A Simulation of the Effects of Diffusion on Hyperpolarized [1-C]-Pyruvate Signal Evolution.

Objective: Hyperpolarized [1-C]-pyruvate magnetic resonance imaging is an emerging metabolic imaging method that offers unprecedented spatiotemporal resolution for monitoring tumor metabolism in vivo. To establish robust imaging biomarkers of metabolism, we must characterize phenomena that may modulate the apparent pyruvate-to-lactate conversion rate (k). Here, we investigate the potential effect of diffusion on pyruvate-to-lactate conversion, as failure to account for diffusion in pharmacokinetic analysis may obscure true intracellular chemical conversion rates.

Model-constrained reconstruction accelerated with Fourier-based undersampling for hyperpolarized [1- C] pyruvate imaging.

Purpose: Model-constrained reconstruction with Fourier-based undersampling (MoReFUn) is introduced to accelerate the acquisition of dynamic MRI using hyperpolarized [1- C]-pyruvate.

Methods: The MoReFUn method resolves spatial aliasing using constraints introduced by a pharmacokinetic model that describes the signal evolution of both pyruvate and lactate. Acceleration was evaluated on three single-channel data sets: a numerical digital phantom that is used to validate the accuracy of reconstruction and model parameter restoration under various SNR and undersampling ratios, prospectively and retrospectively sampled data of an in vitro dynamic multispectral phantom, and retrospectively undersampled imaging data from a prostate cancer patient to test the fidelity of reconstructed metabolite time series.

Projection-based stereolithography for direct 3D printing of heterogeneous ultrasound phantoms.

Modern ultrasound (US) imaging is increasing its clinical impact, particularly with the introduction of US-based quantitative imaging biomarkers. Continued development and validation of such novel imaging approaches requires imaging phantoms that recapitulate the underlying anatomy and pathology of interest. However, current US phantom designs are generally too simplistic to emulate the structure and variability of the human body.

Development of a rational strategy for integration of lactate dehydrogenase A suppression into therapeutic algorithms for head and neck cancer.

Background: Lactate dehydrogenase (LDH) is a critical metabolic enzyme. LDH A (LDHA) overexpression is a hallmark of aggressive malignancies and has been linked to tumour initiation, reprogramming and progression in multiple tumour types. However, successful LDHA inhibition strategies have not materialised in the translational and clinical space.

Technical Note: A deuterated C-urea reference for clinical multiparametric MRI prostate cancer studies including hyperpolarized pyruvate.

Purpose: Metabolic magnetic resonance imaging (MRI) using hyperpolarized [1- C]-pyruvate offers unprecedented new insight into disease and response to therapy. C-enriched reference standards are required to enable fast and accurate calibration for C studies, but care must be taken to ensure that the reference is compatible with both C and H acquisitions. The goal of this study was to optimize the composition of a C-urea reference for a dual-tuned C/ H endorectal coil and minimize imaging artifacts in metabolic and multiparametric MRI studies involving hyperpolarized [1- C]-pyruvate.

Robot-assisted microsurgical vasovasostomy: the learning curve for a pure microsurgeon.

Vasovasostomy success rates improved with the application of the operative microscope in 1975. The robotic platform offers potential advantages including: a stable, ergonomic, scalable control system with three-dimensional visualization and magnification, the elimination of physiological tremor, and simultaneous control of three instruments and a camera. A previous publication revealed a fellowship-trained microsurgeon (PKK) could transition to robot-assisted microsurgical vasovasostomy (RAVV) with comparable outcomes.

"Leaving the comfort of the familiar": fostering workplace cultural awareness through short-term global experiences.

Problem: Facilitating the development of student nurses' cultural competence and translating these experiences into the clinical setting.

Methods: Qualitative methods.

Findings: A short-term global immersion experience informs student nurses' cultural awareness, education, and future clinical practice.

Improving access for Latino immigrants: evaluation of language training adapted to the needs of health professionals.

The number of Latinos in North Carolina grew by almost 400% between 1990 and 2000. The rapid change in demographics in this state and other southeastern states has caught healthcare providers unprepared. Lack of ability to communicate with Latino patients may result in errors in diagnosis or reduced compliance with recommended treatments.

