low anomalies have a better outcome following surgery. For intermediate and high anomalies a staged repair offers better results

  20. Registration and fusion quantification of augmented reality based nasal endoscopic surgery. (United States)

    Chu, Yakui; Yang, Jian; Ma, Shaodong; Ai, Danni; Li, Wenjie; Song, Hong; Li, Liang; Chen, Duanduan; Chen, Lei; Wang, Yongtian


    This paper quantifies the registration and fusion display errors of augmented reality-based nasal endoscopic surgery (ARNES). We comparatively investigated the spatial calibration process for front-end endoscopy and redefined the accuracy level of a calibrated endoscope by using a calibration tool with improved structural reliability. We also studied how registration accuracy was combined with the number and distribution of the deployed fiducial points (FPs) for positioning and the measured registration time. A physically integrated ARNES prototype was customarily configured for performance evaluation in skull base tumor resection surgery with an innovative approach of dynamic endoscopic vision expansion. As advised by surgical experts in otolaryngology, we proposed a hierarchical rendering scheme to properly adapt the fused images with the required visual sensation. By constraining the rendered sight in a known depth and radius, the visual focus of the surgeon can be induced only on the anticipated critical anatomies and vessel structures to avoid misguidance. Furthermore, error analysis was conducted to examine the feasibility of hybrid optical tracking based on point cloud, which was proposed in our previous work as an in-surgery registration solution. Measured results indicated that the error of target registration for ARNES can be reduced to 0.77 ± 0.07 mm. For initial registration, our results suggest that a trade-off for a new minimal time of registration can be reached when the distribution of five FPs is considered. For in-surgery registration, our findings reveal that the intrinsic registration error is a major cause of performance loss. Rigid model and cadaver experiments confirmed that the scenic integration and display fluency of ARNES are smooth, as demonstrated by three clinical trials that surpassed practicality. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. Information from the Registration Service

    CERN Multimedia

    GS Department


    Please note that the Registration Service (Bldg 55-1st floor) will be exceptionally open during the annual end of year closure from 10:00 to 12:00 on the following days: 22, 23, 26, 27,28, 29 et 30 December 2011 and 2,3, et 4 January 2012. All the activities related to the Registration Service will be operational: registration for contractors’ personnel; registrations for professional visits; access cards; car stickers; biometric registration. The Registration Service

  2. A clinical study of vitiligo

    Directory of Open Access Journals (Sweden)

    Martis Jacintha


    Full Text Available A clinical study of one hundred patients having vitiligo revealed the incidence among new patients to be 1.84%. The male/female ratio was 1:1.22. Family history of vitiligo was available in 8% of our patients. The different morphological pattern consisted of vitiligo vulgaris (39 cases, focal vitiligo (27 cases, acrofacial vitiligo (18 cases, lip - tip vitiligo (7 cases, lip vitiligo (5 cases, segmental vitiligo (3 cases and universal vitiligo (1 case. Associated diseases include atopic dermatitis (2 cases, Hansen s disease (2 cases, alopecia areata (1 case, halo naevus (1 case, chronic urticaria (1 case, lichen planus (1 case, diabetes mellitus (9 cases, hypertension (4 cases, hypothyroidism (2 cases, epilepsy (1 case and IHD (1 case.

  3. Children and Clinical Studies: Why Clinical Studies Are Important

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  4. Comparison of the accuracy of voxel based registration and surface based registration for 3D assessment of surgical change following orthognathic surgery.

    Directory of Open Access Journals (Sweden)

    Anas Almukhtar

    Full Text Available PURPOSE: Superimposition of two dimensional preoperative and postoperative facial images, including radiographs and photographs, are used to evaluate the surgical changes after orthognathic surgery. Recently, three dimensional (3D imaging has been introduced allowing more accurate analysis of surgical changes. Surface based registration and voxel based registration are commonly used methods for 3D superimposition. The aim of this study was to evaluate and compare the accuracy of the two methods. MATERIALS AND METHODS: Pre-operative and 6 months post-operative cone beam CT scan (CBCT images of 31 patients were randomly selected from the orthognathic patient database at the Dental Hospital and School, University of Glasgow, UK. Voxel based registration was performed on the DICOM images (Digital Imaging Communication in Medicine using Maxilim software (Medicim-Medical Image Computing, Belgium. Surface based registration was performed on the soft and hard tissue 3D models using VRMesh (VirtualGrid, Bellevue City, WA. The accuracy of the superimposition was evaluated by measuring the mean value of the absolute distance between the two 3D image surfaces. The results were statistically analysed using a paired Student t-test, ANOVA with post-hoc Duncan test, a one sample t-test and Pearson correlation coefficient test. RESULTS: The results showed no significant statistical difference between the two superimposition methods (p<0.05. However surface based registration showed a high variability in the mean distances between the corresponding surfaces compared to voxel based registration, especially for soft tissue. Within each method there was a significant difference between superimposition of the soft and hard tissue models. CONCLUSIONS: There were no significant statistical differences between the two registration methods and it was unlikely to have any clinical significance. Voxel based registration was associated with less variability. Registering on

  5. The Tromsø study: registration of fractures, how good are self-reports, a computerized radiographic register and a discharge register? (United States)

    Joakimsen, R M; Fønnebø, V; Søgaard, A J; Tollan, A; Størmer, J; Magnus, J H


    In order to compare different methods of fracture registration, we sought all nonvertebral fractures suffered during 8 years (1988-95) among 21,441 persons invited to a survey in 1979/80. We registered a total of 54 hip fracture cases through three separate sources (self-report, computer linkage to the local radiographic archives, discharge register), whereas forearm fractures (a total of 291 cases) were registered through two separate sources (self-report, computer linkage to the radiographic archives). The registration of fractures at other sites (a total of 1321 cases) were from one source (computer linkage to the local radiographic archives), and we have compared three ways of obtaining data from this single source (no ascertainment, ascertainment of records coded as fracture, ascertainment of all records). Ninety-three percent of all hip fractures and 97% of all wrist fractures in the entire study population were found by computer linkage to the radiographic archives, whereas the discharge register detected 87% of all the hip fractures. Computer linkage with ascertainment gave no overreporting of fractures. Among the 11,626 persons who answered a follow-up questionnaire in 1994/95, 97% (CI 84-100%) of all hip fractures and 72% (CI 66-78%) of all wrist fractures were self-reported. We conclude that a computerized search of radiographic archives is a viable method of fracture registration.

  6. Accelerating Neuroimage Registration through Parallel Computation of Similarity Metric.

    Directory of Open Access Journals (Sweden)

    Yun-Gang Luo

    Full Text Available Neuroimage registration is crucial for brain morphometric analysis and treatment efficacy evaluation. However, existing advanced registration algorithms such as FLIRT and ANTs are not efficient enough for clinical use. In this paper, a GPU implementation of FLIRT with the correlation ratio (CR as the similarity metric and a GPU accelerated correlation coefficient (CC calculation for the symmetric diffeomorphic registration of ANTs have been developed. The comparison with their corresponding original tools shows that our accelerated algorithms can greatly outperform the original algorithm in terms of computational efficiency. This paper demonstrates the great potential of applying these registration tools in clinical applications.

  7. Pulmonary embolism incidence and fatality trends in chinese hospitals from 1997 to 2008: a multicenter registration study.

    Directory of Open Access Journals (Sweden)

    Yuanhua Yang

    Full Text Available BACKGROUND: There has not been sufficient evidence to support the Asians being less susceptible to pulmonary embolism (PE than other ethnicities, because the prevalence of PE/deep venous thrombosis (DVT in different racial and ethnic groups has not been carefully studied until recently except in Caucasians. To test the hypothesis that the Chinese population has a lower risk for PE, this study comprehensively assessed the hospital-based incidence and case fatality rates for PE during the 1997-2008 in China. METHODS: A registration study of patients with suspected PE syndromes admitted to 60 level-3 hospitals involved in the National Cooperative Project for the Prevention and Treatment of Venous Thromboembolism (NCPPT was conducted from January 1997 to December 2008. The only exclusion criterion was an age of less than 18 years. Helical computed tomography scan, ventilation-perfusion lung scintigraphy or pulmonary angiography was carried out before or after hospitalization. All images were reviewed and evaluated independently by two specialists. RESULTS: A total of 18,206 patients were confirmed with PE from 16,972,182 hospital admissions. The annual incidence was 0.1% (95% CI: 0.1% to 0.2%. The overall incidence of PE in male patients (0.2%, 95% CI: 0.1% to 0.3% was higher than that in female patients (0.1% and 95% CI: 0.0% to 0.1%. An increasing incidence gradient for PE was noticed from Southern to Northern China. In addition, the case fatality rate was apparently decreasing: 25.1% (95% CI: 16.2% to 36.9% in 1997 to 8.7% (95% CI: 3.5% to 15.8% in 2008. CONCLUSIONS: Our findings suggest the relatively stable PE incidence and decreasing fatality trends in Chinese hospitals may be partially attributable to the implementation of the NCCPT and suggest the government should reevaluate the severity of PE so that health resources for the prevention, diagnosis and treatment of PE could be used to their fullest.

  8. Multiple Kernel Point Set Registration. (United States)

    Nguyen, Thanh Minh; Wu, Q M Jonathan


    The finite Gaussian mixture model with kernel correlation is a flexible tool that has recently received attention for point set registration. While there are many algorithms for point set registration presented in the literature, an important issue arising from these studies concerns the mapping of data with nonlinear relationships and the ability to select a suitable kernel. Kernel selection is crucial for effective point set registration. We focus here on multiple kernel point set registration. We make several contributions in this paper. First, each observation is modeled using the Student's t-distribution, which is heavily tailed and more robust than the Gaussian distribution. Second, by automatically adjusting the kernel weights, the proposed method allows us to prune the ineffective kernels. This makes the choice of kernels less crucial. After parameter learning, the kernel saliencies of the irrelevant kernels go to zero. Thus, the choice of kernels is less crucial and it is easy to include other kinds of kernels. Finally, we show empirically that our model outperforms state-of-the-art methods recently proposed in the literature.

  9. ACIR: automatic cochlea image registration (United States)

    Al-Dhamari, Ibraheem; Bauer, Sabine; Paulus, Dietrich; Lissek, Friedrich; Jacob, Roland


    Efficient Cochlear Implant (CI) surgery requires prior knowledge of the cochlea's size and its characteristics. This information helps to select suitable implants for different patients. To get these measurements, a segmentation method of cochlea medical images is needed. An important pre-processing step for good cochlea segmentation involves efficient image registration. The cochlea's small size and complex structure, in addition to the different resolutions and head positions during imaging, reveals a big challenge for the automated registration of the different image modalities. In this paper, an Automatic Cochlea Image Registration (ACIR) method for multi- modal human cochlea images is proposed. This method is based on using small areas that have clear structures from both input images instead of registering the complete image. It uses the Adaptive Stochastic Gradient Descent Optimizer (ASGD) and Mattes's Mutual Information metric (MMI) to estimate 3D rigid transform parameters. The use of state of the art medical image registration optimizers published over the last two years are studied and compared quantitatively using the standard Dice Similarity Coefficient (DSC). ACIR requires only 4.86 seconds on average to align cochlea images automatically and to put all the modalities in the same spatial locations without human interference. The source code is based on the tool elastix and is provided for free as a 3D Slicer plugin. Another contribution of this work is a proposed public cochlea standard dataset which can be downloaded for free from a public XNAT server.

  10. Children and Clinical Studies: Why Clinical Studies Are Important

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  11. Children and Clinical Studies: Why Clinical Studies Are Important

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  12. Children and Clinical Studies: Why Clinical Studies Are Important

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  13. Effects of registration error on parametric response map analysis: a simulation study using liver CT-perfusion images (United States)

    Lausch, A.; Jensen, N. K. G.; Chen, J.; Lee, T. Y.; Lock, M.; Wong, E.


    Purpose: To investigate the effects of registration error (RE) on parametric response map (PRM) analysis of pre and post-radiotherapy (RT) functional images. Methods: Arterial blood flow maps (ABF) were generated from the CT-perfusion scans of 5 patients with hepatocellular carcinoma. ABF values within each patient map were modified to produce seven new ABF maps simulating 7 distinct post-RT functional change scenarios. Ground truth PRMs were generated for each patient by comparing the simulated and original ABF maps. Each simulated ABF map was then deformed by different magnitudes of realistic respiratory motion in order to simulate RE. PRMs were generated for each of the deformed maps and then compared to the ground truth PRMs to produce estimates of RE-induced misclassification. Main findings: The percentage of voxels misclassified as decreasing, no change, and increasing, increased with RE For all patients, increasing RE was observed to increase the number of high post-RT ABF voxels associated with low pre-RT ABF voxels and vice versa. 3 mm of average tumour RE resulted in 18-45% tumour voxel misclassification rates. Conclusions: RE induced misclassification posed challenges for PRM analysis in the liver where registration accuracy tends to be lower. Quantitative understanding of the sensitivity of the PRM method to registration error is required if PRMs are to be used to guide radiation therapy dose painting techniques.

  14. Clinical study of ectopic pregnancy. (United States)

    Chhabra, S; Aher, K; Jaiswal, M


    Ectopic pregnancy remains a leading cause of maternal mortality and accounts for a sizeable proportion of infertility and ectopic recurrence. The possibility that a woman is experiencing an ectopic pregnancy must be considered when evaluating a woman, especially a sterilized woman, who has a possible pregnancy, amenorrhea, abdominal pain, or abnormal bleeding; studies have found that one in six pregnancies occurring after tubal sterilization are ectopic. The authors present a clinical study of 82 cases of ectopic pregnancy admitted to the department of Obstetrics and Gynecology of Mahatma Gandhi Institute of Medical Sciences, Sevagram. Cases of ectopic pregnancy represent 0.99% of total obstetric admissions, of whom 69.51% were diagnosed as such on admission. 40.24% of the women were older than 30 years, while 34.14% were elderly beyond third parity. 70.73% of the women presented before missing their second period. Patients presented with multiple complaints, but the most common was abdominal pain reported by 61.70%. 78.04% were admitted with an acute abdomen, but shock was present in only 7.14% of cases. The main surgical treatment modality was salpingectomy among 59.75%. There was no maternal mortality through postoperative morbidity in the form of paralytic ileus, although fever did occur in some women.

  15. 3D ultrasound computer tomography: update from a clinical study (United States)

    Hopp, T.; Zapf, M.; Kretzek, E.; Henrich, J.; Tukalo, A.; Gemmeke, H.; Kaiser, C.; Knaudt, J.; Ruiter, N. V.


    Ultrasound Computer Tomography (USCT) is a promising new imaging method for breast cancer diagnosis. We developed a 3D USCT system and tested it in a pilot study with encouraging results: 3D USCT was able to depict two carcinomas, which were present in contrast enhanced MRI volumes serving as ground truth. To overcome severe differences in the breast shape, an image registration was applied. We analyzed the correlation between average sound speed in the breast and the breast density estimated from segmented MRIs and found a positive correlation with R=0.70. Based on the results of the pilot study we now carry out a successive clinical study with 200 patients. For this we integrated our reconstruction methods and image post-processing into a comprehensive workflow. It includes a dedicated DICOM viewer for interactive assessment of fused USCT images. A new preview mode now allows intuitive and faster patient positioning. We updated the USCT system to decrease the data acquisition time by approximately factor two and to increase the penetration depth of the breast into the USCT aperture by 1 cm. Furthermore the compute-intensive reflectivity reconstruction was considerably accelerated, now allowing a sub-millimeter volume reconstruction in approximately 16 minutes. The updates made it possible to successfully image first patients in our ongoing clinical study.

  16. Registration of multimodal brain images: some experimental results (United States)

    Chen, Hua-mei; Varshney, Pramod K.


    Joint histogram of two images is required to uniquely determine the mutual information between the two images. It has been pointed out that, under certain conditions, existing joint histogram estimation algorithms like partial volume interpolation (PVI) and linear interpolation may result in different types of artifact patterns in the MI based registration function by introducing spurious maxima. As a result, the artifacts may hamper the global optimization process and limit registration accuracy. In this paper we present an extensive study of interpolation-induced artifacts using simulated brain images and show that similar artifact patterns also exist when other intensity interpolation algorithms like cubic convolution interpolation and cubic B-spline interpolation are used. A new joint histogram estimation scheme named generalized partial volume estimation (GPVE) is proposed to eliminate the artifacts. A kernel function is involved in the proposed scheme and when the 1st order B-spline is chosen as the kernel function, it is equivalent to the PVI. A clinical brain image database furnished by Vanderbilt University is used to compare the accuracy of our algorithm with that of PVI. Our experimental results show that the use of higher order kernels can effectively remove the artifacts and, in cases when MI based registration result suffers from the artifacts, registration accuracy can be improved significantly.

  17. Study on Android BroadcastReceiver Registration Method%Android中的BroadcastReceiver注册方式研究

    Institute of Scientific and Technical Information of China (English)

    鲁晓天; 李永全


    在Android整个系统中,Broadcast作为一种机制,在应用程序之间传输信息。而BroadcastReceiver就是对发送出来的Broadcast进行过滤接受并响应的一类组件,也叫作广播接收器,是Android的四大基本组件之一。不过目前对Broadcast-Receiver进行的介绍不是很多,通过对广播接收器的生命周期,广播类型,注册方式等方面进行介绍,并通过两个实例使读者对广播接收器的注册方式有进一步的了解,对两种注册方式有更直面的认识,明白动态注册和静态注册之间的差异和优缺点,对两种基本的注册方法的使用流程更加清晰。%In the Android Broadcast in the whole system, as a mechanism, the transmission of information between applications. A class of component and BroadcastReceiver is to send out the Broadcast filter to accept and response, also called a broadcast re⁃ceiver, is one of four basic components of Android. But at present on the BroadcastReceiver presentation is not very large, based on the life cycle of the broadcast receiver, broadcast type, registration mode are introduced, and the broadcast receiver register way to further the understanding of the reader through two examples, there are more direct understanding of two registration mode, understand the difference between the dynamic registration and static registration and the advantages and disadvantages, on two kinds of basic registration method using process more clear.

  18. In vivo kinematic study of the tarsal joints complex based on fluoroscopic 3D-2D registration technique. (United States)

    Chen Wang, M D; Geng, Xiang; Wang, Shaobai; Xin Ma, M D; Xu Wang, M D; Jiazhang Huang, M D; Chao Zhang, M D; Li Chen, M S; Yang, Junsheng; Wang, Kan


    The tarsal bones articulate with each other and demonstrate complicated kinematic characteristics. The in vivo motions of these tarsal joints during normal gait are still unclear. Seven healthy subjects were recruited and fourteen feet in total were tested in the current study. Three dimensional models of the tarsal bones were first created using CT scanning. Corresponding local 3D coordinate systems of each tarsal bone was subsequently established for 6DOF motion decompositions. The fluoroscopy system captured the lateral fluoroscopic images of the targeted tarsal region whilst the subject was walking. Seven key pose images during the stance phase were selected and 3D to 2D bone model registrations were performed on each image to determine joint positions. The 6DOF motions of each tarsal joint during gait were then obtained by connecting these positions together. The TNJ (talo-navicular joint) exhibited the largest ROMs (range of motion) on all rotational directions with 7.39±2.75°of dorsi/plantarflexion, 21.12±4.68°of inversion/eversion, and 16.11±4.44°of internal/external rotation. From heel strike to midstance, the TNJ, STJ (subtalar joint), and CCJ (calcaneao-cuboid joint) were associated with 5.97°, 5.04°, and 3.93°of dorsiflexion; 15.46°, 8.21°, and 5.82°of eversion; and 9.75°, 7.6°, and 4.99°of external rotation, respectively. Likewise, from midstance to heel off, the TNJ, STJ, and CCJ were associated with 6.39, 6.19°, and 4.47°of plantarflexion; 18.57°, 11.86°, and 6.32°of inversion and 13.95°, 9.66°, and 7.58°of internal rotation, respectively. In conclusion, among the tarsal joints, the TNJ exhibited the greatest rotational mobility. Synchronous and homodromous rotational motions were detected for TNJ, STJ, and CCJ during the stance phase.

  19. A clinical study of retinoblastoma

    Directory of Open Access Journals (Sweden)

    L Subha


    Full Text Available Aim: The aim was to analyze general incidence, age incidence, laterality, common mode of presentation, staging of the tumor, radiological evidence, histopathological confirmation, management and follow-up of cases, which were diagnosed as retinoblastoma. Design: Interventional case series study from April 1997 to March 2000. Materials and Methods: Detailed history regarding the symptoms such as white reflex, watering, pain, redness, protrusion of eyeball, squint, hyphema, and defective vision were obtained. Family history regarding consanguinity between parents, health of the siblings and other relatives were recorded. Ocular examination included vision, pupillary reaction, detailed fundus examination, ocular tension, and corneal diameter. Investigations included X-ray orbit and skull, computed tomography scan orbit and brain, B-scan orbit, serum and aqueous lactate dehydrogenase; enucleated eyes were subjected to holoprosencephaly (HPE. Enucleation, radiotherapy, cryotherapy and chemotherapy were modalities of treatment. The empty socket and the other apparently normal eye were examined carefully at each visit. Results: The incidence of retinoblastoma is less when compared to other diseases of the eye. There was no sex predilection. Most of the cases diagnosed were sporadic and unilateral. Age of onset is earlier for bilateral cases than unilateral cases. Consanguinity bears close relationship with bilateral involvement. Predominant clinical sign is white reflex in the pupillary area. Majority of cases presented in the second stage of the disease. Enucleation plays a greater role in the management of retinoblastoma. HPE should include several sections of the optic nerve to find out skip lesions.

  20. Accelerating image registration of MRI by GPU-based parallel computation. (United States)

    Huang, Teng-Yi; Tang, Yu-Wei; Ju, Shiun-Ying


    Automatic image registration for MRI applications generally requires many iteration loops and is, therefore, a time-consuming task. This drawback prolongs data analysis and delays the workflow of clinical routines. Recent advances in the massively parallel computation of graphic processing units (GPUs) may be a solution to this problem. This study proposes a method to accelerate registration calculations, especially for the popular statistical parametric mapping (SPM) system. This study reimplemented the image registration of SPM system to achieve an approximately 14-fold increase in speed in registering single-modality intrasubject data sets. The proposed program is fully compatible with SPM, allowing the user to simply replace the original image registration library of SPM to gain the benefit of the computation power provided by commodity graphic processors. In conclusion, the GPU computation method is a practical way to accelerate automatic image registration. This technology promises a broader scope of application in the field of image registration. Copyright © 2011 Elsevier Inc. All rights reserved.

  1. Pesticide Registration Information System (United States)

    U.S. Environmental Protection Agency — PRISM provides an integrated, web portal for all pesticide related data, communications, registrations and transactions for OPP and its stakeholders, partners and...

  2. Visitor Registration System (United States)

    US Agency for International Development — Visitor Registration System (VRS) streamlines visitor check-in and check-out process for expediting visitors into USAID. The system captures visitor information...

  3. Antenna Structure Registrate (United States)

    Department of Homeland Security — This file is an extract of the Antenna Structure Registrate (ASR). The ASR consists of antenna structures that are more than 60.96 meters (200 feet) in height or...

  4. Clinical trials of traumatic cervical spine injury treated with internal fixation:Registration project analysis%创伤性颈椎损伤内固定置入相关临床试验注册项目分析★

    Institute of Scientific and Technical Information of China (English)

    南军; 元虎; 李康杰


    BACKGROUND: Traumatic cervical spine injury cannot be ignored, because it wil injury the spinal cord and thus leads to paralysis if not treat timely and effectively. OBJECTIVE: To search the Chinese Clinical Trial Register, North American Clinical Trial Register and Thomson Reuters Web of Science database and to perform literature metrological analysis on the registered projects and published literatures of the relative clinical trials about the traumatic cervical spine injury. METHODS: The Chinese Clinical Trial Register was searched with the key words of “cervical vertebrae” for the clinical trial program on the traumatic cervical spine injury; the North American Clinical Trial Register was searched with the key words of “cervical vertebra”, “trauma” or “cervical spine”, “Trauma” for the related clinical trials, and a total of 22 registered projects were obtained; the Thomson Reuters Web of Science database was searched with the key words of “neck vertebra, cervical vertebra, vertebrae cervicales, cervical spine, C-Spine, Trauma” for the literatures on the traumatic cervical spine injury published from 2003 to 2012. RESUTLS AND CONCLUSION: There are only five clinical trial registration projects related to the traumatic cervical spine injury in the Chinese Clinical Trial Register, 22 clinical trial registration projects related to the traumatic cervical spine injury in the North American Clinical Trial Register. The clinical trial registration projects in the Chinese Clinical Trial Register are significantly less than those in the North American Clinical Trial Register. The clinical trial registration projects related to the traumatic cervical spine injury searched from the North American Clinical Trial Register are distributed in three states and 17 countries, and mainly distributed in America. The clinical trial registration projects related to the traumatic cervical spine injury are mainly the intervention studies, and most of the

  5. Exclusion of patients with concomitant chronic conditions in ongoing randomised controlled trials targeting 10 common chronic conditions and registered at a systematic review of registration details. (United States)

    Buffel du Vaure, Céline; Dechartres, Agnès; Battin, Constance; Ravaud, Philippe; Boutron, Isabelle


    To systematically assess registration details of ongoing randomised controlled trials (RCTs) targeting 10 common chronic conditions and registered at and to determine the prevalence of (1) trial records excluding patients with concomitant chronic condition(s) and (2) those specifically targeting patients with concomitant chronic conditions. Systematic review of trial registration records. register. All ongoing RCTs registered from 1 January 2014 to 31 January 2015 that assessed an intervention targeting adults with coronary heart disease (CHD), hypertension, heart failure, stroke/transient ischaemic attack, atrial fibrillation, type 2 diabetes, chronic obstructive pulmonary disease, painful condition, depression and dementia with a target sample size ≥100. From the trial registration records, 2 researchers independently recorded the trial characteristics and the number of exclusion criteria and determined whether patients with concomitant chronic conditions were excluded or specifically targeted. Among 319 ongoing RCTs, despite the high prevalence of the concomitant chronic conditions, patients with these conditions were excluded in 251 trials (79%). For example, although 91% of patients with CHD had a concomitant chronic condition, 69% of trials targeting such patients excluded patients with concomitant chronic condition(s). When considering the co-occurrence of 2 chronic conditions, 31% of patients with chronic pain also had depression, but 58% of the trials targeting patients with chronic pain excluded patients with depression. Only 37 trials (12%) assessed interventions specifically targeting patients with concomitant chronic conditions; 31 (84%) excluded patients with concomitant chronic condition(s). Despite widespread multimorbidity, more than three-quarters of ongoing trials assessing interventions for patients with chronic conditions excluded patients with concomitant chronic conditions. Published by the BMJ

  6. Detection and correction of inconsistency-based errors in non-rigid registration (United States)

    Gass, Tobias; Szekely, Gabor; Goksel, Orcun


    In this paper we present a novel post-processing technique to detect and correct inconsistency-based errors in non-rigid registration. While deformable registration is ubiquitous in medical image computing, assessing its quality has yet been an open problem. We propose a method that predicts local registration errors of existing pairwise registrations between a set of images, while simultaneously estimating corrected registrations. In the solution the error is constrained to be small in areas of high post-registration image similarity, while local registrations are constrained to be consistent between direct and indirect registration paths. The latter is a critical property of an ideal registration process, and has been frequently used to asses the performance of registration algorithms. In our work, the consistency is used as a target criterion, for which we efficiently find a solution using a linear least-squares model on a coarse grid of registration control points. We show experimentally that the local errors estimated by our algorithm correlate strongly with true registration errors in experiments with known, dense ground-truth deformations. Additionally, the estimated corrected registrations consistently improve over the initial registrations in terms of average deformation error or TRE for different registration algorithms on both simulated and clinical data, independent of modality (MRI/CT), dimensionality (2D/3D) and employed primary registration method (demons/Markov-randomfield).

  7. Tensor scale-based image registration (United States)

    Saha, Punam K.; Zhang, Hui; Udupa, Jayaram K.; Gee, James C.


    Tangible solutions to image registration are paramount in longitudinal as well as multi-modal medical imaging studies. In this paper, we introduce tensor scale - a recently developed local morphometric parameter - in rigid image registration. A tensor scale-based registration method incorporates local structure size, orientation and anisotropy into the matching criterion, and therefore, allows efficient multi-modal image registration and holds potential to overcome the effects of intensity inhomogeneity in MRI. Two classes of two-dimensional image registration methods are proposed - (1) that computes angular shift between two images by correlating their tensor scale orientation histogram, and (2) that registers two images by maximizing the similarity of tensor scale features. Results of applications of the proposed methods on proton density and T2-weighted MR brain images of (1) the same slice of the same subject, and (2) different slices of the same subject are presented. The basic superiority of tensor scale-based registration over intensity-based registration is that it may allow the use of local Gestalts formed by the intensity patterns over the image instead of simply considering intensities as isolated events at the pixel level. This would be helpful in dealing with the effects of intensity inhomogeneity and noise in MRI.

  8. Cellular recurrent deep network for image registration (United States)

    Alam, M.; Vidyaratne, L.; Iftekharuddin, Khan M.


    Image registration using Artificial Neural Network (ANN) remains a challenging learning task. Registration can be posed as a two-step problem: parameter estimation and actual alignment/transformation using the estimated parameters. To date ANN based image registration techniques only perform the parameter estimation, while affine equations are used to perform the actual transformation. In this paper, we propose a novel deep ANN based image rigid registration that combines parameter estimation and transformation as a simultaneous learning task. Our previous work shows that a complex universal approximator known as Cellular Simultaneous Recurrent Network (CSRN) can successfully approximate affine transformations with known transformation parameters. This study introduces a deep ANN that combines a feed forward network with a CSRN to perform full rigid registration. Layer wise training is used to pre-train feed forward network for parameter estimation and followed by a CSRN for image transformation respectively. The deep network is then fine-tuned to perform the final registration task. Our result shows that the proposed deep ANN architecture achieves comparable registration accuracy to that of image affine transformation using CSRN with known parameters. We also demonstrate the efficacy of our novel deep architecture by a performance comparison with a deep clustered MLP.

  9. Masked object registration in the Fourier domain. (United States)

    Padfield, Dirk


    Registration is one of the most common tasks of image analysis and computer vision applications. The requirements of most registration algorithms include large capture range and fast computation so that the algorithms are robust to different scenarios and can be computed in a reasonable amount of time. For these purposes, registration in the Fourier domain using normalized cross-correlation is well suited and has been extensively studied in the literature. Another common requirement is masking, which is necessary for applications where certain regions of the image that would adversely affect the registration result should be ignored. To address these requirements, we have derived a mathematical model that describes an exact form for embedding the masking step fully into the Fourier domain so that all steps of translation registration can be computed efficiently using Fast Fourier Transforms. We provide algorithms and implementation details that demonstrate the correctness of our derivations. We also demonstrate how this masked FFT registration approach can be applied to improve the Fourier-Mellin algorithm that calculates translation, rotation, and scale in the Fourier domain. We demonstrate the computational efficiency, advantages, and correctness of our algorithm on a number of images from real-world applications. Our framework enables fast, global, parameter-free registration of images with masked regions.

  10. Legislation for trial registration and data transparency

    Directory of Open Access Journals (Sweden)

    Wu Tai-Xiang


    Full Text Available Abstract Public confidence in clinical trials has been eroded by data suppression, misrepresentation and manipulation. Although various attempts have been made to achieve universal trial registration- e.g., Declaration of Helsinki, WHO clinical Trial Registry Platform (WHO ICTRP, the International Committee of Medical Journal Editors requirement- they have not succeeded, probably because they lack the enough power of enforcement. Legislation appears to be the most efficient and effective means to ensure that all researchers register their trials and disseminate their data accurately and in a timely manner. We propose that a global network be established. This could be accomplished in two steps. The first step is to legislate about trial registration and data transparency, such as USA's FDAAA Act 2007; and the second step to establish a global network to ensure uniform, international consistency in policy and enforcement of trial registration and data transparency.

  11. Legislation for trial registration and data transparency. (United States)

    Bian, Zhao-Xiang; Wu, Tai-Xiang


    Public confidence in clinical trials has been eroded by data suppression, misrepresentation and manipulation. Although various attempts have been made to achieve universal trial registration- e.g., Declaration of Helsinki, WHO clinical Trial Registry Platform (WHO ICTRP), the International Committee of Medical Journal Editors requirement- they have not succeeded, probably because they lack the enough power of enforcement.Legislation appears to be the most efficient and effective means to ensure that all researchers register their trials and disseminate their data accurately and in a timely manner. We propose that a global network be established. This could be accomplished in two steps. The first step is to legislate about trial registration and data transparency, such as USA's FDAAA Act 2007; and the second step to establish a global network to ensure uniform, international consistency in policy and enforcement of trial registration and data transparency.

  12. Skull registration for prone patient position using tracked ultrasound (United States)

    Underwood, Grace; Ungi, Tamas; Baum, Zachary; Lasso, Andras; Kronreif, Gernot; Fichtinger, Gabor


    PURPOSE: Tracked navigation has become prevalent in neurosurgery. Problems with registration of a patient and a preoperative image arise when the patient is in a prone position. Surfaces accessible to optical tracking on the back of the head are unreliable for registration. We investigated the accuracy of surface-based registration using points accessible through tracked ultrasound. Using ultrasound allows access to bone surfaces that are not available through optical tracking. Tracked ultrasound could eliminate the need to work (i) under the table for registration and (ii) adjust the tracker between surgery and registration. In addition, tracked ultrasound could provide a non-invasive method in comparison to an alternative method of registration involving screw implantation. METHODS: A phantom study was performed to test the feasibility of tracked ultrasound for registration. An initial registration was performed to partially align the pre-operative computer tomography data and skull phantom. The initial registration was performed by an anatomical landmark registration. Surface points accessible by tracked ultrasound were collected and used to perform an Iterative Closest Point Algorithm. RESULTS: When the surface registration was compared to a ground truth landmark registration, the average TRE was found to be 1.6+/-0.1mm and the average distance of points off the skull surface was 0.6+/-0.1mm. CONCLUSION: The use of tracked ultrasound is feasible for registration of patients in prone position and eliminates the need to perform registration under the table. The translational component of error found was minimal. Therefore, the amount of TRE in registration is due to a rotational component of error.

  13. Validation of accuracy in image co-registration with computed tomography and magnetic resonance imaging in Gamma Knife radiosurgery. (United States)

    Nakazawa, Hisato; Mori, Yoshimasa; Komori, Masataka; Shibamoto, Yuta; Tsugawa, Takahiko; Kobayashi, Tatsuya; Hashizume, Chisa


    The latest version of Leksell GammaPlan (LGP) is equipped with Digital Imaging and Communication in Medicine (DICOM) image-processing functions including image co-registration. Diagnostic magnetic resonance imaging (MRI) taken prior to Gamma Knife treatment is available for virtual treatment pre-planning. On the treatment day, actual dose planning is completed on stereotactic MRI or computed tomography (CT) (with a frame) after co-registration with the diagnostic MRI and in association with the virtual dose distributions. This study assesses the accuracy of image co-registration in a phantom study and evaluates its usefulness in clinical cases. Images of three kinds of phantoms and 11 patients are evaluated. In the phantom study, co-registration errors of the 3D coordinates were measured in overall stereotactic space and compared between stereotactic CT and diagnostic CT, stereotactic MRI and diagnostic MRI, stereotactic CT and diagnostic MRI, and stereotactic MRI and diagnostic MRI co-registered with stereotactic CT. In the clinical study, target contours were compared between stereotactic MRI and diagnostic MRI co-registered with stereotactic CT. The mean errors of coordinates between images were < 1 mm in all measurement areas in both the phantom and clinical patient studies. The co-registration function implemented in LGP has sufficient geometrical accuracy to assure appropriate dose planning in clinical use. © The Author 2014. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  14. Simultaneous 3D–2D image registration and C-arm calibration: Application to endovascular image-guided interventions

    Energy Technology Data Exchange (ETDEWEB)

    Mitrović, Uroš [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000, Slovenia and Cosylab, Control System Laboratory, Teslova ulica 30, Ljubljana 1000 (Slovenia); Pernuš, Franjo [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000 (Slovenia); Likar, Boštjan; Špiclin, Žiga, E-mail: [Faculty of Electrical Engineering, University of Ljubljana, Tržaška 25, Ljubljana 1000, Slovenia and Sensum, Computer Vision Systems, Tehnološki Park 21, Ljubljana 1000 (Slovenia)


    Purpose: Three-dimensional to two-dimensional (3D–2D) image registration is a key to fusion and simultaneous visualization of valuable information contained in 3D pre-interventional and 2D intra-interventional images with the final goal of image guidance of a procedure. In this paper, the authors focus on 3D–2D image registration within the context of intracranial endovascular image-guided interventions (EIGIs), where the 3D and 2D images are generally acquired with the same C-arm system. The accuracy and robustness of any 3D–2D registration method, to be used in a clinical setting, is influenced by (1) the method itself, (2) uncertainty of initial pose of the 3D image from which registration starts, (3) uncertainty of C-arm’s geometry and pose, and (4) the number of 2D intra-interventional images used for registration, which is generally one and at most two. The study of these influences requires rigorous and objective validation of any 3D–2D registration method against a highly accurate reference or “gold standard” registration, performed on clinical image datasets acquired in the context of the intervention. Methods: The registration process is split into two sequential, i.e., initial and final, registration stages. The initial stage is either machine-based or template matching. The latter aims to reduce possibly large in-plane translation errors by matching a projection of the 3D vessel model and 2D image. In the final registration stage, four state-of-the-art intrinsic image-based 3D–2D registration methods, which involve simultaneous refinement of rigid-body and C-arm parameters, are evaluated. For objective validation, the authors acquired an image database of 15 patients undergoing cerebral EIGI, for which accurate gold standard registrations were established by fiducial marker coregistration. Results: Based on target registration error, the obtained success rates of 3D to a single 2D image registration after initial machine-based and

  15. A study of the anatomic changes and dosimetric consequences in adaptive CRT of non-small-cell lung cancer using deformable CT and CBCT image registration. (United States)

    Ma, Changsheng; Hou, Yong; Li, Hongsheng; Li, Dengwang; Zhang, Yingjie; Chen, Siye; Yin, Yong


    The aim of this study is to evaluate anatomic lung tumor changes and dosimetric consequences utilizing the deformable daily kilovolt (KV) cone-beam computer tomography (CBCT) image registration. Five patients diagnosed with NSCLC were treated with three-dimensional conformal radiotherapy (3D CRT) and 10 daily KV CBCT image sets were acquired for each patient. Each CBCT image and plan CT were imported into the deformable image registration (DIR) system. The plan CT image was deformed by the DIR system and a new contour on CBCT was obtained by using the auto-contouring function of the DIR. These contours were individually marked as CBCT f1, CBCT f2,..., and CBCT f10, and imported into a treatment planning system (TPS). The daily CBCT plan was individually generated with the same planning criteria based on new contours. These plans were individually marked as CBCTp1, CBCTp2,..., and CBCTp10, followed by generating a dose accumulation plan (DA plan) in original pCT image contour sets by adding all CBCT plans using Varian Eclipse TPS. The maximum, minimum and mean doses to the plan target volume (PTV) in the 5 DA plans were the same with the CT plans. However, the volume of radiation 5, 10, 20, 30, and 50 Gy of the total lungs in DA plans were less than those of the CT plans. The maximum dose of the spinal cord in the DA plans were average 27.96% less than the CT plans. The mean dose for the left, right, and total lungs in the DA plans were reduced by 13.80%, 23.65%, and 12.96%, respectively. The adaptive 3D CRT based on the deformable registration can reduce the dose to the lung and the spinal cord with the same PTV dose coverage. Moreover, it provides a method for further adaptive radiotherapy exploration.

