Impact of organ-specific dose reduction on the image quality of head and neck CT angiography

OBJECTIVES

Organ-specific dose reduction (OSDR) algorithms can reduce radiation on radiosensitive organs up to 59 %. This study evaluates the influence of a new OSDR algorithm on image quality of head and neck computed tomographic angiography (CTA) in clinical routine.

METHODS

Sixty-two consecutive patients (68 ± 13 years) were randomised into two groups and imaged using 128-row multidetector CT. Group A (n = 31) underwent conventional CTA and group B (n = 31) CTA with a novel OSDR algorithm. Subjective and objective image quality were statistically compared. Subjective image quality was rated on a five-point scale. Signal-to-noise ratio (SNR) and contrast-to-noise ratio (CNR) were calculated with region-of-interest measurements.

RESULTS

The SNR of the common carotid artery and middle cerebral artery was 53.6 ± 22.7 and 43.3 ± 15.3 (group A) versus 54.1 ± 20.5 and 46.2 ± 14.6 (group B). The CNR was 40.0 ± 19.3 and 29.7 ± 12.0 (group A) compared with 40.7 ± 16.8 and 32.9 ± 10.9 (group B), respectively. Subjective image quality was excellent in both groups (mean score 4.4 ± 0.7 versus 4.4 ± 0.6). Differences between the two groups were not significant.

CONCLUSIONS

The novel OSDR algorithm does not compromise image quality of head and neck CTA. Its application can be recommended for CTA in clinical routine to protect the thyroid gland and ocular lenses from unnecessary high radiation.

KEY POINTS

• Organ-specific dose reduction (OSDR) can significantly reduce radiation exposure during CT • OSDR does not compromise image quality of head and neck CTA • OSDR can significantly lower the risk of radiation damage to sensitive organs • OSDR can easily be applied in routine clinical practice.

Public health advocacy for the Berlin Declaration on tuberculosis in the former Soviet Union: The view of Médecins Sans Frontières

To assist international efforts to address major gaps in the availability and accessibility of quality diagnosis and treatment for multi-drug resistant tuberculosis, Médecins Sans Frontières has adapted an approach combining three sets of interlinked strategies: direct provision of medical care, operational research, and public health advocacy. The activities undertaken are reviewed each in turn, with stress on the ways that they impact upon and consolidate each other. In spite of new opportunities, including technologies which significantly improve diagnosis and new, more patient-centred approaches, a much broader international mobilization is needed in order to confront MDR-TB. It is also questionable as to whether existing technologies are successful enough to provide a solid basis for expanded national programs.

[Sickness absence and disability due to psychiatric disorders from a gender perspective - a systematic literature review]

OBJECTIVE

This work is aimed at providing a review of the literature on gender differences in the prevalence of mental disorders at the workplace.

METHODS

A systematic literature search of all original works on sickness absence and disability due to psychiatric disorders published in PubMed from 2000 through to 2011 was undertaken.

RESULTS

Female employees have more frequent and longer sickness absences due to psychiatric disorders. Male employees are at a high risk of disability due to psychiatric disorders.

CONCLUSION

Gender-specific prevention strategies at the workplace should target the prevention of short and long-term consequences for female employees and the long-term impact of psychiatric disorders in male employees. However, there is still a lack of knowledge about implications for gender specific prevention strategies at the workplace.

Stability of thin wetting films on chemically nanostructured surfaces

The morphology and stability of thin volatile wetting films on model chemically patterned surfaces composed of periodic arrays of alternating completely and partially wettable nanostripes are investigated. The equilibrium film morphology is recorded as a function of undersaturation using noncontact atomic force microscopy. Films spanning the entire pattern are found to be stable only for thicknesses in excess of a critical value, h(c), whereas thinner films spontaneously dewet the partially wettable regions of the substrate. The critical thickness h(c) increases linearly with the width of the partially wettable stripes in good agreement with an interface displacement model derived from microscopic density functional theory. These results provide detailed insights into the dewetting of thin films driven by competing intermolecular forces.

