Focused intravascular ultrasonic probe using dimpled transducer elements

High-frequency focused intravascular ultrasonic probes were fabricated in this study using dimple technique based on PMN-PT single crystal and lead-free KNN-KBT-Mn ceramic. The center frequency, bandwidth, and insertion loss of the PMN-PT transducer were 34 MHz, 75%, and 22.9 dB, respectively. For the lead-free probe, the center frequency, bandwidth, and insertion loss were found to be 40 MHz, 72%, and 28.8 dB, respectively. The ultrasonic images of wire phantom and vessels with good resolution were obtained to evaluate the transducer performance. The -6 dB axial and lateral resolutions of the PMN-PT probe were determined to be 58 μm and 131 μm, respectively. For the lead-free probe, the axial and lateral resolutions were found to be 44 μm and 125 μm, respectively. These results suggest that the mechanical dimpling technique has good potential in preparing focused transducers for intravascular ultrasound applications.

Unintentional secondary exogenous corticosteroid exposure and central serous chorioretinopathy

PURPOSE

The purpose of this study is to describe a possible association between unintentional secondary exogenous corticosteroid exposure and central serous chorioretinpathy (CSCR).

METHODS

A retrospective review of three patients diagnosed with CSCR in one or both eyes and a history of possible unintentional secondary corticosteroid exposure. Clinical history, exam findings, optical coherence tomography, fluorescein angiography, and clinical course were reviewed.

RESULTS

Three patients, who did not use corticosteroids, reported suspected unintentional secondary corticosteroid exposure from living with family members or partners using dermatologic corticosteroid cream and/or inhalers frequently. Two of the three patients had a history of recurrent CSCR, one patient involving both eyes. After taking precautions to avoid secondary corticosteroid exposure, all three patients had complete resolution of CSCR without further recurrence during follow-up ranging from 2 to 4 years.

CONCLUSIONS

Patients with CSCR should be queried for both primary and possible unintentional secondary routes of corticosteroid exposure, which may contribute to this condition.

Epidemiological evaluation of spatiotemporal and genotypic clustering of Mycobacterium tuberculosis in Ontario, Canada

BACKGROUND

In Canada, tuberculosis (TB) rates are at a historic low, with the remaining risk concentrated in a few vulnerable population subgroups.

OBJECTIVES

To describe the epidemiology of TB in the Canadian province of Ontario and to characterise risk factors associated with transmission events, identified using genetic typing techniques.

DESIGN

Retrospective analysis of 2186 culture-positive TB cases between August 2007 and December 2011. Temporal trends and risk of spatiotemporal and genotypic clustering were evaluated using Poisson and logistic regression models.

RESULTS

Being in a spatiotemporal cluster was associated with Aboriginal status (odds ratio [OR] 3.63, 95% confidence interval [CI] 1.23-10.71). Cases in genotypic clusters were more likely to report homelessness as a risk factor (adjusted OR [aOR] 2.92, 95%CI 1.74-4.90) or be male (aOR 1.35, 95%CI 1.09-1.68), and were less likely to be aged ≥ 65 years (aOR 0.63, 95%CI 0.49-0.82), foreign-born (aOR 0.32, 95%CI 0.24-0.43) or Aboriginal (aOR 0.40, 95%CI 0.16-0.99). The Beijing lineage had an annual rate of increase of almost 10% (P = 0.047), and was associated with genotypic clustering (aOR 2.84, 95%CI 2.19-3.67).

CONCLUSION

Genotypic data suggest that disease clusters are smaller, but far more common, than would be estimated using spatiotemporal clustering.

Application and a proposed modification of the 2010 McDonald criteria for the diagnosis of multiple sclerosis in a Canadian cohort of patients with clinically isolated syndromes

Background:

The 2005 and 2010 McDonald criteria utilize magnetic resonance imaging (MRI) to provide evidence of disease dissemination in space (DIS) and time (DIT) for the diagnosis of multiple sclerosis (MS) in patients who have clinically isolated syndromes (CIS).

Methods:

Data from 109 CIS patients not satisfying the 2005 criteria at entry into a randomized controlled minocycline trial were analyzed to determine the proportion who would have been diagnosed with MS at screening based on 2010 criteria. The impact of including symptomatic, as well as asymptomatic, MRI lesions to confirm DIT was also explored.

Results:

Thirty percent (33/109) of patients, retrospectively, met the 2010 criteria for a diagnosis of MS at baseline. When both symptomatic and asymptomatic lesions were used to confirm DIT, three additional patients met the 2010 criteria. There was a significant 10.1% increase in the proportion of patients who met the 2010 DIS criteria, compared with the 2005 DIS criteria; however, two patients satisfied the 2005 DIS but not 2010 DIS criteria.