  16. Deformable image registration in radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Seung Jong; Kim, Si Yong [Dept. of Radiation Oncology, Virginia Commonwealth University, Richmond (United States)


    The number of imaging data sets has significantly increased during radiation treatment after introducing a diverse range of advanced techniques into the field of radiation oncology. As a consequence, there have been many studies proposing meaningful applications of imaging data set use. These applications commonly require a method to align the data sets at a reference. Deformable image registration (DIR) is a process which satisfies this requirement by locally registering image data sets into a reference image set. DIR identifies the spatial correspondence in order to minimize the differences between two or among multiple sets of images. This article describes clinical applications, validation, and algorithms of DIR techniques. Applications of DIR in radiation treatment include dose accumulation, mathematical modeling, automatic segmentation, and functional imaging. Validation methods discussed are based on anatomical landmarks, physical phantoms, digital phantoms, and per application purpose. DIR algorithms are also briefly reviewed with respect to two algorithmic components: similarity index and deformation models.

  17. The role of professional education in developing compassionate practitioners: a mixed methods study exploring the perceptions xof health professionals and pre-registration students. (United States)

    Bray, Lucy; O'Brien, Mary R; Kirton, Jennifer; Zubairu, Kate; Christiansen, Angela


    Compassionate practice is a public expectation and a core health professional value. However, in the face of growing public and professional unease about a perceived absence of compassion in health care it is essential that the role of education in developing compassionate practitioners is fully understood. The aim of this study was to explore qualified health professionals' and pre-registration students' understanding of compassion and the role of health professional education in promoting compassionate care. A sequential explanatory mixed methods study collected data using surveys and qualitative semi-structured interviews from qualified health professionals (n=155) and pre-registration students (n=197). Participants were from a range of health and social care disciplines and registered at a UK university. The findings indicate a high level of consensus in relation to participants' understanding of compassion in health care. Acting with warmth and empathy, providing individualised patient care and acting in a way you would like others to act towards you, were seen as the most common features of compassionate care. However, ambiguities and contradictions were evident when considering the role of health professional education in promoting compassionate practice. This study adds to the debate and current understanding of the role of education in fostering compassionate health care practice.

  18. A Surface-Based Spatial Registration Method Based on Sense Three-Dimensional Scanner. (United States)

    Fan, Yifeng; Xu, Xiufang; Wang, Manning


    The purpose of this study was to investigate the feasibility of a surface-based registration method based on a low-cost, hand-held Sense three-dimensional (3D) scanner in image-guided neurosurgery system. The scanner was calibrated prior and fixed on a tripod before registration. During registration, a part of the head surface was scanned at first and the spatial position of the adapter was recorded. Then the scanner was taken off from the tripod and the entire head surface was scanned by moving the scanner around the patient's head. All the scan points were aligned to the recorded spatial position to form a unique point cloud of the head by the automatic mosaic function of the scanner. The coordinates of the scan points were transformed from the device space to the adapter space by a calibration matrix, and then to the patient space. A 2-step patient-to-image registration method was then performed to register the patient space to the image space. The experimental results showed that the mean target registration error of 15 targets on the surface of the phantom was 1.61±0.09 mm. In a clinical experiment, the mean target registration error of 7 targets on the patient's head surface was 2.50±0.31 mm, which was sufficient to meet clinical requirements. It is feasible to use the Sense 3D scanner for patient-to-image registration, and the low-cost Sense 3D scanner can take the place of the current used scanner in the image-guided neurosurgery system.

  19. Study of three-dimensional PET and MR image registration based on higher-order mutual information

    Institute of Scientific and Technical Information of China (English)


    Mutual information has currently been one of the most intensivelyresearched measures. It has been proven to be accurate and effective registrationmeasure. Despite the general promising results, mutual information sometimes mightlead to misregistration because of neglecting spatial information and treating intensityvariations with undue sensitivity. In this paper, an extension of mutual informationframework was proposed in which higher-order spatial information regarding imagestructures was incorporated into the registration processing of PET and MR. Thesecond-order estimate of mutual information algorithm was applied to the registrationof seven patients. Evaluation from Vanderbilt University and our visual inspectionshowed that sub-voxel accuracy and robust results were achieved in all cases withsecond-order mutual information as the similarity measure and with Powell's multi-dimensional direction set method as optimization strategy.``

  20. Evaluation of whole-body MR to CT deformable image registration. (United States)

    Akbarzadeh, A; Gutierrez, D; Baskin, A; Ay, M R; Ahmadian, A; Riahi Alam, N; Lövblad, K O; Zaidi, H


    Multimodality image registration plays a crucial role in various clinical and research applications. The aim of this study is to present an optimized MR to CT whole-body deformable image registration algorithm and its validation using clinical studies. A 3D intermodality registration technique based on B-spline transformation was performed using optimized parameters of the elastix package based on the Insight Toolkit (ITK) framework. Twenty-eight (17 male and 11 female) clinical studies were used in this work. The registration was evaluated using anatomical landmarks and segmented organs. In addition to 16 anatomical landmarks, three key organs (brain, lungs, and kidneys) and the entire body volume were segmented for evaluation. Several parameters--such as the Euclidean distance between anatomical landmarks, target overlap, Dice and Jaccard coefficients, false positives and false negatives, volume similarity, distance error, and Hausdorff distance--were calculated to quantify the quality of the registration algorithm. Dice coefficients for the majority of patients (> 75%) were in the 0.8-1 range for the whole body, brain, and lungs, which satisfies the criteria to achieve excellent alignment. On the other hand, for kidneys, Dice coefficients for volumes of 25% of the patients meet excellent volume agreement requirement, while the majority of patients satisfy good agreement criteria (> 0.6). For all patients, the distance error was in 0-10 mm range for all segmented organs. In summary, we optimized and evaluated the accuracy of an MR to CT deformable registration algorithm. The registered images constitute a useful 3D whole-body MR-CT atlas suitable for the development and evaluation of novel MR-guided attenuation correction procedures on hybrid PET-MR systems.

  1. Information on blinding in registered records of clinical trials

    Directory of Open Access Journals (Sweden)

    Viergever Roderik F


    Full Text Available Abstract Information on blinding is part of the data that should be provided upon registration of a trial at a clinical trials registry. Reporting of blinding is often absent or of low quality in published articles of clinical trials. This study researched the presence and quality of information on blinding in registered records of clinical trials and highlights the important role of data-recording formats at clinical trial registries in ensuring high-quality registration.

  2. Study on Distribution Characteristics of Pediatric Outpatients' Registration Time in Mianyang Fulin Hospital%绵阳富临医院儿科门诊患儿挂号时间分布特征分析

    Institute of Scientific and Technical Information of China (English)



    Objectives To fully understand the distribution characteristics of pediatrics outpatients registration time in Mianyang Fulin Hospital (a first-class grade two hospital), thus to provide a basis for hospital pediatrics outpatient management decisions. Methods Extract data of pediatrics outpatients from hospital information system, with time scope from 2011 to 2014. Study the distribution of outpatients' registration on a quarter by quarter, month by month, week by week and day by day basis. Results 2011-2014, the outpatient amount in the fourth quarter account for 30.31% of the highest, while that in the first quarter account for 19.79%of the lowest. The number of outpatient amount peak in October, November and December, and touch bottom in Febru-ary, January and September. Outpatients' registration time show three peaks in a day, the largest number of registration occur be-tween 9am-10am, 2pm-3pm and 7pm-8pm. Conclusions Collecting the pediatrics outpatients clinical information from hospital information system, and conducting a full investigation of distribution characteristics of outpatients' registration time through statis-tical analysis methods of hospital management can provide decision basis for refined management of pediatrics outpatient service, such as guiding the patients visiting doctors by staggering the peak and allocating human resources scientifically.%目的:全面了解绵阳富临医院(二级甲等综合医院)儿科门诊患儿挂号时间分布特征,为医院儿科门诊管理决策提供依据。方法在医院HIS系统中,提取儿科2011-2014年门诊患儿数据,统计分析门诊患儿挂号季度、月、周及日分布情况。结果2011-2014年,儿科门诊第四季度接诊患儿所占构成比最高(30.31%),第一季度最低(19.79%)。10、11、12月门诊患儿挂号人数居前三位,分别占10.34%、10.11%、9.87%;2、1、9月居后三位。患儿挂号时间在1 d内呈现大中小

  3. Getting our house in order: an audit of the registration and publication of clinical trials supported by the National Institute for Health Research Oxford Biomedical Research Centre and the Musculoskeletal Biomedical Research Unit. (United States)

    Tompson, A C; Petit-Zeman, S; Goldacre, B; Heneghan, C J


    To audit the proportion of clinical trials that had been publically registered and, of the completed trials, the proportion published. 2 major research institutions supported by the National Institute of Health Research (NIHR). The proportion of trials reporting results within 12 months, 24 months and 'ever'. Factors associated with non-publication were analysed using logistic regression. Phases 2-4 clinical trials identified from internal documents and publication lists. In total, 286 trials were identified. We could not find registration for 4 (1.4%) of these, all of which were completed and published. Of the trials with a registered completion date pre-January 2015, just over half (56%) were published, and half of these were published within 12 months (36/147, 25%). For some trials, information on the public registers was found to be out-of-date and/or inaccurate. No clinical trial characteristics were found to be significantly associated with non-publication. We have produced resources to facilitate similar audits elsewhere. It was feasible to conduct an internal audit of registration and publication in 2 major research institutions. Performance was similar to, or better than, comparable cohorts of trials sampled from registries. The major resource input required was manually seeking information: if all registry entries were maintained, then almost the entire process of audit could be automated--and routinely updated--for all research centres and funders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to

  4. VBM with viscous fluid registration of grey matter segments in SPM.

    Directory of Open Access Journals (Sweden)

    João M. S. Pereira


    Full Text Available Improved registration of grey matter segments in SPM has been achieved with the DARTEL algorithm. Previous work from our group suggested, however, that such improvements may not translate to studies of clinical groups. To address the registration issue in atrophic brains, this paper relaxed the condition of diffeomorphism, central to DARTEL, and made use of a viscous fluid registration model with limited regularisation constraints to register the modulated grey matter probability maps to an intra-population template. Quantitative analysis of the registration results after the additional viscous fluid step showed no worsening of co-localisation of fiducials compared to DARTEL or unified segmentation methods, and the resulting voxel based morphometry (VBM analyses were able to better identify atrophic regions and to produce results with fewer apparent false positives. DARTEL showed great sensitivity to atrophy, but the resulting VBM maps presented broad, amorphous regions of significance that are hard to interpret. We propose that the condition of diffeomorphism is not necessary for basic VBM studies in atrophic populations, but also that it has disadvantages that must be taken into consideration before a study. The presented viscous fluid registration method is proposed for VBM studies to enhance sensitivity and localizing power.

  5. VBM with viscous fluid registration of gray matter segments in SPM. (United States)

    Pereira, Joao M S; Acosta-Cabronero, Julio; Pengas, George; Xiong, Li; Nestor, Peter J; Williams, Guy B


    Improved registration of gray matter segments in SPM has been achieved with the DARTEL algorithm. Previous work from our group suggested, however, that such improvements may not translate to studies of clinical groups. To address the registration issue in atrophic brains, this paper relaxed the condition of diffeomorphism, central to DARTEL, and made use of a viscous fluid registration model with limited regularization constraints to register the modulated gray matter probability maps to an intra-population template. Quantitative analysis of the registration results after the additional viscous fluid step showed no worsening of co-localization of fiducials compared to DARTEL or unified segmentation methods, and the resulting voxel based morphometry (VBM) analyses were able to better identify atrophic regions and to produce results with fewer apparent false positives. DARTEL showed great sensitivity to atrophy, but the resulting VBM maps presented broad, amorphous regions of significance that are hard to interpret. We propose that the condition of diffeomorphism is not necessary for basic VBM studies in atrophic populations, but also that it has disadvantages that must be taken into consideration before a study. The presented viscous fluid registration method is proposed for VBM studies to enhance sensitivity and localizing power.

  6. Prostate: registration of digital histopathologic images to in vivo MR images acquired by using endorectal receive coil. (United States)

    Ward, Aaron D; Crukley, Cathie; McKenzie, Charles A; Montreuil, Jacques; Gibson, Eli; Romagnoli, Cesare; Gomez, Jose A; Moussa, Madeleine; Chin, Joseph; Bauman, Glenn; Fenster, Aaron


    To develop and evaluate a technique for the registration of in vivo prostate magnetic resonance (MR) images to digital histopathologic images by using image-guided specimen slicing based on strand-shaped fiducial markers relating specimen imaging to histopathologic examination. The study was approved by the institutional review board (the University of Western Ontario Health Sciences Research Ethics Board, London, Ontario, Canada), and written informed consent was obtained from all patients. This work proposed and evaluated a technique utilizing developed fiducial markers and real-time three-dimensional visualization in support of image guidance for ex vivo prostate specimen slicing parallel to the MR imaging planes prior to digitization, simplifying the registration process. Means, standard deviations, root-mean-square errors, and 95% confidence intervals are reported for all evaluated measurements. The slicing error was within the 2.2 mm thickness of the diagnostic-quality MR imaging sections, with a tissue block thickness standard deviation of 0.2 mm. Rigid registration provided negligible postregistration overlap of the smallest clinically important tumors (0.2 cm(3)) at histologic examination and MR imaging, whereas the tested nonrigid registration method yielded a mean target registration error of 1.1 mm and provided useful coregistration of such tumors. This method for the registration of prostate digital histopathologic images to in vivo MR images acquired by using an endorectal receive coil was sufficiently accurate for coregistering the smallest clinically important lesions with 95% confidence.

  7. Slice-to-volume registration and its potential application to interventional MRI-guided radio-frequency thermal ablation of prostate cancer. (United States)

    Fei, Baowei; Duerk, Jeffrey L; Boll, Daniel T; Lewin, Jonathan S; Wilson, David L


    In this study, we registered live-time interventional magnetic resonance imaging (iMRI) slices with a previously obtained high-resolution MRI volume that in turn can be registered with a variety of functional images, e.g., PET, SPECT, for tumor targeting. We created and evaluated a slice-to-volume (SV) registration algorithm with special features for its potential use in iMRI-guided radio-frequency (RF) thermal ablation of prostate cancer. The algorithm features included a multiresolution approach, two similarity measures, and automatic restarting to avoid local minima. Imaging experiments were performed on volunteers using a conventional 1.5-T MR scanner and a clinical 0.2-T C-arm iMRI system under realistic conditions. Both high-resolution MR volumes and actual iMRI image slices were acquired from the same volunteers. Actual and simulated iMRI images were used to test the dependence of SV registration on image noise, receive coil inhomogeneity, and RF needle artifacts. To quantitatively assess registration, we calculated the mean voxel displacement over a volume of interest between SV registration and volume-to-volume registration, which was previously shown to be quite accurate. More than 800 registration experiments were performed. For transverse image slices covering the prostate, the SV registration algorithm was 100% successful with an error of bladder filling. These preliminary experiments indicate that MR SV registration is sufficiently accurate to aid image-guided therapy.

  8. 2D/3D registration using only single-view fluoroscopy to guide cardiac ablation procedures: a feasibility study (United States)

    Fallavollita, Pascal


    The CARTO XP is an electroanatomical cardiac mapping system that provides 3D color-coded maps of the electrical activity of the heart, however it is expensive and it can only use a single costly magnetic catheter for each patient intervention. Aim: To develop an affordable fluoroscopic navigation system that could shorten the duration of RF ablation procedures and increase its efficacy. Methodology: A 4-step filtering technique was implemented in order to project the tip electrode of an ablation catheter visible in single-view C-arm images in order to calculate its width. The width is directly proportional to the depth of the catheter. Results: For phantom experimentation, when displacing a 7- French catheter at 1cm intervals away from an X-ray source, the recovered depth using a single image was 2.05 +/- 1.47 mm, whereas depth errors improved to 1.55 +/- 1.30 mm when using an 8-French catheter. In clinic experimentation, twenty posterior and left lateral images of a catheter inside the left ventricle of a mongrel dog were acquired. The standard error of estimate for the recovered depth of the tip-electrode of the mapping catheter was 13.1 mm and 10.1 mm respectively for the posterior and lateral views. Conclusions: A filtering implementation using single-view C-arm images showed that it was possible to recover depth in phantom study and proved adequate in clinical experimentation based on isochronal map fusion results.

  9. Stem cells and stem cell therapy for diabetes mellitus:Chinese clinical trial registration information analysis%干细胞及干细胞治疗糖尿病:中国临床试验注册信息分析

    Institute of Scientific and Technical Information of China (English)



    背景:中国临床试验注册中心通过公布研究设计信息、国际统一注册号、审核研究设计、中心随机分配以保障注册临床试验的质量。目的:分析中国临床试验注册中心关于干细胞以及干细胞治疗糖尿病研究的现状。方法:检索2008至2014年中国临床试验注册中心关于干细胞研究的临床试验注册项目,从治疗疾病种类、研究类型、注册时间、注册单位、分布地区等方面对资料进行整理,并对干细胞治疗糖尿病临床试验注册项目进行深入分析。结果与结论:关于干细胞研究的项目共有82项,以治疗血液病(32/39.0%)、神经系统疾病(20/24.4%)、肝病(9/11.0%)、糖尿病(5/6.1%)的试验项目为主,注册时间集中在2012年,主要研究单位是中国武装警察部队总医院、北京大学人民医院和浙江大学医学院附属第一医院,地区分布主要在北京和浙江。关于干细胞治疗糖尿病研究的试验项目有5项,分别为中国武装警察部队总医院的脐带间充质干细胞移植治疗糖尿病研究、新桥医院的间充质干细胞移植治疗糖尿病的有效性及安全性和解放军第452医院自体骨髓干细胞移植治疗糖尿病的临床研究。中国临床试验注册中心关于干细胞以及干细胞治疗糖尿病研究的项目数量不多,提高临床试验注册数量和规范是未来发展的方向。%BACKGROUND:The Chinese Clinicaltrial Register publishes the study design information and internationaly harmonized registration number, reviews study design, and randomly assigns in order to protect the quality of registration. OBJECTIVE:To analyze the current situation of stem cels and stem cel therapy for diabetes melitus in Chinese Clinical Trial Registry. METHODS: We searched the Chinese Clinical Trial Register (2008-2014) for stem cel research, and summarized these studies from the aspects of type of disease, study type, registration

  10. Sequential Treatment of Severe Postmenopausal Osteoporosis Following Teriparatide: Final Results of the Randomized, Controlled European Study of Forsteo (EUROFORS): Trial registration: identifier NCT00191425 (Trial registration date: 12 September 2005)

    DEFF Research Database (Denmark)

    Eastell, Richard; Nickelsen, Thomas; Marin, Fernando


    Abstract It is unclear which treatment should be given after stopping teriparatide therapy for severe osteoporosis. In a prospective, randomized, controlled, 2-yr study, we compared bone mineral density (BMD) effects and clinical safety of 3 follow-up treatments (anabolic with teriparatide...

  11. Recruitment and retention in obesity prevention and treatment trials targeting minority or low-income children: a review of the clinical trials registration database. (United States)

    Cui, Zhaohui; Seburg, Elisabeth M; Sherwood, Nancy E; Faith, Myles S; Ward, Dianne S


    Efforts to recruit and retain participants in clinical trials are challenging, especially in studies that include minority or low-income children. To date, no studies have systematically examined recruitment and retention strategies and their effectiveness in working successfully with this population. We examined strategies employed to recruit or retain minority or low-income children in trials that included an obesity-related behavior modification component. First, completed home-, community-, and school-based trials involving minority or low-income children aged 2-17 years were identified in a search of the registry. Second, a PubMed search of identified trials was conducted to locate publications pertinent to identified trials. Recruitment and retention rates were calculated for studies that included relevant information. Our final analytic sample included 43 studies. Of these, 25 studies reported recruitment or retention strategies, with the amount of information varying from a single comment to several pages; 4 published no specific information on recruitment or retention; and 14 had no publications listed in PubMed. The vast majority (92 %) of the 25 studies reported retention rates of, on average, 86 %. Retention rates were lower in studies that: targeted solely Hispanics or African Americans (vs. mixed races of African Americans, whites, and others); involved children and parents (vs. children only); focused on overweight or obese children (vs. general children), lasted ≥1 year (vs. obesity-related behavior, insulin sensitivity, etc.). Retention rates did not vary based on child age, number of intervention sessions, or sample size. Variable amounts of information were provided on recruitment and retention strategies in obesity-related trials involving minority or low-income children. Although reported retention rates were fairly high, a lack of reporting limited the available information. More and consistent reporting and systematic

  12. The hidden KPI registration accuracy. (United States)

    Shorrosh, Paul


    Determining the registration accuracy rate is fundamental to improving revenue cycle key performance indicators. A registration quality assurance (QA) process allows errors to be corrected before bills are sent and helps registrars learn from their mistakes. Tools are available to help patient access staff who perform registration QA manually.

  13. Axitinib versus sorafenib as a second-line therapy in Asian patients with metastatic renal cell carcinoma: results from a randomized registrational study

    Directory of Open Access Journals (Sweden)

    Qin S


    Full Text Available Shukui Qin,1 Feng Bi,2 Jie Jin,3 Ying Cheng,4 Jun Guo,5 Xiubao Ren,6 Yiran Huang,7 Jamal Tarazi,8 Jie Tang,9 Connie Chen,9 Sinil Kim,8 Dingwei Ye10 1Department of Medical Oncology, PLA Cancer Center, Nanjing Bayi Hospital, Nanjing, Jiangsu, People’s Republic of China; 2Department of Medical Oncology, West China Hospital of Sichuan University, Chengdu, Sichuan Province, People’s Republic of China; 3Department of Urology, Peking University First Hospital, Beijing, People’s Republic of China; 4Department of Oncology, Jilin Provincial Cancer Hospital, Changchun, Jilin Province, People’s Republic of China; 5Department of Renal Cancer and Melanoma, Peking University Cancer Hospital/Institute, Beijing, People’s Republic of China; 6Department of Biology Treatment, Tianjin Oncology Hospital, Tianjin, People’s Republic of China; 7Department of Urology, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China; 8Clinical Development, Pfizer Oncology, San Diego, CA, USA; 9Global Outcomes Research, Pfizer Inc., New York, NY, USA; 10Department of Urology, Fudan University Shanghai Cancer Center, Shanghai, People’s Republic of China Background: This registrational trial evaluated the efficacy, safety, and patient-reported outcomes of axitinib versus sorafenib as a second-line treatment in Asian patients with clear-cell metastatic renal cell carcinoma (mRCC. Methods: In this open-label, multicenter study, previously treated Asian patients with clear-cell mRCC were stratified by Eastern Cooperative Oncology Group performance status and prior therapy and randomized in a 2:1 ratio to receive axitinib (5 mg twice daily or sorafenib (400 mg twice daily. The primary end point was progression-free survival (PFS assessed by a masked independent review committee.Results: A total of 204 Asian patients received axitinib (n=135 or sorafenib (n=69. Median PFS (95% confidence interval [CI] was 6.5 (4.7–9.1 months


    Directory of Open Access Journals (Sweden)

    Sambasiva Rao


    Full Text Available BACKGROUND The duodenal injury can pose a formidable challenge to the surgeon and failure to manage it properly may have devastating results. Over the centuries, there was little to offer the patient of acute abdomen beyond cupping, purgation and enemas, all of which did more harm than good. It was not until 1884 that Mikulicz made an attempt to repair a perforation. Recent statistics indicate roughly 10% of population develop gastric or duodenal ulcer in life time. Roughly 1-3% of population above the age of 20 years have some degree of peptic ulcer activity during any annual period. A detailed history with regards to the signs and symptoms of the patient, a meticulous examination, radiological and biochemical investigations help to arrive at a correct preoperative diagnosis. In this study, a sincere effort has been put to understand the demographic patterns, to understand the underlying aetiology and to understand the effectiveness of the standard methods of investigation and treatment in use today. METHODS This is a 24 months prospective study i.e., from September 2011 to September 2013 carried out at Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation. The study included the patients presenting to Dr. Pinnamaneni Siddhartha Institute of Medical Sciences & Research Foundation to emergency ward with signs and symptoms of hollow viscus perforation. The sample size included 30 cases of duodenal perforation. RESULTS Duodenal ulcer perforation commonly occurs in the age group of 30-60 years, but it can occur in any age group. Majority of the patients were male. Smoking and alcohol consumption were risk factors in most cases (53.3% for the causation of duodenal ulcer perforation. Sudden onset of abdominal pain, situated at epigastrium and right hypochondrium was a constant symptom (100%. Vomiting, constipation and fever were not so common. CONCLUSION The emergency surgical management for perforated duodenal ulcer is by

  15. [Adaptive clinical study methodologies in drug development]. (United States)

    Antal, János


    The evolution of drug development in human, clinical phase studies triggers the overview of those technologies and procedures which are labelled as adaptive clinical trials. The most relevant procedural and operational aspects will be discussed in this overview from points of view of clinico-methodological aspect.

  16. Image registration with uncertainty analysis (United States)

    Simonson, Katherine M.


    In an image registration method, edges are detected in a first image and a second image. A percentage of edge pixels in a subset of the second image that are also edges in the first image shifted by a translation is calculated. A best registration point is calculated based on a maximum percentage of edges matched. In a predefined search region, all registration points other than the best registration point are identified that are not significantly worse than the best registration point according to a predetermined statistical criterion.

  17. [Clinical research III. The causality studies]. (United States)

    Talavera, Juan O; Wacher-Rodarte, Niels H; Rivas-Ruiz, Rodolfo


    The need to solve a clinical problem leads us to establish a starting point to address (risk, prognosis or treatment studies), all these cases seek to attribute causality. Clinical reasoning described in the book Clinical Epidemiology. The architecture of clinical research, offers a simple guide to understanding this phenomenon. And proposes three basic components: baseline, maneuver and outcome. In this model, different systematic errors (bias) are described, which may be favored by omitting characteristics of the three basic components. Thus, omissions in the baseline characteristics cause an improper assembly of the population and susceptibility bias, omissions in the application or evaluation of the maneuver provoke performance bias, and omissions in the assessment of out-come cause detection bias and transfer bias. Importantly, if this way of thinking facilitates understanding of the causal phenomenon, the appropriateness of the variables to be selected in the studies to which attribute or not causality, require additional arguments for evaluate clinical relevance.

  18. A cross validation study of deep brain stimulation targeting: from experts to atlas-based, segmentation-based and automatic registration algorithms. (United States)

    Castro, F Javier Sanchez; Pollo, Claudio; Meuli, Reto; Maeder, Philippe; Cuisenaire, Olivier; Cuadra, Meritxell Bach; Villemure, Jean-Guy; Thiran, Jean-Philippe


    Validation of image registration algorithms is a difficult task and open-ended problem, usually application-dependent. In this paper, we focus on deep brain stimulation (DBS) targeting for the treatment of movement disorders like Parkinson's disease and essential tremor. DBS involves implantation of an electrode deep inside the brain to electrically stimulate specific areas shutting down the disease's symptoms. The subthalamic nucleus (STN) has turned out to be the optimal target for this kind of surgery. Unfortunately, the STN is in general not clearly distinguishable in common medical imaging modalities. Usual techniques to infer its location are the use of anatomical atlases and visible surrounding landmarks. Surgeons have to adjust the electrode intraoperatively using electrophysiological recordings and macrostimulation tests. We constructed a ground truth derived from specific patients whose STNs are clearly visible on magnetic resonance (MR) T2-weighted images. A patient is chosen as atlas both for the right and left sides. Then, by registering each patient with the atlas using different methods, several estimations of the STN location are obtained. Two studies are driven using our proposed validation scheme. First, a comparison between different atlas-based and nonrigid registration algorithms with a evaluation of their performance and usability to locate the STN automatically. Second, a study of which visible surrounding structures influence the STN location. The two studies are cross validated between them and against expert's variability. Using this scheme, we evaluated the expert's ability against the estimation error provided by the tested algorithms and we demonstrated that automatic STN targeting is possible and as accurate as the expert-driven techniques currently used. We also show which structures have to be taken into account to accurately estimate the STN location.

  19. Locally orderless registration

    DEFF Research Database (Denmark)

    Darkner, Sune; Sporring, Jon


    This paper presents a unifying approach for calculating a wide range of popular, but seemingly very different, similarity measures. Our domain is the registration of n-dimensional images sampled on a regular grid, and our approach is well suited for gradient-based optimization algorithms. Our...... approach is based on local intensity histograms and built upon the technique of Locally Orderless Images. Histograms by Locally Orderless Images are well posed and offer explicit control over the 3 inherent and unavoidable scales: the spatial resolution, intensity levels, and spatial extent of local......, and we compare these variations both theoretically, and empirically. Finally, using our algorithm, we explain the empirically observed differences between two popular joint density estimation techniques used in registration: Parzen Windows and Generalized Partial Volume....

  20. Clinical trial participants’ experiences of completing questionnaires: a qualitative study (United States)

    Holmberg, Christine; Karner, Julia J; Rappenecker, Julia; Witt, Claudia M


    Objectives To improve clinical study developments for elderly populations, we aim to understand how they transfer their experiences into validated, standardised self-completed study measurement instruments. We analysed how women (mean 78±8 years of age) participating in a randomised controlled trial (RCT) cognised study instruments used to evaluate outcomes of the intervention. Setting The interview study was nested in an RCT on chronic neck pain using common measurement instruments situated in an elderly community in Berlin, Germany, which comprised of units for independent and assisted-living options. Participants The sample (n=20 women) was selected from the RCT sample (n=117, 95% women, mean age 76 (SD±8) years). Interview participants were selected using a purposive sampling list based on the RCT outcomes. Outcomes We asked participants about their experiences completing the RCT questionnaires. Interviews were analysed thematically, then compared with the questionnaires. Results Interviewees had difficulties in translating complex experiences into a single value on a scale and understanding the relationship of the questionnaires to study aims. Interviewees considered important for the trial that their actual experiences were understood by trial organisers. This information was not transferrable by means of the questionnaires. To rectify these difficulties, interviewees used strategies such as adding notes, adding response categories or skipping an item. Conclusions Elderly interview participants understood the importance of completing questionnaires for trial success. This led to strategies of completing the questionnaires that resulted in ‘missing’ or ambiguous data. To improve data collection in elderly populations, educational materials addressing the differential logics should be developed and tested. Pilot testing validated instruments using cognitive interviews may be particularly important in such populations. Finally, when the target of an

  1. Automatic masking for robust 3D-2D image registration in image-guided spine surgery (United States)

    Ketcha, M. D.; De Silva, T.; Uneri, A.; Kleinszig, G.; Vogt, S.; Wolinsky, J.-P.; Siewerdsen, J. H.


    During spinal neurosurgery, patient-specific information, planning, and annotation such as vertebral labels can be mapped from preoperative 3D CT to intraoperative 2D radiographs via image-based 3D-2D registration. Such registration has been shown to provide a potentially valuable means of decision support in target localization as well as quality assurance of the surgical product. However, robust registration can be challenged by mismatch in image content between the preoperative CT and intraoperative radiographs, arising, for example, from anatomical deformation or the presence of surgical tools within the radiograph. In this work, we develop and evaluate methods for automatically mitigating the effect of content mismatch by leveraging the surgical planning data to assign greater weight to anatomical regions known to be reliable for registration and vital to the surgical task while removing problematic regions that are highly deformable or often occluded by surgical tools. We investigated two approaches to assigning variable weight (i.e., "masking") to image content and/or the similarity metric: (1) masking the preoperative 3D CT ("volumetric masking"); and (2) masking within the 2D similarity metric calculation ("projection masking"). The accuracy of registration was evaluated in terms of projection distance error (PDE) in 61 cases selected from an IRB-approved clinical study. The best performing of the masking techniques was found to reduce the rate of gross failure (PDE > 20 mm) from 11.48% to 5.57% in this challenging retrospective data set. These approaches provided robustness to content mismatch and eliminated distinct failure modes of registration. Such improvement was gained without additional workflow and has motivated incorporation of the masking methods within a system under development for prospective clinical studies.

  2. The Relationship between Work-Life Conflict and Employee Performance: A Study of National Database and Registration Authority Workers in Pakistan

    Directory of Open Access Journals (Sweden)

    Rai Imtiaz Hussain


    Full Text Available Most professionals face work-life conflicts as they move through their profession’s hierarch and progressively advanced stages. This study explores the impact of work-life conflicts on employee performance. A sample of 130 respondents was selected from the National Database and Registration Authority (NADRA.There appears to be a positive and significant relationship between work-life conflicts and performance of employees.Statistical analysis was used to see the impact of gender and marital status on the work-life conflicts and performance of employees. The results indicate that gender had no significant effect on performance and work-life conflicts whereas marital status of the respondents’ had a significant impact on the work-life conflicts.

  3. A comparative study of track registration response of Makrofol-(KG, KL and N) polycarbonate to sup 4 sup 0 Ar ions

    CERN Document Server

    Kumar, A


    In the present work a comparative study of track registration response of sup 4 sup 0 Ar ions in different types of Makrofol polycarbonates viz. Makrofol-KG, KL and N have been done. The etched track parameters viz. bulk etch rate, track etch rate, etch rate ratio, cone angle and etching efficiency were calculated. The variation of etching rates with temperature were found to be exponential and follow the Arrhenius equation. The values of activation energy for bulk and track etching were also calculated. Maximum etchable track length/range were also obtained and compared with the theoretical values obtained from computer program RANGE. From the results it is found that the polycarbonates having same chemical composition manufactured by different chemical processes have slightly different behavior

  4. eHUGS: Enhanced Hierarchical Unbiased Graph Shrinkage for Efficient Groupwise Registration.

    Directory of Open Access Journals (Sweden)

    Guorong Wu

    Full Text Available Effective and efficient spatial normalization of a large population of brain images is critical for many clinical and research studies, but it is technically very challenging. A commonly used approach is to choose a certain image as the template and then align all other images in the population to this template by applying pairwise registration. To avoid the potential bias induced by the inappropriate template selection, groupwise registration methods have been proposed to simultaneously register all images to a latent common space. However, current groupwise registration methods do not make full use of image distribution information for more accurate registration. In this paper, we present a novel groupwise registration method that harnesses the image distribution information by capturing the image distribution manifold using a hierarchical graph with its nodes representing the individual images. More specifically, a low-level graph describes the image distribution in each subgroup, and a high-level graph encodes the relationship between representative images of subgroups. Given the graph representation, we can register all images to the common space by dynamically shrinking the graph on the image manifold. The topology of the entire image distribution is always maintained during graph shrinkage. Evaluations on two datasets, one for 80 elderly individuals and one for 285 infants, indicate that our method can yield promising results.

  5. Intensity-Based Registration for Lung Motion Estimation (United States)

    Cao, Kunlin; Ding, Kai; Amelon, Ryan E.; Du, Kaifang; Reinhardt, Joseph M.; Raghavan, Madhavan L.; Christensen, Gary E.

    Image registration plays an important role within pulmonary image analysis. The task of registration is to find the spatial mapping that brings two images into alignment. Registration algorithms designed for matching 4D lung scans or two 3D scans acquired at different inflation levels can catch the temporal changes in position and shape of the region of interest. Accurate registration is critical to post-analysis of lung mechanics and motion estimation. In this chapter, we discuss lung-specific adaptations of intensity-based registration methods for 3D/4D lung images and review approaches for assessing registration accuracy. Then we introduce methods for estimating tissue motion and studying lung mechanics. Finally, we discuss methods for assessing and quantifying specific volume change, specific ventilation, strain/ stretch information and lobar sliding.

  6. Articulated registration: elastic registration based on a wire-model (United States)

    Martin-Fernandez, Miguel A.; Munyoz-Moreno, Emma; Martin-Fernandez, Marcos; Alberola-Lopez, Carlos


    In this paper we propose a new method of elastic registration of anatomical structures that bears an inner skeleton, such as the knee, hand or spine. Such a method has to deal with great degrees of variability, specially for the case of inter-subject registration; but even for the intra-subject case the degree of variability of images will be large since the structures we bear in mind are articulated. Rigid registration methods are clearly inappropriate for this problem, and well-known elastic methods do not usually incorporate the restriction of maintaining long skeletal structures straight. A new method is therefore needed to deal with such a situation; we call this new method "articulated registration". The inner bone skeleton is modeled with a wire model, where wires are drawn by connecting landmarks located in the main joints of the skeletal structure to be registered (long bones). The main feature of our registration method is that within the bone axis (specifically, where the wires are) an exact registration is guaranteed, while for the remaining image points an elastic registration is carried out based on a distance transform (with respect to the model wires); this causes the registration on long bones to be affine to all practical purposes, while the registration of soft tissue -- far from the bones -- is elastic. As a proof-of-concept of this method we describe the registration of hands on radiographs.

  7. Semiautomated Multimodal Breast Image Registration

    Directory of Open Access Journals (Sweden)

    Charlotte Curtis


    However, due to the highly deformable nature of breast tissues, comparison of 3D and 2D modalities is a challenge. To enable this comparison, a registration technique was developed to map features from 2D mammograms to locations in the 3D image space. This technique was developed and tested using magnetic resonance (MR images as a reference 3D modality, as MR breast imaging is an established technique in clinical practice. The algorithm was validated using a numerical phantom then successfully tested on twenty-four image pairs. Dice's coefficient was used to measure the external goodness of fit, resulting in an excellent overall average of 0.94. Internal agreement was evaluated by examining internal features in consultation with a radiologist, and subjective assessment concludes that reasonable alignment was achieved.

  8. Comparison of Simultaneous and Sequential Two-View Registration for 3D/2D Registration of Vascular Images


    Pathak, Chetna; Van Horn, Mark; Weeks, Susan; Bullitt, Elizabeth


    Accurate 3D/2D vessel registration is complicated by issues of image quality, occlusion, and other problems. This study performs a quantitative comparison of 3D/2D vessel registration in which vessels segmented from preoperative CT or MR are registered with biplane x-ray angiograms by either a) simultaneous two-view registration with advance calculation of the relative pose of the two views, or b) sequential registration with each view. We conclude on the basis of phantom studies that, even i...

