MR imaging of motion with spatial modulation of magnetization

A novel magnetic resonance imaging technique provides direct imaging of motion by spatially modulating the degree of magnetization prior to imaging. The preimaging pulse sequence consists of a radio-frequency (RF) pulse to produce transverse magnetization, a magnetic field gradient to "wrap" the phase along the direction of the gradient, and a second RF pulse to mix the modulated transverse magnetization with the longitudinal magnetization. The resulting images show periodic stripes due to the modulation. Motion between the time of striping and image formation is directly demonstrated as a corresponding displacement of the stripes. This technique can be used to study heart wall motion, to distinguish slowly moving blood from thrombus, and to study the flow of blood and cerebrospinal fluid.

Heart wall motion: improved method of spatial modulation of magnetization for MR imaging

A previously reported method of using magnetic resonance (MR) imaging to study heart wall motion involves a pair of nonselective radio-frequency (RF) pulses, separated by a magnetic field gradient pulse, prior to imaging; this produces images with a regular pattern of stripes that move with the heart wall and that have a sinusoidal intensity profile. It is demonstrated in this study that the substitution of more RF pulses, with their relative amplitudes distributed according to the binomial sequence, results in sharper stripes. This permits the use of a two-dimensional grid of stripes for more detailed studies of heart wall motion and provides a unique method of analyzing regional ventricular myocardial strain.

Breath-hold ultrafast three-dimensional gadolinium-enhanced MR angiography of the aorta and the renal and other visceral abdominal arteries

OBJECTIVES

The objectives of this study were to develop and show the efficacy of a breath-hold ultrafast three-dimensional (3D) spoiled gradient-echo (SPGR) gadolinium-enhanced MR angiographic technique for imaging the aorta and the renal and other visceral arteries of the abdomen; and to compare breath-hold ultrafast 3D SPGR with two-dimensional (2D) time-of-flight (TOF) and non-breath-hold ultrafast 3D SPGR in the same patients.

SUBJECTS AND METHODS

We prospectively studied the abdominal aorta and the renal and other visceral arteries 68 times in 63 consecutive patients with 2D TOF and ultrafast 3D SPGR MR angiography. Thirty-two patients had contrast angiography (n = 23) and/or surgery (n = 24) to serve as a gold standard. All MR imaging studies were performed on a 1.5-T scanner (General Electric Medical Systems, Milwaukee, WI) using an enhanced gradient system with maximum gradient strength of 2.3 gauss/cm reached in 150 microseconds. Axial 2D TOF parameters were: TR/TE, 33/5.5 msec; flip angle, 45 degrees; slice thickness, 2 mm; and no presaturation pulses. Coronal ultrafast 3D SPGR was performed before and after the i.v. administration of 40-60 cc of gadolinium. For the coronal ultrafast 3D SPGR, our parameters were: TR/TE, 4.8-7/1.1; flip angle, 60 degrees; 28-50 slices of 2.0-2.6 mm thickness; and acquisition time, 18-32 sec. Studies were read by a single radiologist [corrected] and were evaluated for the degree of stenosis in the renal, celiac, superior mesenteric, and inferior mesenteric arteries; any vascular anomalies (i.e., retroaortic renal veins and accessory renal or variant hepatic arteries) were noted.

