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AJNR. American Journal of Neuroradiology Feb 2011FA correlation to glioma tumor grade has been mixed if not disappointing. There are several potential underlying fundamental issues that have contributed to these...
BACKGROUND AND PURPOSE
FA correlation to glioma tumor grade has been mixed if not disappointing. There are several potential underlying fundamental issues that have contributed to these results. In an attempt to overcome these past shortfalls, we evaluated characteristics of FA of the solid tissue components of gliomas, including whether high-grade gliomas have a greater variation of FA than low-grade gliomas.
MATERIALS AND METHODS
Thirty-four patients with gliomas (9 grade II, 8 grade III, and 17 grade IV) underwent diffusion tensor imaging at 3T. Mean FA, maximum FA, and minimum FA values were measured within the solid tissue components of the tumors. The variations of FA were evaluated by determining the range of FA values and the maximum SDs of FA. The variations of FA values among different tumor grades were compared statistically. We also correlated FA variations with minimum FA and maximum FA.
RESULTS
The maximum FA, FA range, and maximum SD for grade II tumors were significantly lower than those for grade III and IV tumors (P < .0001 ∼ P = .0164). A very good correlation of maximum FA to FA range (r = 0.931) and maximum SD (r = 0.889) was observed.
CONCLUSIONS
The FA range and maximum SD appear useful for differentiating low- and high-grade gliomas. This analysis added value to the findings on conventional MR imaging. In addition, focal maximum FA is a key factor contributing to the larger FA variation within high-grade gliomas.
Topics: Adolescent; Adult; Aged, 80 and over; Anisotropy; Brain Neoplasms; Child; Child, Preschool; Diffusion Tensor Imaging; Female; Glioma; Humans; Infant; Male; Middle Aged; Retrospective Studies; Severity of Illness Index; Young Adult
PubMed: 20947645
DOI: 10.3174/ajnr.A2267 -
Sports Medicine International Open Nov 2018The purpose of this study was to investigate differences in the acute effects of passive knee extension (PKE) and active knee extension (AKE) stretching on the shear...
The purpose of this study was to investigate differences in the acute effects of passive knee extension (PKE) and active knee extension (AKE) stretching on the shear elastic modulus of the hamstrings. In 20 healthy men, maximum knee extension (maximum range of motion [ROM]) and shear elastic modulus of the hamstrings (biceps femoris long head, semitendinosus, semimembranosus) were measured before (Pre) and after (Post) AKE and PKE stretching. The maximum ROM during stretching was measured. In both stretching methods, maximum ROM increased and the shear elastic modulus decreased (p<0.01), but no difference was found between the procedures. No significant difference was observed in the maximum ROM during stretching between the procedures (p=0.06). The shear elastic modulus was significantly lower in the biceps femoris long head and semimembranosus than in the semitendinosus muscle (p<0.05). Static stretching with PKE and AKE stretching showed an increase in maximum ROM and a decrease in hamstring elasticity, but no difference was found between the methods. Both stretching protocols were effective for reducing elasticity of the biceps femoris long head and semimembranosus.
PubMed: 30539134
DOI: 10.1055/a-0733-6957 -
JAMA Health Forum Aug 2023Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many...
IMPORTANCE
Medicaid is the largest payer of substance use disorder treatment in the US and plays a key role in responding to the opioid epidemic. However, as recently as 2017, many state Medicaid programs still did not cover the full continuum of clinically recommended care.
OBJECTIVE
To determine whether state Medicaid fee-for-service (FFS) programs have expanded coverage and loosened restrictions on access to substance use disorder treatment in recent years.
DESIGN, SETTING, AND PARTICIPANTS
In 2014, 2017, and 2021, a survey on coverage for substance use disorder treatment was conducted among state Medicaid programs and the District of Columbia with FFS programs. This survey was completed by Medicaid program directors or knowledgeable staff. Data analysis was performed in 2022.
MAIN OUTCOMES AND MEASURES
The following were calculated for a variety of substance use disorder treatment services (individual and group outpatient, intensive outpatient, short-term and long-term residential, recovery support, inpatient treatment and detoxification, and outpatient detoxification) and medications (methadone, oral and injectable naltrexone, and buprenorphine): (1) the percentage of Medicaid FFS programs covering these services and medications and (2) the percentage of Medicaid FFS programs using utilization management policies, such as copayments, prior authorizations, and annual maximums.