  9. Trial registration numbers are underreported in biomedical publications.

    Directory of Open Access Journals (Sweden)

    Fleur T van de Wetering

    Full Text Available CONTEXT: Since September 2005, the International Committee of Medical Journal Editors (ICMJE has required that randomised controlled trials (RCTs are prospectively registered in a publicly accessible database. After registration, a trial registration number (TRN is assigned to each RCT, which should make it easier to identify future publications and cross-check published results with associated registry entries, as long as the unique identification number is reported in the article. OBJECTIVE: Our primary objective was to evaluate the reporting of trial registration numbers in biomedical publications. Secondary objectives were to evaluate how many published RCTs had been registered and how many registered RCTs had resulted in a publication, using a sample of trials from the Netherlands Trials Register (NTR. DESIGN, SETTING: TWO DIFFERENT SAMPLES OF RCTS WERE EXAMINED: 1 RCTs published in November 2010 in core clinical journals identified in MEDLINE; 2 RCTs registered in the NTR with a latest expected end date of 31 August 2008. RESULTS: Fifty-five percent (166/302 of the reports of RCTs found in MEDLINE and 60% (186/312 of the published reports of RCTs from the NTR cohort contained a TRN. In both samples, reporting of a TRN was more likely in RCTs published in ICMJE member journals as compared to non-ICMJE member journals (MEDLINE 58% vs. 45%; NTR: 70% vs. 49%. Thirty-nine percent of published RCTs in the MEDLINE sample appear not to have been registered, and 48% of RCTs registered in the NTR seemed not to have been published at least two years after the expected date for study completion. CONCLUSION: Our results show that further promotion and implementation of trial registration and accurate reporting of TRN is still needed. This might be helped by inclusion of the TRN as an item on the CONSORT checklist.

  10. 进口药品注册临床试验的整体策略%Clinical research strategies for imported drugs registration

    Institute of Scientific and Technical Information of China (English)

    康彩练; 高晨燕


    The clinical trial requirements for imported drug are under seri-ous discussion. This article gives the answers for the following questions:are the clinical trials absolute necessary if the drugs want to launch on China's market? How to conduct clinical trials to fulfill the regulation re-quirements? Base on ICHE5 guideline, the amount and content of clini-cal trials depend on the "demand". The key point considered to the "de-mand" is the difference of ethnic and clinical practice, which lies on two important aspects: the disease being treated and molecular characters.Invesitegators should analysis the pharmaeokinetic and pharmakcoinetic/pharmacodynamic characters in different ethnics. And invesitegators should also analysis the clinical practice difference on efficacy and safe-ty. Aim at these difference, the investigators design the corresponding clinical trials. This article will give suggestions to the post-marketing clin-ical trials and global multi-national clinical trials too.%本文从进口药注册临床试验的争论入手,回答是否需要开展注册临床试验和需要开展什么样的注册试验.通过对于ICHE5的解读,阐明进口药的注册临床试验要遵循按需开展的原则,从疾病与分子2个方面分析药代动力学、药代动力学/药效、有效性和安全性的不同地区差异,针对这些差异开展相应的进口注册临床试验.本文也对上市后的试验和国际多中心试验举行了阐述.

  11. Influence of the thickness of silicone registration material as a means for occlusal contact examination--an explorative study with different tooth clenching intensities. (United States)

    Obara, R; Komiyama, O; Iida, T; De Laat, A; Kawara, M


    This study explored the influence of the thickness of silicone registration material on evaluation of the occlusal contact area and number of occlusal contact points, during increasing tooth clenching conditions in normal subjects. Twenty-four subjects with no more than one missing tooth per quadrant participated. Surface electro-myography was recorded from the masseter muscle. As a baseline measurement, intercuspal position was maintained with minimal force, and occlusal contact was recorded using blue silicone material. Occlusal contact was also recorded at 20% maximum voluntary contraction (MVC) and 40% MVC using visual feedback. The occlusal contact area and number of occlusal contact points were analysed using five levels of thickness of silicone registration material: Level 1 (0-149 μm); Level 2 (0-89 μm); Level 3 (0-49 μm); Level 4 (0-29 μm); and Level 5 (0-4 μm). The anterior part and the left and right posterior regions of the dental arch were analysed separately. At all detection levels, the occlusal contact area significantly increased from baseline to 20% MVC and to 40% MVC in the molar area (P MVC and to 40% MVC only when using Level 5. The number of occlusal contact points significantly increased from baseline to 20% MVC and to 40% MVC only when using Level 5 in the molar area (P < 0·05). It suggested that occlusal contacts may be different at low tooth clenching intensity with potential effects on the teeth or periodontal tissues.


    Directory of Open Access Journals (Sweden)



    Full Text Available La configuración de los Registros de Cooperativas como instrumentos de carácter administrativo con eficacia jurídica encierra una serie de dificultades de indudable trascendencia práctica entre los que destaca el control de la actividad registral. En este sentido, la multiplicidad normativa característica del actual escenario jurídico cooperativo propicia la existencia de soluciones divergentes que, al margen de los problemas que plantean sobre un eventual exceso competencial, pueden tener incidencia tanto en la seguridad jurídica como en el tipo y alcance de la fiscalización judicial. Por otro lado, la naturaleza híbrida de los Registros de Cooperativas provoca distorsiones cuya salida no siempre es clara, en cuanto las previsiones legales y reglamentarias chocan con ciertas limitaciones de la normativa administrativa general aplicable: así ocurre singularmente con el principio registral de legitimación en relación con aquellos mecanismos de control en vía administrativa cuya puesta en marcha corresponde de oficio a la propia Administración Pública./The configuration of the Registries of Cooperatives as administrative instruments withlegal effect, raises a series of difficulties of doubtless practical importance. Out of them, wecan underline one: the control behind the registration activity.In this sense, the multiplying number of norms that shape current legal cooperativescene, may involve many divergent resolutions that, on top of the issues caused behind apotential excess of competence, may also has consequences on both the legal security as wellas on the nature and reach of the judicial control.On the other hand, the hybrid character of the Registries of Cooperatives may needsome adjustments whose solution is not always clear, due to the legal and legitimateassessments mismatching some restrictions of the applicable general administrative norm.This can be illustrated behind the registry principle of legitimacy, related to

  13. Clinical management and burden of bipolar disorder: a multinational longitudinal study (WAVE-bd Study

    Directory of Open Access Journals (Sweden)

    Moreno-Manzanaro Miriam


    will be collected. Descriptive analysis with common statistics will be performed. Discussion This study will provide detailed descriptions of the management of BD in different countries, particularly in terms of clinical outcomes and resources used. Thus, it should provide psychiatrists with reliable and up-to-date information about those factors associated with different management patterns of BD. Trial registration no NCT01062607

  14. Multimodality imaging combination in small animal via point-based registration (United States)

    Yang, C. C.; Wu, T. H.; Lin, M. H.; Huang, Y. H.; Guo, W. Y.; Chen, C. L.; Wang, T. C.; Yin, W. H.; Lee, J. S.


    We present a system of image co-registration in small animal study. Marker-based registration is chosen because of its considerable advantage that the fiducial feature is independent of imaging modality. We also experimented with different scanning protocols and different fiducial marker sizes to improve registration accuracy. Co-registration was conducted using rat phantom fixed by stereotactic frame. Overall, the co-registration accuracy was in sub-millimeter level and close to intrinsic system error. Therefore, we conclude that the system is an accurate co-registration method to be used in small animal studies.

  15. Registration Based Retrieval using Texture Measures

    Directory of Open Access Journals (Sweden)

    Swarnambiga AYYACHAMY


    Full Text Available The aim of the study presented in this manuscript was to develop and analyze registration based retrieval of medical image using texture measures. Three main methods are implemented in this work. The first method includes Affine transformation, Demons and Affine with B-spline. The second method implemented is medical image retrieval system using content based medical image retrieval. GLCM, LBP and GLCM with LBP are used for texture based retrieval. Shape based retrieval is processed using canny edge with the Otsu method. From registration based retrieval, Affine with B-Spline performs well and produces best result by increasing the retrieval rate and the next better performances are given by Demons and Affine registration. The results showed that the best results for registration based retrieval are given by Affine with B-Spline registration based retrieval using GLCM+LBP with (100/50. Based on more relevant retrieved images, Brain (100/50 and Knee (100/50 observed to have more relevant retrieved images.

  16. Registration in the Danish Regional Nonmelanoma Skin Cancer Dermatology Database: completeness of registration and accuracy of key variables

    Directory of Open Access Journals (Sweden)

    Anna L Lamberg


    Full Text Available Anna L Lamberg1, Deirdre Cronin-Fenton2, Anne B Olesen11Department of Dermatology, 2Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, C, DenmarkObjective: To validate a clinical database for nonmelanoma skin cancer (NMSC with the aim of monitoring and predicting the prognosis of NMSC treated by dermatologists in clinics in the central and north Denmark regions.Methods: We assessed the completeness of registration of patients and follow-up visits, and positive predictive value (PPV, negative predictive value (NPV, sensitivity, and specificity of registrations in the database. We used the Danish Pathology Registry (DPR (n = 288 and a review of randomly selected medical records (n = 67 from two clinics as gold standards.Results: The completeness of registration of patients was 62% and 76% with DPR and medical record review as gold standards, respectively. The completeness of registration of 1st and 2nd follow up visits was 85% and 69%, respectively. The PPV and NPV ranged from 85% to 99%, and the sensitivity and specificity from 67% to 100%.Conclusion: Overall, the accuracy of variables registered in the NMSC database was satisfactory but completeness of patient registration and follow-up visits were modest. The NMSC database is a potentially valuable tool for monitoring and facilitating improvement of NMSC treatment in dermatology clinics. However, there is still room for improvement of registration of both patients and their follow-up visits.Keywords: nonmelanoma skin cancer, validation, database, positive predictive value, completeness

  17. Real-time automatic registration in optical surgical navigation (United States)

    Lin, Qinyong; Yang, Rongqian; Cai, Ken; Si, Xuan; Chen, Xiuwen; Wu, Xiaoming


    An image-guided surgical navigation system requires the improvement of the patient-to-image registration time to enhance the convenience of the registration procedure. A critical step in achieving this aim is performing a fully automatic patient-to-image registration. This study reports on a design of custom fiducial markers and the performance of a real-time automatic patient-to-image registration method using these markers on the basis of an optical tracking system for rigid anatomy. The custom fiducial markers are designed to be automatically localized in both patient and image spaces. An automatic localization method is performed by registering a point cloud sampled from the three dimensional (3D) pedestal model surface of a fiducial marker to each pedestal of fiducial markers searched in image space. A head phantom is constructed to estimate the performance of the real-time automatic registration method under four fiducial configurations. The head phantom experimental results demonstrate that the real-time automatic registration method is more convenient, rapid, and accurate than the manual method. The time required for each registration is approximately 0.1 s. The automatic localization method precisely localizes the fiducial markers in image space. The averaged target registration error for the four configurations is approximately 0.7 mm. The automatic registration performance is independent of the positions relative to the tracking system and the movement of the patient during the operation.

  18. PPB | What is a Clinical Study (United States)

    The Pleuropulmonary blastoma (PPB) DICER1 Syndrome Study ‹an observational clinical research study‹is enrolling children with PPB and their families. In an observational study, investigators assess health outcomes in groups of participants according to a protocol or research plan.

  19. Clinical and Epidemiological Studies on Rickettsial Infections. (United States)



  20. Summary reports for key Hoodia clinical studies

    CSIR Research Space (South Africa)

    Maharaj, VJ


    Full Text Available The CSIR has acquired the reports to 14 clinical studies in which Hoodia has been assesses, using crude extracts and concentrated active ingredients formulated in a number of different ways. In many of the studies Hoodia was found to be generally...

  1. Registration Summer Camp 2016

    CERN Multimedia


    Reminder: registration for the CERN Staff Association Summer Camp is now open for children from 4 to 6 years old.   More information on the website: The summer camp is open to all children. The proposed cost is 480.-CHF/week, lunch included. The camp will be open weeks 27, 28, 29 and 30, from 8:30 a.m. to 5:30 p.m. For further questions, you are welcome to contact us by email at CERN Staff Association

  2. Study on Household Registration Records Management of University Students%高校学生户籍档案管理问题研究

    Institute of Scientific and Technical Information of China (English)



      本文立足于工作实践,提出改善高校学生户籍管理的方法,力争为高校学生户籍档案管理提供有益的参考。%This article based on the working practice, suggested ways of improving college students' household registration man-agement, and strive to provide useful references for college stu-dents household registration records management.

  3. Closing the gap in nursing education:Comparing nursing registration systems in Australia and China

    Institute of Scientific and Technical Information of China (English)

    Carol Chunfeng Wang


    Aim: To provide a better understanding of how the nursing registration process in China compares to that of Australia and to identify common features and potential barriers that may affect or facilitate the development of China's ever-demanding need for healthcare and nursing education. Background: Chinese nursing graduates are increasingly being used to augment the shortage of nurses in other countries, including Australia. However, China is desperately in need of strategies to cope with its current challenges in healthcare and nursing education. There is little discussion concerning the differences in nursing registration systems between countries, such as China and Australia. It is unknown how the differences and potential similarities of nursing registration systems in these two countries contribute to or impede nurses' training in China; or the potential for these Australia trained Chinese nursing returnees to cope with the challenges China is facing. Evaluation: Using Bereday's four steps comparison method, this paper will describe, explain, compare, and contrast the nursing registration systems of Australia and China. Key issues: Differences were found in the qualification requirements for:(1) initial registration, (2) levels of registration, (3) continuing professional development, (4) requirements of the registration renewal process, and (5) whether each country has a national nursing registration system. These factors may affect nursing education and healthcare development in China. Conclusions: Although differences in the nursing registration process between Australia and China were identified, the insights gained from this study support the development of strategies to help with China's ever-demanding need for nursing education and healthcare development, thereby alleviating its nursing shortage. Implications for nursing management: The implications of globalization of nursing education, research, and clinical practice, coupled with the nursing shortage

  4. Registration of renal SPECT and 2.5D US images. (United States)

    Galdames, Francisco J; Perez, Claudio A; Estévez, Pablo A; Held, Claudio M; Jaillet, Fabrice; Lobo, Gabriel; Donoso, Gilda; Coll, Claudia


    Image registration is the process of transforming different image data sets of an object into the same coordinate system. This is a relevant task in the field of medical imaging; one of its objectives is to combine information from different imaging modalities. The main goal of this study is the registration of renal SPECT (Single Photon Emission Computerized Tomography) images and a sparse set of ultrasound slices (2.5D US), combining functional and anatomical information. Registration is performed after kidney segmentation in both image types. The SPECT segmentation is achieved using a deformable model based on a simplex mesh. The 2.5D US image segmentation is carried out in each of the 2D slices employing a deformable contour and Gabor filters to capture multi-scale image features. Moreover, a renal medulla detection method was developed to improve the US segmentation. A nonlinear optimization algorithm is used for the registration. In this process, movements caused by patient breathing during US image acquisition are also corrected. Only a few reports describe registration between SPECT images and a sparse set of US slices of the kidney, and they usually employ an optical localizer, unlike our method, that performs movement correction using information only from the SPECT and US images. Moreover, it does not require simultaneous acquisition of both image types. The registration method and both segmentations were evaluated separately. The SPECT segmentation was evaluated qualitatively by medical experts, obtaining a score of 5 over a scale from 1 to 5, where 5 represents a perfect segmentation. The 2.5D US segmentation was evaluated quantitatively, by comparing our method with an expert manual segmentation, and obtaining an average error of 3.3mm. The registration was evaluated quantitatively and qualitatively. Quantitatively the distance between the manual segmentation of the US images and the model extracted from the SPECT image was measured, obtaining an

  5. Qualitative study of patient consent for health information exchange in an HIV clinic. (United States)

    Ramos, S Raquel; Bakken, Suzanne


    Health information exchange (HIE) is the secure, electronic transfer and/or accessibility of clinical data among healthcare providers. In the United States (US), the consent process for participation varies state to state. New York State (NYS) mandates written patient consent. The purpose of this study was to examine workflow and perceptions related to obtaining HIE consent in an HIV clinic. We used contextual inquiry to observe the HIE consent-related workflow of four registration clerks for a total of 4 hours on two weekdays and subsequently created a flow chart and sequence model diagram. Clerks were also interviewed and the resulting narrative data were coded into themes. Observational and interview data suggested that patient privacy/confidentiality/trust, high volume workflow, and multiple competing demands affect the patient HIE consent process. Additional qualitative data needs to be gathered from the perspectives of patients and clinicians about the HIE consent process.

  6. [Results of toothlessness treatment by calottic method in the Cracow modification. Clinical studies]. (United States)

    Majewski, S; Wiśniewska, G; Wencel, T


    The purpose of the paper was to control the new method of teeth positioning in complete dentures based on the modification of callottic method in clinical practice. Clinical studies depended on occlusion and articulation estimation, examination of denture statics, control of occlusion height and registration of the patients' subjective experiences. They concerned 81 toothless patients divided into 2 groups according to the specific classification and wearing complete dentures in which the teeth had been positioned according to the modified method and Gysi-Fischer' method. In the groups of patients under examination that had teeth positioned according to the modified method significantly better results of the values estimated than in comparative groups have been achieved. It has been found that using the modified method smooth OA surface of artifical teeth is obtained without necessity of its correction satisfactory denture statics is obtained and rehabilitation of mastication function and adaptation to the dentures take place in a short period of time.

  7. 3D/4D ultrasound registration of bone

    CERN Document Server

    Schers, Jonathan; Daanen, Vincent; Fouard, Céline; Plaskos, Christopher; Kilian, Pascal


    This paper presents a method to reduce the invasiveness of Computer Assisted Orthopaedic Surgery (CAOS) using ultrasound. In this goal, we need to develop a method for 3D/4D ultrasound registration. The premilinary results of this study suggest that the development of a robust and ``realtime'' 3D/4D ultrasound registration is feasible.

  8. Image registration reveals central lens thickness minimally increases during accommodation

    Directory of Open Access Journals (Sweden)

    Schachar RA


    Full Text Available Ronald A Schachar,1 Majid Mani,2 Ira H Schachar31Department of Physics, University of Texas at Arlington, Arlington, TX, 2California Retina Associates, El Centro, 3Byers Eye Institute of Stanford University, Palo Alto, CA, USAPurpose: To evaluate anterior chamber depth, central crystalline lens thickness and lens curvature during accommodation.Setting: California Retina Associates, El Centro, CA, USA.Design: Healthy volunteer, prospective, clinical research swept-source optical coherence biometric image registration study of accommodation.Methods: Ten subjects (4 females and 6 males with an average age of 22.5 years (range: 20–26 years participated in the study. A 45° beam splitter attached to a Zeiss IOLMaster 700 (Carl Zeiss Meditec Inc., Jena, Germany biometer enabled simultaneous imaging of the cornea, anterior chamber, entire central crystalline lens and fovea in the dilated right eyes of subjects before, and during focus on a target 11 cm from the cornea. Images with superimposable foveal images, obtained before and during accommodation, that met all of the predetermined alignment criteria were selected for comparison. This registration requirement assured that changes in anterior chamber depth and central lens thickness could be accurately and reliably measured. The lens radii of curvatures were measured with a pixel stick circle.Results: Images from only 3 of 10 subjects met the predetermined criteria for registration. Mean anterior chamber depth decreased, −67 µm (range: −0.40 to −110 µm, and mean central lens thickness increased, 117 µm (range: 100–130 µm. The lens surfaces steepened, anterior greater than posterior, while the lens, itself, did not move or shift its position as appeared from the lack of movement of the lens nucleus, during 7.8 diopters of accommodation, (range: 6.6–9.7 diopters.Conclusion: Image registration, with stable invariant references for image correspondence, reveals that during accommodation a

  9. Marketing and clinical trials: a case study. (United States)

    Francis, David; Roberts, Ian; Elbourne, Diana R; Shakur, Haleema; Knight, Rosemary C; Garcia, Jo; Snowdon, Claire; Entwistle, Vikki A; McDonald, Alison M; Grant, Adrian M; Campbell, Marion K


    Publicly funded clinical trials require a substantial commitment of time and money. To ensure that sufficient numbers of patients are recruited it is essential that they address important questions in a rigorous manner and are managed well, adopting effective marketing strategies. Using methods of analysis drawn from management studies, this paper presents a structured assessment framework or reference model, derived from a case analysis of the MRC's CRASH trial, of 12 factors that may affect the success of the marketing and sales activities associated with clinical trials. The case study demonstrates that trials need various categories of people to buy in - hence, to be successful, trialists must embrace marketing strategies to some extent. The performance of future clinical trials could be enhanced if trialists routinely considered these factors.

  10. Automated Segmentation of the Parotid Gland Based on Atlas Registration and Machine Learning: A Longitudinal MRI Study in Head-and-Neck Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Xiaofeng [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Wu, Ning; Cheng, Guanghui [Radiation Oncology, Jilin University, Chuangchun, Jilin (China); Zhou, Zhengyang [Department of Radiology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing (China); Yu, David S.; Beitler, Jonathan J.; Curran, Walter J. [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States); Liu, Tian, E-mail: [Radiation Oncology and Winship Cancer Institute, Emory University, Atlanta, Georgia (United States)


    Purpose: To develop an automated magnetic resonance imaging (MRI) parotid segmentation method to monitor radiation-induced parotid gland changes in patients after head and neck radiation therapy (RT). Methods and Materials: The proposed method combines the atlas registration method, which captures the global variation of anatomy, with a machine learning technology, which captures the local statistical features, to automatically segment the parotid glands from the MRIs. The segmentation method consists of 3 major steps. First, an atlas (pre-RT MRI and manually contoured parotid gland mask) is built for each patient. A hybrid deformable image registration is used to map the pre-RT MRI to the post-RT MRI, and the transformation is applied to the pre-RT parotid volume. Second, the kernel support vector machine (SVM) is trained with the subject-specific atlas pair consisting of multiple features (intensity, gradient, and others) from the aligned pre-RT MRI and the transformed parotid volume. Third, the well-trained kernel SVM is used to differentiate the parotid from surrounding tissues in the post-RT MRIs by statistically matching multiple texture features. A longitudinal study of 15 patients undergoing head and neck RT was conducted: baseline MRI was acquired prior to RT, and the post-RT MRIs were acquired at 3-, 6-, and 12-month follow-up examinations. The resulting segmentations were compared with the physicians' manual contours. Results: Successful parotid segmentation was achieved for all 15 patients (42 post-RT MRIs). The average percentage of volume differences between the automated segmentations and those of the physicians' manual contours were 7.98% for the left parotid and 8.12% for the right parotid. The average volume overlap was 91.1% ± 1.6% for the left parotid and 90.5% ± 2.4% for the right parotid. The parotid gland volume reduction at follow-up was 25% at 3 months, 27% at 6 months, and 16% at 12 months. Conclusions: We have validated

  11. Clinical evidence for Japanese population based on prospective studies--linking clinical trials and clinical practice. (United States)

    Ogawa, Hisao; Kojima, Sunao


    "Evidence-based medicine (EBM)" implies effective and high quality practice for patients based on well-grounded medical science. The success of clinical trials in Japan is essential to build original evidence specific for Japanese patients. Based on this concept, we have performed several large-scale clinical trials to provide EBM, including the Japanese Antiplatelets Myocardial Infarction Study [JAMIS; clinical improvement in acute myocardial infarction (AMI) patients with antiplatelet therapy], the Japanese beta-Blockers and Calcium Antagonists Myocardial Infarction (JBCMI; comparison of the effects of beta-blockers and calcium antagonists on cardiovascular events in post-AMI patients), a multicenter study for aggressive lipid-lowering strategy by HMG-CoA reductase inhibitors in patients with AMI (MUSASHI; effects of statin therapy on cardiovascular events in patients with AMI), and the Japanese Primary Prevention of Atherosclerosis with Aspirin for Diabetes (JPAD trial; efficacy of low-dose aspirin therapy for primary prevention of atherosclerotic events in type 2 diabetic patients). The results of these prospective studies were directly linked with clinical practice. We have acquired the know-how of large-scale clinical trials; an important point is to have passion for "buildup evidence specific for the Japanese" and to recruit subjects for enrollment after explaining the significance of "clinical trials for the Japanese".

  12. Cardiovascular drugs : discrepancies in demographics between pre- and post-registration use

    NARCIS (Netherlands)

    Wieringa, NF; de Graeff, PA; van der Werf, GT; Vos, R


    Objectives: To study discrepancies in demographic characteristics between patients participating in pre-registration phase III trials of cardiovascular drugs, registered in the Netherlands, and patient populations in daily practice representing the actual users of the drugs after registration. Metho


    Directory of Open Access Journals (Sweden)



    Full Text Available Retinal vein occlusion is the most common retinal occlusive disorder encountered by opthalmologists and is usually associated with a variable amount of visual loss.The study was conducted over a period of 22 months, we performed a combined analysis of risk factors, clinical presentation, management and complication of these 51 patients

  14. Accelerated gradient-based free form deformable registration for online adaptive radiotherapy (United States)

    Yu, Gang; Liang, Yueqiang; Yang, Guanyu; Shu, Huazhong; Li, Baosheng; Yin, Yong; Li, Dengwang


    The registration of planning fan-beam computed tomography (FBCT) and daily cone-beam CT (CBCT) is a crucial step in adaptive radiation therapy. The current intensity-based registration algorithms, such as Demons, may fail when they are used to register FBCT and CBCT, because the CT numbers in CBCT cannot exactly correspond to the electron densities. In this paper, we investigated the effects of CBCT intensity inaccuracy on the registration accuracy and developed an accurate gradient-based free form deformation algorithm (GFFD). GFFD distinguishes itself from other free form deformable registration algorithms by (a) measuring the similarity using the 3D gradient vector fields to avoid the effect of inconsistent intensities between the two modalities; (b) accommodating image sampling anisotropy using the local polynomial approximation-intersection of confidence intervals (LPA-ICI) algorithm to ensure a smooth and continuous displacement field; and (c) introducing a ‘bi-directional’ force along with an adaptive force strength adjustment to accelerate the convergence process. It is expected that such a strategy can decrease the effect of the inconsistent intensities between the two modalities, thus improving the registration accuracy and robustness. Moreover, for clinical application, the algorithm was implemented by graphics processing units (GPU) through OpenCL framework. The registration time of the GFFD algorithm for each set of CT data ranges from 8 to 13 s. The applications of on-line adaptive image-guided radiation therapy, including auto-propagation of contours, aperture-optimization and dose volume histogram (DVH) in the course of radiation therapy were also studied by in-house-developed software.

  15. Good clinical practices in phase I studies. (United States)

    Decousus, H; Perpoint, B; Mismetti, P; Ollagnier, M; Queneau, P


    In France, official guidelines for good clinical practices in clinical trials were issued in 1987. In December 1988, a law was passed that fixed the requirements for carrying out experiments in healthy subjects. It will be completed by official guidelines for the structures in which experiments on healthy subjects (and patients as well, when the investigation would not benefit the health of the patients) may be conducted. Hence a battery of recent legal instructions precisely state what good clinical practices are in the setting of phase I studies. Of particular importance are: subject recruitment and selection methods and procedures; specific competence of the investigator, in particular to interpret the pre-trial data; necessary and sufficient facilities to guarantee the subjects' safety; careful quality control to check all laboratory procedures; necessity of written standard operating procedures.

  16. Left ventricular noncompaction: Clinical-echocardiographic study

    Directory of Open Access Journals (Sweden)

    Nikolić Aleksandra


    Full Text Available Background/Aim. Left ventricular noncompaction (LVNC is a disorder in endomyocardial morphogenesis, seen either isolated (in the absence of other cardiac anomalies or in association with congenital heart disease and some neuromuscular diseases. Intrauterine arrest of the compaction of myocardial fibers is postulated to be the reason of LVNC. Recognition of this condition is extremely important due to its high mortality and morbidity that lead to progressive heart failure, ventricular arrhythmias and thromboembolic events. The aim of this study was to determine the prevalence and clinical presentation of LVNC among consecutive outpatients according to clinical and echocardiographyic findings. Methode. A total of 3,854 consecutive patients examined at the Institute for Cardiovascular Diseases within a period January 2006 - January 2007 were included in the study. All the patients underwent echocardiographic examination using the same equipment (Vivid 7, GE Medical System. Echocardiographic parameters and clinical presentation in patients with echocardiographic criteria for LVNC were analyzed. Results. Analyzing 3,854 consecutive outpatients, using two-dimensional Color Doppler echocardiography from January 2006 to January 2007, 12 patients met the criteria for LVNC. Seven of them were male. The mean age at diagnosis was 45 ± 15 years. Analyzing clinical manifestation of LVNC it was found that seven patients had signs of heart failure, six had arrhythmias with no embolic events. Conclusion. Our results suggest that the real prevalence of LVNC may be higher than expected. New studies have to be done to solve this problem.

  17. Registration Delay and Student Performance (United States)

    Siefken, Jason


    Tracking the difference between the time a first-year student is allowed to register for a course and the time he or she does register for a course (a student's registration delay), we notice a negative correlation between registration delay and final grade in a course. The difference between a student who registers within the first two minutes…

  18. 16 CFR 1130.8 - Requirements for Web site registration or alternative e-mail registration. (United States)


    ... registration. (a) Link to registration page. The manufacturer's Web site, or other Web site established for the... web page that goes directly to “Product Registration.” (b) Purpose statement. The registration page... registration page. The Web site registration page shall request only the consumer's name, address,...

  19. Trials registration: a new era in Thailand. (United States)

    Kulvichit, Kittisak; Tulvatana, Wasee; Thinkhamrop, Bandit; Tatsanavivat, Pyatat


    Registration of clinical trials or research can result in many benefits. Patients have access to pertinent information. We have a better and more indicative picture of research status in areas where registration is mandatory. Researchers can use the information to form a common interest group and collaborate their research as well as to avoid unnecessary duplication. Registered information can also enable detection of defective design and can lead to improvements of trial protocol or its implementation. Most importantly, it can help to reduce problems of publication bias and selective reporting. Journals do not like to publish negative or inconclusive results. Pharmaceutical companies are reluctant to report results that may jeopardize their revenue. We need absolute transparency to utilize evidence with trust.

  20. A-mode ultrasound-based registration in computer-aided surgery of the skull. (United States)

    Amstutz, Christoph; Caversaccio, Marco; Kowal, Jens; Bächler, Richard; Nolte, Lutz-Peter; Häusler, Rudolf; Styner, Martin


    To evaluate the integration and accuracy of A (amplitude)-mode ultrasound-based surface matching for noninvasive registration of the head into a frameless computer-aided surgery system for otorhinology and skull base surgery. Experimental study and case series. Academic medical center. Twelve patients underwent anterior and paranasal skull base surgery with the routine use of a computer-aided surgery system. A computer-aided surgery system, based on an optoelectronic localizer, was used to track the skull and the surgical tools, including the A-mode ultrasound probe. The A-mode probe was a 10-MHz immersion transducer. An acoustic lens attached to the transducer focused the ultrasonic beam to a depth of 1 to 10 mm. Accuracy tests were performed for the ultrasound setup. Different surface point distributions were evaluated with respect to matching accuracy on a human cadaver skull specimen equipped with fiducial markers. The matching comparison was based on the fiducial registration error. For the clinical evaluation, the laboratory setup was transferred to the operating room. Noninvasive registration of the skull by using A-mode ultrasound in computer-aided surgery (practical and clinical measurements). The accuracy tests on the human skull specimen revealed that the mean +/- SD fiducial registration error was 1.00 +/- 0.19 mm in the best series for A-mode ultrasound surface matchings and was robust with respect to different sets of surface points. The mean +/- SD root mean square error from the 12 A-mode ultrasound matchings in the patient study was 0.49 +/- 0.20 mm. A-mode ultrasound surface matching can be used as a noninvasive and accurate registration procedure in computer-aided surgery of the head.

  1. Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study

    Directory of Open Access Journals (Sweden)

    Samantha Sevenhuysen


    Full Text Available Question: What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL activities, compared to a traditional paired teaching approach? Design: Qualitative study utilising focus groups. Participants: Twenty-four physiotherapy students and 12 clinical educators. Intervention: Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies. Results: Peer-assisted learning appears to reduce the students’ anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Conclusion: Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. Registration: ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015 Physiotherapy students and clinical educators perceive several ways in which

  2. dPIRPLE: a joint estimation framework for deformable registration and penalized-likelihood CT image reconstruction using prior images (United States)

    Dang, H.; Wang, A. S.; Sussman, Marc S.; Siewerdsen, J. H.; Stayman, J. W.


    Sequential imaging studies are conducted in many clinical scenarios. Prior images from previous studies contain a great deal of patient-specific anatomical information and can be used in conjunction with subsequent imaging acquisitions to maintain image quality while enabling radiation dose reduction (e.g., through sparse angular sampling, reduction in fluence, etc). However, patient motion between images in such sequences results in misregistration between the prior image and current anatomy. Existing prior-image-based approaches often include only a simple rigid registration step that can be insufficient for capturing complex anatomical motion, introducing detrimental effects in subsequent image reconstruction. In this work, we propose a joint framework that estimates the 3D deformation between an unregistered prior image and the current anatomy (based on a subsequent data acquisition) and reconstructs the current anatomical image using a model-based reconstruction approach that includes regularization based on the deformed prior image. This framework is referred to as deformable prior image registration, penalized-likelihood estimation (dPIRPLE). Central to this framework is the inclusion of a 3D B-spline-based free-form-deformation model into the joint registration-reconstruction objective function. The proposed framework is solved using a maximization strategy whereby alternating updates to the registration parameters and image estimates are applied allowing for improvements in both the registration and reconstruction throughout the optimization process. Cadaver experiments were conducted on a cone-beam CT testbench emulating a lung nodule surveillance scenario. Superior reconstruction accuracy and image quality were demonstrated using the dPIRPLE algorithm as compared to more traditional reconstruction methods including filtered backprojection, penalized-likelihood estimation (PLE), prior image penalized-likelihood estimation (PIPLE) without registration, and

  3. Reversal of dental fluorosis: A clinical study. (United States)

    Mehta, Dhaval N; Shah, Jigna


    This study was conducted to evaluate the clinical reversal of dental fluorosis with various combinations of calcium, vitamin D3, and ascorbic acid, along with changes in levels of certain biochemical parameters concerned with dental fluorosis. The role of fluoride level of drinking water in the etiology of dental fluorosis and the prevalence of dental fluorosis in both dentitions and teeth were also assessed. A total number of 50 patients with clinical features of dental fluorosis without trauma and any adverse habits were selected. Of these, in 30 co-operative patients, estimation of water fluoride level and pretreatment and post-treatment serum and urine fluoride levels were done with ion selective electrode method. The selected 30 patients were divided into three groups, that is, group A, group B, and group C, and were given various combinations of medications like calcium with vitamin D3 supplements, ascorbic acid with vitamin D3 supplements, and chlorhexidine mouthwash (placebo) for three months, respectively. These 30 patients were assessed for any change in the clinical grading of dental fluorosis. No change in clinical grading of dental fluorosis was noted. Considerable reduction in serum and urine fluoride levels was noted in both group A and group B patients. Dental fluorosis was noted in permanent teeth more commonly than deciduous teeth, and permanent maxillary central incisors had the highest prevalence rate. This study comprises only 30 patients with three months of follow-up. So, this sample of patients and duration of follow-up period are conclusive to observe changes in biochemical parameters but not sufficient to observe changes in clinical grading.

  4. Fast parallel image registration on CPU and GPU for diagnostic classification of Alzheimer's disease

    NARCIS (Netherlands)

    D.P. Shamonin (Denis); E.E. Bron (Esther); B.P.F. Lelieveldt (Boudewijn); M. Smits (Marion); S.K. Klein (Stefan); M. Staring (Marius)


    textabstractNonrigid image registration is an important, but time-consuming task in medical image analysis. In typical neuroimaging studies, multiple image registrations are performed, i.e., for atlas-based segmentation or template construction. Faster image registration routines would therefore be

  5. Fast parallel image registration on CPU and GPU for diagnostic classification of Alzheimer's disease

    NARCIS (Netherlands)

    Shamonin, D.P.; Bron, E.E.; Lelieveldt, B.P.F.; Smits, M.; Klein, S.; Staring, M.


    Nonrigid image registration is an important, but time-consuming task in medical image analysis. In typical neuroimaging studies, multiple image registrations are performed, i.e., for atlas-based segmentation or template construction. Faster image registration routines would therefore be beneficial.

  6. Nail disorders in children, a clinical study

    Directory of Open Access Journals (Sweden)

    Ayşe Akbaş


    Full Text Available Introduction: Aims of the study to investigate the frequency and the nature ofnail disorders in children significant clinical data is available. Nail disorders although common in children in some parts of our country. This study was carried out to document the clinical and demographic pattern of nail disorders in a dermatology outpatient clinic of a pediatric hospital in Ankara, Turkey. Material and Methods: All consecutive patients a total of 3000 children from age 0-16 were admitted to dermatology outpatient clinic of Ankara Pediatric Hematology and Oncology Education and Research Hospital during January 2011 to December 2011 were studied and retrospectively evaluated for age, gender, drug use, diseases, systemic or genetic disorders and demographic features. Diagnostic evaluation results were noted and patients were categorized for demographic features and diagnosis. Results: These 133 patients (M: F 58:75, %44 vs 56, respectively were under 16 years of age and have 17 different dermatological disorders related with nail symptoms. Fifty three of (39,8% these patient were under 2 years of age, 31 (23.3% were between 3-5 years, 30 (22.5% were between 6-11 years old, 19 of 133 (14%, 2 were between 11-16 years of age. Through all of ages and independent of gender the most etiologies of nail disorders were, onychomadesis, paronychia, onycholysis, onychomycosis and systemic nail presentation of systemic dermatosis. Conclusion: Nail disorders are different in children than in adults. In our study, the first 5 years of age was found in 53% of nail disorders. Nail disorders are uncommon but may be seen as a part of a systemic disease and may be associated with cosmetic and psychologic problem.

  7. Clinical and histopathological study of palmoplantar keratoderma

    Directory of Open Access Journals (Sweden)

    Mahajan P


    Full Text Available Study of palmo-plantar keratoderma in eighty-two cases showed that twenty different diseases, both hereditary and acquired were responsible for palmoplantar keratoderma. Maximum number of cases were of hereditary variety of palmoplantar keratoderma (Unna-Thost syndrome (28.05%. Whereas psoriasis was the leading cause among the acquired conditions (17.07%. Two histopathological types of Unna-Thost syndrome and their correlation with clinical features are reported.