RESULTS

Breath-hold ultrafast 3D SPGR correctly identified 31 of 31 stenoses of the renal artery for a sensitivity, specificity, and accuracy of 100%. Two-dimensional TOF detected 23 of 31 renal artery stenoses for a sensitivity, specificity, and accuracy of 74%, 98%, and 87% respectively. Breath-hold ultrafast 3D SPGR underestimated two renal arteries as having severe osteal stenoses that were graded correctly by 2D TOF and by angiography as occlusions. Eight of nine (89%) accessory renal arteries were correctly identified with breath-hold ultrafast 3D SPGR: Two-dimensional TOF identified six of nine (67%). Breath-hold ultrafast 3D SPGR identified one accessory and two reconstituted renal arteries missed by 2D TOF and conventional contrast angiography that were confirmed at surgery. Ultrafast 3D SPGR and 2D TOF correctly identified 20 of 20 celiac, superior mesenteric, and inferior mesenteric artery osteal stenoses or occlusions for a sensitivity, specificity, and accuracy of 100%. Three Riolan's arcs were correctly identified by breath-hold 3D SPGR but were missed by 2D TOF: Forty of the 63 patients did not have conventional contrast angiography and were managed surgically (n = 9) or medically (n = 31) based on the results of the MR angiograms and clinical data. Breath-hold ultrafast 3D SPGR MR angiography correctly identified and graded 48 of 51 renal, celiac, superior mesenteric, and inferior mesenteric artery stenoses or occlusions. Two-dimensional TOF MR angiography correctly identified and graded 45 of 51 renal, celiac, superior mesenteric, and inferior mesenteric artery stenoses and occlusions.

CONCLUSION

Breath-hold ultrafast 3D SPGR when combined with 2D TOF accurately identified and graded all (51 of 51) renal, celiac, superior mesenteric, and inferior mesenteric artery stenoses or occlusions.

Guidelines on the insertion and management of central venous access devices in adults

Central venous access devices are used in many branched of medicine where venous access is required for either long-term or a short-term care. These guidelines review the types of access devices available and make a number of major recommendations. Their respective advantages and disadvantages in various clinical settings are outlined. Patient care prior to, and immediately following insertion is discussed in the context of possible complications and how these are best avoided. There is a section addressing long-term care of in-dwelling devices. Techniques of insertion and removal are reviewed and management of the problems which are most likely to occur following insertion including infection, misplacement and thrombosis are discussed. Care of patients with coagulopathies is addressed and there is a section addressing catheter-related problems.

Validation of tagging with MR imaging to estimate material deformation

Myocardial tagging with magnetic resonance imaging is useful for non-invasive estimation of in vivo heart wall deformation. To validate the method of strain estimation and quantify the error of deformation estimates, a deformable silicone gel phantom in the shape of a cylindrical anulus was built and imaged. Four observers digitized the displacement of magnetic tags in two deformation modes: axial shear, caused by a 45 degrees rotation of the inner cylinder, and azimuthal shear, caused by a 13.5-mm longitudinal translation of the inner cylinder. In axial shear, good agreement was found between the angular displacement of stripes painted on the gel and an analytic solution. Displacement of magnetic tags also agreed with that solution. Interobserver and observer-model errors in deformation estimates were quantified for homogeneous and nonhomogeneous strain analysis. In homogeneous strain analysis, errors in point localization produced relatively large errors, which were reduced in nonhomogeneous strain analysis. Both estimates were unbiased across the range of deformations.

k-space weighted image contrast (KWIC) for contrast manipulation in projection reconstruction MRI

A novel technique for manipulating contrast in projection reconstruction MRI is described. The method takes advantage of the fact that the central region of k-space is oversampled, allowing one to choose different filters to enhance or reduce the amount that each view contributes to the central region, which dominates image contrast. The technique is implemented into a fast spin-echo (FSE) sequence, and it is shown that multiple T(2)-weighted images can be reconstructed from a single image data set. These images are shown to be nearly identical to those acquired with the Cartesian-sampled FSE sequence at different effective echo times. Further, it is demonstrated that T(2) maps can be generated from a single image data set. This technique also has the potential to be useful in dynamic contrast enhancement studies, capable of yielding a series of images at a significantly higher effective temporal resolution than what is currently possible with other methods, without sacrificing spatial resolution.

