Help a mother out: The impact of acute care surgeon response in postpartum hemorrhage.

Introduction: A Code White (CW) activation is a hospital-wide alert for postpartum hemorrhage (PPH) and acute care surgeons (ACS) were added to the response team to assist in resuscitation. A multidisciplinary training program was also implemented. This study aimed to evaluate the impact of ACS involvement and training on maternal outcomes.

Update on micronutrients in bariatric surgery.

Purpose Of Review: Obesity is a growing worldwide epidemic. Obese patients are often deficient in micronutrients despite macronutrient excess. Bariatric surgery is an increasingly utilized modality in the treatment of obesity and obesity-related conditions.

Hippocampal morphometry in population-based incident Alzheimer's disease and vascular dementia: the HAAS.

Background: Hippocampal changes may be a useful biomarker for Alzheimer's disease if they are specific to dementia sub-type. We compare hippocampal volume and shape in population-based incident cases of Alzheimer's disease and vascular dementia (VaD).

Methods: Participants are Japanese-American men from the Honolulu Asia Aging Study.

Active shape modeling with electric flows.

Physics-based particle systems are an effective tool for shape modeling. Also, there has been much interest in the study of shape modeling using deformable contour approaches. In this paper, we describe a new deformable model with electric flows based upon computer simulations of a number of charged particles embedded in an electrostatic system.

Performance measure characterization for evaluating neuroimage segmentation algorithms.

Characterizing the performance of segmentation algorithms in brain images has been a persistent challenge due to the complexity of neuroanatomical structures, the quality of imagery and the requirement of accurate segmentation. There has been much interest in using the Jaccard and Dice similarity coefficients associated with Sensitivity and Specificity for evaluating the performance of segmentation algorithms. This paper addresses the essential characteristics of the fundamental performance measure coefficients adopted in evaluation frameworks.

Taser X26 discharges in swine: ventricular rhythm capture is dependent on discharge vector.

Background: Data from our previous studies indicate that Taser X26 stun devices can acutely alter cardiac function in swine. We hypothesized that most transcardiac discharge vectors would capture ventricular rhythm, but that other vectors, not traversing the heart, would fail to capture the ventricular rhythm.

Methods: Using an Institutional Animal Care and Use Committee (IACUC) approved protocol, four Yorkshire pigs (25-36 kg) were anesthetized, paralyzed with succinylcholine (2 mg/kg), and then exposed to 10 second discharges from a police-issue Taser X26.

Acute effects of MK63 stun device discharges in miniature swine.

Objective: Electromuscular incapacitation (EMI) devices are being used and evaluated by both military and law enforcement agencies. Although the gross muscular response is obvious, physiological responses to these devices are poorly understood. We hypothesized that the intense, repetitive, muscle contractions evoked by EMI devices would cause dose-dependent metabolic acidosis, accompanied by neuromuscular or cardiac injury.

Age effects on hippocampal structural changes in old men: the HAAS.

Understanding the variability of the hippocampus in human brain research is essential. The effect of age on the hippocampus has been explored in several studies that have been focused on either normal aging or neural degeneration. Shape analysis of magnetic resonance imaging (MRI) provides morphological measures for brain structures.

TASER X26 discharges in swine produce potentially fatal ventricular arrhythmias.

Objectives: Data from the authors and others suggest that TASER X26 stun devices can acutely alter cardiac function in swine. The authors hypothesized that TASER discharges degrade cardiac performance through a mechanism not involving concurrent acidosis.

Methods: Using an Institutional Animal Care and Use Committee (IACUC)-approved protocol, Yorkshire pigs (25-71 kg) were anesthetized, paralyzed with succinylcholine (SCh; 2 mg/kg), and then exposed to two 40-second discharges from a TASER X26 with a transcardiac vector.

Acute effects of TASER X26 discharges in a swine model.

Background: Very little objective laboratory data are available describing the physiologic effects of stun guns or electromuscular incapacitation devices (EIDs). Unfortunately, there have been several hundred in-custody deaths, which have been temporally associated with the deployment of these devices. Most of the deaths have been attributed to specific cardiac and metabolic effects.

Neuromuscular effects of stun device discharges.

Background: Stun guns or electromuscular incapacitation devices (EMIs) generate between 25,000 and 250,000 V and can be discharged continuously for as long as 5 to 10 min. In the United States, over 200,000 individuals have been exposed to discharges from the most common type of device used. EMI devices are being used increasingly despite a lack of objective laboratory data describing the physiological effects and safety of these devices.

An electrostatic deformable model for medical image segmentation.

A new deformable model, the charged fluid model (CFM), that uses the simulation of charged elements was used to segment medical images. Poisson's equation was used to guide the evolution of the CFM in two steps. In the first step, the elements of the charged fluid were distributed along the propagating interface until electrostatic equilibrium was achieved.

Segmentation of brain MR images using a charged fluid model.

In this paper, we developed a new deformable model, the charged fluid model (CFM), that uses the simulation of a charged fluid to segment anatomic structures in magnetic resonance (MR) images of the brain. Conceptually, the charged fluid behaves like a liquid such that it flows through and around different obstacles. The simulation evolves in two steps governed by Poisson's equation.

Sensitivity of patient-specific numerical simulation of cerebal aneurysm hemodynamics to inflow boundary conditions.