  8. Pre-registration adult nurses' knowledge of safe transfusion practice: Results of a 12 month follow-up study. (United States)

    Smith, Fiona C; Donaldson, Jayne; Pirie, Liz


    This research project ascertained student nurses' knowledge retention of safe transfusion practice following a standardised teaching and learning programme (produced by the Scottish National Blood Transfusion Service, United Kingdom (UK)) within a School of Nursing in Scotland, UK. Several studies including the Serious Hazard of Transfusion (SHOT) annual reports demonstrated that there are risks to the patient in receiving blood components: receiving the wrong blood was the most common risk associated with blood transfusion (Ottewill, 2003; SHOT, 2007). This evaluative study used a questionnaire to assess the level of knowledge students (n=118) attained on the day of the session, 4-6 months and 11-12 months following the session. The study provided an insight into the effectiveness of a standardised teaching approach and highlighted areas for review in light of incorrect answers elicited. Despite all receiving the Standardised Programme, there was a wide range of initial overall scores achieved. The study demonstrated, within the small sample completing at all 3 time points, that there is clear degradation of knowledge during the study period. The influence of experience on knowledge retention appears to have a positive effect at 6 months but no appreciable effect at 12 months. These outcomes merit further, more robust and multi centre investigation to identify if there is replication of results.

  9. Clinical and Statistical Study on Canine Impaction

    Directory of Open Access Journals (Sweden)

    Adina-Simona Coșarcă


    Full Text Available Aim: The aim of this study was to perform a clinical and statistical research on permanent impacted canine patients among those with dental impaction referred to and treated at the Oral and Maxillo-Facial Surgery Clinic of Tîrgu Mureș, over a four years period (2009-2012. Materials and methods: The study included 858 patients having dental impaction, and upon clinical records, different parameters, like frequency, gender, age, quadrant involvement, patient residence, associated complications, referring specialist and type of treatment, related to canine impaction, were assessed. Results: The study revealed: about 10% frequency of canine impaction among dental impactions; more frequent in women, in the first quadrant (tooth 13; most cases diagnosed between the age of 10-19 years; patients under 20 were referred by an orthodontist, those over 20 by a dentist; surgical exposure was more often performed than odontectomy. Conclusions: Canine impaction is the second-most frequent dental impaction in dental arch after third molars; it occurs especially in women. Due to its important role, canine recovery within dental arch is a goal to be achieved, whenever possible. Therefore, diagnose and treatment of canine impaction requires an interdisciplinary approach (surgical and orthodontic

  10. 3D-2D image registration for target localization in spine surgery: investigation of similarity metrics providing robustness to content mismatch (United States)

    De Silva, T.; Uneri, A.; Ketcha, M. D.; Reaungamornrat, S.; Kleinszig, G.; Vogt, S.; Aygun, N.; Lo, S.-F.; Wolinsky, J.-P.; Siewerdsen, J. H.


    In image-guided spine surgery, robust three-dimensional to two-dimensional (3D-2D) registration of preoperative computed tomography (CT) and intraoperative radiographs can be challenged by the image content mismatch associated with the presence of surgical instrumentation and implants as well as soft-tissue resection or deformation. This work investigates image similarity metrics in 3D-2D registration offering improved robustness against mismatch, thereby improving performance and reducing or eliminating the need for manual masking. The performance of four gradient-based image similarity metrics (gradient information (GI), gradient correlation (GC), gradient information with linear scaling (GS), and gradient orientation (GO)) with a multi-start optimization strategy was evaluated in an institutional review board-approved retrospective clinical study using 51 preoperative CT images and 115 intraoperative mobile radiographs. Registrations were tested with and without polygonal masks as a function of the number of multistarts employed during optimization. Registration accuracy was evaluated in terms of the projection distance error (PDE) and assessment of failure modes (PDE  >  30 mm) that could impede reliable vertebral level localization. With manual polygonal masking and 200 multistarts, the GC and GO metrics exhibited robust performance with 0% gross failures and median PDE  registration to fail at a rate of  >14% however, GO maintained robustness with a 0% gross failure rate. Overall, the GI, GC, and GS metrics were susceptible to registration errors associated with content mismatch, but GO provided robust registration (median PDE  =  5.5 mm, 2.6 mm IQR) without manual masking and with an improved runtime (29.3 s). The GO metric improved the registration accuracy and robustness in the presence of strong image content mismatch. This capability could offer valuable assistance and decision support in spine level localization in a

  11. Three modality image registration of brain SPECT/CT and MR images for quantitative analysis of dopamine transporter imaging (United States)

    Yamaguchi, Yuzuho; Takeda, Yuta; Hara, Takeshi; Zhou, Xiangrong; Matsusako, Masaki; Tanaka, Yuki; Hosoya, Kazuhiko; Nihei, Tsutomu; Katafuchi, Tetsuro; Fujita, Hiroshi


    Important features in Parkinson's disease (PD) are degenerations and losses of dopamine neurons in corpus striatum. 123I-FP-CIT can visualize activities of the dopamine neurons. The activity radio of background to corpus striatum is used for diagnosis of PD and Dementia with Lewy Bodies (DLB). The specific activity can be observed in the corpus striatum on SPECT images, but the location and the shape of the corpus striatum on SPECT images only are often lost because of the low uptake. In contrast, MR images can visualize the locations of the corpus striatum. The purpose of this study was to realize a quantitative image analysis for the SPECT images by using image registration technique with brain MR images that can determine the region of corpus striatum. In this study, the image fusion technique was used to fuse SPECT and MR images by intervening CT image taken by SPECT/CT. The mutual information (MI) for image registration between CT and MR images was used for the registration. Six SPECT/CT and four MR scans of phantom materials are taken by changing the direction. As the results of the image registrations, 16 of 24 combinations were registered within 1.3mm. By applying the approach to 32 clinical SPECT/CT and MR cases, all of the cases were registered within 0.86mm. In conclusions, our registration method has a potential in superimposing MR images on SPECT images.

  12. 2D/3D registration for X-ray guided bronchoscopy using distance map classification. (United States)

    Xu, Di; Xu, Sheng; Herzka, Daniel A; Yung, Rex C; Bergtholdt, Martin; Gutierrez, Luis F; McVeigh, Elliot R


    In X-ray guided bronchoscopy of peripheral pulmonary lesions, airways and nodules are hardly visible in X-ray images. Transbronchial biopsy of peripheral lesions is often carried out blindly, resulting in degraded diagnostic yield. One solution of this problem is to superimpose the lesions and airways segmented from preoperative 3D CT images onto 2D X-ray images. A feature-based 2D/3D registration method is proposed for the image fusion between the datasets of the two imaging modalities. Two stereo X-ray images are used in the algorithm to improve the accuracy and robustness of the registration. The algorithm extracts the edge features of the bony structures from both CT and X-ray images. The edge points from the X-ray images are categorized into eight groups based on the orientation information of their image gradients. An orientation dependent Euclidean distance map is generated for each group of X-ray feature points. The distance map is then applied to the edge points of the projected CT images whose gradient orientations are compatible with the distance map. The CT and X-ray images are registered by matching the boundaries of the projected CT segmentations to the closest edges of the X-ray images after the orientation constraint is satisfied. Phantom and clinical studies were carried out to validate the algorithm's performance, showing a registration accuracy of 4.19(± 0.5) mm with 48.39(± 9.6) seconds registration time. The algorithm was also evaluated on clinical data, showing promising registration accuracy and robustness.

  13. Clinical, biochemical & cytomorphologic study on Hashimoto's thyroiditis (United States)

    Thomas, Tina; Sreedharan, Suja; Khadilkar, Urmila N.; Deviprasad, D; Kamath, M. Panduranga; Bhojwani, Kiran M.; Alva, Arathi


    Background & objectives: Despite, the extensive salt iodization programmes implemented in India, the prevalence of goiter has not reduced much in our country. The most frequent cause of hypothyroidism and goiter in iodine sufficient areas is Hashimoto's thyroiditis (HT). This study records the clinical presentation, biochemical status, ultrasonographic picture and cytological appearance of this disease in a coastal endemic zone for goiter. Methods: Case records of patients with cytological diagnosis of HT were studied in detail, with reference to their symptoms, presence of goiter, thyroid function status, antibody levels and ultrasound picture. Detailed cytological study was conducted in selected patients. Results: A total of 144 patients with cytological proven HT/lymphocytic thyroiditis were studied. Ninety per cent of the patients were females and most of them presented within five years of onset of symptoms. Sixty eight per cent patients had diffuse goiter, 69 per cent were clinically euthyroid and 46 per cent were biochemically mildly hypothyroid. Antibody levels were elevated in 92.3 per cent cases. In majority of patients the sonographic picture showed heterogeneous echotexture with increased vascularity. Cytological changes were characteristic. Interpretation & conclusions: Our study showed predominance of females in the study population in 21-40 yr age group with diffuse goiter. We suggest that in an endemic zone for goiter, all women of the child bearing age should be screened for HT. PMID:25758571

  14. Clinical study on osteoradionecrosis of the jaws

    Energy Technology Data Exchange (ETDEWEB)

    Okano, Atsuo; Kato, Joji


    In the present study osteoradionecrosis which had developed after radiotherapy for malignant tumor was studied clinically and therapeutically and the following results were obtained. 1. The subjects were 28 patients with squamous cell carcinoma and 2 patients with adenoid cystic carcinoma aged 38 to 72. The ratio of male: female was 3.3 : 1. The time of manifestation was 1 month-14 years after irradiation. The main symptoms were pain and exposed bone mainly in the region of mandibular molar tooth. 2. Osteoradionecrosis was observed in 10 cases supposed to be induced by tooth extraction but also in 5 edentulous cases. 3. When the osteoradionecrosis cases were classified into limited area type and wide range type on the basis of clinical findings. X-ray of the jaws showed the presence of bone resorption and induration together in many wide range type cases. 4. Scintigram of bone showed widespread accumulation of radiation even in clinically limited area type, and the picture of some loss of bone and the intensity of the accumulation were considered to be extremely useful as an index in making therapeutical plans and decisions on the prognosis of tumor of the jaws. 5. As the method of treatment, sequestrectomy was performed in 14 of 19 cases of the limited area type and 4 of 11 cases of the wide range type and excision of the jaws in 4 cases. 6. Hyperbaric oxygen therapy was carried out in 3 cases and had good effect. (J.P.N.).

  15. Pose-aware C-arm for automatic re-initialization of interventional 2D/3D image registration. (United States)

    Fotouhi, Javad; Fuerst, Bernhard; Johnson, Alex; Lee, Sing Chun; Taylor, Russell; Osgood, Greg; Navab, Nassir; Armand, Mehran


    In minimally invasive interventions assisted by C-arm imaging, there is a demand to fuse the intra-interventional 2D C-arm image with pre-interventional 3D patient data to enable surgical guidance. The commonly used intensity-based 2D/3D registration has a limited capture range and is sensitive to initialization. We propose to utilize an opto/X-ray C-arm system which allows to maintain the registration during intervention by automating the re-initialization for the 2D/3D image registration. Consequently, the surgical workflow is not disrupted and the interaction time for manual initialization is eliminated. We utilize two distinct vision-based tracking techniques to estimate the relative poses between different C-arm arrangements: (1) global tracking using fused depth information and (2) RGBD SLAM system for surgical scene tracking. A highly accurate multi-view calibration between RGBD and C-arm imaging devices is achieved using a custom-made multimodal calibration target. Several in vitro studies are conducted on pelvic-femur phantom that is encased in gelatin and covered with drapes to simulate a clinically realistic scenario. The mean target registration errors (mTRE) for re-initialization using depth-only and RGB [Formula: see text] depth are 13.23 mm and 11.81 mm, respectively. 2D/3D registration yielded 75% success rate using this automatic re-initialization, compared to a random initialization which yielded only 23% successful registration. The pose-aware C-arm contributes to the 2D/3D registration process by globally re-initializing the relationship of C-arm image and pre-interventional CT data. This system performs inside-out tracking, is self-contained, and does not require any external tracking devices.



    青木, 正治; 熊本, 悦明


    Clinical statistical studies on hematuria were performed in outpatients who were seen at our Department, during the 7-year period from 1974 through 1980. Of the 11,574 outpatients studied, the total number of outpatients with hematuria 1,705; macroscopic hematuria was found in 446 cases (3.9%) and microscopic hematuria was in 1,259 cases (10.9%). The most frequent cause of macroscopic hematuria was malignant urinary tumors and that of microscopic hematuria was urinary tract infections. Macros...

  17. Pro Forma Registration of Companies

    DEFF Research Database (Denmark)

    Werlauff, Erik


    The article analyses the view taken by Community law on companies' pro forma registration in another EU or EEA country. Community law recognises pro forma registration under company law, i.e. a brass plate is sufficient, whereas it does not recognise pro forma registration under tax law, i.......e. a brass plate is not sufficient. The article provides reasons for the differential treatment of the two contexts and clarifies the difference on the basis of the Hubbard criterion, in which it was ruled that the effectiveness of Community law cannot vary according to the various branches of national law....

  18. Clinical Study on Ocular Trauma in Children

    Institute of Scientific and Technical Information of China (English)

    Zicai Huang; Hongni Li; Yixia Huang; Zhongxia Zhou


    Purpose: To investigate the clinical characteristics of ocular trauma in children and put forward the major treatment and prevention of ocular trauma in children.Methods: To analyze the clinical data by 77 eyes in 77 cases of ocular trauma in children from April 1999 to February 2002. Results: The male and female were in the ratio of 2.21: 1. Right eye ocular traumas were more than left ones. Ocular penetrating trauma was 83.12% and blunt trauma 12.99%. 41 cases (53.25%) were injured by themselves while 33 cases by others. 90.91% patients came from the countryside.Conclusion: The rate of blindness of children with ocular trauma could be reduced by prompt treatment. The study indicated that ocular trauma preventive publicity should be faced in the countryside in order to improve the understanding of the severity of ocular trauma and treat it as a social problem.

  19. Robust diffusion imaging framework for clinical studies

    CERN Document Server

    Maximov, Ivan I; Neuner, Irene; Shah, N Jon


    Clinical diffusion imaging requires short acquisition times and good image quality to permit its use in various medical applications. In turn, these demands require the development of a robust and efficient post-processing framework in order to guarantee useful and reliable results. However, multiple artefacts abound in in vivo measurements; from either subject such as cardiac pulsation, bulk head motion, respiratory motion and involuntary tics and tremor, or imaging hardware related problems, such as table vibrations, etc. These artefacts can severely degrade the resulting images and render diffusion analysis difficult or impossible. In order to overcome these problems, we developed a robust and efficient framework enabling the use of initially corrupted images from a clinical study. At the heart of this framework is an improved least trimmed squares diffusion tensor estimation algorithm that works well with severely degraded datasets with low signal-to-noise ratio. This approach has been compared with other...

  20. Cryogenic Thermophysical Studies for Clinical Medicine

    Institute of Scientific and Technical Information of China (English)



    Cryogenic technology has been widely used in clinical medicine and in pharmaceutics, so thermophysical studies are extremely important to solve problems during freezing and thawing. This paper reports some recent research in clinical medicine, including cryo-injury, cryosurgery, and cryopreservation of some important cells and tissues. Microscopic images of the freezing process with a cryomicroscope system show that the dendritic ice growth is affected by the solution concentration, the cooling rate, and the number of embryos. An enthalpy method is used for the freeze-thaw analysis of the cryosurgery with a program developed to predict the temperature profile and the interface motion, which compares well with experimental results. A very rapid cooling technique is developed by quenching the samples into subcooled liquid nitrogen for vitrification of cells and tissues. An analytical method developed to prevent the fracture of arteries during freezing has been verified by the electronic microscopic investigation.

  1. Transcranial Direct Current Stimulation and Power Spectral Parameters: a tDCS/EEG co-registration study

    Directory of Open Access Journals (Sweden)

    Anna Lisa Mangia


    Full Text Available Transcranial direct current stimulation (tDCS delivers low electric currents to the brain through the scalp. Constant electric currents induce shifts in neuronal membrane excitability, resulting in secondary changes in cortical activity. Concomitant electroencephalography (EEG monitoring during tDCS can provide valuable information on the tDCS mechanisms of action. This study examined the effects of anodal tDCS on spontaneous cortical activity in a resting brain to disclose possible modulation of spontaneous oscillatory brain activity. EEG activity was measured in ten healthy subjects during and after a session of anodal stimulation of the postero-parietal cortex to detect the tDCS-induced alterations. Changes in the theta, alpha, beta and gamma power bands were investigated. Three main findings emerged: 1 an increase in theta band activity during the first minutes of stimulation; 2 an increase in alpha and beta power during and after stimulation; 3 a widespread activation in several brain regions.

  2. Secondary diabetic ketoacidosis and severe hypoglycaemia in patients with established type 1 diabetes mellitus in China: a multicentre registration study. (United States)

    Li, Jin; Yang, Daizhi; Yan, Jinhua; Huang, Bin; Zhang, Yan; Weng, Jianping


    Diabetic ketoacidosis (DKA) and severe hypoglycaemia are common acute complications of type 1 diabetes mellitus (T1DM). This study aimed to determine the incidence of, and risk factors for, these complications in Chinese patients with established T1DM. This cross-sectional study recruited patients with established T1DM from 16 centres in Guangdong Province, China. Incidence rates were expressed as episodes/100 patient-years. Regression models identified risk factors for the occurrence and recurrence of secondary DKA and severe hypoglycaemia. A total of 611 patients with established T1DM (53.7% women) were recruited. The incidence of secondary DKA and severe hypoglycaemia was 26.4 (22.4, 31.0) and 68.8 (62.2, 76.0)/100 patient-years, respectively. Significant risk factors for secondary DKA were female gender [relative risk (RR) = 2.12], medical reimbursement rate diet (RR = 1.76), smoking (RR = 2.18) and poor glycaemic control [glycated haemoglobin A1c (HbA1c)/1.0% increase; RR = 1.15]. Overweight/obesity was a protective factor (RR = 0.57). Significant risk factors for severe hypoglycaemia included male gender (RR = 1.71), medical reimbursement rate diet ('never controlled' or 'sometimes controlled' vs. 'usually controlled', RR = 2.09 or 2.02, respectively), exercise control modifiable risk factors. Copyright © 2014 John Wiley & Sons, Ltd.

  3. Improvement of drug exposure data in a registration of congenital anomalies. Pilot-study : Pharmacist and mother as sources for drug exposure data during pregnancy

    NARCIS (Netherlands)

    Van den Berg, LTWDJ; Feenstra, N; Sorensen, HT; Cornel, MC


    We examined the possibilities of improving the retrospective collection of data an drug use during pregnancy. The European Registration of Congenital Anomalies (EUROCAT) has registered information on maternal drug exposure in the northern Netherlands through a question on the notification form for t

  4. Computer Registration Becoming Mandatory

    CERN Multimedia


    Following the decision by the CERN Management Board (see Weekly Bulletin 38/2003), registration of all computers connected to CERN's network will be enforced and only registered computers will be allowed network access. The implementation has started with the IT buildings, continues with building 40 and the Prevessin site (as of Tuesday 4th November 2003), and will cover the whole of CERN before the end of this year. We therefore recommend strongly that you register all your computers in CERN's network database (Ethernet and wire-less cards) as soon as possible without waiting for the access restriction to take force. This will allow you accessing the network without interruption and help IT service providers to contact you in case of problems (security problems, viruses, etc.) • Users WITH a CERN computing account register at: (CERN Intranet page) • Visitors WITHOUT a CERN computing account (e.g. short term visitors) register at:

  5. Computer Registration Becoming Mandatory

    CERN Multimedia


    Following the decision by the CERN Management Board (see Weekly Bulletin 38/2003), registration of all computers connected to CERN's network will be enforced and only registered computers will be allowed network access. The implementation has started with the IT buildings, continues with building 40 and the Prevessin site (as of Tuesday 4th November 2003), and will cover the whole of CERN before the end of this year. We therefore recommend strongly that you register all your computers in CERN's network database including all network access cards (Ethernet AND wireless) as soon as possible without waiting for the access restriction to take force. This will allow you accessing the network without interruption and help IT service providers to contact you in case of problems (e.g. security problems, viruses, etc.) Users WITH a CERN computing account register at: (CERN Intranet page) Visitors WITHOUT a CERN computing account (e.g. short term visitors) register at:

  6. Long-range neural activity evoked by premotor cortex stimulation: a TMS/EEG co-registration study

    Directory of Open Access Journals (Sweden)

    Marco eZanon


    Full Text Available The premotor cortex is one of the fundamental structures composing the neural networks of the human brain. It is implicated in many behaviors and cognitive tasks, ranging from movement to attention and eye-related activity. Therefore, neural circuits that are related to premotor cortex have been studied to clarify their connectivity and/or role in different tasks. In the present work, we aimed to investigate the propagation of the neural activity evoked in the dorsal premotor cortex using transcranial magnetic stimulation/electroencephalography (TMS/EEG. Towards this end, interest was focused on the neural dynamics elicited in long-ranging temporal and spatial networks. Twelve healthy volunteers underwent a single-pulse TMS protocol in a resting condition with eyes closed, and the evoked activity, measured by EEG, was compared to a sham condition in a time window ranging from 45 msec to about 200 msec after TMS. Spatial and temporal investigations were carried out with sLORETA. TMS was found to induce propagation of neural activity mainly in the contralateral sensorimotor and frontal cortices, at about 130 msec after delivery of the stimulus. Different types of analyses showed propagated activity also in posterior, mainly visual, regions, in a time window between 70 and 130 msec. Finally, a likely rebounding activation of the sensorimotor and frontal regions, was observed in various time ranges. Taken together, the present findings further characterize the neural circuits that are driven by dorsal premotor cortex activation in healthy humans.

  7. [Shared web-based data center for multi-institutional clinical trials: evaluation of UMIN-INDICE (university hospital medical information network-internet data and information center for medical research)in clinical trials of JIVROSG (Japan interventional radiology in oncology study group)]. (United States)

    Sone, Miyuki; Arai, Yasuaki; Kiuchi, Takahiro; Ishikawa, Hirono; Aoki, Noriaki; Inaba, Yoshitaka; Yoshioka, Tetsuya; Aramaki, Takeshi; Kobayashi, Takeshi; Matsuoka, Toshiyuki; Anai, Hiroshi; Tanigawa, Noboru; Osuga, Keigo; Takeuchi, Yoshito; Okusaka, Takushi; Kanazawa, Susumu; Matsui, Osamu; Endo, Keigo


    A patient registration system is mandatory for establishing the scientific credibility of the multi-center clinical trials. The Japan Interventional Radiology in Oncology Study Group (JIVROSG) was organized in 2002 to establish evidence supporting the procedures used in interventional radiology. The Internet Data and Information Center for Medical Research (INDICE), provided by the University Hospital Medical Information Network(UMIN), has been utilized for patient registration in the clinical trials of JIVROSG. In this study, the safety and efficacy of UMIN-INDICE were evaluated. From 2002 to 2010, 18 clinical trials, including one international trial, were conducted. A total of 736 patients were enrolled from 51 institutions. No significant trouble was encountered during this period. A questionnaire survey demonstrated that 90% of participating researchers could use this system without difficulties. UMIN-INDICE may contribute to promoting clinical trials as an infrastructure of multicenter studies.

  8. [Depression and dementia: perspectives from clinical studies]. (United States)

    Nozaki, Shoko; Yoshimura, Kimio; Mimura, Masaru


    In this review, we present an overview of clinical studies that addressed the relationship between depression and dementia or cognitive decline. Cross-sectional studies and meta-analyses have repeatedly shown an association between late-life depression (LLD) and dementia, particularly Alzheimer's disease (AD) and vascular dementia; however, the findings of cohort studies have been inconsistent. Furthermore, studies on the association between depression with a younger age of onset and dementia have yielded inconsistent results. Regarding cognitive decline associated with LLD, several studies have reported an association between LLD and mild cognitive impairment, suggesting that depression itself can cause persistent cognitive impairment. Other studies have compared the cognitive profile between LLD and depression with a younger age of onset, but their results have been inconclusive, especially regarding the association between memory impairment and the age of onset of depression. LLD is associated with vascular change and white matter degeneration of the brain, as shown by magnetic resonance imaging (MRI). Recently, several studies reported an association between gray matter change and LLD. Studies currently in progress employ functional brain imaging methods such as single-photon emission computed tomography, functional MRI, and positron emission tomography. Clinically, it is important to understand how subtypes of depression can be defined in terms of risk of developing dementia, and to devise effective treatments. One paper explored the possibility of detecting depression associated with AD by measuring the blood Aβ40/Aβ42 levels, and other studies have suggested that symptoms of apathy and loss of interest are associated with conversion of depression to AD. Unfortunately, current antidepressants may have limited efficacy on depression with dementia; therefore, further investigation for devising methods of predicting conversion of depression to dementia and

  9. The right inferior frontal cortex in response inhibition: A tDCS-ERP co-registration study. (United States)

    Cunillera, Toni; Brignani, Debora; Cucurell, David; Fuentemilla, Lluís; Miniussi, Carlo


    In any given common situation, when an individual controls him/herself or obeys and stops a current action when asked to do, it is because the brain executes an inhibitory process. This ability is essential for adaptive behaviour, and it is also a requirement for accurate performance in daily life. It has been suggested that there are two main inhibitory functions related to behaviour, as inhibition is observed to affect behaviour at different time intervals. Proactive inhibition permits the subject to control his behavioural response over time by creating a response tendency, while reactive inhibition is considered to be a process that usually inhibits an already initiated response. In this context, it has been established that inhibitory function is implemented by specific fronto-basal-ganglia circuits. In the present study, we investigated the role of the right inferior frontal cortex (rIFC) in response inhibition by combining into a single task the Go-NoGo task and the Stop-Signal task. Concurrently, we applied transcranial direct current stimulation (tDCS) over the IFC and recorded electroencephalography (EEG). Thus, we obtained online EEG measurements of the tDCS-induced modifications in the IFC together with the participant's performance in a response inhibition task. We found that applying bilateral tDCS on the IFC (right anodal/left cathodal) significantly increased proactive inhibition, although the behavioural parameters indicative of reactive inhibition were unaffected by the stimulation. Finally, the inhibitory-P3 component reflected a similar modulation under both inhibitory conditions induced by the stimulation. Our data indicates that an online tDCS-ERP approach is achievable, but that a tDCS bilateral montage may not be the most efficient one for modulating the rIFC.

  10. Does novel oral anticoagulant improve anticoagulation for non-valvular atrial fibrillation associated stroke: An inpatient registration study in Shanghai

    Institute of Scientific and Technical Information of China (English)

    Feng-Di Liu; Rong Zhao; Xue-Mei Wang; Shuo Wang; Xiao-Lei Shen; Xiao-Xiao Tao; Bo Zheng


    Objective:To summarize the use rate,safety,efficacy of antithrombotics in stroke/transient ischemic attack (TIA) prevention,and reasons for not using dabigatran etexilate (DE) in Shanghai,China.Methods:Non-valvular atrial fibrillation (NVAF)-associated stroke patients were prospectively registered as an electronic database.Use rate of antithrombofics and reasons for not using DE were extracted during follow-up.Patients' baseline characteristics,recurrent ischemic stroke/TIA events and bleeding complications were analyzed.Patients:From April 2012 to August 2014,110 inpatients with NVAF-associated stroke were studied in our hospital.NVAF was diagnosed by 12-lead electrocardiogram,24 h Holter and echocardiography.Results:Before introduction of DE (April 2013),use rates of warfarin and antiplatelets were 28.9% (11/38) and 60.5% (23/38)respectively; after that,use rates of warfarin,DE,and antiplatelets were 20.8% (15/72),12.5% (9/72),and 43.1% (31/72).The DE did not improve use of anticoagulants (P =0.639).There were 19 (17.3%) recurrent ischemic stroke events up to October 2015; two (9.5%) in the non-user group,10 (18.5%) in the antiplatelet group,and seven (20.0%) in the anticoagulants group (P =0.570).Furthermore,recurrence rates were similar between the DE group (20.0%) and the Warfarin group (20.0%,P =1.000).The most common reason for not using DE was financial concerns (61.0%),followed by inconvenience to purchase (14.0%) and hemorrhage concerns (11.0%).Two patients using warfarin found fecal occult blood so they stopped warfarin and began to use antiplatelet drugs.No bleeding event occurred in the other groups.Only one patient had side effects (dyspepsia and gastroesophageal reflux)from DE.Conclusion:The use rate of either DE or warfarin in Shanghai was low; DE had not improved anticoagulation therapy for NVAF patients in Shanghai mainly because DE had not been covered by health insurance.

  11. Planning a study abroad clinical experience. (United States)

    Wright, Dolores J


    Not only is globalization expanding areas of human activity, it is also influencing the variety of educational offerings in universities. Therefore, globalization must be considered by nurse educators as they reevaluate ways of preparing nursing students to meet the health care needs of populations they currently serve and will care for in the future. Study abroad programs have been encouraged to be part of the college experience in the United States for more than 30 years; however, these programs have been relatively lacking in nursing education. Most of the study abroad programs described in the nursing literature are research-based or first-person accounts of an experience and provide little information about planning a study abroad program. This article describes a study abroad learning experience for senior nursing students and discusses the issues such as student selection, student safety, and available clinical experiences that need to be considered before undertaking such an endeavor.

  12. Drug Establishments Current Registration Site (United States)

    U.S. Department of Health & Human Services — The Drug Establishments Current Registration Site (DECRS) is a database of current information submitted by drug firms to register establishments (facilities) which...

  13. Spherical Demons: Fast Surface Registration (United States)

    Yeo, B.T. Thomas; Sabuncu, Mert; Vercauteren, Tom; Ayache, Nicholas; Fischl, Bruce; Golland, Polina


    We present the fast Spherical Demons algorithm for registering two spherical images. By exploiting spherical vector spline interpolation theory, we show that a large class of regularizers for the modified demons objective function can be efficiently implemented on the sphere using convolution. Based on the one parameter subgroups of diffeomorphisms, the resulting registration is diffeomorphic and fast – registration of two cortical mesh models with more than 100k nodes takes less than 5 minutes, comparable to the fastest surface registration algorithms. Moreover, the accuracy of our method compares favorably to the popular FreeSurfer registration algorithm. We validate the technique in two different settings: (1) parcellation in a set of in-vivo cortical surfaces and (2) Brodmann area localization in ex-vivo cortical surfaces. PMID:18979813

  14. Evaluation of 3 different registration techniques in image-guided bimaxillary surgery. (United States)

    Sun, Yi; Luebbers, Heinz-Theo; Agbaje, Jimoh Olubanwo; Schepers, Serge; Vrielinck, Luc; Lambrichts, Ivo; Politis, Constantinus


    Perioperative navigation is an upcoming tool in orthognathic surgery. This study aimed to access the feasibility of the technique and to evaluate the success rate of 3 different registration methods--facial surface registration, anatomic landmark-based registration, and template-based registration. The BrainLab navigation system (BrainLab AG, Feldkirchen, Germany) was used as an additional precision tool for 85 patients who underwent bimaxillary orthognathic surgery from February 2010 to June 2012. Eighteen cases of facial surface-based registration, 63 cases of anatomic landmark-based registration, and 8 cases of template-based registration were analyzed. The overall success rate of facial surface-based registration was 39%, which was significant lower than template-based (100%, P = 0.013) and anatomic landmark-based registration (95%, P bimaxillary orthognathic surgery has been proved to be feasible. The registration process is the critical point regarding success of intraoperative navigation. Anatomic landmark-based registration is a reliable technique for image-guided bimaxillary surgery. In contrast, facial surface-based registration is highly unreliable.

  15. A clinical and investigational study of donovanosis

    Directory of Open Access Journals (Sweden)

    Veeranna S


    Full Text Available A clinical and investigational study of 25 cases of Donovanosis was undertaken. The incidence was found to be 1.53% of all STD cases and 2.9% of GUD. M:F ratio was 2.12:1. Incidence was more in unmarried people. Fleshy exuberant type was seen in 88% of cases. Two patients (8% had extragenital ulcers. Donovan bodies were found in 88%. Pseudo elephantiasis was seen in 8 patients. Biopsy was done in 8 cases and showed ocanthosis, plasma cell infiltration and pseudo epitheliomatous hyperplasia. One patient developed squamous cell carcinoma of vulva.

  16. Implementing reflection: insights from pre-registration mental health students. (United States)

    Donovan, Moira O


    Reflection and reflective practice continues to be contentious issues in nursing. The focus of this article is the use of reflection by pre-registration mental health students. The broad aim of this preliminary study was to discover student mental health nurses' perceptions of reflection as a learning strategy during clinical placement. Using a constructivist grounded theory methodology [Charmaz, K., 2000. Grounded theory: Objectivist and Constructivist Methods. In: Denzin, N., Lincoln, Y. (Eds.), Handbook of Qualitative Research, second ed. Sage, Thousand Oaks, California], five students were interviewed individually in their clinical placements. Data analysis revealed three major categories: understanding the process of reflection, using reflection in clinical practice, and needing support and guidance. Findings indicated that students were primarily using reflection-on-action, but to varying extents. Overall, students felt that reflection facilitated their learning. Factors were discovered that both helped and hindered students' use of reflection. These included level of preparation to reflect, a limited culture of reflection and the level of support from preceptors, clinical staff, clinical placement co-ordinators, and lecturers. In conclusion, it appears that a collaborative approach between students, Health Service Providers and institutes of nursing is vital for the successful development and implementation of reflective learning strategies in clinical placement. Suggestions are made as to how a collaborative approach may be developed to enhance this process.

  17. Post-operative assessment in Deep Brain Stimulation based on multimodal images: registration workflow and validation (United States)

    Lalys, Florent; Haegelen, Claire; Abadie, Alexandre; Jannin, Pierre


    Object Movement disorders in Parkinson disease patients may require functional surgery, when medical therapy isn't effective. In Deep Brain Stimulation (DBS) electrodes are implanted within the brain to stimulate deep structures such as SubThalamic Nucleus (STN). This paper describes successive steps for constructing a digital Atlas gathering patient's location of electrodes and contacts for post operative assessment. Materials and Method 12 patients who had undergone bilateral STN DBS have participated to the study. Contacts on post-operative CT scans were automatically localized, based on black artefacts. For each patient, post operative CT images were rigidly registered to pre operative MR images. Then, pre operative MR images were registered to a MR template (super-resolution Collin27 average MRI template). This last registration was the combination of global affine, local affine and local non linear registrations, respectively. Four different studies were performed in order to validate the MR patient to template registration process, based on anatomical landmarks and clinical scores (i.e., Unified Parkinson's disease rating Scale). Visualisation software was developed for displaying into the template images the stimulated contacts represented as cylinders with a colour code related to the improvement of the UPDRS. Results The automatic contact localization algorithm was successful for all the patients. Validation studies for the registration process gave a placement error of 1.4 +/- 0.2 mm and coherence with UPDRS scores. Conclusion The developed visualization tool allows post-operative assessment for previous interventions. Correlation with additional clinical scores will certainly permit to learn more about DBS and to better understand clinical side-effects.

  18. 44 CFR 206.112 - Registration period. (United States)


    ... 44 Emergency Management and Assistance 1 2010-10-01 2010-10-01 false Registration period. 206.112... Households § 206.112 Registration period. (a) Initial period. The standard FEMA registration period is 60...) Extension of the registration period. The regional administrator or his/her designee may extend the...

  19. The role of image registration in brain mapping. (United States)

    Toga, A W; Thompson, P M


    Image registration is a key step in a great variety of biomedical imaging applications. It provides the ability to geometrically align one dataset with another, and is a prerequisite for all imaging applications that compare datasets across subjects, imaging modalities, or across time. Registration algorithms also enable the pooling and comparison of experimental findings across laboratories, the construction of population-based brain atlases, and the creation of systems to detect group patterns in structural and functional imaging data. We review the major types of registration approaches used in brain imaging today. We focus on their conceptual basis, the underlying mathematics, and their strengths and weaknesses in different contexts. We describe the major goals of registration, including data fusion, quantification of change, automated image segmentation and labeling, shape measurement, and pathology detection. We indicate that registration algorithms have great potential when used in conjunction with a digital brain atlas, which acts as a reference system in which brain images can be compared for statistical analysis. The resulting armory of registration approaches is fundamental to medical image analysis, and in a brain mapping context provides a means to elucidate clinical, demographic, or functional trends in the anatomy or physiology of the brain.

  20. Angular cheilitis: a clinical and microbial study. (United States)

    Ohman, S C; Dahlén, G; Möller, A; Ohman, A


    The purpose of this prospective study was to re-examine the relative importance of various factors in the pathogenesis of angular cheilitis. Sixty-four patients with cheilitis were examined clinically and microbiologically. In addition, a subsample of 23 patients was examined for serum iron and transferrin. The clinical appearance of the lip lesions fell into 4 categories. A ground rhagad at the corner of the mouth involving adjacent skin, was the most frequent type among dentate patients, whereas among denture wearers a deep lesion following the labial marginal sulcus was frequently observed. Dentate patients and denture wearers with cheilitis often had atopic constitution or cutaneous diseases. Pathogenic microorganisms were cultured from the lesions in all 64 patients; Staphylococcus aureus in 40 patients and Candida albicans in 45. The results of this study indicate a correlation between angular cheilitis and pathogenic microorganisms. Furthermore, among dentate patients, a correlation exists between cutaneous discomfort and angular cheilitis. Other etiological factors suggested for this disorder were found to be of subordinate importance.

  1. Evidence-based review of clinical studies on pulpotomy. (United States)


    Although pulpotomy procedures have a long history of clinical application, comparatively few dental clinical trials have evaluated this treatment approach. In this section, we provide an analysis of recent clinical studies evaluating pulpotomy procedures in dental patients.

  2. 基于B/S模式的自考报名系统的设计与实现%Design and Implementation of Self-Study Examination Registration System Based on B/S Mode

    Institute of Scientific and Technical Information of China (English)



    With the rapid development of science and technology, Self Registration handmade can ’t meet the needs of students and staff. This article takes in Vocational School of Wuhan Textile University Self-study examination registration as the back-ground, after working in the registration system analysis tests the functional requirements, design and implement a Self-study Registration system based on B/S mode. After nearly two years of use shows that the system allows to get rid of a vocational col-lege and spend a lot of time, manpower and resources handmade management to achieve a standardized management, work effi-ciency is greatly improved, since the candidates for applicants to provide a convenient remote.%随着科技日新月异的发展,纯手工的自考报名方式已经不能满足考生和工作人员的需要。该文以武汉纺织大学高职学院自考报名的现状为背景,经过系统分析自考报名工作中的功能需求,设计并实现了基于B/S模式的自考报名系统。通过近两年来的使用证明,该系统使高职学院摆脱了耗费大量人力物力和时间的纯手工管理,达到了规范化的管理,工作效率大大提高,为自考生异地报考提供了便利。

  3. elastix: a toolbox for intensity-based medical image registration. (United States)

    Klein, Stefan; Staring, Marius; Murphy, Keelin; Viergever, Max A; Pluim, Josien P W


    Medical image registration is an important task in medical image processing. It refers to the process of aligning data sets, possibly from different modalities (e.g., magnetic resonance and computed tomography), different time points (e.g., follow-up scans), and/or different subjects (in case of population studies). A large number of methods for image registration are described in the literature. Unfortunately, there is not one method that works for all applications. We have therefore developed elastix, a publicly available computer program for intensity-based medical image registration. The software consists of a collection of algorithms that are commonly used to solve medical image registration problems. The modular design of elastix allows the user to quickly configure, test, and compare different registration methods for a specific application. The command-line interface enables automated processing of large numbers of data sets, by means of scripting. The usage of elastix for comparing different registration methods is illustrated with three example experiments, in which individual components of the registration method are varied.