Tracking and finite element analysis of stripe deformation in magnetic resonance tagging

Magnetic resonance tissue tagging allows noninvasive in vivo measurement of soft tissue deformation. Planes of magnetic saturation are created, orthogonal to the imaging plane, which form dark lines (stripes) in the image. The authors describe a method for tracking stripe motion in the image plane, and show how this information can be incorporated into a finite element model of the underlying deformation. Human heart data were acquired from several imaging planes in different orientations and were combined using a deformable model of the left ventricle wall. Each tracked stripe point provided information on displacement orthogonal to the original tagging plane, i.e., a one-dimensional (1-D) constraint on the motion. Three-dimensional (3-D) motion and deformation was then reconstructed by fitting the model to the data constraints by linear least squares. The average root mean squared (rms) error between tracked stripe points and predicted model locations was 0.47 mm (n=3,100 points). In order to validate this method and quantify the errors involved, the authors applied it to images of a silicone gel phantom subjected to a known, well-controlled, 3-D deformation. The finite element strains obtained were compared to an analytic model of the deformation known to be accurate in the central axial plane of the phantom. The average rms errors were 6% in both the reconstructed shear strains and 16% in the reconstructed radial normal strain.

Expression of receptor tyrosine kinase Axl and its ligand Gas6 in rheumatoid arthritis: evidence for a novel endothelial cell survival pathway

Angiogenesis and synovial cell hyperplasia are characteristic features of rheumatoid arthritis (RA). Many growth and survival factors use receptors belonging to the tyrosine kinase family that share conserved motifs within the intracellular catalytic domains. To understand further the molecular basis of cellular hyperplasia in RA, we have used degenerate primers based on these motifs and RNA obtained from the synovium of a patient with RA to perform reverse transcriptase-polymerase chain reaction. We report detection of the receptor tyrosine kinase (RTK) Axl in RA synovium and we document the expression pattern of Axl in capillary endothelium, in vascular smooth muscle cells of arterioles and veins, and in a subset of synovial cells in RA synovial tissue. Gas6 (for growth arrest-specific gene 6), which is a ligand for Axl and is related to the coagulation factor protein S, was found in synovial fluid and tissue from patients with RA and osteoarthritis. Axl expression and function was studied in human umbilical vein endothelial cells (HUVECs). Gas6 bound to HUVECs; soluble Axl inhibited this binding. Exogenous Gas6 protected HUVECs from apoptosis in response to growth factor withdrawal and from TNFalpha-mediated cytotoxicity. These findings may reveal a new aspect of vascular physiology, which may also be relevant to formation and maintenance of the abnormal vasculature in the rheumatoid synovium.

Use of Gd-DTPA and fast gradient-echo and spin-echo MR imaging to demonstrate renal function in the rabbit

The paramagnetic magnetic resonance (MR) imaging contrast agent gadolinium diethylenetriaminepentaacetic acid (DTPA) is freely filtered at the glomerulus and is neither secreted nor reabsorbed by the renal tubules. Fast MR imaging techniques, either gradient-echo or spin-echo, can be used to document the passage of Gd-DTPA through the renal tubules, as reflected by alteration in the MR signal intensity within the different anatomic regions of the kidney. Gradient-echo (repetition time of 35 msec, echo time of 7 msec, flip angles of 10 degrees-100 degrees) and spin-echo (repetition time of 35 msec, echo time of 8 msec) pulse sequences were used to acquire 20 consecutive images, one every 12 seconds, of the rabbit kidney. Both pulse sequences depicted the time course of Gd-DTPA distribution through the kidney but with distinctly different patterns of MR signal change. These dynamic MR images provide an MR nephrogram that directly demonstrates renal morphology and indirectly reflects the functional status of the renal vasculature, renal perfusion, and tubular concentrating ability.

In vivo human cervical spinal cord deformation and displacement in flexion

STUDY DESIGN

In vivo, quasi-static distortion of the human cervical spinal cord was measured in five volunteers during flexion of the neck using a motion-tracking magnetic resonance imaging technique.

OBJECTIVES

To measure cord distortion and movement in living subjects.