RESULTS
This study had response rates of 92% in 2014 and 2017 (47 of 51 states) and 90% in 2021 (46 of 51 states). For the 2021 wave, data are reported for the 38 non-managed care organization plan-only states. Between 2017 and 2021, coverage of individual and group outpatient treatment increased to 100% of states, and use of annual maximums for medications decreased to 3% or less (n ≤ 1). However, important gaps in coverage persisted, particularly for more intensive services: 10% of Medicaid FFS programs (n = 4) did not cover intensive outpatient treatment, 13% (n = 5) did not cover short-term residential care, and 33% (n = 13) did not cover long-term residential care. Use of utilization controls, such as copays, prior authorizations, and annual maximums, decreased but continued to be widespread.
CONCLUSIONS AND RELEVANCE
In this survey study of state Medicaid FFS programs, increases in coverage and decreases in use of utilization management policies over time were observed for substance use disorder treatment and medications. However, these findings suggest that some states still lag behind and impose barriers to treatment. Future research should work to identify the long-term ramifications of these barriers for patients.
Topics: United States; Humans; Medicaid; Opioid Epidemic; Analgesics, Opioid; Methadone; Substance-Related Disorders
PubMed: 37566428
DOI: 10.1001/jamahealthforum.2023.2502 -
Conservation Physiology 2019Antarctic notothenioids, some of which lack myoglobin (Mb) and/or haemoglobin (Hb), are considered extremely stenothermal, which raises conservation concerns since Polar...
Antarctic notothenioids, some of which lack myoglobin (Mb) and/or haemoglobin (Hb), are considered extremely stenothermal, which raises conservation concerns since Polar regions are warming at unprecedented rates. Without reliable estimates of maximum cardiac output ([Formula: see text]), it is impossible to assess their physiological scope in response to warming seas. Therefore, we compared cardiac performance of two icefish species, (HbMb) and (HbMb), with a related notothenioid, (HbMb) using an perfused heart preparation. The maximum [Formula: see text], heart rate ( ), maximum cardiac work ( ) and relative ventricular mass of at 1°C were comparable to temperate-water teleosts, and acute warming to 4°C increased and , as expected. In contrast, icefish hearts accommodated a higher maximum stroke volume ( ) and maximum [Formula: see text] at 1°C, but their unusually large hearts had a lower and maximum afterload tolerance than at 1°C. Furthermore, maximum , maximum [Formula: see text] and were all significantly higher for the HbMb condition compared with the HbMb condition, a potential selective advantage when coping with environmental warming. Like , both icefish species increased at 4°C. Acutely warming increased maximum [Formula: see text], while (like ) held at 4°C for 1 week maintained maximum [Formula: see text] when tested at 4°C. These experiments involving short-term warming should be followed up with long-term acclimation studies, since the maximum cardiac performance of these three Antarctic species studied seem to be tolerant of temperatures in excess of predictions associated with global warming.
PubMed: 31620287
DOI: 10.1093/conphys/coz049 -
Therapeutics and Clinical Risk... 2018This study investigated the factors associated with coronary artery stenosis in outpatients. Furthermore, the usefulness of maximum carotid intima-media thickness...
BACKGROUND
This study investigated the factors associated with coronary artery stenosis in outpatients. Furthermore, the usefulness of maximum carotid intima-media thickness (maximum-IMT) as a surrogate marker of coronary artery stenosis was evaluated.
METHODS
We conducted a single-center retrospective study. A total of 601 outpatients (338 males; 263 females; mean age, 69.8±10.0 years) who underwent coronary computed tomography angiography between April 2006 and March 2012 were analyzed. The associations between coronary artery stenosis (≥75%) as determined by coronary computed tomography angiography and clinical and laboratory parameters were evaluated by multivariate logistic regression. Validation of maximum-IMT as measured by ultrasonography as a surrogate marker of coronary artery stenosis was analyzed by receiver operating characteristic (ROC) curve analysis.