Phase behavior of colloidal suspensions with critical solvents in terms of effective interactions

We study the phase behavior of colloidal suspensions the solvents of which are considered to be binary liquid mixtures undergoing phase segregation. We focus on the thermodynamic region close to the critical point of the accompanying miscibility gap. There, due to the colloidal particles acting as cavities in the critical medium, the spatial confinements of the critical fluctuations of the corresponding order parameter result in the effective, so-called critical Casimir forces between the colloids. Employing an approach in terms of effective, one-component colloidal systems, we explore the possibility of phase coexistence between two phases of colloidal suspensions, one being rich and the other being poor in colloidal particles. The reliability of this effective approach is discussed.

Critical Casimir effect for colloids close to chemically patterned substrates

Colloids immersed in a critical or near-critical binary liquid mixture and close to a chemically patterned substrate are subject to normal and lateral critical Casimir forces of dominating strength. For a single colloid, we calculate these attractive or repulsive forces and the corresponding critical Casimir potentials within mean-field theory. Within this approach we also discuss the quality of the Derjaguin approximation and apply it to Monte Carlo simulation data available for the system under study. We find that the range of validity of the Derjaguin approximation is rather large and that it fails only for surface structures which are very small compared to the geometric mean of the size of the colloid and its distance from the substrate. For certain chemical structures of the substrate, the critical Casimir force acting on the colloid can change sign as a function of the distance between the particle and the substrate; this provides a mechanism for stable levitation at a certain distance which can be strongly tuned by temperature, i.e., with a sensitivity of more than 200 nm/K.

Precursor films in wetting phenomena

The spontaneous spreading of non-volatile liquid droplets on solid substrates poses a classic problem in the context of wetting phenomena. It is well known that the spreading of a macroscopic droplet is in many cases accompanied by a thin film of macroscopic lateral extent, the so-called precursor film, which emanates from the three-phase contact line region and spreads ahead of the latter with a much higher speed. Such films have been usually associated with liquid-on-solid systems, but in the last decade similar films have been reported to occur in solid-on-solid systems. While the situations in which the thickness of such films is of mesoscopic size are fairly well understood, an intriguing and yet to be fully understood aspect is the spreading of microscopic, i.e. molecularly thin, films. Here we review the available experimental observations of such films in various liquid-on-solid and solid-on-solid systems, as well as the corresponding theoretical models and studies aimed at understanding their formation and spreading dynamics. Recent developments and perspectives for future research are discussed.

Complete wetting of elastically responsive substrates

We analyze theoretically complete wetting of a substrate supporting an array of parallel, vertical plates which can tilt elastically. The adsorbed liquid tilts the plates, inducing clustering, and thus modifies the substrate geometry. In turn, this change in geometry alters the wetting properties of the substrate and, consequently, the adsorption of liquid. This geometry-wetting feedback loop leads to stepped adsorption isotherms with each step corresponding to an abrupt change in the substrate geometry. We discuss how this can be used for constructing substrates with tunable wetting and adsorption properties.

Toxicity and elemental composition of particulate matter from outdoor and indoor air of elementary schools in Munich, Germany

Outdoor particulate matter (PM(10)) is associated with detrimental health effects. However, individual PM(10) exposure occurs mostly indoors. We therefore compared the toxic effects of classroom, outdoor, and residential PM(10). Indoor and outdoor PM(10) was collected from six schools in Munich during teaching hours and in six homes. Particles were analyzed by scanning electron microscopy and X-ray spectroscopy (EDX). Toxicity was evaluated in human primary keratinocytes, lung epithelial cells and after metabolic activation by several human cytochromes P450. We found that PM(10) concentrations during teaching hours were 5.6-times higher than outdoors (117 ± 48 μg/m(3) vs. 21 ± 15 μg/m(3), P < 0.001). Compared to outdoors, indoor PM contained more silicate (36% of particle number), organic (29%, probably originating from human skin), and Ca-carbonate particles (12%, probably originating from paper). Outdoor PM contained more Ca-sulfate particles (38%). Indoor PM at 6 μg/cm(2) (10 μg/ml) caused toxicity in keratinocytes and in cells expressing CYP2B6 and CYP3A4. Toxicity by CYP2B6 was abolished with the reactive oxygen species scavenger N-acetylcysteine. We concluded that outdoor PM(10) and indoor PM(10) from homes were devoid of toxicity. Indoor PM(10) was elevated, chemically different and toxicologically more active than outdoor PM(10). Whether the effects translate into a significant health risk needs to be determined. Until then, we suggest better ventilation as a sensible option.