SUMMARY OF BACKGROUND DATA

In situ spinal cord measurements in human and rhesus monkey cadavers taken at full flexion demonstrate that the entire cervical cord elongates approximately 10% of its length at a neutral position, but no data are available at other angles of flexion, or in living subjects.

METHODS

The spatial modulation of magnetization pulse sequence created a series of parallel lines in the image that deform with the tissue. A custom-designed device was built to guide the flexion of the neck and enhance motion reproducibility. Midsagittal plane images were acquired before and after flexion. The tagged line pattern in each pair of magnetic resonance images was compared to compute distortion and movement of the cervical spinal cord at varying degrees of flexion.

RESULTS

Between a neutral posture and full flexion, the entire cord (C2-C7) elongated linearly with head flexion, increasing 10% and 6% of its initial length along the posterior and anterior surfaces, respectively. Average displacement was on the order of 1-3 mm, and varied with region. Specifically, the upper cord showed caudad movement in the spinal canal, and the lower cord moved cephalad, again with larger movements on the posterior surface.

CONCLUSIONS

The cervical cord elongates and displaces significantly during head flexion in human volunteers, offering valuable information regarding the normal milieu of the cord.

Validation of an optical flow method for tag displacement estimation

We present a validation study of an optical-flow method for the rapid estimation of myocardial displacement in magnetic resonance tagged cardiac images. This registration and change visualization (RCV) software uses a hierarchical estimation technique to compute the flow field that describes the warping of an image of one cardiac phase into alignment with the next. This method overcomes the requirement of constant pixel intensity in standard optical-flow methods by preprocessing the input images to reduce any intensity bias which results from the reduction in stripe contrast throughout the cardiac cycle. To validate the method, SPAMM-tagged images were acquired of a silicon gel phantom with simulated rotational motion. The pixel displacement was estimated with the RCV method and the error in pixel tracking was <4% 1000 ms after application of the tags, and after 30 degrees of rotation. An additional study was performed using a SPAMM-tagged multiphase slice of a canine left ventricle. The true displacement was determined using a previously validated active contour model (snakes). The error between methods was 6.7% at end systole. The RCV method has the advantage of tracking all pixels in the image in a substantially shorter period than the snakes method.

Pulmonary perfusion: respiratory-triggered three-dimensional MR imaging with arterial spin tagging--preliminary results in healthy volunteers

The authors used a spin-tagging method of magnetic resonance perfusion imaging to measure pulmonary perfusion in eight healthy volunteers with use of a respiratory-triggered three-dimensional pulse sequence. The average signal intensity (SI) decrease upon arterial labeling was 24%. The perfusion SI increased by 21% after exercise (P = .02). Focal blood flow abnormalities were observed in a patient with chronic obstructive pulmonary disease.

Simultaneous acquisition of multiple resolution images for dynamic contrast enhanced imaging of the breast

An imaging technique is described that allows the reconstruction of a series of images at high temporal rates, while simultaneously providing images at high spatial resolution. The method allows one to arbitrarily choose from among several combinations of temporal/spatial resolutions during postprocessing. This flexibility is accomplished by strategically interleaving multiple undersampled projection reconstruction datasets (or subapertures), in which each set can be used to reconstruct a high temporal resolution image. Images with increasingly higher spatial resolutions can subsequently be formed by combining two or more subaperture datasets. The technique is demonstrated in vivo to assess the kinetics of contrast enhancement and to visualize the architectural features of suspicious breast lesions.

MR imaging with spatial modulation of magnetization in the evaluation of chronic central pulmonary thromboemboli

PURPOSE

To assess the diagnostic value of magnetic resonance (MR) imaging with SPAMM (spatial modulation of magnetization) in the identification of chronic central pulmonary thromboemboli.