RESULTS
The estimated glomerular filtration rate (eGFR: mL/min/1.73 m) (odds ratio [OR] 0.985, <0.01), diabetes mellitus (OR 1.98, <0.05), and maximum-IMT (mm) (OR 1.76, <0.01) were significantly associated with coronary artery stenosis (≥75%). In analysis of each group categorized by identified factors, such as renal impairment (eGFR <60 mL/min/1.73 m) and diabetes mellitus, the ROC curve of maximum-IMT was significant in the group of patients with diabetes mellitus without renal impairment (<0.01) (cutoff value of maximum-IMT, 2.0 mm; sensitivity, 0.74; and specificity, 0.54) but not in other groups.
CONCLUSION
Renal impairment, diabetes mellitus, and increased maximum-IMT may be significant risk factors of coronary artery stenosis. Maximum-IMT as measured by ultrasonography may be a useful surrogate marker for coronary artery stenosis in patients with diabetes mellitus without renal impairment but not in other patients.
PubMed: 30147324
DOI: 10.2147/TCRM.S168926 -
Sensors (Basel, Switzerland) Oct 2015In a surface acoustic wave (SAW) wireless sensor with a reflective delay line structure, three reflectors are often used to eliminate 2π ambiguity of phase measurement....
In a surface acoustic wave (SAW) wireless sensor with a reflective delay line structure, three reflectors are often used to eliminate 2π ambiguity of phase measurement. The maximum range of the measured parameter and the maximum accuracy have recently been attracting much research attention. In this paper, an analytical formula for all the factors influencing the measurement range and accuracy of the delay line SAW sensor are deduced for the first time. The factors include: the sensor sensitivity, the topology of the delay line, the available wireless bandwidth and the allowed maximum phase measuring error of the reading system, which is easier to retrieve and more fully describes the possible noises than SNR. Additionally, many designers believe that increasing the reflector could improve accuracy continuously or realize multi-resolution measurement. However, they ignore some certain criteria that the reflector location must satisfy. The reachable maximum accuracy by every increase of a reflector is also presented. A SAW temperature sensor system using 128° YX-LiNbO3 is designed to verify the above theoretical analysis.
PubMed: 26492251
DOI: 10.3390/s151026643 -
Acta Crystallographica. Section E,... Sep 2012The asymmetric unit of the title compound, C(6)H(11)N(3)O, consists of two independent mol-ecules in which the cyclo-pentane rings adopt envelope conformations with...
The asymmetric unit of the title compound, C(6)H(11)N(3)O, consists of two independent mol-ecules in which the cyclo-pentane rings adopt envelope conformations with CH(2) grouping as the flap and the semicarbazone groups are essentially planar, with maximums deviation of 0.0311 (12) and 0.0285 (12) Å. In the crystal, N-H⋯O, N-H⋯N and C-H⋯O hydrogen bonds link the mol-ecules to form sheets lying parallel to the ab plane.
PubMed: 22969569
DOI: 10.1107/S1600536812034599 -
PloS One 2020Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there...
BACKGROUND
Posture is influenced by many factors and dental occlusion seems to have its role on postural stabilization. Our rationale to perform the study was to find out if there are differences of static plantar pressure and stabilometric parameters depending on different dental conditions.
METHODS
The observational study consisted in plantar pressure assessment and stabilometric analysis of 95 right-handed healthy volunteer subjects (mean age 22.94 ± 2.52 years) by using the PoData system. Each subject followed four measurements with open eyes: mandibular postural position, maximum intercuspation, biting on cotton rolls and maximum mouth opening. Plantar pressure was recorded on 1st and 5th metatarsal heads and heel, and was expressed as percentage of weight distribution on each foot. The recorded centre of pressure (CoP) parameters were: CoP path length, 90%confidence ellipse area and maximum CoP speed. Statistical analysis used repeated-measures ANOVA with Bonferroni posthoc analysis and Friedman test.
RESULTS
Loading on the left 5th metatarsal head was significantly higher in maximum mouth opening condition when compared to maximum intercuspation and to biting on cotton rolls. The left heel loading was significantly lower in the maximum mouth opening in comparison to maximum intercuspation. The CoP path length and maximum CoP speed were significantly higher in maximum mouth opening compared to the other three conditions. Confidence ellipse area had significantly lower values in maximum intercuspation and in the biting on cotton rolls conditions compared to the mandibular postural position, and in maximum intercuspation compared to maximum mouth opening.