Conclusion:

Using 2010 McDonald criteria, 30% of the CIS patients could be diagnosed with MS using a single MRI scan. Inclusion of symptomatic lesions in the DIT criteria further increases this proportion to 33%.

High frequency PMN-PT single crystal focusing transducer fabricated by a mechanical dimpling technique

High frequency (∼30MHz and ∼80MHz) focusing ultrasound transducers were fabricated using a PMN-0.28PT single crystal by a mechanical dimpling technique. The dimpled single crystal was used as an active element for the focusing transducer. Compared with a plane transducer, the focusing transducer fabricated with a dimpled active element exhibits much broader bandwidth and higher sensitivity. Besides, a high quality image can be obtained by the 30MHz focusing transducer, in which the -6dB axial and lateral resolution is 27μm and 139μm, respectively. These results prove that the dimpling technique is capable to fabricate the high frequency focusing transducers with excellent performance for imaging applications.

PMN-PT single crystal focusing transducer fabricated using a mechanical dimpling technique

A ∼5MHz focusing PMN-PT single crystal ultrasound transducer has been fabricated utilizing a mechanical dimpling technique, where the dimpled crystal wafer was used as an active element of the focusing transducer. For the dimpled focusing transducer, the effective electromechanical coupling coefficient was enhanced significantly from 0.42 to 0.56. The dimpled transducer also yields a -6dB bandwidth of 63.5% which is almost double the bandwidth of the plane transducer. An insertion loss of the dimpled transducer (-18.1dB) is much lower than that of the plane transducer. Finite element simulation also reveals specific focused beam from concave crystal surface. These promising results show that the dimpling technique can be used to develop high-resolution focusing single crystal transducers.

High-frequency ultrasonic transducer based on lead-free BSZT piezoceramics

This paper describes the fabrication and evaluation of a high-frequency (40MHz) transducer based on lead-free piezoceramics for ultrasonic imaging. The transducer with an aperture size of 0.9mm has been fabricated using barium strontium zirconate titanate ((Ba(0.95)Sr(0.05))(Zr(0.05)Ti(0.95))O(3), abbreviated as BSZT) ceramics. The lead-free BSZT has a piezoelectric d(33) coefficient of 300 pC/N and an electromechanical coupling factor k(t) of 0.45. High-frequency ultrasound transducers were fabricated and a bandwidth of 76.4% has been achieved with an insertion loss of -26dB. Applications in high resolution biological and medical imaging could be possible with this lead-free material.

The causal relationship between electricity consumption and economic growth in a Gaming and Tourism Center: The case of Macao SAR, the People's Republic of China

A number of Asian cities decided to establish gaming and resort facilities in order to capitalize on the growing number of gamblers and their family members in Asia. In doing so, they expect to sustain economic growth but, on the other hand, will consume a considerable amount of energy. Nevertheless, the causal relationship between economic growth and electricity consumption in this type of service-oriented territories has never been investigated. Using the historical data obtained from the Government of Macao SAR, we found that electricity consumption and economic growth in terms of gross domestic product are co-integrated for the period of 1999 Quarter 1-2008 Quarter 4. Moreover, vector error correction (VEC) models indicated a lack of short-run relationships but showed that there was a long-run equilibrium relationship between electricity consumption and gross domestic product. The accuracy of VEC models was assessed by using the mean squared error and the mean absolute error. The error analysis shows that VEC models reproduced time series of gross domestic product and electricity consumption in difference form accurately.

An integrated microfluidic chip with 40 MHz lead-free transducer for fluid analysis

The design, fabrication, and evaluation of a high-frequency transducer made from lead-free piezoceramic for the application of microfluidic analysis is described. Barium strontium zirconate titanate [(Ba(0.95)Sr(0.05))(Zr(0.05)Ti(0.95))O(3), abbreviated as BSZT] ceramic has been chosen to be the active element of the transducer. The center frequency and bandwidth of this high-frequency ultrasound transducer have been measured to be 43 MHz and 56.1%, respectively. The transducer was integrated into a microfluidic channel and used to measure the sound velocity and attenuation of the liquid flowing in the channel. Results suggest that lead-free high-frequency transducers could be used for in situ analysis of property of the fluid flowing through the microfluidic system.