MATERIALS AND METHODS

Twelve patients with pulmonary hypertension and five healthy volunteers were prospectively studied with a 1.5-T MR imaging system. The SPAMM technique was integrated into a conventional cardiac-synchronized spin-echo (SE) sequence. Six of the 12 patients had central thromboemboli.

RESULTS

In the healthy subjects, intravascular stripes in the central pulmonary arteries disappeared as a result of flow within 100 msec after the R wave. Areas of persistent stripes were identified in seven of eight central pulmonary arteries with thromboemboli. Conversely, in the 16 central pulmonary arteries without clot, intraluminal stripes disappeared despite the presence of flow-related signal (sensitivity = 88%, specificity = 100%, accuracy = 96%).

CONCLUSION

SPAMM appears to be a simple and effective technique for differentiating central pulmonary arterial thromboemboli from flow-related signal frequently observed with pulmonary hypertension.

Cardiac imaging at 4 Tesla

Although higher magnetic field strength is a means to increase SNR in MRI, cardiac imaging has been difficult at high fields due to decreased RF penetration. Using a tailored cardiac coil constructed of two transmit surface coils with a four-element multicoil for signal reception, the authors demonstrate high-quality heart images acquired on a 4-T scanner. These images show an increase in SNR of approximately 2.5-fold over imaging at 1.5 T. This improvement in image quality can be used to increase in-plane resolution, reduce slice thickness, or reduce total scan time. Magn Reson Med 45:176-178, 2001.

Integrated MRI assessment of regional function and perfusion in canine myocardial infarction

A single integrated examination using regional measurements of perfusion from contrast-enhanced MRI and three-dimensional (3D) strain from tissue-tagged MRI was developed to differentiate infarcted myocardium from adjacent tissue with functional abnormalities. Ten dogs were studied at baseline and 10 days after a 2-hour occlusion of the left anterior descending coronary artery (LAD). Strain was determined using a 3D finite element model. Two-dimensional measurements of hypoenhancing regions were highly correlated with myocardial viability (r = 0.96). Signal intensity versus time curves obtained from contrast-enhanced MRI were used for quantitative perfusion analysis. The remote and adjacent noninfarcted tissue of the dogs with LAD occlusion, as well as the infarcted tissue, exhibited abnormal deformation patterns as compared to normal dogs (positive predictive value (PPV) of strain determination of infarction = 66%). Integration of contrast-enhanced MRI results with 3D strain analysis enabled the delineation of the myocardial infarction (PPV = 100%) from functionally compromised myocardium. This integrated cardiac examination shows promise for noninvasive serial assessment of potentially jeopardized noninfarcted myocardium to study the process of infarct remodeling and expansion.

Adaptor protein SKAP55R is associated with myeloid differentiation and growth arrest

Activation of the SRC family of protein tyrosine kinases is an important component of intracellular signaling in hematopoiesis, but their critical substrates are less well understood. In this report, we describe the cloning and functional characterization of murine SKAP55R (mSKAP55R), an SRC family kinase substrate. Expression of mSKAP55R was examined by Northern blot. Phosphorylation of mSKAP55R was examined by transient transfection of COS cells. For overexpression studies, mSKAP55R was cloned into a bicistronic murine stem cell virus-based retrovirus. Transduced cells (FDC-P1 cell line and murine bone marrow) were FACS isolated by expression of the selectable marker green fluorescent protein.mSKAP55R showed 90% amino acid identity to the recently published human SKAP55R. mSKAP55R contained a central pleckstrin homology domain, a C-terminal SH3 domain, and a putative SRC kinase consensus substrate DEIY(260). mSKAP55R was expressed in all hematopoietic lineages, with relative mRNA levels greatest in cells of the myeloid and erythroid lineages. Induced myeloid differentiation of M1 and HL-60 cell lines was associated with an eight-fold increase in mSKAP55R mRNA. Transient expression of mSKAP55R in COS cells demonstrated that tyrosine 260 was the predominant site of phosphorylation by FYN kinase. Furthermore, this phosphotyrosine was essential for coimmunoprecipitation of FYN with mSKAP55R. Enforced expression of mSKAP55R inhibited in vitro growth of the myeloid FDC-P1 cell line and primary hematopoietic progenitors. In contrast, a tyrosine 260 mutant mSKAP55R had no effect on in vitro growth. These studies implicate mSKAP55R in the processes of myeloid differentiation and growth arrest.