PRACTICAL IMPLICATIONS

Indoor air PM(10) on an equal weight base is toxicologically more active than outdoor PM(10). In addition, indoor PM(10) concentrations are about six times higher than outdoor air. Thus, ventilation of classrooms with outdoor air will improve air quality and is likely to provide a health benefit. It is also easier than cleaning PM(10) from indoor air, which has proven to be tedious.

Collective dynamics of colloids at fluid interfaces

The evolution of an initially prepared distribution of micron-sized colloidal particles, trapped at a fluid interface and under the action of their mutual capillary attraction, is analyzed by using Brownian dynamics simulations. At a separation λ given by the capillary length of typically 1mm, the distance dependence of this attraction exhibits a crossover from a logarithmic decay, formally analogous to two-dimensional gravity, to an exponential decay. We discuss in detail the adaptation of a particle-mesh algorithm, as used in cosmological simulations to study structure formation due to gravitational collapse, to the present colloidal problem. These simulations confirm the predictions, as far as available, of a mean-field theory developed previously for this problem. The evolution is monitored by quantitative characteristics which are particularly sensitive to the formation of highly inhomogeneous structures. Upon increasing λ the dynamics shows a smooth transition from the spinodal decomposition expected for a simple fluid with short-ranged attraction to the self-gravitational collapse scenario.

Critical Casimir forces for Ising films with variable boundary fields

Monte Carlo simulations based on an integration scheme for free energy differences is used to compute critical Casimir forces for three-dimensional Ising films with various boundary fields. We study the scaling behavior of the critical Casimir force, including the scaling variable related to the boundary fields. Finite size corrections to scaling are taken into account. We pay special attention to that range of surface field strengths within which the force changes from repulsive to attractive upon increasing the temperature. Our data are compared with other results available in the literature.

Shock waves in capillary collapse of colloids: a model system for two-dimensional screened Newtonian gravity

Using Brownian dynamics simulations, density functional theory, and analytical perturbation theory we study the collapse of a patch of interfacially trapped, micrometer-sized colloidal particles, driven by long-ranged capillary attraction. This attraction is formally analogous to two-dimensional (2D) screened Newtonian gravity with the capillary length λ as the screening length. Whereas the limit λ→∞ corresponds to the global collapse of a self-gravitating fluid, for finite λ[over ^] we predict theoretically and observe in simulations a ringlike density peak at the outer rim of a disclike patch, moving as an inbound shock wave. Possible experimental realizations are discussed.

Capillary interactions in Pickering emulsions

The effective capillary interaction potentials for small colloidal particles trapped at the surface of liquid droplets are calculated analytically. Pair potentials between capillary monopoles and dipoles, corresponding to particles floating on a droplet with a fixed center of mass and subjected to external forces and torques, respectively, exhibit a repulsion at large angular separations and an attraction at smaller separations, with the latter resembling the typical behavior for flat interfaces. This change of character is not observed for quadrupoles, corresponding to free particles on a mechanically isolated droplet. The analytical results are compared with the numerical minimization of the surface free energy of the droplet in the presence of spherical or ellipsoidal particles.

Magnetization of multicomponent ferrofluids

The solution of the mean spherical approximation (MSA) integral equation for isotropic multicomponent dipolar hard sphere fluids without external fields is used to construct a density functional theory (DFT), which includes external fields, in order to obtain an analytical expression for the external field dependence of the magnetization of ferrofluidic mixtures. This DFT is based on a second-order Taylor series expansion of the free energy density functional of the anisotropic system around the corresponding isotropic MSA reference system. The ensuing results for the magnetic properties are in quantitative agreement with our canonical ensemble Monte Carlo simulation data presented here.