  4. Registration accuracy and quality of real-life images.

    Directory of Open Access Journals (Sweden)

    Wei-Yen Hsu

    Full Text Available BACKGROUND: A common registration problem for the application of consumer device is to align all the acquired image sequences into a complete scene. Image alignment requires a registration algorithm that will compensate as much as possible for geometric variability among images. However, images captured views from a real scene usually produce different distortions. Some are derived from the optic characteristics of image sensors, and others are caused by the specific scenes and objects. METHODOLOGY/PRINCIPAL FINDINGS: An image registration algorithm considering the perspective projection is proposed for the application of consumer devices in this study. It exploits a multiresolution wavelet-based method to extract significant features. An analytic differential approach is then proposed to achieve fast convergence of point matching. Finally, the registration accuracy is further refined to obtain subpixel precision by a feature-based modified Levenberg-Marquardt method. Due to its feature-based and nonlinear characteristic, it converges considerably faster than most other methods. In addition, vignette compensation and color difference adjustment are also performed to further improve the quality of registration results. CONCLUSIONS/SIGNIFICANCE: The performance of the proposed method is evaluated by testing the synthetic and real images acquired by a hand-held digital still camera and in comparison with two registration techniques in terms of the squared sum of intensity differences (SSD and correlation coefficient (CC. The results indicate that the proposed method is promising in registration accuracy and quality, which are statistically significantly better than other two approaches.

  5. Population based ranking of frameless CT-MRI registration methods

    Energy Technology Data Exchange (ETDEWEB)

    Opposits, Gabor; Kis, Sandor A.; Tron, Lajos; Emri, Miklos [Debrecen Univ. (Hungary). Dept. of Nuclear Medicine; Berenyi, Ervin [Debrecen Univ. (Hungary). Dept. of Biomedical Laboratory and Imaging Science; Takacs, Endre [Rotating Gamma Ltd., Debrecen (Hungary); Dobai, Jozsef G.; Bognar, Laszlo [Debrecen Univ., Medical Center (Hungary). Dept. of Neurosurgery; Szuecs, Bernadett [ScanoMed Ltd., Debrecen (Hungary)


    Clinical practice often requires simultaneous information obtained by two different imaging modalities. Registration algorithms are commonly used for this purpose. Automated procedures are very helpful in cases when the same kind of registration has to be performed on images of a high number of subjects. Radiotherapists would prefer to use the best automated method to assist therapy planning, however there are not accepted procedures for ranking the different registration algorithms. We were interested in developing a method to measure the population level performance of CT-MRI registration algorithms by a parameter of values in the [0,1] interval. Pairs of CT and MRI images were collected from 1051 subjects. Results of an automated registration were corrected manually until a radiologist and a neurosurgeon expert both accepted the result as good. This way 1051 registered MRI images were produced by the same pair of experts to be used as gold standards for the evaluation of the performance of other registration algorithms. Pearson correlation coefficient, mutual information, normalized mutual information, Kullback-Leibler divergence, L{sub 1} norm and square L{sub 2} norm (dis)similarity measures were tested for sensitivity to indicate the extent of (dis)similarity of a pair of individual mismatched images. The square Hellinger distance proved suitable to grade the performance of registration algorithms at population level providing the developers with a valuable tool to rank algorithms. The developed procedure provides an objective method to find the registration algorithm performing the best on the population level out of newly constructed or available preselected ones.

  6. Korean Clinic Based Outcome Measure Studies

    Directory of Open Access Journals (Sweden)

    Jongbae Park


    Full Text Available Background: Evidence based medicine has become main tools for medical practice. However, conducting a highly ranked in the evidence hierarchy pyramid is not easy or feasible at all times and places. There remains a room for descriptive clinical outcome measure studies with admitting the limit of the intepretation. Aims: Presents three Korean clinic based outcome measure studies with a view to encouraging Korean clinicians to conduct similar studies. Methods: Three studies are presented briefly here including 1 Quality of Life of liver cancer patients after 8 Constitutional acupuncture; 2 Developing a Korean version of Measuring yourself Medical Outcome profile (MYMOP; and 3 Survey on 5 Shu points: a pilot In the first study, we have included 4 primary or secondary liver cancer patients collecting their diagnostic X-ray film and clinical data f개m their hospital, and asked them to fill in the European Organization Research and Treatment of Cancer, Quality of Life Questionnaire before the commencement of the treatment. The acupuncture treatment is set up format but not disclosed yet. The translation and developing a Korean version of outcome measures that is Korean clinician friendly has been sought for MYMOP is one of the most appropriate one. The permission was granted, the translation into Korean was done, then back translated into English only based on the Korean translation by the researcher who is bilingual in both languages. The back translation was compared by the original developer of MYMOP and confirmed usable. In order to test the existence of acupoints and meridians through popular forms of Korean acupuncture regimes, we aim at collecting opinions from 101 Korean clinicians that have used those forms. The questions asked include most effective symptoms, 5 Shu points, points those are least likely to use due to either adverse events or the lack of effectiveness, theoretical reasons for the above proposals, proposing outcome measures


    Directory of Open Access Journals (Sweden)

    G. Kishore Babu


    Full Text Available BACKGROUND Abdominal trauma continues to account for a large number of trauma-related injuries and deaths. Motor vehicle accidents and urban violence, respectively, are the leading causes of blunt and penetrating trauma to this area of the body. Unnecessary deaths and complications can be minimized by improved resuscitation, evaluation and treatment. The new techniques and diagnostic tools available are important in the management of abdominal trauma. These improved methods, however, still depend on experience and clinical judgment for application and determination of the best care for the injured patient. The aim of the study is to 1. Analyse the incidence, clinical characteristics, diagnosis, indications for laparotomy, therapeutic methods and morbidity & mortality rates. 2. To study nature of blunt abdominal trauma. 3. To assess patient for surgical intervention and to avoid negative laparotomy. 4. To assess morbidity rate in different organs injury. 5. To evaluate modalities of treatment, complications and prognosis. MATERIALS AND METHODS This study is a prospective study on 97 patients with Blunt injuries to the abdomen admitted in S.V.R.R.G.G. Hospital, Tirupati during October 2013-15. Inclusion Criteria Patients > 13 years, with Blunt injury to abdomen either by RTA, fall, object contact, assault giving written informed consent. Exclusion Criteria Patients <13 yrs. Blunt injuries due to blasts, patients with severe cardiothoracic and head injuries who are hemodynamically unstable. CONCLUSION Blunt Trauma to abdomen is on rise due to excessive use of motor vehicles. It poses a therapeutic and diagnostic dilemma for the attending surgeon due to wide range of clinical manifestations ranging from no early physical findings to progression to shock. So, the Trauma surgeon should rely on his physical findings in association with use of modalities like x-ray abdomen, USG abdomen and abdominal paracentesis. Hollow viscus perforations are

  8. The clinical studies to developing BV Partner

    Directory of Open Access Journals (Sweden)

    Kwon Gi-Rok


    Full Text Available Objective: This study was performed to examine the Herbal Acupuncture decrease the side effect of Bee Venom. Methods: We treated Bee Venom and various Herbal Acupuncture mixed Bee Venom using double blind test to 70th health youth, and checked pain, edema size, CBC, Serum biochemistry and Thermography. Results:1. Herbal Acupuncture made by Morus bombycis Koidzumi showed good results to decrease the side effect of Bee Venom than any other Herbal Acupuncture. 2. We examined CBC, ESR and Serum biochemistry before and after treated. Special change was not showed. 3. We observed the pain and edema after treated Bee Venom and Morus bombycis Koidzumi Herbal Acupuncture mixed Bee Venom. We knew that Morus bombycis Koidzumi Herbal Acupuncture was decrease the pain and edema due to Bee Venom. 4. According to these clinical studies, Morus bombycis Koidzumi Herbal Acupuncture has a possibility to be a good partner of Bee Venom.

  9. Clinical studies on mercury poisoning in cattle

    Energy Technology Data Exchange (ETDEWEB)

    Sonoda, M.; Nakamura, R.; Too, K.; Matsuhashi, A.; Ishimoto, H.; Sasaki, R.; Ishida, K.; Takahashi, M.


    A sporadic outbreak of an unknown disease occurred among dairy cattle, from early February to late May 1955, in Japan. The characteristic symptoms of this disease were dyspnea and depilation; out of 29 cases, 8 died while 2 were slaughtered. Clinical studies have disclosed that the symptoms were similar to those found in cases of mercury poisoning as described by others. So the animals' feed was suspected of being the cause of the sickness. It was confirmed that the incident was due to poisoning resulting from ingestion of linseed meal treated with a mercurial fungicide. From the results of the testing anamnesis, it was found that 171 cattle were fed with the meal and 29 cases were affected. In veiw of the wide use of mercurial preparations for treating seed grains against fungi infection, a further experimental study was made on the effects of the feed and fungicide upon calves.

  10. A Bayesian nonrigid registration method to enhance intraoperative target definition in image-guided prostate procedures through uncertainty characterization (United States)

    Pursley, Jennifer; Risholm, Petter; Fedorov, Andriy; Tuncali, Kemal; Fennessy, Fiona M.; Wells, William M.; Tempany, Clare M.; Cormack, Robert A.


    Purpose: This study introduces a probabilistic nonrigid registration method for use in image-guided prostate brachytherapy. Intraoperative imaging for prostate procedures, usually transrectal ultrasound (TRUS), is typically inferior to diagnostic-quality imaging of the pelvis such as endorectal magnetic resonance imaging (MRI). MR images contain superior detail of the prostate boundaries and provide substructure features not otherwise visible. Previous efforts to register diagnostic prostate images with the intraoperative coordinate system have been deterministic and did not offer a measure of the registration uncertainty. The authors developed a Bayesian registration method to estimate the posterior distribution on deformations and provide a case-specific measure of the associated registration uncertainty. Methods: The authors adapted a biomechanical-based probabilistic nonrigid method to register diagnostic to intraoperative images by aligning a physician's segmentations of the prostate in the two images. The posterior distribution was characterized with a Markov Chain Monte Carlo method; the maximum a posteriori deformation and the associated uncertainty were estimated from the collection of deformation samples drawn from the posterior distribution. The authors validated the registration method using a dataset created from ten patients with MRI-guided prostate biopsies who had both diagnostic and intraprocedural 3 Tesla MRI scans. The accuracy and precision of the estimated posterior distribution on deformations were evaluated from two predictive distance distributions: between the deformed central zone-peripheral zone (CZ-PZ) interface and the physician-labeled interface, and based on physician-defined landmarks. Geometric margins on the registration of the prostate's peripheral zone were determined from the posterior predictive distance to the CZ-PZ interface separately for the base, mid-gland, and apical regions of the prostate. Results: The authors observed


    Directory of Open Access Journals (Sweden)

    Sobha Rani


    Full Text Available INTRODUCTION: A sliding hernia is a type of hernia in which posterior wall of the sac is not only formed by the parietal peritoneum, but also by sigmoid colon with its mesentery on its left side; caecum on right side and often with portion of bladder in both sides. During surgery care is taken not t o separate the content from the sac as the posterior wall of the sac is formed by the sliding component itself and attempts to dissect it from wall results in vascular injury to the structure and end in ischemic insult of the sliding component. Thus slidin g hernia is important for the special surgical technique and care during intraoperative period which decreases the morbidity. AIMS AND OBJECTIVE S : To study the incidence of sliding hernia in S.V.R.R.G. General Hospital Tirupati . To know the presentation, o rgan involved in the sliding, post - operative complications in the management of sliding hernias. METHODOLOGY : STUDY DESIGN: Prospective Clinical Study , STUDY AREA: Sri Venka teswara Medical College Tirupat i . SOURCE OF DATA: This study is an observational study in which 600 patients with hernia were studied and 40 patients with sliding component during intra operative period were studied in a period of 12 months. S AMPLE SIZE: 40 patients fulfilling the inclusion criteria . METHOD OF COLLECTION OF DATA: Detai led history taking , Complete clinical examination , Appropriate Investigations Blood & Urine Examination, USG , Surgery is performed & Operative findings were recorded. INCLUSION CRITERIA: Patients more than 13 years, with inguinal hernia giving written inform ed consent. EXCLUSION C RITERIA: Patients less than 13 yrs. Patients with comorbid conditions like heart diseases, liver and renal diseases. SOFTWARE: Statistical software mainly SPSS 11.0 and Systat 8.00 was used for the analysis of the data and Microsoft word and excel have been used to generate graphs tables etc. CONCLUSION: In the observational study done on 40 ca ses of

  12. Interactive initialization of 2D/3D rigid registration

    Energy Technology Data Exchange (ETDEWEB)

    Gong, Ren Hui; Güler, Özgür [The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children' s National Medical Center, Washington, DC 20010 (United States); Kürklüoglu, Mustafa [Department of Cardiac Surgery, Children' s National Medical Center, Washington, DC 20010 (United States); Lovejoy, John [Department of Orthopaedic Surgery and Sports Medicine, Children' s National Medical Center, Washington, DC 20010 (United States); Yaniv, Ziv, E-mail: [The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children' s National Medical Center, Washington, DC 20010 and Departments of Pediatrics and Radiology, George Washington University, Washington, DC 20037 (United States)


    Purpose: Registration is one of the key technical components in an image-guided navigation system. A large number of 2D/3D registration algorithms have been previously proposed, but have not been able to transition into clinical practice. The authors identify the primary reason for the lack of adoption with the prerequisite for a sufficiently accurate initial transformation, mean target registration error of about 10 mm or less. In this paper, the authors present two interactive initialization approaches that provide the desired accuracy for x-ray/MR and x-ray/CT registration in the operating room setting. Methods: The authors have developed two interactive registration methods based on visual alignment of a preoperative image, MR, or CT to intraoperative x-rays. In the first approach, the operator uses a gesture based interface to align a volume rendering of the preoperative image to multiple x-rays. The second approach uses a tracked tool available as part of a navigation system. Preoperatively, a virtual replica of the tool is positioned next to the anatomical structures visible in the volumetric data. Intraoperatively, the physical tool is positioned in a similar manner and subsequently used to align a volume rendering to the x-ray images using an augmented reality (AR) approach. Both methods were assessed using three publicly available reference data sets for 2D/3D registration evaluation. Results: In the authors' experiments, the authors show that for x-ray/MR registration, the gesture based method resulted in a mean target registration error (mTRE) of 9.3 ± 5.0 mm with an average interaction time of 146.3 ± 73.0 s, and the AR-based method had mTREs of 7.2 ± 3.2 mm with interaction times of 44 ± 32 s. For x-ray/CT registration, the gesture based method resulted in a mTRE of 7.4 ± 5.0 mm with an average interaction time of 132.1 ± 66.4 s, and the AR-based method had mTREs of 8.3 ± 5.0 mm with interaction times of 58 ± 52 s. Conclusions: Based on

  13. Hospital Registration Process Reengineering Using Simulation Method

    Directory of Open Access Journals (Sweden)

    Qiang Su


    Full Text Available With increasing competition, many healthcare organizations have undergone tremendous reform in the last decade aiming to increase efficiency, decrease waste, and reshape the way that care is delivered. This study focuses on the operational efficiency improvement of hospital’s registration process. The operational efficiency related factors including the service process, queue strategy, and queue parameters were explored systematically and illustrated with a case study. Guided by the principle of business process reengineering (BPR, a simulation approach was employed for process redesign and performance optimization. As a result, the queue strategy is changed from multiple queues and multiple servers to single queue and multiple servers with a prepare queue. Furthermore, through a series of simulation experiments, the length of the prepare queue and the corresponding registration process efficiency was quantitatively evaluated and optimized.

  14. Key influences identified by first year undergraduate nursing students as impacting on the quality of clinical placement: A qualitative study. (United States)

    Cooper, John; Courtney-Pratt, Helen; Fitzgerald, Mary


    Despite the fact that high quality clinical placement is an integral component of pre-registration nursing education for the development of the future nursing workforce, the literature identifies an ongoing struggle to 'get it right'. To examine qualitative data gathered through the Quality Clinical Placements Evaluation project to identify what pre-registration nursing students deemed helpful and not helpful influences on their first year Professional Experience Placement. A total of 553 first year undergraduate nursing students from 2010 to 2012 were enrolled in the programme and all were invited to complete a validated survey to measure the quality of their first clinical placement. A total of 361 completed surveys were returned. This paper examines the data provided through open-ended questions within the survey related to most helpful and least helpful aspects of their clinical experience. An inductive analysis approach using NVIVO allowed inherent areas to emerge from the raw data forming three key themes that influenced the experience of students. Feeling welcomed, individual versus team attitudes, and student expectations of supervising ward nurses were the themes identified that were perceived by the student as important to the success of learning and the quality of the experience overall. The findings echo previous research into the student experience of clinical placement; however the focus regarding the need for students to have a quality relationship with the supervising nurse is an area that warrants further exploration. Furthermore, we argue that students should be purposely engaged in the tertiary sector and provided guidance and strategies related to forming and maintaining relationships with those that supervise their clinical placement, in order to ensure consistent positive experiences. The outcomes from this study suggest that a missing component is teaching undergraduates how to manage relationships in clinical settings. Copyright © 2015

  15. Robust linear registration of CT images using random regression forests (United States)

    Konukoglu, Ender; Criminisi, Antonio; Pathak, Sayan; Robertson, Duncan; White, Steve; Haynor, David; Siddiqui, Khan


    Global linear registration is a necessary first step for many different tasks in medical image analysis. Comparing longitudinal studies1, cross-modality fusion2, and many other applications depend heavily on the success of the automatic registration. The robustness and efficiency of this step is crucial as it affects all subsequent operations. Most common techniques cast the linear registration problem as the minimization of a global energy function based on the image intensities. Although these algorithms have proved useful, their robustness in fully automated scenarios is still an open question. In fact, the optimization step often gets caught in local minima yielding unsatisfactory results. Recent algorithms constrain the space of registration parameters by exploiting implicit or explicit organ segmentations, thus increasing robustness4,5. In this work we propose a novel robust algorithm for automatic global linear image registration. Our method uses random regression forests to estimate posterior probability distributions for the locations of anatomical structures - represented as axis aligned bounding boxes6. These posterior distributions are later integrated in a global linear registration algorithm. The biggest advantage of our algorithm is that it does not require pre-defined segmentations or regions. Yet it yields robust registration results. We compare the robustness of our algorithm with that of the state of the art Elastix toolbox7. Validation is performed via 1464 pair-wise registrations in a database of very diverse 3D CT images. We show that our method decreases the "failure" rate of the global linear registration from 12.5% (Elastix) to only 1.9%.

  16. [Purine metabolism in ankylosing spondylitis: clinical study]. (United States)

    Jiménez Balderas, F J; Robles, E J; Juan, L; Badui, E; Arellano, H; Espinosa Said, L; Mintz Spiro, G


    We undertook a prospective study of 23 male patients with Ankylosing Spondylitis (AS) (New York Criteria), 18 HLA-B27 positive and 5 HLA-B27 negative, five of them had hyperuricemia. The following data of evolution were taken into consideration: age at onset of disease, time course of the disease, presence of urolithiasis, heart disease, flares of uveitis. Clinical activity and degree of disability were evaluated every one to 3 months; on each visit, every patient had determinations of serum and urinary uric acid levels, serum and phosphorus, erythrocyte sedimentation rate (ESR), serum protein electrophoresis, as well as X-ray films of the vertebral spine and pelvis. Three groups of patients were detected, all of them with equal age at onset, duration of disease, frequency of B27, peripheral arthritis, and leukocytosis. One group had hyperuricemia (5 of 23 patients, 80% of them HLA-B27 positive) and a lesser degree of clinical activity of the disease (p less than .001, a higher frequency of uveitis (40%, lower levels of serum gammaglobulins (p less than 0.05) and ESR (p less than 0.05), a lesser degree of ankylosis of the spine, and a better functional prognosis than the other groups. Another group (8 of 23 patients, 75% of them were HLA-B27 positive) had normouricemia and hyperuricosuria, and showed a higher frequency of fever (50%), an abnormal urinalysis, and urolithiasis (25%).

  17. Controlled outcome studies of child clinical hypnosis. (United States)

    Adinolfi, Barbara; Gava, Nicoletta


    Background Hypnosis is defined as "as an interaction in which the hypnotist uses suggested scenarios ("suggestions") to encourage a person's focus of attention to shift towards inner experiences". Aim of the work The focus of this review is to summarize the findings of controlled outcome studies investigating the potential of clinical hypnosis in pediatric populations. We will examine the following themes: anesthesia, acute and chronic pain, chemotherapy-related distress, along with other specific medical issues. Results Hypnosis is an effective method to reduce pain and anxiety before, during and after the administration of anesthetics, during local dental treatments, invasive medical procedures and in burn children. Hypnosis can be successfully used to manage recurrent headaches, abdominal pain, irritable bowel syndrome and chemotherapy-related distress. Hypnosis has an important role in managing symptoms and improving the quality of life of children suffering from asthma and cystic fibrosis and in facilitating the treatment of insomnia in school-age children. Finally, hypnosis can be effectively used for the treatment of some habitual disorders such as nocturnal enuresis and dermatologic conditions, including atopic dermatitis and chronic eczema Conclusions Clinical hypnosis seems to be a useful, cheap and side-effects free tool to manage fear, pain and several kinds of stressful experiences in pediatric populations. Children who receive self-hypnosis trainings achieve significantly greater improvements in their physical health, quality of life, and self-esteem.

  18. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)


    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays bloo

  19. Evidence Based Studies in Clinical Transfusion Medicine

    NARCIS (Netherlands)

    A.J.G. Jansen (Gerard)


    textabstractAfter the introduction of blood component therapy in the 1960s, more and more attention is given to clinical transfusion medicine. Although blood transfusion is an important treatment in different clinical settings, there are still lack of much randomized clinical trials. Nowadays

  20. [Lymphocytic duodenosis: etiological study and clinical presentations]. (United States)

    Santolaria, Santos; Dominguez, Manuel; Alcedo, Javier; Abascal, Manuel; García-Prats, M Dolores; Marigil, Miguel; Vera, Jesus; Ferrer, Margarita; Montoro, Miguel


    Lymphocytic duodenosis (LD) is a characteristic lesion in the initial phases of celiac disease (CD) but can be associated with many other entities. The aim of this study was to evaluate the prevalence of distinct causes of LD and possible differences in clinical presentation according to etiology. A retrospective study was performed that included 194 patients diagnosed with LD (more than 25 intraepithelial lymphocytes per 100 epithelial cells). A preestablished strategy to evaluate the cause of the disease was followed that included celiac serology (antitransglutaminase antibodies), HLA-DQ2/DQ8 genotypes, diagnosis of Helicobacter pylori and small intestinal bacterial overgrowth (SIBO). Diagnosis of CD was established on the basis of clinical and histological response to a gluten-free diet in patients with positive serology or compatible findings on HLA-DQ2 (at least one of the alleles) or -DQ8 (both alleles) study. The most frequent cause of LD was CD (39%), followed by SBBO (22%), H.pylori (14%), CD and SIBO (12%), and other causes (13%). Most of the patients (83%) had a compatible HLA-DQ2 or -DQ8 genotype. In these patients, the most frequent diagnosis was CD (46%), while in the absence of HLA-DQ2/DQ8, the most frequent diagnoses were SIBO (44%) and H. pylori (22%). CD was the most frequent diagnosis in patients referred for dyspepsia, diarrhea and anemia, while H. pylori was the most frequent diagnosis in patients with abdominal pain. The most common causes of LD in our environment are CD, followed by SIBO and H. pylori infection. Copyright © 2013 Elsevier España, S.L. and AEEH y AEG. All rights reserved.

  1. Do emergency medicine journals promote trial registration and adherence to reporting guidelines? A survey of "Instructions for Authors". (United States)

    Sims, Matthew T; Henning, Nolan M; Wayant, C Cole; Vassar, Matt


    The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of emergency medicine journals. We performed a web-based data abstraction from the "Instructions for Authors" of the 27 Emergency Medicine journals catalogued in the Expanded Science Citation Index of the 2014 Journal Citation Reports and Google Scholar Metrics h5-index to identify whether each journal required, recommended, or made no mention of the following reporting guidelines: EQUATOR Network, ICMJE, ARRIVE, CARE, CONSORT, STARD, TRIPOD, CHEERS, MOOSE, STROBE, COREQ, SRQR, SQUIRE, PRISMA-P, SPIRIT, PRISMA, and QUOROM. We also extracted whether journals required or recommended trial registration. Authors were blinded to one another's ratings until completion of the data validation. Cross-tabulations and descriptive statistics were calculated using IBM SPSS 22. Of the 27 emergency medicine journals, 11 (11/27, 40.7%) did not mention a single guideline within their "Instructions for Authors," while the remaining 16 (16/27, 59.3%) mentioned one or more guidelines. The QUOROM statement and SRQR were not mentioned by any journals whereas the ICMJE guidelines (18/27, 66.7%) and CONSORT statement (15/27, 55.6%) were mentioned most often. Of the 27 emergency medicine journals, 15 (15/27, 55.6%) did not mention trial or review registration, while the remaining 12 (12/27, 44.4%) at least mentioned one of the two. Trial registration through was mentioned by seven (7/27, 25.9%) journals while the WHO registry was mentioned by four (4/27, 14.8%). Twelve (12/27, 44.4%) journals mentioned trial registration through any registry platform. The aim of this study was to evaluate the current state of two publication practices, reporting guidelines requirements and clinical trial registration requirements, by analyzing the "Instructions for Authors" of

  2. Clinical studies of IGFBP-2 by radioimmunoassay

    DEFF Research Database (Denmark)

    Blum, W F; Horn, N; Kratzsch, J


    A specific radioimmunoassay for human IGFBP-2 was developed using a polyclonal antiserum directed against a partial sequence (hIGFBP-2(176-190)). The tracer was prepared by radioiodination of a [Tyr]o-hIGFBP-2(176-190) derivative. The assay was used to study IGFBP-2 levels in numerous clinical...... and experimental situations. There was little circadian fluctuations of serum level which showed a marked age-dependence with high levels at birth and senescence and low levels during puberty. Decreased IGFBP-2 levels were present in untreated insulin-dependent diabetes mellitus (IDDM), in acromegaly and during...... dexamethasone suppression test. GH deficiency, fasting, IGF-I administration to patients with GH receptor deficiency, hepatic failure and insulinomas caused a moderate increase of serum IGFBP-2. Markedly elevated levels were found in chronic renal failure, non-islet cell tumour induced hypoglycemia...


    Directory of Open Access Journals (Sweden)

    Bharat Kumar


    Full Text Available AIM This study is designed to enumerate various causes of ocular trauma, clinical spectrum of presentation and to evaluate the visual outcome after appropriate management. MATERIALS AND METHODS A prospective study was conducted on total of 136 patients from the places in and around Kakinada, East Godavari District of Andhra Pradesh, India. A detailed work up of all patients including slit lamp biomicroscopy, direct, indirect ophthalmoscopy and ultra sonography B scan was done. RESULTS Observations from the study were analyzed, discussed and compared with the existing studies in the literature. Mean age group of patients belong to young adults between 20-30 years (57.9%, males (81% affected more than females. Illiterates, Agricultural labourers, Industrial workers affected more. Road Traffic Accidents (25.73%, industrial injuries (22.05% and agricultural hazards (19.11% being the major cause of unilateral eye injury. Closed globe injuries (80.88% more common than Open globe injuries (19.12. CONCLUTIONS Ophthalmic injuries due to innumerable causes results in various types of ocular trauma, leading to untold misery, visual impairment and economic burden to the family, society and country as a whole. Health education regarding use of preventive measures, seeking early treatment and appropriate rehabilitation are very much recommended to reduce the burden of morbidity due to ocular trauma.

  4. Mesiodens: a clinical and radiographic study. (United States)

    Kim, Su-Gwan; Lee, Sang-Ho


    The term 'mesiodens' refers to a supernumerary tooth present in the midline of the maxilla between the two central incisors. This study seeks to investigate the characteristics of mesiodens among children in Korea. The study population consisted of 40 children whose ages ranged from 4 to-26-years. The characteristics of mesiodens were obtained from radiographs and clinical examination results, and were confirmed by surgical intervention. Results showed that males were affected approximately 4 times as frequendy as females. Twenty-five percent of the patients had more than 1 supernumerary tooth. About 66% of the mesiodens were conical in shape and about 52% of the mesiodens were in the upward position. The age and sex distribution, number of mesiodens per patient, shape, direction, size, and effect on permanent maxillary incisors are also presented in this study. The incidence of mesiodens has been estimated at 0.15% to 1% of the population. It occurs more frequently in boys than in girls, with the ratio being approximately 2:1. In this study, a male:female ratio of 4:1 for the prevalence for mesiodens was found. Ten (25%) out of the 40 patients had 2 mesiodens.

  5. Target registration and target positioning errors in computer-assisted neurosurgery: proposal for a standardized reporting of error assessment. (United States)

    Widmann, Gerlig; Stoffner, Rudolf; Sieb, Michael; Bale, Reto


    Assessment of errors is essential in development, testing and clinical application of computer-assisted neurosurgery. Our aim was to provide a comprehensive overview of the different methods to assess target registration error (TRE) and target positioning error (TPE) and to develop a proposal for a standardized reporting of error assessment. A PubMed research on phantom, cadaver or clinical studies on TRE and TPE has been performed. Reporting standards have been defined according to (a) study design and evaluation methods and (b) specifications of the navigation technology. The proposed standardized reporting includes (a) study design (controlled, non-controlled), study type (non-anthropomorphic phantom, anthropomorphic phantom, cadaver, patient), target design, error type and subtypes, space of TPE measurement, statistics, and (b) image modality, scan parameters, tracking technology, registration procedure and targeting technique. Adoption of the proposed standardized reporting may help in the understanding and comparability of different accuracy reports. Copyright (c) 2009 John Wiley & Sons, Ltd.

  6. A Comparison of FFD-based Nonrigid Registration and AAMs Applied to Myocardial Perfusion MRI

    DEFF Research Database (Denmark)

    Ólafsdóttir, Hildur; Stegmann, Mikkel Bille; Ersbøll, Bjarne Kjær;


    Little work has been done on comparing the performance of statistical model-based approaches and nonrigid registration algorithms. This paper deals with the qualitative and quantitative comparison of active appearance models (AAMs) and a nonrigid registration algorithm based on free......-form deformations (FFDs). AAMs are known to be much faster than nonrigid registration algorithms. On the other hand nonrigid registration algorithms are independent of a training set as required to build an AAM. To obtain a further comparison of the two methods, they are both applied to automatically register multi......-slice myocardial perfusion images. The images are acquired by magnetic resonance imaging, from infarct patients. A registration of these sequences is crucial for clinical practice, which currently is subjected to manual labor. In the paper, the pros and cons of the two registration approaches are discussed...

  7. Corneal topography matching by iterative registration. (United States)

    Wang, Junjie; Elsheikh, Ahmed; Davey, Pinakin G; Wang, Weizhuo; Bao, Fangjun; Mottershead, John E


    Videokeratography is used for the measurement of corneal topography in overlapping portions (or maps) which must later be joined together to form the overall topography of the cornea. The separate portions are measured from different viewpoints and therefore must be brought together by registration of measurement points in the regions of overlap. The central map is generally the most accurate, but all maps are measured with uncertainty that increases towards the periphery. It becomes the reference (or static) map, and the peripheral (or dynamic) maps must then be transformed by rotation and translation so that the overlapping portions are matched. The process known as registration, of determining the necessary transformation, is a well-understood procedure in image analysis and has been applied in several areas of science and engineering. In this article, direct search optimisation using the Nelder-Mead algorithm and several variants of the iterative closest/corresponding point routine are explained and applied to simulated and real clinical data. The measurement points on the static and dynamic maps are generally different so that it becomes necessary to interpolate, which is done using a truncated series of Zernike polynomials. The point-to-plane iterative closest/corresponding point variant has the advantage of releasing certain optimisation constraints that lead to persistent registration and alignment errors when other approaches are used. The point-to-plane iterative closest/corresponding point routine is found to be robust to measurement noise, insensitive to starting values of the transformation parameters and produces high-quality results when using real clinical data.

  8. Efficient Hyperelastic Regularization for Registration

    DEFF Research Database (Denmark)

    Darkner, Sune; Hansen, Michael S; Larsen, Rasmus;


    For most image registration problems a smooth one-to-one mapping is desirable, a diffeomorphism. This can be obtained using priors such as volume preservation, certain kinds of elasticity or both. The key principle is to regularize the strain of the deformation which can be done through penalizat......For most image registration problems a smooth one-to-one mapping is desirable, a diffeomorphism. This can be obtained using priors such as volume preservation, certain kinds of elasticity or both. The key principle is to regularize the strain of the deformation which can be done through...... penalization of the eigen values of the stress tensor. We present a computational framework for regularization of image registration for isotropic hyper elasticity. We formulate an efficient and parallel scheme for computing the principal stain based for a given parameterization by decomposing the left Cauchy...... elastic priors such at the Saint Vernant Kirchoff model, the Ogden material model or Riemanian elasticity. We exemplify the approach through synthetic registration and special tests as well as registration of different modalities; 2D cardiac MRI and 3D surfaces of the human ear. The artificial examples...

  9. Study on Dynamic Registration System for Pesticides POPs%杀虫剂类POPs动态申报机制研究

    Institute of Scientific and Technical Information of China (English)

    李扬; 王瑛; 黄启飞; 杨延梅


    Based on management methods of pesticides POPs registration in Japan , the United States , European Union and UNEP, declaration and registration system for chemicals, pollutants and solid waste was analyzed for establishing dynamic registration system in China. Environmental Protection Bureaus of each level in China were responsible for administration of dynamic registration. Declarers included producers and sellers of the pesticides POPs, investigating staffs in environmental protection bureau as well as insiders. The contents in the declaration consisted of storage location, name of chemicals, quantity, supervisor mode, and related change information. The dynamic registration once a year for establishing basic data information of pesticides POPs, to take measures to scientifically prevent pollution and to provide information for eliminating pesticides POPs danger.%通过研究日本、美国、欧盟、联合国环境保护署关于杀虫剂类POPs的申报管理机制,分析我国关于化学品、污染物和固体废物的申报、登记制度,欲建立我国杀虫剂类POPs动态申报机制.我国杀虫剂类POPs动态申报以各级环保部门为管理主体,以杀虫剂类POPs的生产单位和流通机构、各级环保部门、知情群众为申报主体,以杀虫剂类POPs的存放地点、种类名称、数量、管理状态、相关变更信息为申报内容,实现每年1次的杀虫剂类POPs申报,从而建立我国杀虫剂类POPs基础数据信息,为制定科学的污染防治措施,消除杀虫剂类POPs的危害提供信息支撑.


    Directory of Open Access Journals (Sweden)

    Kishore Babu


    Full Text Available INTRODUCTION Ileal perforation is a common problem seen in tropical countries, the commonest cause being typhoid fever. In western countries the causes are malignancy, trauma and mechanical aetiology, in the order of frequency.1,2,3 Over the years a definite changing trend has been observed in ileal perforations both in terms of causes, treatment and prognosis. Better antibiotics, aggressive surgery and the elimination of conservative treatment, better preoperative and postoperative care have all significantly contributed to the improvement in patient outcome.4,5 But still cases of ileal perforation cause a significant morbidity and mortality that persists despite the significant changes in health care over the years. AIMS AND OBJECTIVES To study the aetiology, presentation, management outcome and the factors influencing prognosis and outcome in ileal perforations. MATERIAL & METHODS Study Setting S. V. Medical College, Department of General Surgery, Tirupati. Study Period Patients attending S. V. Medical College, Department of General Surgery with perforation during the period from November 2012 to October 2015. Inclusion Criteria Patients between age group of more than 14 years presenting with pain abdomen and who are diagnosed to have ileal perforation in the intra operative period are selected. Exclusion Criteria Patients with peritonitis due to other causes like gastric, duodenum or large bowel perforation are excluded. Study Method The present study is a prospective study done on 28 patients of ileal perforation due to typhoid complication, nonspecific and traumatic perforations. History, clinical examination, investigations, operative findings, post-operative complications were recorded. In patients with non-traumatic perforations Widal test was done. CONCLUSION Typhoid fever and traumatic aetiology are the most common cause of Ileal perforation, followed by TB. Patients are more of male gender and are in reproductive age group. Widal

  11. A prospective comparison between auto-registration and manual registration of real-time ultrasound with MR images for percutaneous ablation or biopsy of hepatic lesions. (United States)

    Cha, Dong Ik; Lee, Min Woo; Song, Kyoung Doo; Oh, Young-Taek; Jeong, Ja-Yeon; Chang, Jung-Woo; Ryu, Jiwon; Lee, Kyong Joon; Kim, Jaeil; Bang, Won-Chul; Shin, Dong Kuk; Choi, Sung Jin; Koh, Dalkwon; Seo, Bong Koo; Kim, Kyunga


    To compare the accuracy and required time for image fusion of real-time ultrasound (US) with pre-procedural magnetic resonance (MR) images between positioning auto-registration and manual registration for percutaneous radiofrequency ablation or biopsy of hepatic lesions. This prospective study was approved by the institutional review board, and all patients gave written informed consent. Twenty-two patients (male/female, n = 18/n = 4; age, 61.0 ± 7.7 years) who were referred for planning US to assess the feasibility of radiofrequency ablation (n = 21) or biopsy (n = 1) for focal hepatic lesions were included. One experienced radiologist performed the two types of image fusion methods in each patient. The performance of auto-registration and manual registration was evaluated. The accuracy of the two methods, based on measuring registration error, and the time required for image fusion for both methods were recorded using in-house software and respectively compared using the Wilcoxon signed rank test. Image fusion was successful in all patients. The registration error was not significantly different between the two methods (auto-registration: median, 3.75 mm; range, 1.0-15.8 mm vs. manual registration: median, 2.95 mm; range, 1.2-12.5 mm, p = 0.242). The time required for image fusion was significantly shorter with auto-registration than with manual registration (median, 28.5 s; range, 18-47 s, vs. median, 36.5 s; range, 14-105 s, p = 0.026). Positioning auto-registration showed promising results compared with manual registration, with similar accuracy and even shorter registration time.