An effective approach to violence prevention: traditional martial arts in middle school.

This study replicated and extended the design and outcome measures of several small studies. In these studies, juveniles at high risk for violence and delinquency showed decreased violence and positive changes in psychological risk factors after being required to take a school-linked course in traditional martial arts. In the present study, 60 boys in a large urban middle school were required to take a traditional martial arts course in their school.

From concept to application: the impact of a community-wide intervention to improve the delivery of preventive services to children.

Objective: To improve health outcomes of children, the US Maternal and Child Health Bureau has recommended more effective organization of preventive services within primary care practices and more coordination between practices and community-based agencies. However, applying these recommendations in communities is challenging because they require both more complex systems of care delivery within organizations and more complex interactions between them. To improve the way that preventive health care services are organized and delivered in 1 community, we designed, implemented, and assessed the impact of a health care system-level approach, which involved addressing multiple care delivery processes, at multiple levels in the community, the practice, and the family.

Rhenium oxo complexes of a chelating diyne ligand. Synthesis and study of the kinetics of protonation.

A series of oxo complexes, Re(O)X(diyne) (X = I, Me, Et), have been prepared from 2,7-nonadiyne and Re(O)I(3)(PPh(3))(2). Addition of B(C(6)F(5))(3) to Re(O)I(2,7-nonadiyne) (5) results in coordination of the oxo ligand to the boron. The protonation of Re(O)(X)(2-butyne)(2) and Re(O)(X)(2,7-nonadiyne)(2) with a variety of acids has been examined.

Linking clinical and public health approaches to improve access to health care for socially disadvantaged mothers and children. A feasibility study.

Objective: To test the feasibility of combining home- and office-based interventions to improve access to health care and health outcomes of Medicaid-eligible mothers and infants.

Design: Randomized trial in 2 counties in North Carolina (1 rural, 1 urban). Information on health and developmental outcomes was obtained by face-to-face interviews, medical chart abstractions, hospital medical records, and state data tapes.

Access to care: a home visitation program that links public health nurses, physicians, mothers, and babies.

The purpose of the project here was to develop and test interventions designed to improve access to care and health outcomes for Medicaid-eligible infants during their first 6 months of life. The goal of the intervention was to overcome personal and structural barriers to care by combining the efforts of county health departments and private physicians' offices in 2 counties in North Carolina. The project combined home visits and an office intervention.

The association of mast cells and atherosclerosis: a morphologic study of early atherosclerotic lesions in young people.

Mast cell products, such as histamine, may contribute to the initiation and progression of the atherosclerotic plaque. To determine the relationship that may exist between early atherosclerotic plaques and mast cells we studied the aortas and coronary arteries of 115 young subjects aged 15 to 34 years who had traumatic deaths. Lesions were classified as normal intima, fatty streaks, fibro-fatty plaques, and fibrous plaques.

A model program for providing health services for migrant farmworker mothers and children.

A bilingual, multidisciplinary team of health professionals collaborated with a migrant health center in North Carolina to develop a model program to deliver primary health care services to migrant farmworker women and children. The program included case finding and outreach, coordination of maternal and child health services locally as well as interstate, and innovative health education programming. Data were collected on the health status of 359 pregnant migrant farmworker women and 560 children, ages birth to 5 years, the majority of Mexican descent, who received primary care services at the center.

Fatal big cat attacks.

Two cases of fatal attacks by large cats are presented. In the first case, a 30-year-old female zoo worker was attacked by a jaguar that had escaped its cage. In the second case, a 2-year-old girl was fatally injured by her father's pet leopard.

Autopsy of teleosts from contaminated areas.

A systematic procedure provides one method of assessing xenobiotic-induced abnormalities in fish following environmental exposures. Behavioral, external (or gross), histopathological, and internal organ changes allow determination of the severity of toxicant impact on an endemic population provided a sufficient number of specimens is analyzed. Over the past 15 years, these methods have led to the establishment of causal factors in metal- and metalloid-induced toxicity.