Cardiac-respiratory gating method for magnetic resonance imaging of the heart

In studies of transmural myocardial function, acquisitions of high spatial and temporal resolution tagged cardiac images often exceed the practical time limit for breath-hold fast imaging techniques. Therefore, a dual cardiac-respiratory gating device has been constructed to acquire SPAMM-tagged cardiac MR images at or near end-expiration during spontaneous breathing, by providing an external trigger to a conventional MRI system. Combined cardiac and respiratory gating essentially eliminates the respiratory motion artifacts in tagged cardiac MR images. Compared to cardiac-gated images obtained during intermittent breath-holds, cardiac-respiratory gated images show improved tag-myocardium contrast due to magnetization recovery during inspiration.

Pulmonary MR angiography with contrast agent at 4 Tesla: a preliminary result

In this study, pulmonary MR angiography (MRA) using a tailored coil at 4 Tesla in conjunction with an intravenous injection of contrast agent is described. Three-dimensional gradient-echo images were obtained during the intravenous injection of 0.05, 0.1, and 0.2 mmol/kg body weight of gadodiamide to investigate the signal enhancement effect of the contrast agent in pulmonary arteries qualitatively and quantitatively. In the qualitative analysis, the subsegmental branches were visualized on every dose. In the quantitative analysis, the average contrast-to-noise ratios (CNRs) of the main pulmonary arteries increased in a dose-dependent manner. However, the CNRs of segmental arteries did not increase as the dose of contrast agent increased, as observed at 1.5 Tesla MRI. These observations demonstrate the feasibility of delineating the pulmonary vasculature using a contrast agent; however, our results also suggest possible high-field-related disabilities that need to be overcome before high-field (> or =4 Tesla) MRI can be used to full advantage.

RheoScale: A tool to aggregate and quantify experimentally determined substitution outcomes for multiple variants at individual protein positions

Human mutations often cause amino acid changes (variants) that can alter protein function or stability. Some variants fall at protein positions that experimentally exhibit "rheostatic" mutation outcomes (different amino acid substitutions lead to a range of functional outcomes). In ongoing studies of rheostat positions, we encountered the need to aggregate experimental results from multiple variants, to describe the overall roles of individual positions. Here, we present "RheoScale" which generates quantitative scores to discriminate rheostat positions from those with "toggle" (most substitutions abolish function) or "neutral" (most substitutions have wild-type function) outcomes. RheoScale scores facilitate correlations of experimental data (such as binding affinity or stability) with structural and bioinformatic analyses. The RheoScale calculator is encoded into a Microsoft Excel workbook and an R script. Example analyses are shown for three model protein systems, including one assessed via deep mutational scanning. The RheoScale calculator quickly and efficiently provided quantitative descriptions that were in good agreement with prior qualitative observations. As an example application, scores were compared to the example proteins' structures; strong rheostat positions tended to occur in dynamic locations. In the future, RheoScale scores can be easily integrated into computational studies to facilitate improved algorithms for predicting outcomes of human variants.