  12. Parastomal hernias -- clinical study of therapeutic strategies. (United States)

    Târcoveanu, E; Vasilescu, A; Cotea, E; Vlad, N; Palaghia, M; Dănilă, N; Variu, M


    Parastomal hernias are parietal defects adjacent to the stomasite, after ileostomy and colostomy. Their incidence is variable and they are generally underestimated. Between 2001 and 2010 at the First Surgical Clinic Iasi, we treated 861 incisional hernias, of which there were 31 parastomal hernias in 26 patients (3%), 5 of which were recurrent parastomal hernias. Parastomal hernias have been explored clinically, through imaging and intraoperatively.Because our experience and literature review have demonstrated that a mesh repair is a safe procedure in the treatment of parastomal hernia, in 2010 we initiated a prospective randomized trial on the use of prophylactic polypropylene mesh at the time of stoma formation to reduce the risk of parastomal hernia. We enrolled in the study 20 patients with mesh implanted at the primary operation and 22 patients without mesh. The inclusion criteria were: patients with low rectal cancer, stage II-III, irradiated, obese, with a history of hernias, patients who do physical work. Most parastomal hernias were asymptomatic; only six cases with parastomal hernias required emergency surgical treatment. We performed local tissue repair in 16 cases (4 cases with recurrent parastomal hernia, stoma relocation in one case), sublay mesh repair in 15 cases (one case with recurrent parastomal hernia; stoma relocation in 5 cases). Postoperative morbidity registered included 4 wound infections (one case after mesh repair which required surgical reintervention) and stoma necrosis in one case with strangulation parastomal hernia with severe postoperative evolution and death. After local tissue repair recurrences were seen in 6 cases, after mesh repair we registered recurrence only in one case and no relapse after the relocation of the stoma. The patients with prophylactic mesh at the time of stoma formation to reduce the risk of parastomal hernia were followed for a median of 20 months(range 12 to 28 months) by clinical examination and ultrasound

  13. Statistical Issues in TBI Clinical Studies

    Directory of Open Access Journals (Sweden)

    Paul eRapp


    Full Text Available The identification and longitudinal assessment of traumatic brain injury presents several challenges. Because these injuries can have subtle effects, efforts to find quantitative physiological measures that can be used to characterize traumatic brain injury are receiving increased attention. The results of this research must be considered with care. Six reasons for cautious assessment are outlined in this paper. None of the issues raised here are new. They are standard elements in the technical literature that describes the mathematical analysis of clinical data. The purpose of this paper is to draw attention to these issues because they need to be considered when clinicians evaluate the usefulness of this research. In some instances these points are demonstrated by simulation studies of diagnostic processes. We take as an additional objective the explicit presentation of the mathematical methods used to reach these conclusions. This material is in the appendices. The following points are made:1. A statistically significant separation of a clinical population from a control population does not ensure a successful diagnostic procedure.2. Adding more variables to a diagnostic discrimination can, in some instances, actually reduce classification accuracy.3. A high sensitivity and specificity in a TBI versus control population classification does not ensure diagnostic successes when the method is applied in a more general neuropsychiatric population. 4. Evaluation of treatment effectiveness must recognize that high variability is a pronounced characteristic of an injured central nervous system and that results can be confounded by either disease progression or spontaneous recovery. A large pre-treatment versus post-treatment effect size does not, of itself, establish a successful treatment.5. A procedure for discriminating between treatment responders and nonresponders requires, minimally, a two phase investigation. This procedure must include a


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    Kiran Kumar


    Full Text Available Carcinoma of the breast is one of the commonest cancers occurring in female and accounts for 1/3rd of all the malignant diseases occurring in them. It is mainly a disease of the developed countries and accounts for 1,00,000 deaths annually. Breast carcinoma is classified as Early breast cancer, Locally advanced breast cancer and Metastatic breast cancer. By definition early stage breast cancer constitutes breast tumors of clinical stages I, IIa and T2N1M0. Early breast cancer is the one diagnosed by mammography. Women when approaches at this stage, they can go for breast conservation surgery. Not all women are candidates for this approach, and some require mastectomy as part of their treatment. AIM To observe the incidence of early breast carcinoma with particular reference to the time taken by the patients to seek medical advice after the symptoms have developed i.e. the average time taken by the patients to seek medical advice, their appropriate management and prognosis. MATERIALS AND METHODS This prospective study was conducted over a period of 2 years from Oct-2012 to Oct-2014 in 30 female patients aged between 25-65 years who were presented with lump in breast of size ≤5cms with or without pain, with or without lymph nodes to the outpatient department. All the patients were thoroughly asked about history, examined clinically, investigated, staged and managed by surgery either Breast Conservation Surgery or Modified Radical Mastectomy. Postoperative complications were recorded and followed up regularly. RESULTS The incidence of early breast cancer in this study was 0.98% with peak age incidence between 40-60 years and duration of symptoms <6 months in 18 patients. Breast Conservation Surgery + axillary dissection + Radiotherapy was done in 23%. Prognosis was good in these patients with no local recurrence and death. CONCLUSION The prognosis of early stage breast carcinoma patients in this study was good. To have long term tumor free and

  15. Radar image registration and rectification (United States)

    Naraghi, M.; Stromberg, W. D.


    Two techniques for radar image registration and rectification are presented. In the registration method, a general 2-D polynomial transform is defined to accomplish the geometric mapping from one image into the other. The degree and coefficients of the polynomial are obtained using an a priori found tiepoint data set. In the second part of the paper, a rectification procedure is developed that models the distortion present in the radar image in terms of the radar sensor's platform parameters and the topographic variations of the imaged scene. This model, the ephemeris data and the digital topographic data are then used in rectifying the radar image. The two techniques are then used in registering and rectifying two examples of radar imagery. Each method is discussed as to its benefits, shortcomings and registration accuracy.

  16. Efficient Hyperelastic Regularization for Registration

    DEFF Research Database (Denmark)

    Darkner, Sune; Hansen, Michael Sass; Larsen, Rasmus;


    For most image registration problems a smooth one-to-one mapping is desirable, a diffeomorphism. This can be obtained using priors such as volume preservation, certain kinds of elasticity or both. The key principle is to regularize the strain of the deformation which can be done through penalizat......For most image registration problems a smooth one-to-one mapping is desirable, a diffeomorphism. This can be obtained using priors such as volume preservation, certain kinds of elasticity or both. The key principle is to regularize the strain of the deformation which can be done through...... penalization of the eigen values of the stress tensor. We present a computational framework for regularization of image registration for isotropic hyper elasticity. We formulate an efficient and parallel scheme for computing the principal stain based for a given parameterization by decomposing the left Cauchy...

  17. Language proficiency and nursing registration. (United States)

    Müller, Amanda


    This discussion paper focuses on English proficiency standards for nursing registration in Australia, how Australia has dealt with the issue of language proficiency, and the factors which have led to the establishment of the current language standards. Also, this paper will provide a comparison of the two language tests that are currently accepted in Australia (OET and IELTS), including the appropriateness of these tests and the minimum standards used. The paper will also examine the use of educational background as an indicator of language proficiency. Finally, communication-based complaints in the post-registration environment will be explored, and some discussion will be provided about why pre-registration measures might have failed to prevent such problematic situations from occurring.

  18. Bioavailability studies and the clinical pharmacologist: correlation of drug distribution with clinical effects. (United States)

    Ogilvie, R I


    Bioavailability studies can be interpreted only when clinical information is available which correlates drug distribution with both efficacious and toxic clinical effects. The clinical pharmacologist should be instrumental in the development of safe and effective drug therapy by the systematic application of well designed clinical trials, the clear definition of therapeutically desirable clinical responses, and the development and application of improved techniques of measuring these effects.

  19. Periodontal conditions in vegetarians: a clinical study. (United States)

    Staufenbiel, I; Weinspach, K; Förster, G; Geurtsen, W; Günay, H


    Investigations about possible correlations between vegetarian diet and periodontal conditions are rare and characterized by small case numbers. The aim of this clinical study was to investigate the influence of a vegetarian diet on periodontal parameters with an appropriate sample size. A total of 200 patients, 100 vegetarians and 100 non-vegetarians, were included in the study. All patients were examined including a full mouth assessment of the periodontal and dental conditions. In addition, a questionnaire was handed out to ask for patients' oral hygiene habits and level of education. For statistical analysis the Mann-Whitney Test (χ(2) for analysis of the questionnaire) was applied (level of significance: Pvegetarians versus 41.72 years non-vegetarians). Vegetarians had significantly lower probing pocket depths (P=0.039), bleeding on probing (P=0.001), periodontal screening index (P=0.012), a better hygiene index (Pvegetarians. Furthermore, vegetarians had a higher level of education (PVegetarians revealed better periodontal conditions (less inflammation signs, less periodontal damage and a better dental home care). However, it should be considered that vegetarians are not only avoiding meat in their nutrition but are also characterized by an overall healthier life style.


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    Full Text Available Introduction-Heart disease complicating pregnancy is considered as a high risk situation. Increased cardiac demands during the course of pregnancy potentially increase morbidity and mortality in women with underlying heart disease. AIM: To determine maternal and fetal outcome in women with heart disease complicating pregnancy, To emphasize on proper protocol for managing pregnancy complicated by heart disease, To correlate the time of booking & NYHA grading with maternal & fetal outcome. Risk of adverse outcome is more in rural population as compared to its urban counterpart. METHOD: A prospective clinical study of 25 cases of pregnancy complicated by heart disease, reporting to tertiary care hospital for delivery, was carried out to find out the incidence and maternal and fetal outcome. RESULTS: The incidence of heart disease in pregnancy in the present study was 0.6%. Most of the women (91% belonged to low socioeconomic class in the rural population. Rheumatic heart lesions constituted 77% of the cases. Mitral stenosis was the commonest lesion in 40% of cases. Ten (40% women delivered spontaneously vaginally at term. Cesarean section was performed in 14 cases (56%. There were 5 maternal deaths. There were no perinatal deaths. CONCLUSION: Early diagnosis of heart disease, regular antenatal check-up, institutional delivery, limiting family size can reduce the maternal and perinatal mortality and morbidity associated with heart disease


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    Sushma Ramteke


    Full Text Available BACKGROUND Fistula in ano is one of the common problem faced in today’s world. Fistula in ano is track lined by granulation tissue that connect deeply in the anal canal or rectum and superficially on the skin around the anus. It usually results from cryptoglandular infection causing abscess, which burst spontaneously or was drained inadequately. The study is conducted to find most common aetiological factor and to evaluate various surgical technique and their outcome. The aim of the study is to- 1. Study the incidence of various aetiologies of fistula in ano. 2. Study the clinical presentation of fistula in ano. 3. Evaluate different modalities of surgical approach and their outcome. MATERIALS AND METHODS This prospective study was conducted at Late Lakhiram Agrawal Memorial Government Medical College, Raigarh, during the study period of July 2015 to July 2016. All the 50 cases were included in this study who were above 15 year of age diagnosed with fistula in ano on the basis of clinical examination who underwent surgical procedure. RESULTS In present study of 50 cases, 60% of cases were in the age group of 31-50 years. Male:female ratio was 9:1. 80% of cases belong to low socioeconomic status. The most common mode of presentation was discharging sinus in 96% of cases. 70% of patient had past history of burst abscess or surgical drainage of abscess. 90% of cases have single external opening. 80% of cases had posterior external opening. Most of the fistula are of low anal type, which was 92% and rest of the patient had an internal opening situated above the anorectal ring. The most common surgical approach done was fistulectomy. Only fistulectomy was done in 80% of patients. Fistulectomy with sphincterectomy was done in two patients. These two patients had associated anal fissure. Fistulectomy with seton placement was done in two patients of high level of fistula type. Fistulotomy was done in four patients (8%, these were of low fistula type


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    Full Text Available INTRODUCTION Gastric outlet obstruction (GOO is obstruction in the first part of duodenum secondary to cicatrised duodenal ulcer or proximally where the diagnosis of carcinoma is most probable. GOO can be a diagnostic and treatment dilemma. Once a mechanical obstruction is confirmed, differentiate between benign and malignant processes. Cicatrized duodenal ulcer was the most common cause of GOO. But with increased awareness, change in the dietary habits and availability of H2 receptor blockers and Proton Pump Inhibitors and H pylori kits all have resulted in decreased incidence of patients requiring surgery and also the complications like pyloric stenosis have reduced. At the same time the incidence of antral carcinoma of stomach producing GOO has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibro optic endoscope. AIMS & OBJECTIVES To study and identify the cause of cases of GOO with respect to benign peptic ulcer and malignancy of stomach. MATERIALS AND METHODS An observational study comparing of 30 cases of GOO. An elaborate study of the cases with regard to history, clinical features, routine and special investigation, pre operative treatment, operative findings, post operative management and complications in the post operative period is done. Apart from routine surgical profile special investigations like serum electrolytes, barium meal study, Upper GI Endoscopy and ultrasound abdomen and pelvis will be carried. For peptic ulcer disease truncal vagotomy with posterior gastrojejunostomy was done and for carcinoma partial gastrectomy with Billroth II reconstruction or anterior GJ or palliative resection with anterior GJ were done. INCLUSION CRITERIA 1. Peptic ulcer disease 2. Carcinoma pyloric antrum, 3. Benign neoplasm of stomach. EXCLUSION CRITERIA 1. Carcinoma stomach with liver metastasis, ascites, peritoneal implantation, 2. Gastro duodenal tuberculosis. ETHICAL ISSUES

  3. Alcohol education and training in pre-registration nursing: a national survey to determine curriculum content in the United Kingdom (UK). (United States)

    Holloway, Aisha S; Webster, Brian J


    Alcohol-related harm impacts significantly on the health of the population. Nurses are often among the first health professionals that many patients with alcohol-related problems come into contact with and have been identified as playing a key role but may be ill-prepared to respond. Future nurses need to have the skills, knowledge and clinical confidence to respond to patients suffering from alcohol-related harm. A pre-registration curriculum that ensures a nursing workforce fit for practice in responding to alcohol-related harm is necessary. To determine the level of alcohol education and training content in the pre-registration curriculum for nursing in the United Kingdom (UK). To establish whether there are variations in the pre-registration curriculum content across the UK. A descriptive study. All 68 UK Higher Education Institutions offering a total of 111 pre-registration courses for nurses were invited to participate in the study. Twenty nine completed questionnaires were returned, a response rate of 26%. The largest number of identified responders were from England (n=15), with 3 from Scotland and 1 each from Wales and Northern Ireland. Nine Universities chose not to identify themselves. An online semi-structured questionnaire survey was used to collect the study data. Teaching of alcohol and alcohol related harm was mainly delivered during the second year of a pre-registration nursing programme provided mainly to adult and mental health students. Overall, the majority of alcohol related content that is provided within the responding pre-registration nursing courses relates to biophysiology, aetiology, and pharmacological and non-pharmacological interventions. This study highlights the need for a greater and more relevant focus of alcohol education to pre-registration nursing students of all fields of practice incorporating an integrated approach across all years of study. Copyright © 2012 Elsevier Ltd. All rights reserved.

  4. 75 FR 9614 - Importer of Controlled Substances; Notice of Registration (United States)


    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration By Notice dated October 16, 2009, and published in the Federal Register on October 28, 2009 (74 FR 55584), Clinical Supplies... Administration (DEA) to be registered as an importer of Poppy Straw Concentrate (9670), a basic class...

  5. 76 FR 77253 - Importer of Controlled Substances; Notice of Registration (United States)


    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration By Notice dated September 27, 2011, and published in the Federal Register on October 7, 2011, 76 FR 62446, Fisher Clinical... Enforcement Administration (DEA) to be registered as an importer of the following basic classes of...

  6. 76 FR 51400 - Importer of Controlled Substances; Notice of Registration (United States)


    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration By Notice dated May 13, 2011, and published in the Federal Register on May 27, 2011, 76 FR 30968, Almac Clinical Services Inc... Enforcement Administration (DEA) to be registered as an importer of the following basic classes of...

  7. 75 FR 44285 - Importer of Controlled Substances; Notice of Registration (United States)


    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration By Notice dated April 20, 2010, and published in the Federal Register on April 26, 2010, (75 FR 21661), Almac Clinical Services... Enforcement Administration (DEA) to be registered as an importer of the basic classes of controlled...

  8. 76 FR 25374 - Importer of Controlled Substances; Notice of Registration (United States)


    ... Enforcement Administration Importer of Controlled Substances; Notice of Registration By Notice dated November 18, 2010, and published in the Federal Register on December 3, 2010, 75 FR 75494, Clinical Supplies... Enforcement Administration (DEA) to be registered as an importer of Sufentanil (9740), a basic class...


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    Full Text Available BACKGROUND : S tructural abnormalities of the heart and great vessels are fairly common congenital lab normalities with the incidenceof8 in 1000 live births. With the advent of real time scanners fetal cardia can atomy can be analyze d echocardiographically. The earlier diagnosis will make an impact on clinical management of fetus with congenital heart disease. It helps intimely triage and optimal management of specific congenital heart disease either structural , functional orarrhythmia . OBJECTIVES : This study was conducted to note the spectrum of congenital heart diseases detected on fetal echo in pregnant mothers referred with high risk for CHD sand to assess the outcome of prenatally detected congenital heart diseases. MATERIAL S AND METHODS : T he study is aprospective descriptive study conducted in a tertiary care pediatric hospital in Mumbai over period of one year . P regnant mothers were referred for fetal echo , where pregnancy was considered as high risk for CHDs due to maternal , fetalfactorsorabnormallevel 1 scan.Fetal echowas performed by a trained pediatric cardiologistat 18 to 20 week of gestation using HP sonos 2000 echocardiographicmachinewith3/3.5 Hz transducer. Cardiac lesionsandoutcome of pregnancy was noted by postnatal follow - up of patients. RESULTS : A total of 170 patients underwent fetal echo , 13 patients have not delivered and 48 were lost to follow - up. Fetal echo was normal in 130(76.4% and abnormalities were detected in 40(23.5%.Structural anomalies were seen in 24(14.1% , arrhythmia in 5(2.9% and functional abnormalities in 11(6.4%.On outcome analysis84 (77.1% arealive , IUD /terminationof pregnancyoccurred in 18(16.5% , neonatal death in 6 (5.5% , infant death in 1 (0.9%. CONCLUSIONS : All ranges of CHDs can be diagnosed by fetal echocardiography . O utcome of prenatally detected complex congenital heart disease is poor ; nonetheless earlier detection provides a n opportunity for early interventions and


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    Full Text Available BACKGROUND AND OBJECTIVES: Choledocholithiasis complicates the working and management of cholelithiasis necessitating additional diagnostic procedures, increasing morbidity and mortality. CBD stone generally remain asymptomatic but when symptoms start appearing, cause a lot of suffering. There are various treatment modalities available presently. The objective of our study was to study the incidence, various modes of clinical presentations and different modalities of treatment in common bile duct stones. MATERIALS AND METHODS: 35 Patients were prospectively studied from July 2012 to June 2014 as in-patients in Victoria Hospital. RESULTS: CBD stones occurred predominantly in elderly females and presented from subclinical jaundice to complications in the form of biliary pancreatitis and cholangitis. USG abdomen with LFT was able to diagnose majority of the CBD stones preoperatively. Per operative cholangiogram was used selectively in case USG was inconclusive, ERCP was used in patients presenting with severe obstructive jaundice, pancreatitis, cholangitis, minimal CBD ductal dilation. Open exploration was the main focus with a wide variety of procedures performed according to specific indications. CONCLUSION: CBD was more common in elderly female patients probably due to neglected gall bladder stones. CBD stones can occur from occult asymptomatic stones only with altered LFT to symptomatic presentation in the form of cholangitis, pancreatitis. USG abdomen was inexpensive and easily available imaging modality to diagnose CBD stones with per operative cholangiogram being needed in minority of the cases. While ERCP was good in treating complications of CBD stones and early stages of the disease; the more advanced stage of the disease with gross CBD ductal dilation and multiple stones open CBD exploration were more productive.

  11. Navigation of total knee arthroplasty: rotation of components and clinical results in a prospectively randomized study

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    Efe Turgay


    Full Text Available Abstract Background Navigation was introduced into total knee arthroplasty (TKA to improve accuracy of component position, function and survival of implants. This study was designed to assess the outcome of navigated TKA in comparison with conventional implantation with the focus on rotational component position and clinical mid-term results. Methods In a prospectively randomized single-blinded approach, 90 patients with primary gonarthrosis were assigned to three different groups. Thirty patients each were assigned to NexGen LPS without and with navigation (groups 1 and 2, and 30 patients to navigation with the Stryker Scorpio PS (group 3. The navigation system used was the imageless Stryker KneeTrac, version 1.0. Clinical outcome was assessed by a blinded observer applying the Knee Society Score (KSS and a visual analogue scale (VAS for pain. CT scans and radiographs were conducted prior to and 12 weeks after index surgery. Results Seventy-nine patients were available for clinical evaluation at 3 ± 0.4 years follow-up. Four implants had to be revised for early loosening or infection (4.4%. Four patients had died and three patients were not able to follow the invitation for clinical assessment. Functional results in the KSS were significantly lower after navigated TKA. Operation time and incisions with navigation were significantly longer. Significantly less radiological outliers with navigation were found for coronal alignment of the femur, only. Conclusion In this series, no beneficial effect for navigation in TKA could be shown assessing clinical data, as functional results in the presented series seemed to be lower after first generation navigated TKA. The clinical mid- to long-term value of navigation remains to be evaluated in larger patient series or meta-analyses at longer follow-up. Trial registration number DRKS 00000430

  12. Comparing the Effectiveness of a Clinical Registry and a Clinical Data Warehouse for Supporting Clinical Trial Recruitment: A Case Study (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual


    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost. PMID:21347102

  13. Comparing the effectiveness of a clinical registry and a clinical data warehouse for supporting clinical trial recruitment: a case study. (United States)

    Weng, Chunhua; Bigger, J Thomas; Busacca, Linda; Wilcox, Adam; Getaneh, Asqual


    This paper reports a case study comparing the relative efficiency of using a Diabetes Registry or a Clinical Data Warehouse to recruit participants for a diabetes clinical trial, TECOS. The Clinical Data Warehouse generated higher positive predictive accuracy (31% vs. 6.6%) and higher participant recruitment than the Registry (30 vs. 14 participants) in a shorter time period (59 vs. 74 working days). We identify important factors that increase clinical trial recruitment efficiency and lower cost.

  14. Rapid registration of multimodal images using a reduced number of voxels (United States)

    Huang, Xishi; Hill, Nicholas A.; Ren, Jing; Peters, Terry M.


    Rapid registration of multimodal cardiac images can improve image-guided cardiac surgeries and cardiac disease diagnosis. While mutual information (MI) is arguably the most suitable registration technique, this method is too slow to converge for real time cardiac image registration; moreover, correct registration may not coincide with a global or even local maximum of MI. These limitations become quite evident when registering three-dimensional (3D) ultrasound (US) images and dynamic 3D magnetic resonance (MR) images of the beating heart. To overcome these issues, we present a registration method that uses a reduced number of voxels, while retaining adequate registration accuracy. Prior to registration we preprocess the images such that only the most representative anatomical features are depicted. By selecting samples from preprocessed images, our method dramatically speeds up the registration process, as well as ensuring correct registration. We validated this registration method for registering dynamic US and MR images of the beating heart of a volunteer. Experimental results on in vivo cardiac images demonstrate significant improvements in registration speed without compromising registration accuracy. A second validation study was performed registering US and computed tomography (CT) images of a rib cage phantom. Two similarity metrics, MI and normalized crosscorrelation (NCC) were used to register the image sets. Experimental results on the rib cage phantom indicate that our method can achieve adequate registration accuracy within 10% of the computation time of conventional registration methods. We believe this method has the potential to facilitate intra-operative image fusion for minimally invasive cardio-thoracic surgical navigation.

  15. Performance evaluation of MIND demons deformable registration of MR and CT images in spinal interventions (United States)

    Reaungamornrat, S.; De Silva, T.; Uneri, A.; Goerres, J.; Jacobson, M.; Ketcha, M.; Vogt, S.; Kleinszig, G.; Khanna, A. J.; Wolinsky, J.-P.; Prince, J. L.; Siewerdsen, J. H.


    Accurate intraoperative localization of target anatomy and adjacent nervous and vascular tissue is essential to safe, effective surgery, and multimodality deformable registration can be used to identify such anatomy by fusing preoperative CT or MR images with intraoperative images. A deformable image registration method has been developed to estimate viscoelastic diffeomorphisms between preoperative MR and intraoperative CT using modality-independent neighborhood descriptors (MIND) and a Huber metric for robust registration. The method, called MIND Demons, optimizes a constrained symmetric energy functional incorporating priors on smoothness, geodesics, and invertibility by alternating between Gauss-Newton optimization and Tikhonov regularization in a multiresolution scheme. Registration performance was evaluated for the MIND Demons method with a symmetric energy formulation in comparison to an asymmetric form, and sensitivity to anisotropic MR voxel-size was analyzed in phantom experiments emulating image-guided spine-surgery in comparison to a free-form deformation (FFD) method using local mutual information (LMI). Performance was validated in a clinical study involving 15 patients undergoing intervention of the cervical, thoracic, and lumbar spine. The target registration error (TRE) for the symmetric MIND Demons formulation (1.3  ±  0.8 mm (median  ±  interquartile)) outperformed the asymmetric form (3.6  ±  4.4 mm). The method demonstrated fairly minor sensitivity to anisotropic MR voxel size, with median TRE ranging 1.3-2.9 mm for MR slice thickness ranging 0.9-9.9 mm, compared to TRE  =  3.2-4.1 mm for LMI FFD over the same range. Evaluation in clinical data demonstrated sub-voxel TRE (preserved topology with sub-voxel invertibility (0.001 mm) and positive-determinant spatial Jacobians. The approach therefore appears robust against realistic anisotropic resolution characteristics in MR and yields registration

  16. Segmenting the Parotid Gland using Registration and Level Set Methods

    DEFF Research Database (Denmark)

    Hollensen, Christian; Hansen, Mads Fogtmann; Højgaard, Liselotte;

    The bilateral parotid glands were segmented using a registration scheme followed by level set segmentation. A training set consisting of computerized tomography from 10 patients with segmentation of the bilateral glands were used to optimize the parameters of registration and level set segmentation....... The method was evaluated on a test set consisting of 8 corresponding data sets. The attained total volume Dice coefficient and mean Haussdorff distance were 0.61 ± 0.20 and 15.6 ± 7.4 mm respectively. The method has improvement potential which could be exploited in order for clinical introduction....

  17. Primary pontine hemorrhage. A clinical study

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Jun; Kagimoto, Hiroshi; Maeda, Masanobu; Soda, Takao [Shimane Prefectural Central Hospital, Izumo (Japan)


    We studied the relationship between outcome and clinical symptoms or CT findings of 34 cases with primary pontine hemorrhage diagnosed by CT scan from April 1994 to March 1999. This series comprised 19 males and 15 females ranging in age from 45 to 89 years with a mean of 67.1 years. According to their outcome at discharge, the cases were divided into 6 groups. Sixteen cases died within 2 weeks after onset (group AD), 4 cases died with complication in the chronic phase (group D), 3 cases were severely disabled to bed-ridden state (group C), 2 cases recovered to a daily life with wheelchair (group B), 4 cases recovered to a daily life with partial assistance (group A), and 5 cases showed a full recovery (group J). The factors significantly correlated with bed outcome are as follows: young age, consciousness disturbance, respiratory disturbance, tachycardia over 90 beats per minute, hyperthermia over 39 deg C, abnormal pupils, loss of oculocephalic reflex, tetraplegia, decerebrate rigidity, bilateral extension or over 30 mm transverse diameter of the hematoma. (author)


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    Full Text Available Fistula in Ano is a benign treatable lesion of the rectum and the anal canal. Cryptoglandular infection accounts for about 90% of these cases. Majority of the infections are Acute and a minority contributed by chronic low grade infection hence pointing to varying etiologies. The pathogenesis has been attributed to the bursting open of an acute or inadequately treated Anorectal abscess into the peri anal skin. Diagnosis of the condition can be made easily with a good source of light, a proctoscope and a meticulous digital examination. Establishing a cure in this condition is difficult owing to two reasons. Firstly, the site of the infection makes the patient reluctant to subject themselves to examination. Secondly, a significant percent of these diseases persist or recur when appropriate surgery is not done or when the post op care is inadequate. Mostly it affects the young and the middle age group thus affecting productive man hours and quality of life. MATERIALS AND METHODS: All cases of clinically diagnosed Fistulae-in-ano above the age of 12 years, admitted in various surgical units in K.R. Hospital (attached to Government Medical College, Mysore during the study period December 1, 2008 to May 31, 2010. REUSLTS: Age Incidence, Sex Incidence, Socio Economic Status, Modes of Presentation, No. of External Openings, Situation of External Openings, Level of Fistulae, Type of surgical treatment, Associated with Fissure in Ano, Postoperative complication and Results were studied. CONCLUSION: Commonest age of presentation in our series is 30-40 years – 40%. Males are more commonly affected. Ratio Male: Female::3:1, Disease is more commonly seen in people with lower socio economic status group. 80% High socio economic class 20%. Discharging sinus is the commonest mode of presentation 72% and pain 72% and 84% pass history of perianal abscess was the presenting symptoms.

  19. Nail alterations during pregnancy: a clinical study. (United States)

    Erpolat, Seval; Eser, Ayla; Kaygusuz, Ikbal; Balci, Hatice; Kosus, Aydin; Kosus, Nermin


    During pregnancy, cutaneous and appendageal alterations manifest and may cause concern in the subject. The nails may be affected by pregnancy. This study investigated the frequency and nature of nail changes occurring during pregnancy in 312 healthy, 18-40-year-old pregnant women in gestation weeks 16-40. After a routine obstetric examination at the obstetrics and gynecology clinic at the study institution, all subjects submitted to an examination of all fingernails and toenails. Only nail alterations that had developed during pregnancy were recorded. Any nail changes that had occurred before the start of gestation were not considered. Data were presented as percentages. The Shapiro-Wilk and chi-squared tests were used to make categorical comparisons. A P-value of nail pathologies were detected in 116 (37.2%) of the 312 subjects. The most commonly found nail change was leukonychia (24.4%). Ingrown toenail (9.0%) and onychoschizia (9.0%) represented the second most common nail changes. Rapid nail growth and subungual hyperkeratosis were observed in 6.7% and 4.2%, respectively, of subjects. When the alterations were evaluated according to gestational age, the most common nail pathology was leukonychia at both 14-28 weeks (16.3%) and 29-42 weeks (27.4%) of pregnancy. Leukonychia, onychoschizia, onycholysis, and brittle nail pathologies were frequently observed at 29-42 weeks of pregnancy (P = 0.047). A large proportion of nail changes that occur during pregnancy are benign and do not require treatment. However, these changes may cause significant cosmetic stress in women.

  20. Clinical studies on inferior right hepatic veins

    Institute of Scientific and Technical Information of China (English)

    Xue Xing; Hong Li; Wei-Guo Liu


    BACKGROUND:Many small veins are called accessory, short hepatic veins in addition to the right, middle and left hepatic veins. The size of these veins varied from a pinhole to 1 cm; the size of inferior right hepatic veins (IRHVs) is thicker than that of short hepatic veins or more than 1 cm occasionally. Adults have a higher incidence rate of the IRHV. DATA SOURCES:A literature search of the PubMed database was conducted and research articles were reviewed. RESULTS:The size of IRHVs is related to the size of the right hepatic vein, i.e. the larger the diameter of the right hepatic vein, the smaller the diameter of the IRHVs, and vice versa. The IRHVs are divided into superior, medial and inferior groups, separately named the superior, medial and inferior right hepatic veins according to the position of the IRHV entering the inferior vena cava. The superior right hepatic vein mainly drains the superior part of segmentⅦ, and the medial right hepatic vein drains the middle part of segmentⅦ. A thicker IRHV mainly drains segmentⅥ and the inferior part of segmentⅦ and a thinner IRHV drains the inferior part of segmentⅤ. CONCLUSIONS:The clinical signiifcance of these studies on IRHVs is varied: (1) Hepatic caudate lobe resection could be introduced after study on the veins of that lobe. (2) It is very important to identify the draining region of the IRHV for guiding hepatic segmentectomy. The postero-inferior area of the right lobe can be preserved along with the hypertrophic IRHV even if the entire main right hepatic vein is resected during segmentectomy ofⅦ andⅧwith right hepatic vein resection for patients with primary liver cancer. (3) The ligation of the major hepatic vein for the treatment of juxtahepatic vein injury is recommended because of severe hemorrhagic shock and dififculty in

  1. A longitudinal study of empathy in pre-clinical and clinical medical students and clinical supervisors. (United States)

    Mahoney, Sarah; Sladek, Ruth M; Neild, Tim


    Although appropriate empathy in health professionals is essential, a loss of empathy can occur during medical education. The structure of clinical learning may be one factor that is implicated in a loss of empathy. This study examines student and doctor empathy, and possible associations between empathy and the structure of clinical learning. There were three groups of participants: medical students (n = 281), who completed a longitudinal survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the beginning and end of the 2013 academic year; private doctors (medical practitioners) in South Australia (n = 78) who completed a survey consisting of the Jefferson Scale of Empathy and an open question about empathy at the end of the students' academic year; and doctors (medical practitioners) from public teaching hospitals (n = 72) in southern Adelaide, South Australia who completed a survey consisting of the Jefferson Scale of Empathy at the end of the students' academic year . Year one students' empathy scores at the end of the year (102.8 ± 17.7) were significantly lower than at the start of the year (112.3 ± 9.6) p empathy scores by year groups or across the two time points. Empathy scores were almost identical for private and hospital clinicians and higher than average scores for students. Free-text comments highlighted the importance students and doctors place on empathy. Students described issues that adversely affected their empathy, including specific incidents, systemic issues, and course structure, but also described some positive role models. Doctors' comments focused on the importance of empathy but qualified its meaning in the therapeutic setting. Medical students and practitioners alike ascribe importance to empathy in clinical practice, yet its developmental course remains poorly understood with possible decrement across the course of medical education. A more sophisticated understanding of empathy

  2. What is a clinical decision analysis study?

    Directory of Open Access Journals (Sweden)

    Aleem Ilyas


    Full Text Available Decision making in clinical practice often involves the need to make complex and intricate decisions with important long-term consequences. Decision analysis is a tool that allows users to apply evidence-based medicine to make informed and objective clinical decisions when faced with complex situations. A Decision Tree, together with literature-derived probabilities and defined outcome values, is used to model a given problem and help determine the best course of action. Sensitivity analysis allows an exploration of important variables on final clinical outcomes. A decision-maker can thereafter establish a preferred method of treatment and explore variables which influence the final outcome. The present paper is intended to give an overview of decision analysis and its application in clinical decision making.

  3. Image Classifying Registration for Gaussian & Bayesian Techniques: A Review

    Directory of Open Access Journals (Sweden)

    Rahul Godghate,


    Full Text Available A Bayesian Technique for Image Classifying Registration to perform simultaneously image registration and pixel classification. Medical image registration is critical for the fusion of complementary information about patient anatomy and physiology, for the longitudinal study of a human organ over time and the monitoring of disease development or treatment effect, for the statistical analysis of a population variation in comparison to a so-called digital atlas, for image-guided therapy, etc. A Bayesian Technique for Image Classifying Registration is well-suited to deal with image pairs that contain two classes of pixels with different inter-image intensity relationships. We will show through different experiments that the model can be applied in many different ways. For instance if the class map is known, then it can be used for template-based segmentation. If the full model is used, then it can be applied to lesion detection by image comparison. Experiments have been conducted on both real and simulated data. It show that in the presence of an extra-class, the classifying registration improves both the registration and the detection, especially when the deformations are small. The proposed model is defined using only two classes but it is straightforward to extend it to an arbitrary number of classes.

  4. USDA registration and rectification requirements (United States)

    Allen, R.


    Some of the requirements of the United States Department of Agriculture for accuracy of aerospace acquired data, and specifically, requirements for registration and rectification of remotely sensed data are discussed. Particular attention is given to foreign and domestic crop estimation and forecasting, forestry information applications, and rangeland condition evaluations.

  5. What drives Users' Website Registration?

    NARCIS (Netherlands)

    T. Li (Ting); P.A. Pavlou (Paul)


    textabstractUser registration is an important prerequisite for the success of many websites by enabling users to gain access to domain information and personalized content. It is not always desirable for users, however, because they need to disclose personal information. This paper examines what dri

  6. Efficient nonrigid registration using ranked order statistics

    DEFF Research Database (Denmark)

    Tennakoon, Ruwan B.; Bab-Hadiashar, Alireza; de Bruijne, Marleen


    Non-rigid image registration techniques are widely used in medical imaging applications. Due to high computational complexities of these techniques, finding appropriate registration method to both reduce the computation burden and increase the registration accuracy has become an intense area...... of research. In this paper we propose a fast and accurate non-rigid registration method for intra-modality volumetric images. Our approach exploits the information provided by an order statistics based segmentation method, to find the important regions for registration and use an appropriate sampling scheme...... to target those areas and reduce the registration computation time. A unique advantage of the proposed method is its ability to identify the point of diminishing returns and stop the registration process. Our experiments on registration of real lung CT images, with expert annotated landmarks, show...

  7. 75 FR 4383 - Pesticide Products: Registration Applications (United States)


    ... AGENCY Pesticide Products: Registration Applications AGENCY: Environmental Protection Agency (EPA). ACTION: Notice. SUMMARY: This notice announces receipt of applications to register pesticide products... comments by the comment period deadline identified. II. Registration Applications EPA received applications...