Object: Due to the difficulty of obtaining patient-specific velocity measurements during imaging, many assumptions have to be made while imposing inflow boundary conditions in numerical simulations conducted using patient-specific, imaging-based cerebral aneurysm models. These assumptions can introduce errors, resulting in lack of agreement between the computed flow fields and the true blood flow in the patient. The purpose of this study is to evaluate the effect of the assumptions made while imposing inflow boundary conditions on aneurysmal hemodynamics.

Repeated thoracic discharges from a stun device.

Background: Little objective laboratory data are available describing the physiologic effects of stun guns or electromuscular incapacitation (EMI) devices, but increasing morbidity and even deaths are associated with their use. We hypothesized that exposure to EMI discharges in a model animal system would induce clinically significant acidosis and cardiac arrhythmia.

Methods: Ten Yucatan mini-pigs, six experimental and four sham controls, were anesthetized with ketamine, xylazine, and glycopyrrolate.

Skull-stripping magnetic resonance brain images using a model-based level set.

The segmentation of brain tissue from nonbrain tissue in magnetic resonance (MR) images, commonly referred to as skull stripping, is an important image processing step in many neuroimage studies. A new mathematical algorithm, a model-based level set (MLS), was developed for controlling the evolution of the zero level curve that is implicitly embedded in the level set function. The evolution of the curve was controlled using two terms in the level set equation, whose values represented the forces that determined the speed of the evolving curve.

Normal variants of Microcephalin and ASPM do not account for brain size variability.

Normal human brain volume is heritable. The genes responsible for variation in brain volume are not known. Microcephalin (MCPH1) and ASPM (abnormal spindle-like microcephaly associated) have been proposed as candidate genes as mutations in both genes are associated with microcephaly, and common variants of each gene are apparently under strong positive selective pressure.

LONI visualization environment.

Over the past decade, the use of informatics to solve complex neuroscientific problems has increased dramatically. Many of these research endeavors involve examining large amounts of imaging, behavioral, genetic, neurobiological, and neuropsychiatric data. Superimposing, processing, visualizing, or interpreting such a complex cohort of datasets frequently becomes a challenge.

A Web-based telemedicine system for diabetic retinopathy screening using digital fundus photography.

The purpose was to design and implement a Web-based telemedicine system for diabetic retinopathy screening using digital fundus cameras and to make the software publicly available through Open Source release. The process of retinal imaging and case reviewing was modeled to optimize workflow and implement use of computer system. The Web-based system was built on Java Servlet and Java Server Pages (JSP) technologies.

Phase I study of the sequential combination of interleukin-12 and interferon alfa-2b in advanced cancer: evidence for modulation of interferon signaling pathways by interleukin-12.

Purpose: To evaluate the safety of sequentially administered recombinant (r) human (h) interleukin-12 (IL-12) and interferon alfa-2b (IFN-alpha-2b) in patients with advanced cancer and to determine the effects of endogenously produced IFN-gamma on Janus kinase-signal transducer and activator of transcription (Jak-STAT) signal transduction in patient peripheral-blood mononuclear cells (PBMCs).

Patients And Methods: Forty-nine patients with metastatic cancer received rhIL-12 on day 1 and IFN-alpha-2b on days 2 to 6 of either a 14-day (n = 43) or a 7-day treatment cycle (n = 6). rhIL-12 was initially administered subcutaneously at a dose of 100 ng/kg, whereas IFN-alpha-2b was escalated from 1 to 10 million units (MU) in cohorts of three patients (1, 3, 5, 7, or 10 MU).

The LONI Debabeler: a mediator for neuroimaging software.

Brain image analysis often involves processing neuroimaging data with different software packages. Using different software packages together requires exchanging files between them; the output files of one package are used as input files to the next package in the processing sequence. File exchanges become problematic when different packages use different file formats or different conventions within the same file format.

Expression of STAT1 and STAT2 in malignant melanoma does not correlate with response to interferon-alpha adjuvant therapy.

Interferon-alpha (IFN-alpha) is used as an adjuvant therapy in patients with malignant melanoma and who have undergone surgical resection of high-risk lesions. Defective expression or activation of STAT1 or STAT2 has been shown to correlate with IFN-alpha or resistance in vitro; however, recent data from our laboratory suggest that the anti-tumor effects of IFN-alpha are dependent on STAT1 signaling within host immune cells. We measured STAT1 and STAT2 expression in 28 melanoma biopsies (8 cutaneous lesions; 1 lung metastasis; 19 nodal metastases) obtained from patients prior to the initiation of adjuvant IFN-alpha therapy.

Intra-arterial administration of TNF-alpha followed by arterial ablation is an effective therapy for a regionally confined TNF-resistant rat mammary adenocarcinoma.

Tumor necrosis factor-alpha (TNF-alpha) is an immunomodulatory cytokine that has exhibited anti-tumor activity in a variety of experimental systems. However, the toxicities associated with systemic administration of TNF-alpha have limited its clinical utility and have led to the investigation of targeted delivery techniques with the ability to present the TNF-alpha dose directly to the vascular bed of the tumor. The intra-arterial (IA) administration of TNF-alpha to patients with liver metastases represents one such approach, and recent work suggests that subsequent ablation of the tumor's arterial supply via embolization may enhance the efficacy of intra-arterial treatments (hepatic chemoembolization).