Identification of biochemically neutral positions in liver pyruvate kinase

Understanding how each residue position contributes to protein function has been a long-standing goal in protein science. Substitution studies have historically focused on conserved protein positions. However, substitutions of nonconserved positions can also modify function. Indeed, we recently identified nonconserved positions that have large substitution effects in human liver pyruvate kinase (hLPYK), including altered allosteric coupling. To facilitate a comparison of which characteristics determine when a nonconserved position does vs does not contribute to function, the goal of the current work was to identify neutral positions in hLPYK. However, existing hLPYK data showed that three features commonly associated with neutral positions-high sequence entropy, high surface exposure, and alanine scanning-lacked the sensitivity needed to guide experimental studies. We used multiple evolutionary patterns identified in a sequence alignment of the PYK family to identify which positions were least patterned, reasoning that these were most likely to be neutral. Nine positions were tested with a total of 117 amino acid substitutions. Although exploring all potential functions is not feasible for any protein, five parameters associated with substrate/effector affinities and allosteric coupling were measured for hLPYK variants. For each position, the aggregate functional outcomes of all variants were used to quantify a "neutrality" score. Three positions showed perfect neutral scores for all five parameters. Furthermore, the nine positions showed larger neutral scores than 17 positions located near allosteric binding sites. Thus, our strategy successfully enriched the dataset for positions with neutral and modest substitutions.

Central venous access devices

Central venous access devices are used in hospital and in the long term for patients who receive therapy in the community. This article explores the history and development of these devices as well as the nurses role in their insertion and care.

Rheostat functional outcomes occur when substitutions are introduced at nonconserved positions that diverge with speciation

When amino acids vary during evolution, the outcome can be functionally neutral or biologically-important. We previously found that substituting a subset of nonconserved positions, "rheostat" positions, can have surprising effects on protein function. Since changes at rheostat positions can facilitate functional evolution or cause disease, more examples are needed to understand their unique biophysical characteristics. Here, we explored whether "phylogenetic" patterns of change in multiple sequence alignments (such as positions with subfamily specific conservation) predict the locations of functional rheostat positions. To that end, we experimentally tested eight phylogenetic positions in human liver pyruvate kinase (hLPYK), using 10-15 substitutions per position and biochemical assays that yielded five functional parameters. Five positions were strongly rheostatic and three were non-neutral. To test the corollary that positions with low phylogenetic scores were not rheostat positions, we combined these phylogenetic positions with previously-identified hLPYK rheostat, "toggle" (most substitution abolished function), and "neutral" (all substitutions were like wild-type) positions. Despite representing 428 variants, this set of 33 positions was poorly statistically powered. Thus, we turned to the in vivo phenotypic dataset for E. coli lactose repressor protein (LacI), which comprised 12-13 substitutions at 329 positions and could be used to identify rheostat, toggle, and neutral positions. Combined hLPYK and LacI results show that positions with strong phylogenetic patterns of change are more likely to exhibit rheostat substitution outcomes than neutral or toggle outcomes. Furthermore, phylogenetic patterns were more successful at identifying rheostat positions than were co-evolutionary or eigenvector centrality measures of evolutionary change.

Maintaining vascular access devices: the nurse's role

The role of the nurse in maintaining vascular access devices has altered dramatically with the advance in vascular access device technology and the greater involvement in selection of the device and its insertion, maintenance and removal. Up-to-date knowledge and the use of evidence-based practice underpinned by good scientific research is the key to vascular access device maintenance. The routine maintenance of vascular access devices is a shared responsibility between the nurse and the patient, so that the nurse has an important part to play in the adequate preparation and education of the patient. The nurse therefore has a responsibility to ensure the maintenance of vascular access devices in order to increase the benefits to the patient and decrease the risk of serious complications.

Linogram reconstruction for magnetic resonance imaging (MRI)

Reconstruction of magnetic resonance images (MRIs) by backprojection, which commonly uses techniques analogous to those employed for X-ray computed tomography, is discussed. The recently developed method of linogram reconstruction, an alternative to conventional/backprojection methods of reconstruction from projections, has been adapted for MRI, taking advantage of MRI's flexibility in choosing projection geometry. By avoiding the computationally intensive interpolations required for backprojection, linograms offer significant savings in reconstruction time over conventional backprojection and may offer a slight improvement in resolution as well.