  8. Implicit reference-based group-wise image registration and its application to structural and functional MRI. (United States)

    Geng, Xiujuan; Christensen, Gary E; Gu, Hong; Ross, Thomas J; Yang, Yihong


    In this study, an implicit reference group-wise (IRG) registration with a small deformation, linear elastic model was used to jointly estimate correspondences between a set of MRI images. The performance of pair-wise and group-wise registration algorithms was evaluated for spatial normalization of structural and functional MRI data. Traditional spatial normalization is accomplished by group-to-reference (G2R) registration in which a group of images are registered pair-wise to a reference image. G2R registration is limited due to bias associated with selecting a reference image. In contrast, implicit reference group-wise (IRG) registration estimates correspondences between a group of images by jointly registering the images to an implicit reference corresponding to the group average. The implicit reference is estimated during IRG registration eliminating the bias associated with selecting a specific reference image. Registration performance was evaluated using segmented T1-weighted magnetic resonance images from the Nonrigid Image Registration Evaluation Project (NIREP), DTI and fMRI images. Implicit reference pair-wise (IRP) registration-a special case of IRG registration for two images-is shown to produce better relative overlap than IRG for pair-wise registration using the same small deformation, linear elastic registration model. However, IRP-G2R registration is shown to have significant transitivity error, i.e., significant inconsistencies between correspondences defined by different pair-wise transformations. In contrast, IRG registration produces consistent correspondence between images in a group at the cost of slightly reduced pair-wise RO accuracy compared to IRP-G2R. IRG spatial normalization of the fractional anisotropy (FA) maps of DTI is shown to have smaller FA variance compared with G2R methods using the same elastic registration model. Analyses of fMRI data sets with sensorimotor and visual tasks show that IRG registration, on average, increases the


    Directory of Open Access Journals (Sweden)

    Kumbha Thulasi Ram


    Full Text Available NTRIDUCTION : Stroke is one of the important causes of morbidity and mortality all over the world. Incidence of stroke steadily increases with age. Experts are concerned of the emerging stroke epidemic in India. Stroke affecting the young has potentially devastating consequence son the individual and his family. Certain risk factors are unique to the young. I t needs more studies for identification and modification of risk factors. The study aims to evaluate clinical features, risk factors, etiology and mortality of stroke in young patients. METHODS : 74 young patients satisfying the inclusion criteria were included in this study. A detailed history was taken from young stroke patients, systemic examination and required investigations were done. Data was collected in standardized proforma and analysed. RESULTS: Stroke in young accounts for 7.95% of stroke cases of all age groups. The mean age of the patients was 34.66 ± 7.48 years. Among 74 patients, 47(63.51% were male and 27(36.49% were female. Seizures, decreased consciousness, speech involvement and motor deficit were observed in 33.78%, 44.59%, 22.97% and 100% of cases respectively. 82.43% patients had ischemic and 17.57% patients had hemorrhagic stroke. Among ischemic stroke, large artery atherosclerosis was 16.21%, tuberculous meningoencephalitis with vasculitis was 16.21%, lacunar stroke was 10.81%, CVT was 10.81% and cardio embolic stroke was 6.76%. Smoking (59.45%, alcoholism (58.10%, hypertension (43.24%, coronary artery disease (8.10%, diabetes mellitus (10.81%, elevated total cholesterol (25.67%, elevated low density lipo proteins (22.97%, elevated triglycerides (27.02% and low HDL (22.97% were important risk factors. Carotid doppler was abnormal in 9.45% of patients. 6.76% patients had mitral stenosis in echocardiogram. Low protein C and protein S were found in 1.35% of patients. Eight (10.81% patients died during the hospital stay. INTERPRETATION AND CONCLUSIONS: The major risk

  10. Corneal stromal dystrophies: a clinical pathologic study

    Directory of Open Access Journals (Sweden)

    Elvira Barbosa Abreu


    Full Text Available INTRODUCTION: Corneal dystrophy is defined as bilateral and symmetric primary corneal disease, without previous associated ocular inflammation. Corneal dystrophies are classified according to the involved corneal layer in superficial, stromal, and posterior dystrophy. Incidence of each dystrophy varies according to the geographic region studied. PURPOSE: To evaluate the prevalence of stromal corneal dystrophies among corneal buttons specimens obtained by penetrating keratoplasty (PK in an ocular pathology laboratory and to correlate the diagnosis with patient age and gender. METHODS: Corneal button cases of penetrating keratoplasty from January-1996 to May-2009 were retrieved from the archives of The Henry C. Witelson Ophthalmic Pathology Laboratory and Registry, Montreal, Canada. The cases with histopathological diagnosis of stromal corneal dystrophies were stained with special stains (Peroxid acid Schiff, Masson trichrome, Congo red analyzed under polarized light, and alcian blue for classification and correlated with epidemiological information (age at time of PK and gender from patients' file. RESULTS: 1,300 corneal buttons cases with clinical diagnose of corneal dystrophy were retrieved. Stromal corneal dystrophy was found in 40 (3.1% cases. Lattice corneal dystrophy was the most prevalent with 26 cases (65%. Nineteen were female (73.07% and the PK was performed at average age of 59.3 years old. Combined corneal dystrophy was found in 8 (20% cases, 5 (62.5% of them were female and the average age of the penetrating keratoplasty was 54.8 years old. Granular corneal dystrophy was represented by 5 (12.5% cases, and 2 (40% of them were female. Penetrating keratoplasty was performed at average age of 39.5 years old in granular corneal dystrophy cases. Macular corneal dystrophy was present in only 1 (2.5% case, in a 36 years old female. CONCLUSION: Systematic histopathological approach and evaluation, including special stains in all stromal

  11. Solid Mesh Registration for Radiotherapy Treatment Planning

    DEFF Research Database (Denmark)

    Noe, Karsten Østergaard; Sørensen, Thomas Sangild


    We present an algorithm for solid organ registration of pre-segmented data represented as tetrahedral meshes. Registration of the organ surface is driven by force terms based on a distance field representation of the source and reference shapes. Registration of internal morphology is achieved usi...... to complete. The proposed method has many potential uses in image guided radiotherapy (IGRT) which relies on registration to account for organ deformation between treatment sessions....

  12. [Changing surgical therapy because of clinical studies?]. (United States)

    Schwenk, W; Haase, O; Müller, J M


    The randomised controlled clinical trial (RCT) is a powerful instrument to evaluate different therapeutic regimens. In a survey among 115 physicians visiting the 25th annual meeting of the Surgical Society of Berlin and Brandenburg, the RCT was judged to be very important when changes of therapeutic strategies are discussed. 90 % of all participants claimed to use data from RCTs in the clinical routine and 89 % would participate in such a trial. In official (e. g. discussions during coffee breaks at scientific meetings) or non-medical (e. g. non-scientific press or media) sources of information were assessed as irrelevant for decisions regarding therapeutic strategies. However, in contrast to this view laparoscopic cholecystectomy was introduced into clinical practice rapidly because patients informed by external (non-medical) sources preferred to be operated on with the "modern" technique. Clinical trials with a high level of evidence had no relevant influence on the rapid distribution of laparoscopic cholecystectomy. Controversial discussions concerning the extent of lymphadenectomy with gastric resection for carcinoma demonstrate that the value of excellent clinical RCTs is low if their results challenge a stable paradigma of the surgical scientific society. To allow a rational judgement, new surgical technologies should undergo a scientific gradual evaluation in agreement with the principles of evidence based medicine.

  13. Using Clinical Gait Case Studies to Enhance Learning in Biomechanics (United States)

    Chester, Victoria


    Clinical case studies facilitate the development of clinical reasoning strategies through knowledge and integration of the basic sciences. Case studies have been shown to be more effective in developing problem-solving abilities than the traditional lecture format. To enhance the learning experiences of students in biomechanics, clinical case…

  14. [Clinical studies of pediatric malabsorption syndromes]. (United States)

    Hosoyamada, Takashi


    Multiple cases with various types of pediatric malabsorption syndromes were evaluated. The clinical manifestations, laboratory findings, pathophysiology, and histopathological descriptions of each patient were analyzed in an effort to clear the pathogenesis of the malabsorption syndromes and the treatments were undertaken. The cases studied, included one patient with cystic fibrosis, two with lactose intolerance with lactosuria (Durand type), one with primary intestinal lymphangiectasia, two with familial hypobetalipoproteinemia, one with Hartnup disease, one with congenital chroride diarrhea, one with acrodermatitis enteropathica, one with intestinal nodular lymphoid hyperplasia (NLH), five with intractable diarrhea of early infancy and four with glycogenosis type Ia. Each case description and outcome is described below: 1. A 15-year-old Japanese boy with cystic fibrosis presented with severe symptoms, including pancreatic insufficiency, bronchiectasis, pneumothorax and hemoptysis. His prognosis was poor. Analysis of the CFTR genes of this patient revealed a homozygous large deletion from intron 16 to 17b. 2. In the sibling case of Durand type lactose intolerance, the subjects'disaccaridase activity of the small bowel, including lactase, were within normal limits. The results of per oral and per intraduodenal lactose tolerance tests confirmed lactosuria in both. These observations suggested, not only an abnormal gastric condition, but also duodenal and intestinal mucosal abnormal permeability of lactose. 3. In the case of primary intestinal lymphangiectasia, the subject had a lymphedematous right arm and hand, a grossly coarsened mucosal pattern of the upper gastrointestinal tract (identified via radiologic examination) and the presence of lymphangiectasia (confirmed via duodenal mucosal biopsy). The major laboratory findings were hypoalbuminemia, decreased immunoglobulin levels and lymphopenia resulting from loss of lymph fluid and protein into the gastro

  15. 21 CFR 710.6 - Notification of registrant; cosmetic product establishment registration number. (United States)


    ... 21 Food and Drugs 7 2010-04-01 2010-04-01 false Notification of registrant; cosmetic product... OF HEALTH AND HUMAN SERVICES (CONTINUED) COSMETICS VOLUNTARY REGISTRATION OF COSMETIC PRODUCT ESTABLISHMENTS § 710.6 Notification of registrant; cosmetic product establishment registration number....

  16. 9 CFR 2.30 - Registration. (United States)


    ... sign the registration form. (2) In any situation in which a school or department of a university or... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Registration. 2.30 Section 2.30... WELFARE REGULATIONS Research Facilities § 2.30 Registration. (a) Requirements and procedures. (1)...

  17. Evaluation of Registration Methods on Thoracic CT

    DEFF Research Database (Denmark)

    Murphy, K.; van Ginneken, B.; Reinhardt, J.;


    EMPIRE10 (Evaluation of Methods for Pulmonary Image REgistration 2010) is a public platform for fair and meaningful comparison of registration algorithms which are applied to a database of intra-patient thoracic CT image pairs. Evaluation of non-rigid registration techniques is a non trivial task...

  18. Establishing a multicenter longitudinal clinical cohort Study in ...

    African Journals Online (AJOL)

    ... clinical cohort Study in Ethiopia: Advanced Clinical Monitoring of Antiretroviral Treatment Project. ... Ethiopian Journal of Health Sciences ... Using similar recruitment procedures, a total of 120 children were enrolled in each of retrospective ...


    Directory of Open Access Journals (Sweden)



    Full Text Available Otomycosis or “Otitis externa myotica” refers to a fungal or yeast infection of the external auditory meatus. Fungi can be isolated in up to 40 percent of all cases of external otitis, especially “Aspergillus niger and Candida albicans”. It has a worldwide distribution with higher prev alence in the hot, humid and dusty climate of the tropical and subtropical regions and sometimes in association with immunosuppression and poor hygienic conditions. The purpose of this study is to analyse the etiology, clinical manifestations, microbial pa ttern of otomycosis and treatment.

  20. Operational Efficiency of an Immunization Clinic Attached to Rural Health Training Centre in Delhi, India: A Time and Motion Study

    Directory of Open Access Journals (Sweden)

    Varun Kumar


    Full Text Available Background. Obtaining baseline data about current patterns of work is important for assessing the effects of interventions designed to improve care delivery. Time and motion studies allow for the most accurate measurement of structured components. Therefore, the present study was conducted to study the operational efficiency of an immunization clinic in Delhi, India. Methods. An observational cross-sectional study was conducted at the immunization clinic of Rural Health Training Centre in Delhi, India, from January 2014 to March 2014. The study composed two stage evaluations, a passive observation and a time and motion study. Systemic random sampling method was used to select 863 mothers/caregivers attending the immunization clinic. Results. At the immunization clinic, the study participants spent 64.1% of their total time in waiting. For new cases, the mean time taken for initial registration and receiving postvaccination advice was found to be significantly longer than old cases. Delivering health care services took more time during Mondays and also during the first hour of the day. Conclusion. Results of this study will guide public health decision-makers at all government levels in planning and implementation of immunization programs in developing countries.

  1. Compliance with clinical trial registration and reporting guidelines by Latin American and Caribbean journals Adherencia a las iniciativas de registro de ensayos clínicos y guías de reporte por revistas de América Latina y Caribe Adesão às iniciativas de registro de ensaios clínicos e normas de notificação por periódicos da América Latina e do Caribe

    Directory of Open Access Journals (Sweden)

    Chimaraoke Iko


    Full Text Available The objective of this study was to determine to what extent Latin American and Caribbean biomedical journals have endorsed and complied with clinical trial registration and reporting guidelines. A search of randomized clinical trials was carried out using the LILACS database. The randomized clinical trials identified through the search were assessed to determine whether trial registration and CONSORT guidance was mentioned. Information regarding endorsement of the ICMJE, trial registration and other reporting guidelines was extracted from the online instructions for authors of the journals included in the study. The search identified 477 references. We assessed a random sample of 240 titles of which 101 were randomized clinical trials published in 56 journals. Trial registration was reported in 19.8% of the randomized clinical trials, 6.9% were prospectively registered and 3% mentioned CONSORT. The ICMJE was mentioned by 68% of the journals and 36% of journals required trial registration. Fewer journals provided advice on reporting guidelines: CONSORT (13%, PRISMA (1.8%, STROBE (1.8%, and the EQUATOR network (3.6%. Wider endorsement of trial registration and adherence to reporting guidelines is necessary in clinical trials conducted in Latin America and the Caribbean.Se evaluó el nivel de apoyo y cumplimiento a las iniciativas de registro de ensayos clínicos y de guías de reporte de revistas biomédicas de América Latina y Caribe. Se realizó una búsqueda de ensayos clínicos aleatoria en LILACS. Los ensayos clínicos aleatorios fueron evaluados para determinar si los autores informaron del registro de ensayos clínicos y mencionaron la guía CONSORT. Se evaluaron las instrucciones para los autores de las revistas que publicaron los ensayos clínicos aleatorios con el fin de determinar las indicaciones, en relación al registro de ensayos clínicos, las guías de reporte y el ICMJE. Se identificaron 477 citas; una muestra aleatoria de 240

  2. Multi-modal inter-subject registration of mouse brain images (United States)

    Li, Xia; Yankeelov, Thomas E.; Rosen, Glenn; Gore, John C.; Dawant, Benoit M.


    The importance of small animal imaging in fundamental and clinical research is growing rapidly. These studies typically involve micro PET, micro MR, and micro CT images as well as optical or fluorescence images. Histological images are also often used to complement and/or validate the in vivo data. As is the case for human studies, automatic registration of these imaging modalities is a critical component of the overall analysis process, but, the small size of the animals and thus the limited spatial resolution of the in vivo images present specific challenges. In this paper, we propose a series of methods and techniques that permit the inter-subject registration of micro MR and histological images. We then compare results obtained by registering directly MR volumes to each other using a non-rigid registration algorithm we have developed at our institution with results obtained by registering first the MR volumes to their corresponding histological volume, which we reconstruct from 2D cross-sections, and then registering histological volumes to each other. We show that the second approach is preferable.

  3. Automated registration of multispectral MR vessel wall images of the carotid artery

    Energy Technology Data Exchange (ETDEWEB)

    Klooster, R. van ' t; Staring, M.; Reiber, J. H. C.; Lelieveldt, B. P. F.; Geest, R. J. van der, E-mail: [Department of Radiology, Division of Image Processing, Leiden University Medical Center, 2300 RC Leiden (Netherlands); Klein, S. [Department of Radiology and Department of Medical Informatics, Biomedical Imaging Group Rotterdam, Erasmus MC, Rotterdam 3015 GE (Netherlands); Kwee, R. M.; Kooi, M. E. [Department of Radiology, Cardiovascular Research Institute Maastricht, Maastricht University Medical Center, Maastricht 6202 AZ (Netherlands)


    Purpose: Atherosclerosis is the primary cause of heart disease and stroke. The detailed assessment of atherosclerosis of the carotid artery requires high resolution imaging of the vessel wall using multiple MR sequences with different contrast weightings. These images allow manual or automated classification of plaque components inside the vessel wall. Automated classification requires all sequences to be in alignment, which is hampered by patient motion. In clinical practice, correction of this motion is performed manually. Previous studies applied automated image registration to correct for motion using only nondeformable transformation models and did not perform a detailed quantitative validation. The purpose of this study is to develop an automated accurate 3D registration method, and to extensively validate this method on a large set of patient data. In addition, the authors quantified patient motion during scanning to investigate the need for correction. Methods: MR imaging studies (1.5T, dedicated carotid surface coil, Philips) from 55 TIA/stroke patients with ipsilateral <70% carotid artery stenosis were randomly selected from a larger cohort. Five MR pulse sequences were acquired around the carotid bifurcation, each containing nine transverse slices: T1-weighted turbo field echo, time of flight, T2-weighted turbo spin-echo, and pre- and postcontrast T1-weighted turbo spin-echo images (T1W TSE). The images were manually segmented by delineating the lumen contour in each vessel wall sequence and were manually aligned by applying throughplane and inplane translations to the images. To find the optimal automatic image registration method, different masks, choice of the fixed image, different types of the mutual information image similarity metric, and transformation models including 3D deformable transformation models, were evaluated. Evaluation of the automatic registration results was performed by comparing the lumen segmentations of the fixed image and

  4. Graph-based surface extraction of the liver using locally adaptive priors for multimodal interventional image registration (United States)

    Kadoury, Samuel; Wood, Bradford J.; Venkatesan, Aradhana M.; Ardon, Roberto; Jago, James; Kruecker, Jochen


    The 3D fusion of tracked ultrasound with a diagnostic CT image has multiple benefits in a variety of interventional applications for oncology. Still, manual registration is a considerable drawback to the clinical workflow and hinders the widespread clinical adoption of this technique. In this paper, we propose a method to allow for an image-based automated registration, aligning multimodal images of the liver. We adopt a model-based approach that rigidly matches segmented liver shapes from ultrasound (U/S) and diagnostic CT imaging. Towards this end, a novel method which combines a dynamic region-growing method with a graph-based segmentation framework is introduced to address the challenging problem of liver segmentation from U/S. The method is able to extract liver boundary from U/S images after a partial surface is generated near the principal vector from an electromagnetically tracked U/S liver sweep. The liver boundary is subsequently expanded by modeling the problem as a graph-cut minimization scheme, where cost functions used to detect optimal surface topology are determined from adaptive priors of neighboring surface points. This allows including boundaries affected by shadow areas by compensating for varying levels of contrast. The segmentation of the liver surface is performed in 3D space for increased accuracy and robustness. The method was evaluated in a study involving 8 patients undergoing biopsy or radiofrequency ablation of the liver, yielding promising surface segmentation results based on ground-truth comparison. The proposed extended segmentation technique improved the fiducial landmark registration error compared to a point-based registration (7.2mm vs. 10.2mm on average, respectively), while achieving tumor target registration errors that are statistically equivalent (p > 0.05) to state-of-the-art methods.

  5. 3D ultrasound to stereoscopic camera registration through an air-tissue boundary. (United States)

    Yip, Michael C; Adebar, Troy K; Rohling, Robert N; Salcudean, Septimiu E; Nguan, Christopher Y


    A novel registration method between 3D ultrasound and stereoscopic cameras is proposed based on tracking a registration tool featuring both ultrasound fiducials and optical markers. The registration tool is pressed against an air-tissue boundary where it can be seen both in ultrasound and in the camera view. By localizing the fiducials in the ultrasound volume, knowing the registration tool geometry, and tracking the tool with the cameras, a registration is found. This method eliminates the need for external tracking, requires minimal setup, and may be suitable for a range of minimally invasive surgeries. A study of the appearance of ultrasound fiducials on an air-tissue boundary is presented, and an initial assessment of the ability to localize the fiducials in ultrasound with sub-millimeter accuracy is provided. The overall accuracy of registration (1.69 +/- 0.60 mm) is a noticeable improvement over other reported methods and warrants patient studies.

  6. The evaluation of composite dose using deformable image registration in adaptive radiotherapy for head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Chul Hwan; Ko, Seong Jin; Kim, Chang Soo; Kim, Jung Hoon; Kim, Dong Hyun; Choi, Seok Yoon; Ye, Soo Young; Kang, Se Sik [Dept. of Radiological Science, College of Health Sciences, Catholic University of Pusan, Pusan (Korea, Republic of)


    In adaptive radiotherapy(ART), generated composite dose of surrounding normal tissue on overall treatment course which is using deformable image registration from multistage images. Also, compared with doses summed by each treatment plan and clinical significance is considered. From the first of May, 2011 to the last of July, 2012. Patients who were given treatment and had the head and neck cancer with 3-dimension conformal radiotherapy or intensity modulated radiotherapy, those who were carried out adaptive radiotherapy cause of tumor shrinkage and weight loss. Generated composite dose of surrounding normal tissue using deformable image registration was been possible, statistically significant difference was showed to mandible(48.95±3.89 vs 49.10±3.55 Gy), oral cavity(36.93±4.03 vs 38.97±5.08 Gy), parotid gland(35.71±6.22 vs 36.12±6.70 Gy) and temporomandibular joint(18.41±9.60 vs 20.13±10.42 Gy) compared with doses summed by each treatment plan. The results of this study show significant difference between composite dose by deformable image registration and doses summed by each treatment plan, composite dose by deformable image registration may generate more exact evaluation to surrounding normal tissue in adaptive radiotherapy.

  7. The role of the nurse teacher in clinical practice: an empirical study of Finnish student nurse experiences. (United States)

    Saarikoski, Mikko; Warne, Tony; Kaila, Päivi; Leino-Kilpi, Helena


    This paper focuses on the role of the nurse teacher (NT) in supporting student nurse education in clinical practice. The paper draws on the outcomes of a study aimed at exploring student nurse experiences of the pedagogical relationship with NTs during their clinical placements. The participants (N=549) were student nurses studying on pre-registration nursing programmes in Finland. Data were analysed using descriptive statistics, cross-tabulation and ANOVA. The study showed that the core aspect of NTs work in clinical practice revolved around the relationship between student, mentor and NT. Higher levels of satisfaction were experienced in direct proportion to the number of meetings held between the student and NT. However, whilst the importance of this relationship has been reported elsewhere, an additional aspect of this relationship emerged in the data analysis. Those NT who facilitated good face to face contact also used other methods to enhance the relationship, particularly e-mail, virtual learning environment and texting. This outcome suggests that NT's interpersonal and communicative skills are as important as their clinical knowledge and skills in promoting effective learning in the clinical practice area. The paper argues for such approaches to be utilised within the emergent opportunities afforded by new communication and educational technologies.

  8. Study of three-color fiducial registration for augment reality%增强现实三色立体基准注册技术的研究

    Institute of Scientific and Technical Information of China (English)

    徐彤; 王涌天


    讨论了在增强现实(Augment Reality)的三色立体基准注册(Registration)技术中需要解决的问题.增强现实的三色立体基准注册技术是一种新的基于视觉的三维注册技术,主要论述了在此三维注册技术中如何通过滤波消除三色立体基准注册中的图像噪声以及如何通过重心拟和法获得注册基准的像斜率.

  9. Cryptogenic Polyneuropathy : Clinical, Environmental, And Genetic Studies


    Lindh, Jonas


    Objectives: The purpose of this medical thesis was to describe the clinical and neurophysiological features and to evaluate the health related quality of life (HR-QoL) in patients with cryptogenic polyneuropathy. We also wanted to investigate different occupational, and leisure time exposures as determinants for cryptogenic polyneuropathy, and to analyze whether polymorphisms for the null alleles of Glutathione S-Transferase Mu-1 (GSTM1), and Theta-1 (GSTT1), and a low activity genetic variat...

  10. [Organizational ethics: a study in ophthalmologic clinics]. (United States)

    Sanches, Maria Aparecida; Scarpi, Marinho Jorge


    Research on the field of organizational ethics to investigate to which extent ophthalmologic clinics, inserted in the competitive atmosphere, in the condition of organizations in search of survival, subordinate ethics to competitiveness in the managerial praxis, that is, in the administrative sphere. Kohlberg is taken as theoretical reference, approaching the theme of ethical subordination to competitiveness. The instrument to evaluate moral behaviors of organizations, elaborated by Licht, is applied. The quantitative method is used, adopting analytic instruments, such as Q of Yule and non parametric tests, when dealing with the data of 41 ophthalmologic clinics. The results of the research seem to indicate that administrators of ophthalmologic clinics of greater performance subordinate ethical principles to competitiveness, seeking to assure the survival of the company and, when confronted with the instrument to evaluate their moral behavior, proposed by Kohlberg, have a significantly smaller presence in the postconventional stage than administrators of ophthalmologic clinics with a smaller performance. One may affirm, according to non parametric tests, at the level of significance of 0.05, that the levels of moral development of the two groups differ significantly. The obtained results are according to the literature, especially concerning the "paradox of the ethical subordination and competitiveness". They also suggest that the warrant of the survival of the company tends to reduce the perception of the groups in power regarding the problems that happen in the community, and that a reduction of the ethical values subordinated to competition occurs, and such reduction provokes growing feelings of economical disputes in the social sphere.

  11. 优秀运动员文化教育注册制度设计研究%Study on Registration System Design of Elite Athletes' Education

    Institute of Scientific and Technical Information of China (English)

    孙国友; 孙艳秋; 苏新荣


    In accordance with Chinese Constitution, the Education Act and the Compulsory Education Law, and our country'ssystem and the contradictions, problems and characteristics of elite athletes' education, the research draws lessons from home and overseas about the athletes' registration management system, and adheres to the principles of operability, legality as well as monitoring. It made preliminary designs on elite athletes' education registration system in management of students recruit, education and teaching management and organizational management to provide an operable path to the education of elite athletes.%以我国宪法、教育法和义务教育法等有关法律规定为法律依据,以我国的举国体制为体制依据,以我国优秀运动员文化教育的诸多矛盾、问题和特点为现实依据,借鉴国内外运动员注册管理制度,坚持可操作性、合法性及可监控性等原则,从招生管理、学籍管理、教育教学管理以及组织管理等方面,对我国优秀运动员文化教育注册制度进行初步设计,为加强优秀运动员文化教育事业提供具有较强操作性的实施路径。

  12. Celiac Patients: A Randomized, Controlled Clinical Study

    Directory of Open Access Journals (Sweden)

    Giuseppe Mazzarella


    Full Text Available A lifelong gluten-free diet (GFD is mandatory for celiac disease (CD but has poor compliance, justifying novel strategies. We found that wheat flour transamidation inhibited IFN-γ secretion by intestinal T cells from CD patients. Herein, the primary endpoint was to evaluate the ability of transamidated gluten to maintain GFD CD patients in clinical remission. Secondary endpoints were efficacy in prevention of the inflammatory response and safety at the kidney level, where reaction products are metabolized. In a randomized single blinded, controlled 90-day trial, 47 GFD CD patients received 3.7 g/day of gluten from nontransamidated (12 or transamidated (35 flour. On day 15, 75% and 37% of patients in the control and experimental groups, respectively, showed clinical relapse (=0.04 whereas intestinal permeability was mainly altered in the control group (50% versus 20%, =0.06. On day 90, 0 controls and 14 patients in the experimental group completed the challenge with no variation of antitransglutaminase IgA (=0.63, Marsh-Oberhuber grading (=0.08, or intestinal IFN-γ mRNA (>0.05. Creatinine clearance did not vary after 90 days of treatment (=0.46. In conclusion, transamidated gluten reduced the number of clinical relapses in challenged patients with no changes of baseline values for serological/mucosal CD markers and an unaltered kidney function.

  13. Cross-sectional and longitudinal analysis of cancer vaccination trials registered on the US Clinical Trials Database demonstrates paucity of immunological trial endpoints and decline in registration since 2008

    Directory of Open Access Journals (Sweden)

    Lu L


    Full Text Available Liangjian Lu,1 Haixi Yan,1 Vijay Shyam-Sundar,1 Tobias Janowitz2 1School of Clinical Medicine, 2Cancer Research UK, Cambridge Institute, Li Ka Shing Centre, University of Cambridge, Cambridge, UK Introduction: Cancer vaccination has been researched as a means of treating and preventing cancer, but successful translational efforts yielding clinical therapeutics have been limited. Numerous reasons have been offered in explanation, pertaining both to the vaccine formulation, and the clinical trial methodology used. This study aims to characterize the tumor vaccine clinical trial landscape quantitatively, and explore the possible validity of the offered explanations including the translational obstacles posed by the current common endpoints.Methods: We performed a detailed cross-sectional and longitudinal analysis of tumor vaccine trials (n=955 registered in the US Clinical Trials database.Results: The number of tumor vaccine trials initiated per annum has declined 30% since a peak in 2008. In terms of vaccine formulation, 25% of trials use tumor cell/lysate preparations; whereas, 73% of trials vaccinate subjects against defined protein/peptide antigens. Also, 68% of trials do not use vectors for antigen delivery. Both these characteristics of tumor vaccines have remained unchanged since 1996. The top five types of cancer studied are: melanoma (22.6%; cervical cancer (13.0%; breast cancer (11.3%; lung cancer (9.5%; and prostate cancer (9.4%. In addition, 86% of the trials are performed where there is established disease rather than prophylactically, of which 67% are performed exclusively in the adjuvant setting. Also, 42% of Phase II trials do not measure any survival-related endpoint, and only 23% of Phase III trials assess the immune response to vaccination.Conclusion: The clinical trial effort in tumor vaccination is declining, necessitating a greater urgency in identifying and removing the obstacles to clinical translation. These obstacles may

  14. Hierarchical segmentation-assisted multimodal registration for MR brain images. (United States)

    Lu, Huanxiang; Beisteiner, Roland; Nolte, Lutz-Peter; Reyes, Mauricio


    Information theory-based metric such as mutual information (MI) is widely used as similarity measurement for multimodal registration. Nevertheless, this metric may lead to matching ambiguity for non-rigid registration. Moreover, maximization of MI alone does not necessarily produce an optimal solution. In this paper, we propose a segmentation-assisted similarity metric based on point-wise mutual information (PMI). This similarity metric, termed SPMI, enhances the registration accuracy by considering tissue classification probabilities as prior information, which is generated from an expectation maximization (EM) algorithm. Diffeomorphic demons is then adopted as the registration model and is optimized in a hierarchical framework (H-SPMI) based on different levels of anatomical structure as prior knowledge. The proposed method is evaluated using Brainweb synthetic data and clinical fMRI images. Both qualitative and quantitative assessment were performed as well as a sensitivity analysis to the segmentation error. Compared to the pure intensity-based approaches which only maximize mutual information, we show that the proposed algorithm provides significantly better accuracy on both synthetic and clinical data.

  15. Efficient convex optimization approach to 3D non-rigid MR-TRUS registration. (United States)

    Sun, Yue; Yuan, Jing; Rajchl, Martin; Qiu, Wu; Romagnoli, Cesare; Fenster, Aaron


    In this study, we propose an efficient non-rigid MR-TRUS deformable registration method to improve the accuracy of targeting suspicious locations during a 3D ultrasound (US) guided prostate biopsy. The proposed deformable registration approach employs the multi-channel modality independent neighbourhood descriptor (MIND) as the local similarity feature across the two modalities of MR and TRUS, and a novel and efficient duality-based convex optimization based algorithmic scheme is introduced to extract the deformations which align the two MIND descriptors. The registration accuracy was evaluated using 10 patient images by measuring the TRE of manually identified corresponding intrinsic fiducials in the whole gland and peripheral zone, and performance metrics (DSC, MAD and MAXD) for the apex, mid-gland and base of the prostate were also calculated by comparing two manually segmented prostate surfaces in the registered 3D MR and TRUS images. Experimental results show that the proposed method yielded an overall mean TRE of 1.74 mm, which is favorably comparable to a clinical requirement for an error of less than 2.5 mm.


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND AND OBJECTIVES: To compare the clinical features and biochemical profile in DKA. To assess the response in the patients with standard treatment of DKA. Clinical descriptions of polyuric states resembling diabetes mellitus have been described in the Ebers papyrus of Egypt in 15th century BC . 1,2 A yurvedic literature from the times of Charaka and Sushrutha, the ancient Indian physicians identified two forms of “MadhuMeha” ( H oneyed Urine in 400 BC . 3 John Rolo of England in 1797 was one of 1st who coined the term diabetes mellitus. William Prout of E ngland described diabetic coma during 1810 – 20. In 1886, Dreschfeld8 described DKA and HHNS (Hyper osmolar Hyperglycemic Non - ketotic Syndrome. In 1922 Banting , Best, Collip and Macleod isolated and clinically used insulin and later won Nobel prize for that memorable invention. SETTING: Inpatients of king George Hospital attached to Andhra Medical College, Visakhapatnam . METHODS: Diagnosis of diabetic ketoacidosis was made according to the inclusion criteria. Hyperglycemia >250 mg/dl, acidosis with blood pH <7.3, serum bicarbonate <15 mEq/l, urine positive for ketones. RESULTS: Of the 100 patients admitted for diabetic ketoacidosis; 84 had type 2 diabetes (84% and 16(16% were type I diabetes. Average age at the time of presentation was 42.9±12.9 years. Th e commonest precipitating factor was infection (56% followed by other factors (28% and irregular treatment (16%. The most common clinical features at the time of presentation were vomiting, abdominal pain, acidotic breathing and dehydration. The values for RBS, HCO3, and pH were 355.3±69.1, 14.9±3.4 and 7.2±0.1 respectively. INTERPRETATION AND CONCLUSION: Most common precipitating factors are infection and omission of insulin or irregular treatment. Most common clinical features at the time of presentati on are vomiting, abdominal pain, dehydration, acidotic breathing and tachycardia. Mortality rate in diabetic

  17. Summer Camp July 2017 - Registration

    CERN Multimedia

    EVE et École


    The CERN Staff Association’s Summer Camp will be open for children from 4 to 6 years old during four weeks, from 3 to 28 July. Registration is offered on a weekly basis for 450 CHF, lunch included. This year, the various activities will revolve around the theme of the Four Elements. Registration opened on 20 March 2017 for children currently attending the EVE and School of the Association. It will be open from 3 April for children of CERN Members of Personnel, and starting from 24 April for all other children. The general conditions are available on the website of the EVE and School of CERN Staff Association: For further questions, please contact us by email at

  18. Groupwise registration of aerial images


    Arandjelovic, Ognjen; Pham, Duc-Son; Venkatesh, Svetha


    This paper addresses the task of time separated aerial image registration. The ability to solve this problem accurately and reliably is important for a variety of subsequent image understanding applications. The principal challenge lies in the extent and nature of transient appearance variation that a land area can undergo, such as that caused by the change in illumination conditions, seasonal variations, or the occlusion by non-persistent objects (people, cars). Our work introduces several n...

  19. A novel approach for establishing benchmark CBCT/CT deformable image registrations in prostate cancer radiotherapy. (United States)

    Kim, Jinkoo; Kumar, Sanath; Liu, Chang; Zhong, Hualiang; Pradhan, Deepak; Shah, Mira; Cattaneo, Richard; Yechieli, Raphael; Robbins, Jared R; Elshaikh, Mohamed A; Chetty, Indrin J


    Deformable image registration (DIR) is an integral component for adaptive radiation therapy. However, accurate registration between daily cone-beam computed tomography (CBCT) and treatment planning CT is challenging, due to significant daily variations in rectal and bladder fillings as well as the increased noise levels in CBCT images. Another significant challenge is the lack of 'ground-truth' registrations in the clinical setting, which is necessary for quantitative evaluation of various registration algorithms. The aim of this study is to establish benchmark registrations of clinical patient data. Three pairs of CT/CBCT datasets were chosen for this institutional review board approved retrospective study. On each image, in order to reduce the contouring uncertainty, ten independent sets of organs were manually delineated by five physicians. The mean contour set for each image was derived from the ten contours. A set of distinctive points (round natural calcifications and three implanted prostate fiducial markers) were also manually identified. The mean contours and point features were then incorporated as constraints into a B-spline based DIR algorithm. Further, a rigidity penalty was imposed on the femurs and pelvic bones to preserve their rigidity. A piecewise-rigid registration approach was adapted to account for the differences in femur pose and the sliding motion between bones. For each registration, the magnitude of the spatial Jacobian (|JAC|) was calculated to quantify the tissue compression and expansion. Deformation grids and finite-element-model-based unbalanced energy maps were also reviewed visually to evaluate the physical soundness of the resultant deformations. Organ DICE indices (indicating the degree of overlap between registered organs) and residual misalignments of the fiducial landmarks were quantified. Manual organ delineation on CBCT images varied significantly among physicians with overall mean DICE index of only 0.7 among redundant

  20. A novel approach for establishing benchmark CBCT/CT deformable image registrations in prostate cancer radiotherapy (United States)

    Kim, Jinkoo; Kumar, Sanath; Liu, Chang; Zhong, Hualiang; Pradhan, Deepak; Shah, Mira; Cattaneo, Richard; Yechieli, Raphael; Robbins, Jared R.; Elshaikh, Mohamed A.; Chetty, Indrin J.


    Deformable image registration (DIR) is an integral component for adaptive radiation therapy. However, accurate registration between daily cone-beam computed tomography (CBCT) and treatment planning CT is challenging, due to significant daily variations in rectal and bladder fillings as well as the increased noise levels in CBCT images. Another significant challenge is the lack of ‘ground-truth’ registrations in the clinical setting, which is necessary for quantitative evaluation of various registration algorithms. The aim of this study is to establish benchmark registrations of clinical patient data. Three pairs of CT/CBCT datasets were chosen for this institutional review board approved retrospective study. On each image, in order to reduce the contouring uncertainty, ten independent sets of organs were manually delineated by five physicians. The mean contour set for each image was derived from the ten contours. A set of distinctive points (round natural calcifications and three implanted prostate fiducial markers) were also manually identified. The mean contours and point features were then incorporated as constraints into a B-spline based DIR algorithm. Further, a rigidity penalty was imposed on the femurs and pelvic bones to preserve their rigidity. A piecewise-rigid registration approach was adapted to account for the differences in femur pose and the sliding motion between bones. For each registration, the magnitude of the spatial Jacobian (|JAC|) was calculated to quantify the tissue compression and expansion. Deformation grids and finite-element-model-based unbalanced energy maps were also reviewed visually to evaluate the physical soundness of the resultant deformations. Organ DICE indices (indicating the degree of overlap between registered organs) and residual misalignments of the fiducial landmarks were quantified. Manual organ delineation on CBCT images varied significantly among physicians with overall mean DICE index of only 0.7 among redundant

  1. New graduate nurses' clinical competence, clinical stress, and intention to leave: a longitudinal study in Taiwan. (United States)

    Cheng, Ching-Yu; Tsai, Hsiu-Min; Chang, Chia-Hao; Liou, Shwu-Ru


    This longitudinal research study aimed to develop a pregraduation clinical training program for nursing students before graduation and evaluate its effect on students' self-perceived clinical competence, clinical stress, and intention to leave current job. A sample of 198 students returned the questionnaires before and after the program. They were followed up at 3, 6, and 12 months after graduation. Results showed that posttest clinical competence was significantly higher than pretest competence, positively related to clinical competence at 3 and 12 months, and negatively related to clinical stress at 3 months. The clinical competence at 3 months was positively related to clinical competence at 6 and 12 months, and clinical competence at 6 months was related to intention to leave at 12 months. Intention to leave at 6 months was positively related to intention to leave at 3 and 12 months. Clinical stress at 3 months was positively related to clinical stress at 6 and 12 months, but not related to intention to leave at any time points. The training program improved students' clinical competence. The stressful time that was correlated with new graduate nurses' intention to leave their job was between the sixth and twelfth months after employment.