CONCLUSION
In young adults with an optimum functional occlusion the static plantar pressure is influenced by the maximum mouth opening. An improved postural stability was recorded in maximum intercuspation (a condition used during swallowing) in comparison to mandibular postural position (a condition that allows relaxation of the masticatory muscles after functional moments).
Topics: Adult; Female; Humans; Male; Masticatory Muscles; Mouth; Postural Balance; Posture; Pressure; Young Adult
PubMed: 32045439
DOI: 10.1371/journal.pone.0228816 -
The Science of the Total Environment Mar 2021We aimed to examine the impact of weather on COVID-19 confirmed cases in South Asian countries, namely, Afghanistan, Bangladesh, India, Pakistan, and Sri Lanka. Data on...
We aimed to examine the impact of weather on COVID-19 confirmed cases in South Asian countries, namely, Afghanistan, Bangladesh, India, Pakistan, and Sri Lanka. Data on daily confirmed cases, together with weather parameters, were collected from the first day of COVID confirmed cases in each country to 31 August 2020. The weather parameters were Rainfall (mm), relative humidity (%), maximum and minimum temperature (°C), surface pressure (kPa), maximum air pollutants matter PM 2.5 (μg/m) and maximum wind speed (m/s). Data were analyzed for each investigated countries separately by using the Autoregressive Integrated Moving Average with Explanatory Variables (ARIMAX) model. We found that maximum wind speed had significant negative impact on COVID-19 transmission in India (-209.45, 95% confidence interval (CI): -369.13, -49.77) and Sri Lanka (-2.77, 95% CI: -4.77, -0.77). Apart from India, temperature had mixed effects (i.e., positive or negative) in four countries in South Asia. For example, maximum temperature had negative impact (-30.52, 95% CI: -60.24, -0.78) in Bangladesh and positive impact (5.10, 95% CI: 0.06, 10.14) in Afghanistan. Whereas rainfall had negative effects (-48.64, 95% CI: -80.17, -17.09) in India and mixed effects in Pakistan. Besides, maximum air pollutants matter PM 2.5 was negatively associated with the confirmed cases of COVID-19. In conclusion, maximum wind speed, rainfall, air pollutants (maximum PM 2.5) and temperature are four variables that could play a vital role in the transmission of COVID-19. Although there is a mixed conclusion regarding weather parameters and COVID-19 transmission, we recommend developing environmental policies regarding the transmission of COVID-19 in South Asian countries.
Topics: Afghanistan; Bangladesh; COVID-19; Humans; India; Pakistan; SARS-CoV-2; Sri Lanka; Weather
PubMed: 33162141
DOI: 10.1016/j.scitotenv.2020.143315 -
Journal of Food Protection Nov 2011The minimum and maximum growth temperatures and the maximum growth rates at 10, 30, 37, and 40°C were determined for 24 group II Clostridium botulinum strains. Genetic...
The minimum and maximum growth temperatures and the maximum growth rates at 10, 30, 37, and 40°C were determined for 24 group II Clostridium botulinum strains. Genetic diversity of the strains was revealed by amplified fragment length polymorphism (AFLP) analysis. The minimum growth temperatures ranged from 6.2 to 8.6°C, and the maximum growth temperatures ranged from 34.7 to 39.9°C. The mean maximum growth temperatures and mean maximum growth rates of type E strains at 37°C were significantly higher than those of type B and type F strains. A significant correlation between maximum growth rates at 37°C and maximum growth temperatures was found for all strains. Some type E strains with a high minimum growth temperature also had a higher maximum growth rate at 37°C than at 30°C, which suggests that some group II C. botulinum strains are more mesophilic in their growth properties than others. We found relatively small differences between AFLP clusters, indicating that diverse genetic background among the strains was not reflected in the growth properties. The growth characteristics of group II C. botulinum and some type E strains with mesophilic growth properties may have an impact on inoculation studies and predictive modeling for assessing the safety of foods.
Topics: Botulinum Toxins; Clostridium botulinum; Colony Count, Microbial; Consumer Product Safety; Food Contamination; Food Microbiology; Food Preservation; Genetic Variation; Humans; Kinetics; Polymorphism, Restriction Fragment Length; Temperature
PubMed: 22054179
DOI: 10.4315/0362-028X.JFP-11-187