Piezoelectric dispenser based on a piezoelectric-metal-cavity actuator

A piezoelectric dispenser has been fabricated based on the idea of a piezoelectric-metal-cavity (PMC) actuator. The PMC actuator consists of a metal ring sandwiched between two identical piezoelectric unimorphs. The radial contraction of the piezoelectric ceramic is converted into a flextensional motion of the unimorph, causing a large flexural displacement in the center part of the actuator. With the PMC actuator as a fluid chamber, the large flexural actuation can be used to produce the displacement needed to eject fluid. By applying an appropriate voltage to the piezoelectric unimorphs, a drop-on-demand ejection of ink or water can be achieved. The efficiency of fluid ejection can be enhanced after installing a valve in the fluid chamber. With the simple PMC structure, the dispenser can be operated with a low driving voltage of 12-15 V.

Co-morbidities of patients with knee osteoarthritis

OBJECTIVES

To study the co-morbidities of general practice patients with knee osteoarthritis.

DESIGN

Cross-sectional study.

SETTING

Two private general practice clinics in Hong Kong.

PATIENTS

All patients presenting at the two clinics were screened for osteoarthritis of the knee based on American College of Rheumatology diagnostic criteria. Patients with osteoarthritis then completed a semi-instructed questionnaire.

RESULTS

A total of 455 patients were recruited into the study. Over half (56%) had knee pain plus more than three other diagnostic criteria. Almost all (95%) of the patients with osteoarthritis had no signs of inflammation at the time of screening. Their mean age was 54 years. Overall, 78% of them had at least one musculoskeletal co-morbidity and 82% had at least one non-musculoskeletal co-morbidity. On average they had 3.2 co-morbidities, of which 1.7 were musculoskeletal and 1.5 were non-musculoskeletal. Problems related to the back, upper limbs, neck, and lower limbs were the four most common musculoskeletal co-morbidities, of which neck problems were significantly more common among younger patients (55 years or below) [odds ratio for older to younger patients was 0.62; 95% confidence interval, 0.4-0.9]. The four commonest non-musculoskeletal co-morbidities were cardiovascular, gastro-intestinal, respiratory, and endocrine, of which cardiovascular diseases (odds ratio=8.76; 95% confidence interval, 5.6-13.7), endocrine problems (4.56; 2.8-7.4), and central nervous system diseases (12.74; 1.6-102.8) were significantly likely among older patients (more than 55 years).

CONCLUSION

General practitioners should be alert to the presence of co-morbidities when managing patients with osteoarthritis of the knee.

Low level IGF-1 and common variable immune deficiency: an unusual combination

A relation between growth hormone (GH) deficiency and immunoglobulin deficiency has been suggested previously in a few cases. We describe a patient with an insulin-like growth factor 1 (IGF-1) deficiency and common variable immune deficiency and briefly review earlier publications on the possible interaction between IGF-1 and the immune system. IGF-1 is the downstream mediator of GH. In this patient, GH and IGF-1 levels were both low. The GH response to a GH-releasing hormone test was normal whereas no subsequent IGF-1 response was seen. In our cohort of 14 patients with hypogammaglobulinaemia, two turned out to have slightly decreased IGF-1 serum levels and one patient with a thymoma had an increased IGF-1 level. Even though IGF-1 may be connected to B lymphocyte differentiation, in this patient we hypothesise there is a common impairment in the IGF-1 and IgG pathways.

A study on the disk-shaped piezoelectric transformer with multiple outputs

In this study, a modified disk-shaped multiple-output piezoelectric transformer operated at the fundamental radial vibration mode has been presented. A derived equivalent circuit for the multioutput piezoelectric transformer was used to analyze the performance. Two piezoelectric transformers, a symmetrically electroded piezoelectric transformer with dual outputs and an asymmetrically electroded piezoelectric transformer with triple outputs, were fabricated with lead zirconate titanate piezoelectric ceramics. The characteristics of the two piezoelectric transformers were investigated experimentally. The piezoelectric transformer with multiple outputs has potential to be used in power supply units and other electronic circuits.

Lead-free acoustic emission sensors

Acoustic emission (AE) sensors have been fabricated using both soft- and hard-type lead-free (Na0.5K0.5)NbO3-based ceramics. The acoustic and electromechanical properties of the ceramics have been determined using the resonance technique. The lead-free AE sensors were calibrated using a laser source and compared to a commercial sensor. A lead zirconate titanate (PZT) 5H ceramics AE sensor has also been fabricated and calibrated for comparison. It was found that the sensitivity of lead-free AE sensors is comparable to that of the lead-based PZT sensor. To evaluate the sensors for potential application, they have been used in the detection of AE in an impact test. The lead-free sensors can reproduce AE signals accurately without giving artifacts and have potential use in commercial AE systems.