  2. Diffusion Maps for Multimodal Registration

    Directory of Open Access Journals (Sweden)

    Gemma Piella


    Full Text Available Multimodal image registration is a difficult task, due to the significant intensity variations between the images. A common approach is to use sophisticated similarity measures, such as mutual information, that are robust to those intensity variations. However, these similarity measures are computationally expensive and, moreover, often fail to capture the geometry and the associated dynamics linked with the images. Another approach is the transformation of the images into a common space where modalities can be directly compared. Within this approach, we propose to register multimodal images by using diffusion maps to describe the geometric and spectral properties of the data. Through diffusion maps, the multimodal data is transformed into a new set of canonical coordinates that reflect its geometry uniformly across modalities, so that meaningful correspondences can be established between them. Images in this new representation can then be registered using a simple Euclidean distance as a similarity measure. Registration accuracy was evaluated on both real and simulated brain images with known ground-truth for both rigid and non-rigid registration. Results showed that the proposed approach achieved higher accuracy than the conventional approach using mutual information.

  3. 3-D Registration on Carotid Artery imaging data: MRI for different timesteps

    CERN Document Server

    Bizopoulos, Paschalis A; Michalis, Lampros K; Koutsouris, Dimitrios D; Fotiadis, Dimitrios I


    A common problem which is faced by the researchers when dealing with arterial carotid imaging data is the registration of the geometrical structures between different imaging modalities or different timesteps. The use of the "Patient Position" DICOM field is not adequate to achieve accurate results due to the fact that the carotid artery is a relatively small structure and even imperceptible changes in patient position and/or direction make it difficult. While there is a wide range of simple/advanced registration techniques in the literature, there is a considerable number of studies which address the geometrical structure of the carotid artery without using any registration technique. On the other hand the existence of various registration techniques prohibits an objective comparison of the results using different registration techniques. In this paper we present a method for estimating the statistical significance that the choice of the registration technique has on the carotid geometry. One-Way Analysis of...

  4. Two Solutions for Registration of Ultrasound to MRI for Image-Guided Prostate Interventions (United States)

    Moradi, Mehdi; Janoos, Firdaus; Fedorov, Andriy; Risholm, Petter; Kapur, Tina; Wolfsberger, Luciant D.; Nguyen, Paul L.; Tempany, Clare M; Wells, William M


    Ultrasound-guided prostate interventions could benefit from incorporating the radiologic localization of the tumor which can be acquired from multiparametric MRI. To enable this integration, we propose and compare two solutions for registration of T2 weighted MR images with transrectal ultrasound. Firstly, we propose an innovative and practical approach based on deformable registration of binary label maps obtained from manual segmentation of the gland in the two modalities. This resulted in a target registration error of 3.6±1.7 mm. Secondly, we report a novel surface-based registration method that uses a biomechanical model of the tissue and results in registration error of 3.2±1.3 mm. We compare the two methods in terms of accuracy, clinical use and technical limitations. PMID:23366095

  5. Performance evaluation of grid-enabled registration algorithms using bronze-standards

    CERN Document Server

    Glatard, T; Montagnat, J


    Evaluating registration algorithms is difficult due to the lack of gold standard in most clinical procedures. The bronze standard is a real-data based statistical method providing an alternative registration reference through a computationally intensive image database registration procedure. We propose in this paper an efficient implementation of this method through a grid-interfaced workflow enactor enabling the concurrent processing of hundreds of image registrations in a couple of hours only. The performances of two different grid infrastructures were compared. We computed the accuracy of 4 different rigid registration algorithms on longitudinal MRI images of brain tumors. Results showed an average subvoxel accuracy of 0.4 mm and 0.15 degrees in rotation.

  6. Deformable registration of multi-modal data including rigid structures

    Energy Technology Data Exchange (ETDEWEB)

    Huesman, Ronald H.; Klein, Gregory J.; Kimdon, Joey A.; Kuo, Chaincy; Majumdar, Sharmila


    Multi-modality imaging studies are becoming more widely utilized in the analysis of medical data. Anatomical data from CT and MRI are useful for analyzing or further processing functional data from techniques such as PET and SPECT. When data are not acquired simultaneously, even when these data are acquired on a dual-imaging device using the same bed, motion can occur that requires registration between the reconstructed image volumes. As the human torso can allow non-rigid motion, this type of motion should be estimated and corrected. We report a deformation registration technique that utilizes rigid registration for bony structures, while allowing elastic transformation of soft tissue to more accurately register the entire image volume. The technique is applied to the registration of CT and MR images of the lumbar spine. First a global rigid registration is performed to approximately align features. Bony structures are then segmented from the CT data using semi-automated process, and bounding boxes for each vertebra are established. Each CT subvolume is then individually registered to the MRI data using a piece-wise rigid registration algorithm and a mutual information image similarity measure. The resulting set of rigid transformations allows for accurate registration of the parts of the CT and MRI data representing the vertebrae, but not the adjacent soft tissue. To align the soft tissue, a smoothly-varying deformation is computed using a thin platespline(TPS) algorithm. The TPS technique requires a sparse set of landmarks that are to be brought into correspondence. These landmarks are automatically obtained from the segmented data using simple edge-detection techniques and random sampling from the edge candidates. A smoothness parameter is also included in the TPS formulation for characterization of the stiffness of the soft tissue. Estimation of an appropriate stiffness factor is obtained iteratively by using the mutual information cost function on the result

  7. [Limitations and pitfalls of clinical studies in oncology]. (United States)

    Cerny, Thomas


    Nowadays results of clinical studies in oncology are often first found and commented in the news media because of their high relevance to the pharmaceutical market. The limits and pitfalls of clinical studies are manifold and not always appreciated even by specialists as well as journalists and politicians. The planning of a study is a most crucial phase, and most deficits are due to inappropriate design and conduct of a study. Adequate and skilful interpretation of a study is often hampered by many known but mostly overlooked variable pitfalls. Today there is an overrepresentation of pharmaceutically sponsored studies and a painful lack of well-designed academic studies with really meaningful endpoints for patient care. This paper touches several important aspects of today's shortcomings of clinical studies in oncology and highlights the importance of strengthening the academic clinical research. Evidence-based medicine needs to be more clinically relevant, and therefore we need well-designed, and critically interpreted studies in the future.

  8. Non-rigid registration of a 3D ultrasound and a MR image data set of the female pelvic floor using a biomechanical model

    Directory of Open Access Journals (Sweden)

    Rexilius Jan


    Full Text Available Abstract Background The visual combination of different modalities is essential for many medical imaging applications in the field of Computer-Assisted medical Diagnosis (CAD to enhance the clinical information content. Clinically, incontinence is a diagnosis with high clinical prevalence and morbidity rate. The search for a method to identify risk patients and to control the success of operations is still a challenging task. The conjunction of magnetic resonance (MR and 3D ultrasound (US image data sets could lead to a new clinical visual representation of the morphology as we show with corresponding data sets of the female anal canal with this paper. Methods We present a feasibility study for a non-rigid registration technique based on a biomechanical model for MR and US image data sets of the female anal canal as a base for a new innovative clinical visual representation. Results It is shown in this case study that the internal and external sphincter region could be registered elastically and the registration partially corrects the compression induced by the ultrasound transducer, so the MR data set showing the native anatomy is used as a frame for the US data set showing the same region with higher resolution but distorted by the transducer Conclusion The morphology is of special interest in the assessment of anal incontinence and the non-rigid registration of normal clinical MR and US image data sets is a new field of the adaptation of this method incorporating the advantages of both technologies.

  9. Real-time registration of 3D to 2D ultrasound images for image-guided prostate biopsy. (United States)

    Gillies, Derek J; Gardi, Lori; De Silva, Tharindu; Zhao, Shuang-Ren; Fenster, Aaron


    During image-guided prostate biopsy, needles are targeted at tissues that are suspicious of cancer to obtain specimen for histological examination. Unfortunately, patient motion causes targeting errors when using an MR-transrectal ultrasound (TRUS) fusion approach to augment the conventional biopsy procedure. This study aims to develop an automatic motion correction algorithm approaching the frame rate of an ultrasound system to be used in fusion-based prostate biopsy systems. Two modes of operation have been investigated for the clinical implementation of the algorithm: motion compensation using a single user initiated correction performed prior to biopsy, and real-time continuous motion compensation performed automatically as a background process. Retrospective 2D and 3D TRUS patient images acquired prior to biopsy gun firing were registered using an intensity-based algorithm utilizing normalized cross-correlation and Powell's method for optimization. 2D and 3D images were downsampled and cropped to estimate the optimal amount of image information that would perform registrations quickly and accurately. The optimal search order during optimization was also analyzed to avoid local optima in the search space. Error in the algorithm was computed using target registration errors (TREs) from manually identified homologous fiducials in a clinical patient dataset. The algorithm was evaluated for real-time performance using the two different modes of clinical implementations by way of user initiated and continuous motion compensation methods on a tissue mimicking prostate phantom. After implementation in a TRUS-guided system with an image downsampling factor of 4, the proposed approach resulted in a mean ± std TRE and computation time of 1.6 ± 0.6 mm and 57 ± 20 ms respectively. The user initiated mode performed registrations with in-plane, out-of-plane, and roll motions computation times of 108 ± 38 ms, 60 ± 23 ms, and 89 ± 27 ms, respectively, and corresponding

  10. A prospective clinical study of polycarboxylate cement in periapical surgery

    National Research Council Canada - National Science Library

    Peñarrocha-Diago, M-A; Ortega-Sánchez, B; García-Mira, B; Maestre-Ferrín, L; Peñarrocha-Oltra, D; Gay-Escoda, C

    .... A prospective clinical study was made of 25 patients subjected to periapical surgery with ultrasound and magnifying loupes, in which polycarboxylate cement was used as retrograde filling material...

  11. Strategies to design clinical studies to identify predictive biomarkers in cancer research. (United States)

    Perez-Gracia, Jose Luis; Sanmamed, Miguel F; Bosch, Ana; Patiño-Garcia, Ana; Schalper, Kurt A; Segura, Victor; Bellmunt, Joaquim; Tabernero, Josep; Sweeney, Christopher J; Choueiri, Toni K; Martín, Miguel; Fusco, Juan Pablo; Rodriguez-Ruiz, Maria Esperanza; Calvo, Alfonso; Prior, Celia; Paz-Ares, Luis; Pio, Ruben; Gonzalez-Billalabeitia, Enrique; Gonzalez Hernandez, Alvaro; Páez, David; Piulats, Jose María; Gurpide, Alfonso; Andueza, Mapi; de Velasco, Guillermo; Pazo, Roberto; Grande, Enrique; Nicolas, Pilar; Abad-Santos, Francisco; Garcia-Donas, Jesus; Castellano, Daniel; Pajares, María J; Suarez, Cristina; Colomer, Ramon; Montuenga, Luis M; Melero, Ignacio


    The discovery of reliable biomarkers to predict efficacy and toxicity of anticancer drugs remains one of the key challenges in cancer research. Despite its relevance, no efficient study designs to identify promising candidate biomarkers have been established. This has led to the proliferation of a myriad of exploratory studies using dissimilar strategies, most of which fail to identify any promising targets and are seldom validated. The lack of a proper methodology also determines that many anti-cancer drugs are developed below their potential, due to failure to identify predictive biomarkers. While some drugs will be systematically administered to many patients who will not benefit from them, leading to unnecessary toxicities and costs, others will never reach registration due to our inability to identify the specific patient population in which they are active. Despite these drawbacks, a limited number of outstanding predictive biomarkers have been successfully identified and validated, and have changed the standard practice of oncology. In this manuscript, a multidisciplinary panel reviews how those key biomarkers were identified and, based on those experiences, proposes a methodological framework-the DESIGN guidelines-to standardize the clinical design of biomarker identification studies and to develop future research in this pivotal field. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. Vertebral surface registration using ridgelines/crestlines (United States)

    Tan, Sovira; Yao, Jianhua; Yao, Lawrence; Summers, Ronald M.; Ward, Michael M.


    The Iterative Closest Point (ICP) algorithm is an efficient and popular technique for surface registration. It however suffers from the well-known problem of local minima that make the algorithm stop before it reaches the desired global solution. ICP can be improved by the use of landmarks or features. We recently developed a level set capable of evolving on the surface of an object represented by a triangular mesh. This level set permits the segmentation of portions of a surface based on curvature features. The boundary of a segmented portion forms a ridgeline/crestline. We show that the ridgelines/crestlines and corresponding enclosed surfaces extracted by the algorithm can substantially improve ICP registration. We compared the performance of an ICP algorithm in three setups: 1) ICP without landmarks. 2) ICP using ridgelines. 3) ICP using ridgelines and corresponding enclosed surfaces. Our material consists of vertebral body surfaces extracted for a study about the progression of Ankylosing Spondylitis. Same vertebrae scanned at intervals of one or two years were rigidly registered. Vertebral body rims and the end plate surfaces they enclose were used as landmarks. The performance measure was the mean error distance between the registered surfaces. From the one hundred registrations that we performed the average mean error was respectively 0.503mm, 0.335mm and 0.254mm for the three setups. Setup 3 almost halved the average error of setup 1. Moreover the error range is dramatically reduced from [0.0985, 2.19]mm to just [0.0865, 0.532]mm, making the algorithm very robust.

  13. Impact of document type on reporting quality of clinical drug trials: a comparison of registry reports, clinical study reports, and journal publications. (United States)

    Wieseler, Beate; Kerekes, Michaela F; Vervoelgyi, Volker; McGauran, Natalie; Kaiser, Thomas


    To investigate to what extent three types of documents for reporting clinical trials provide sufficient information for trial evaluation. Retrospective analysis Primary studies and corresponding documents (registry reports, clinical study reports, journal publications) from 16 health technology assessments of drugs conducted by the German Institute for Quality and Efficiency in Health Care between 2006 and February 2011. Data analysis We assessed reporting quality for each study and each available document for six items on methods and six on outcomes, and dichotomised them as "completely reported" or "incompletely reported." For each document type, we calculated the proportion of studies with complete reporting for methods and outcomes, per item and overall, and compared the findings. We identified 268 studies. Publications, study reports and registry reports were available for 192 (72%), 101 (38%), and 78 (29%) studies, respectively. Reporting quality was highest in study reports, which overall provided complete information for 90% of items (1086/1212). Registry reports provided more complete information on outcomes than on methods (overall 330/468 (71%) v 147/468 (31%)); the same applied to publications (594/1152 (52%) v 458/1152 (40%)). In the matched pairs analysis, reporting quality was poorer in registry reports than in study reports for overall methods and outcomes (P<0.001 in each case). Compared with publications, reporting quality was poorer in registry reports for overall methods (P<0.001), but better for outcomes (P=0.005). Registry reports and publications insufficiently report clinical trials but may supplement each other. Measures to improve reporting include the mandatory worldwide implementation of adequate standards for results registration.



    Sudheer Darbha; Giddaluru Srihari


    BACKGROUND The aim of the study is to study the most common organisms encountered and their sensitivity and resistance to antibiotics in postoperative wound infection and to study relation of emergency and elective surgery to postoperative wound infection and to study efficacy of different modes of preoperative preparation on postoperative wound infection and to study distribution of postoperative wound infection among different surgeries based on bacterial contamination such a...

  15. Oral mucocele: A clinical and histopathological study (United States)

    More, Chandramani B; Bhavsar, Khushbu; Varma, Saurabh; Tailor, Mansi


    Background: Oral mucocele is the most common benign minor (accessory) salivary gland lesion, caused due to mechanical trauma to the excretory duct of the gland. Clinically they are characterized by single or multiple, soft, fluctuant nodule, ranging from the normal color of the oral mucosa to deep blue. It affects at any age and is equally present in both sexes with highest incidence in second decade of life. They are classified as extravasation or retention type. Objectives: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. Results: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48%) was more common than the retention type (15.52%). The most common affected site was lower lip (36.20%) followed by ventral surface of the tongue (25.86%). The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%), and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%). It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%), trauma (5.18%) and numerous lesions (72.41%). Conclusion: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common. PMID:25364184

  16. Evaluation of accuracy of B-spline transformation-based deformable image registration with different parameter settings for thoracic images. (United States)

    Kanai, Takayuki; Kadoya, Noriyuki; Ito, Kengo; Onozato, Yusuke; Cho, Sang Yong; Kishi, Kazuma; Dobashi, Suguru; Umezawa, Rei; Matsushita, Haruo; Takeda, Ken; Jingu, Keiichi


    Deformable image registration (DIR) is fundamental technique for adaptive radiotherapy and image-guided radiotherapy. However, further improvement of DIR is still needed. We evaluated the accuracy of B-spline transformation-based DIR implemented in elastix. This registration package is largely based on the Insight Segmentation and Registration Toolkit (ITK), and several new functions were implemented to achieve high DIR accuracy. The purpose of this study was to clarify whether new functions implemented in elastix are useful for improving DIR accuracy. Thoracic 4D computed tomography images of ten patients with esophageal or lung cancer were studied. Datasets for these patients were provided by DIR-lab ( and included a coordinate list of anatomical landmarks that had been manually identified. DIR between peak-inhale and peak-exhale images was performed with four types of parameter settings. The first one represents original ITK (Parameter 1). The second employs the new function of elastix (Parameter 2), and the third was created to verify whether new functions improve DIR accuracy while keeping computational time (Parameter 3). The last one partially employs a new function (Parameter 4). Registration errors for these parameter settings were calculated using the manually determined landmark pairs. 3D registration errors with standard deviation over all cases were 1.78 (1.57), 1.28 (1.10), 1.44 (1.09) and 1.36 (1.35) mm for Parameter 1, 2, 3 and 4, respectively, indicating that the new functions are useful for improving DIR accuracy, even while maintaining the computational time, and this B-spline-based DIR could be used clinically to achieve high-accuracy adaptive radiotherapy. © The Author 2014. Published by Oxford University Press on behalf of The Japan Radiation Research Society and Japanese Society for Radiation Oncology.

  17. Prospective Clinical Study of Precision Oncology in Solid Tumors. (United States)

    Sohal, Davendra P S; Rini, Brian I; Khorana, Alok A; Dreicer, Robert; Abraham, Jame; Procop, Gary W; Saunthararajah, Yogen; Pennell, Nathan A; Stevenson, James P; Pelley, Robert; Estfan, Bassam; Shepard, Dale; Funchain, Pauline; Elson, Paul; Adelstein, David J; Bolwell, Brian J


    Systematic studies evaluating clinical benefit of tumor genomic profiling are lacking. We conducted a prospective study in 250 patients with select solid tumors at the Cleveland Clinic. Eligibility required histopathologic diagnosis, age of 18 years or older, Eastern Cooperative Oncology Group performance status 0-2, and written informed consent. Tumors were sequenced using FoundationOne (Cambridge, MA). Results were reviewed at the Cleveland Clinic Genomics Tumor Board. Outcomes included feasibility and clinical impact. Colorectal (25%), breast (18%), lung (13%), and pancreatobiliary (13%) cancers were the most common diagnoses. Median time from consent to result was 25 days (range = 3-140). Of 223 evaluable samples, 49% (n = 109) of patients were recommended a specific therapy, but only 11% (n = 24) received such therapy: 12 on clinical trials, nine off-label, three on-label. Lack of clinical trial access (n = 49) and clinical deterioration (n = 29) were the most common reasons for nonrecommendation/nonreceipt of genomics-driven therapy.

  18. A clinical and radiological study of peroneal tendon pathology. (United States)

    Giza, Eric; Mak, Walter; Wong, Stephanie E; Roper, Glade; Campanelli, Valentina; Hunter, John C


    The proportion of patients with clinical findings referable to peroneal pathology and magnetic resonance imaging (MRI)-diagnosed peroneal tendon pathology is unknown. Previous studies have correlated surgical findings with clinical data and preoperative MRI, but there are no published studies that reference clinical examination findings to imaging findings. To determine the relationship between peroneal tendon pathology as diagnosed by MRI and clinical findings of peroneal tendon pathology. Fifty-six patients who had both MRI evidence of peroneal tendon pathology and an associated clinical examination of the ankle were evaluated over a 3-year period at a tertiary care institution. Clinical examination criteria included lateral ankle tenderness, dislocation/snapping, and lateral ankle pain. A board-certified, fellowship-trained musculoskeletal radiologist confirmed the presence of MRI findings consistent with peroneal tendon pathology. Of the 56 patients with positive findings on MRI, 27 patients had an associated positive clinical exam and 29 patients had a negative clinical exam. The positive predictive value of MRI for peroneal tendon tears with positive clinical findings was 48% (95% confidence interval = 35% to 61%). Patients with MRI findings of peroneal tendon pathology should undergo careful clinical examination, as the positive predictive value of MRI for peroneal tendon pathology with actual clinical findings is low. This study demonstrates that peroneal tendon tears are often incidental findings on MRI.

  19. WE-AB-BRA-12: Virtual Endoscope Tracking for Endoscopy-CT Image Registration

    Energy Technology Data Exchange (ETDEWEB)

    Ingram, W; Rao, A; Wendt, R; Court, L [The University of Texas MD Anderson Cancer Center, Houston, TX (United States); The University of Texas Graduate School of Biomedical Sciences, Houston, TX (United States); Yang, J; Beadle, B [The University of Texas MD Anderson Cancer Center, Houston, TX (United States)


    Purpose: The use of endoscopy in radiotherapy will remain limited until we can register endoscopic video to CT using standard clinical equipment. In this phantom study we tested a registration method using virtual endoscopy to measure CT-space positions from endoscopic video. Methods: Our phantom is a contorted clay cylinder with 2-mm-diameter markers in the luminal surface. These markers are visible on both CT and endoscopic video. Virtual endoscope images were rendered from a polygonal mesh created by segmenting the phantom’s luminal surface on CT. We tested registration accuracy by tracking the endoscope’s 6-degree-of-freedom coordinates frame-to-frame in a video recorded as it moved through the phantom, and using these coordinates to measure CT-space positions of markers visible in the final frame. To track the endoscope we used the Nelder-Mead method to search for coordinates that render the virtual frame most similar to the next recorded frame. We measured the endoscope’s initial-frame coordinates using a set of visible markers, and for image similarity we used a combination of mutual information and gradient alignment. CT-space marker positions were measured by projecting their final-frame pixel addresses through the virtual endoscope to intersect with the mesh. Registration error was quantified as the distance between this intersection and the marker’s manually-selected CT-space position. Results: Tracking succeeded for 6 of 8 videos, for which the mean registration error was 4.8±3.5mm (24 measurements total). The mean error in the axial direction (3.1±3.3mm) was larger than in the sagittal or coronal directions (2.0±2.3mm, 1.7±1.6mm). In the other 2 videos, the virtual endoscope got stuck in a false minimum. Conclusion: Our method can successfully track the position and orientation of an endoscope, and it provides accurate spatial mapping from endoscopic video to CT. This method will serve as a foundation for an endoscopy-CT registration

  20. The use of track registration detectors to reconstruct contemporary and historical airborne radon ( sup 2 sup 2 sup 2 Rn) and radon progeny concentrations for a radon-lung cancer epidemiologic study

    CERN Document Server

    Steck, D J


    Epidemiologic studies that investigate the relationship between radon and lung cancer require accurate estimates for the long-term average concentrations of radon progeny in dwellings. Year-to-year and home-to-home variations of radon in domestic environments pose serious difficulties for reconstructing an individual's long-term radon-related exposure. The use of contemporary radon gas concentrations as a surrogate for radon-related dose introduces additional uncertainty in dose assessment. Studies of glass exposed in radon chambers and in a home show that radon progeny deposited on, and implanted in, glass hold promise for reconstructing past radon concentrations in a variety of atmospheres. We developed an inexpensive track registration detector for the Iowa Radon Lung Cancer Study (IRLCS) that simultaneously measures contemporary airborne radon concentrations, surface deposited alpha activity density, and implanted sup 2 sup 1 sup 0 Po activity density. The implanted activity is used to reconstruct the cum...

  1. Localization of brachytherapy seeds in ultrasound by registration to fluoroscopy (United States)

    Fallavollita, P.; KarimAghaloo, Z.; Burdette, E. C.; Song, D. Y.; Abolmaesumi, P.; Fichtinger, G.


    Motivation: In prostate brachytherapy, transrectal ultrasound (TRUS) is used to visualize the anatomy, while implanted seeds can be seen in C-arm fluoroscopy or CT. Intra-operative dosimetry optimization requires localization of the implants in TRUS relative to the anatomy. This could be achieved by registration of TRUS images and the implants reconstructed from fluoroscopy or CT. Methods: TRUS images are filtered, compounded, and registered on the reconstructed implants by using an intensity-based metric based on a 3D point-to-volume registration scheme. A phantom was implanted with 48 seeds, imaged with TRUS and CT/X-ray. Ground-truth registration was established between the two. Seeds were reconstructed from CT/X-ray. Seven TRUS filtering techniques and two image similarity metrics were analyzed as well. Results: For point-to-volume registration, noise reduction combined with beam profile filter and mean squares metrics yielded the best result: an average of 0.38 +/- 0.19 mm seed localization error relative to the ground-truth. In human patient data C-arm fluoroscopy images showed 81 radioactive seeds implanted inside the prostate. A qualitative analysis showed clinically correct agreement between the seeds visible in TRUS and reconstructed from intra-operative fluoroscopy imaging. The measured registration error compared to the manually selected seed locations by the clinician was 2.86 +/- 1.26 mm. Conclusion: Fully automated seed localization in TRUS performed excellently on ground-truth phantom, adequate in clinical data and was time efficient having an average runtime of 90 seconds.

  2. Agile multi-scale decompositions for automatic image registration (United States)

    Murphy, James M.; Leija, Omar Navarro; Le Moigne, Jacqueline


    In recent works, the first and third authors developed an automatic image registration algorithm based on a multiscale hybrid image decomposition with anisotropic shearlets and isotropic wavelets. This prototype showed strong performance, improving robustness over registration with wavelets alone. However, this method imposed a strict hierarchy on the order in which shearlet and wavelet features were used in the registration process, and also involved an unintegrated mixture of MATLAB and C code. In this paper, we introduce a more agile model for generating features, in which a flexible and user-guided mix of shearlet and wavelet features are computed. Compared to the previous prototype, this method introduces a flexibility to the order in which shearlet and wavelet features are used in the registration process. Moreover, the present algorithm is now fully coded in C, making it more efficient and portable than the mixed MATLAB and C prototype. We demonstrate the versatility and computational efficiency of this approach by performing registration experiments with the fully-integrated C algorithm. In particular, meaningful timing studies can now be performed, to give a concrete analysis of the computational costs of the flexible feature extraction. Examples of synthetically warped and real multi-modal images are analyzed.

  3. Exposing the tensions of implementing supervision in pre-registration nurse education. (United States)

    Felton, Anne; Sheppard, Fiona; Stacey, Gemma


    This discussion will examine the complexities of implementing group clinical supervision in pre-registration nurse education. Exploration is based upon the authors' experiences of facilitating clinical supervision with mental health branch students on the Diploma/BSc program at one higher education institution in the UK. It will provide the history and context of clinical supervision in nursing and apply this to the educational setting. This discussion aims to move beyond the rhetoric surrounding clinical supervision to expose the underlying tensions which we propose influence the clinical supervision process in pre-registration nurse education. These include the potential confusion of role for the supervisor, conflict of responsibilities and the potentially vulnerable position they may adopt. However, despite these tensions it is proposed that clinical supervision has a key role within graduate pre-registration nursing education.

  4. Methodological Aspects in Studies Based on Clinical Routine Data. (United States)

    Kennes, Lieven Nils


    Randomized controlled clinical trials are regarded as the gold standard for comparing different clinical interventions, but generally their conduct is operationally cumbersome, time-consuming, and expensive. Studies and investigations based on clinical routine data on the contrary utilize existing data acquired under real-life conditions and are increasingly popular among practitioners. In this paper, methodological aspects of studies based on clinical routine data are discussed. Important limitations and considerations as well as unique strengths of these types of studies are indicated and exemplarily demonstrated in a recent real-case study based on clinical routine data. In addition two simulation studies reveal the impact of bias in studies based on clinical routine data on the type I error rate and false decision rate in favor of the inferior intervention. It is concluded that correctly analyzing clinical routine data yields a valuable addition to clinical research; however, as a result of a lack of statistical foundation, internal validity, and comparability, generalizing results and inferring properties derived from clinical routine data to all patients of interest has to be considered with extreme caution. Grünenthal GmbH.

  5. Successful Registration of Proton Tracks With Bubble Detector

    Institute of Scientific and Technical Information of China (English)

    T.Doke; J.Kikuchi; M.Komiyama


    A study of registration of proton tracks with T-15 type of bubble detectors is carried out. The bubble detectors are made in China Institute of Atomic Energy. 210 MeV proton beam used to irradiate the bubble detectors is accelerated by the cyclotron at the Institute of Physical and Chemical Research(RIKEN) in Wako, Japan. The study shows that T-15 type of bubble detectors can be used to record proton tracks directly. A proton track is composed of a few bubbles because of the short recordable range of proton in the detectors, Successful registration of proton tracks will extend the

  6. An exploration of the role of pharmacists within general practice clinics: the protocol for the pharmacists in practice study (PIPS

    Directory of Open Access Journals (Sweden)

    Tan Edwin


    Full Text Available Abstract Background Medication-related problems are a serious concern in Australian primary care. Pharmacist interventions have been shown to be effective in identifying and resolving these problems. Collaborative general practitioner-pharmacist services currently available in Australia are limited and underused. Limitations include geographical isolation of pharmacists and lack of communication and access to patient information. Co-location of pharmacists within the general practice clinics is a possible solution. There have been no studies in the Australian setting exploring the role of pharmacists within general practice clinics. The aim of this study is to develop and test a multifaceted practice pharmacist role in primary care practices to improve the quality use of medicines by patients and clinic staff. Methods/design This is a multi-centre, prospective intervention study with a pre-post design and a qualitative component. A practice pharmacist will be located in each of two clinics and provide short and long patient consultations, drug information services and quality assurance activities. Patients receiving long consultation with a pharmacist will be followed up at 3 and 6 months. Based on sample size calculations, at least 50 patients will be recruited for long patient consultations across both sites. Outcome measures include the number, type and severity of medication-related problems identified and resolved; medication adherence; and patient satisfaction. Brief structured interviews will be conducted with patients participating in the study to evaluate their experiences with the service. Staff collaboration and satisfaction with the service will be assessed. Discussion This intervention has the potential to optimise medication use in primary care clinics leading to better health outcomes. This study will provide data about the effectiveness of the proposed model for pharmacist involvement in Australian general practice clinics

  7. Oral mucocele: A clinical and histopathological study

    Directory of Open Access Journals (Sweden)

    Chandramani B More


    Objectives: To analyze the data between 2010 and 2011 of, clinically and histopathologically diagnosed 58 oral mucoceles for age, gender, type, site, color, cause, symptoms and dimension. Results: Oral mucoceles were highly prevalent in the age group of 15-24 years, were seen in 51.72% of males and 48.28% of females, with a ratio of 1.07:1. The extravasation type (84.48% was more common than the retention type (15.52%. The most common affected site was lower lip (36.20% followed by ventral surface of the tongue (25.86%. The lowest frequency was observed in floor of mouth, upper lip and palate. The maximum numbers of mucoceles were asymptomatic (58.62%, and the color of the overlying mucosa had color of adjacent normal mucosa (48.28%. It was also observed that most of the mucoceles had diameter ranging from 5 to 14 mm. The causative factors of the lesion were lip biting (22.41%, trauma (5.18% and numerous lesions (72.41%. Conclusion: Oral Mucoceles are frequently seen in an oral medicine service, mainly affecting young people and lower lip, measuring around 5 to 14 mm and the extravasation type being the most common.

  8. [Surgical clinical studies and their practical realization]. (United States)

    Uhl, W; Wente, M N; Büchler, M W


    The employment of the optimal therapeutic option according to the best current knowledge is called evidence-based medicine (EBM). Moreover, considering the cost explosion in public health systems, EBM should contribute towards economical and targeted use of the restricted resources and towards quality assurance in medicine. Obviously, this is applicable to the operative specialties and can be termed as evidence-based surgery. Surgeons have to do their "homework" about this subject and to perform randomized controlled trials (the gold standard with the greatest evidence) on a large scale, in order to come up to this expectation in future. Evidence-based therapy is essential for the preservation and especially for the further development and evolution of high-quality surgery with, at the same time, quality assurance in the new millenium. This article presents the definition of EBM and its implication in the operative fields. Fundamental principles for the practical conduct of clinical randomized controlled trials are defined and the specific problems in surgery are discussed.

  9. Corticosteroid myopathy: a clinical and pathological study. (United States)

    Khaleeli, A A; Edwards, R H; Gohil, K; McPhail, G; Rennie, M J; Round, J; Ross, E J


    In six patients with Cushing's syndrome and three with steroid myopathy, the clinical, functional, biochemical and structural characteristics of myopathy are described. Proximal muscle weakness occurred in all the patients, preferentially affected the lower limbs and was accompanied by muscle wasting in all but one patient. Force measurements confirmed quadriceps weakness in every patient. Vastus lateralis muscle biopsies showed light microscopic abnormalities in two of three patients with steroid myopathy and one of five patients with Cushing's syndrome. Type II fibre atrophy was the commonest abnormality. Reduced type II mean fibre areas occurred in all the patients with steroid myopathy and were common in Cushing's syndrome patients. Type I mean fibre areas were also reduced in two of the former group and one of the latter group and two further patients in this group had areas at the lower end of the normal range. Abnormalities in electron microscopy, mitochondrial function tests and chemical content of skeletal muscle were frequent and are described and discussed. A plasma creatine kinase activity (CK) at the lower end of the normal range, a myopathic electromyogram (EMG) and a raised 24-h urinary 3-methylhistidine/creatinine ratio on a creatine free diet were other characteristic findings in both groups of patients.

  10. Clinical Study on Treatment of Infantile Rotaviral

    Institute of Scientific and Technical Information of China (English)

    魏连波; 李智军; 陈宝田; 栾图; 高云飞; 李吉来; 孙升云


    Objective: To observe the clinical effect of guava leaf (GL) in treating infantile rotaviral enteritis.Methods: Sixty-two patients of rotaviral enteritis were randomly divided into the treated group treated with GL and the control group treated with Gegen Qinlian Decoction. The time for ceasing diarrhea, content of Na+ in blood, content of Na+ and glucose in stool, and the rate of negative conversion of human rotavirus antigen (HRVA) were observed.Results: The 3-day recovery rate in the treated group (87.1%) was significantly higher than that in the control group (58.1%, P<0.05). The time of ceasing diarrhea in the treated group (25.1±9.5 hrs) was significantly shorter than that in the control group (38.7±15.2 hrs, P<0.01). Moreover, content of Na+ and glucose in stool were reduced obviously in the treated group but not in the control group; and negative conversion rate of HRVA in the former group also got better than that in the latter group (87.1% vs 58.1%, P<0.05). Consequently, the effect of GL was superior to that of the control significantly.Conclusion: GL has good curative effect on infantile rotaviral enteritis.

  11. To embed or not to embed? A longitudinal study exploring the impact of curriculum design on the evidence-based practice profiles of UK pre-registration nursing students. (United States)

    Scurlock-Evans, Laura; Upton, Penney; Rouse, Joanne; Upton, Dominic


    The use of Evidence-Based Practice (EBP) is increasingly emphasized within healthcare. However, little research has focused on nurses' pre-registration training; particularly regarding the impact of curriculum-design on learning EBP. This study compared the impact of embedding EBP throughout the curriculum, with modular-based teaching, on pre-registration nursing students' EBP profiles. A longitudinal panel study. A convenience sample of fifty-six pre-registration nursing students (55.4% studying an embedded EBP-curriculum and 44.6% studying a modular EBP-curriculum), were recruited from a UK University between 2011 and 2014. Participants completed the Student Evidence-Based Practice Questionnaire (S-EBPQ) in the first, second and third year of their course. This questionnaire measures four EBP domains: frequency of use, attitude, knowledge and skills in retrieving and reviewing evidence, and knowledge and skills in applying and sharing evidence. Two-way mixed between-within Analyses of Variance revealed significant improvements across all domains, except attitude (which remained broadly positive across all years), for both curriculum-groups. No significant differences in this improvement were identified between the two curricula overall. However, the direction and rate of change of scores on the retrieving and applying subscales (but not frequency of use) for the two groups differed across time; specifically those on the embedded curriculum showed a dip in scores on these subscales in year 2. This appeared to be related to associated features of the course such as the timing of placements and delivery of theory. Taking a modular or embedded approach to EBP may have little impact on students' final EBP profiles. However, careful consideration should be given to the timing of related course features which may play a key role in students' perceptions of their knowledge and skills in its application. Further research should explore how curriculum-design might build on

  12. Clinical Study of Tuina for Stiff Neck

    Institute of Scientific and Technical Information of China (English)

    吴耀持; 张峻峰; 汪崇淼; 王健雄; 张沈煜


    Objective: To observe the clinical effect of Tuina for stiffneck. Methods: All of 216 cases with stiff neck were randomly allocated into a tuina group (110 cases) and a control group (106 cases). The patients in the tuina group were treated with "Three Parts, Four Points,Five Manipulation" tuina therapy, while those in the control group were treated with pucturing Wailaogong (Ex-UE 8), Houxi (SI 3), Jianjing (GB 21) and Ashi points in the affected side,Once a day, and 3 times constitute one treatment course. The effect was observed after 2-course treatments. Result: The effective rate in the tuina group and the control group was 93.64% and 83.02%, respectively, and there was statistical difference between the two groups (P < 0.05).Conclusion: The tuina therapy of "Three Parts, Four Points, Five Manipulations" is better than simple acupuncture therapy in treating stiff neck.%目的:观察推拿治疗落枕的临床疗效.方法:将216例落枕患者随机分为推拿组110例和对照组106例,推拿组用"三部四穴五法"推拿法治疗,对照组针刺患侧外劳宫、后溪、肩井和阿是穴.每日1次,3次为1个疗程;治疗2个疗程后观察疗效. 结果:推拿组有效率为93.64%,对照组为83.02%,两者比较有统计学意义(P<0.05)结论:"三部四穴五法"推拿法治疗落枕明显优于单纯针刺疗法.

  13. Automated registration of partially defective surfaces by local landmark identification. (United States)

    Malthan, Dirk; Ehrlich, Günther; Stallkamp, Jan; Dammann, Florian; Schwaderer, Erwin; Maassen, Marcus M


    In computer- and robot-assisted surgery, the term "registration" refers to the definition of the geometrical relationship between the coordinate system of a surgical planning system and that of the patient. Within the context of the development of a navigation and control system for computer- and robot-assisted surgery of the lateral skull base, it was desirable to realize an algorithm for automated registration of partially defective surfaces that is reliable and suitable for use in clinical practice. A registration algorithm based on the use of local fingerprints for specific points on a surface (so-called "spin images") was developed. Anatomical patient landmarks were identified automatically and assigned to CT data, performing a cross-correlation analysis and an investigation of the geometrical consistency. The algorithm was evaluated within the development of the navigation and robotic control system in a laboratory setting. Under laboratory conditions it could be shown that partially defective surfaces (simulated by, for example, adding white noise, or reducing or smoothing the polygon data) were correctly recognized and thereby registered. In particular, the algorithm proved its excellence in interpreting partially modified topologies. The proposed procedure can be used to accomplish dynamic intra-operative registration of the skull bone by the generati