We present simulation and phantom studies demonstrating a strong correlation between errors in shear wave arrival time estimates and the lateral position of the local speckle pattern in targets with fully developed speckle. We hypothesize that the observed arrival time variations are largely due to the underlying speckle pattern, and call the effect speckle bias. Arrival time estimation is a key step in quantitative shear wave elastography, performed by tracking tissue motion via cross-correlation of RF ultrasound echoes or similar methods. Variations in scatterer strength and interference of echoes from scatterers within the tracking beam result in an echo that does not necessarily describe the average motion within the beam, but one favoring areas of constructive interference and strong scattering. A swept-receive image, formed by fixing the transmit beam and sweeping the receive aperture over the region of interest, is used to estimate the local speckle pattern. Metrics for the lateral position of the speckle are found to correlate strongly (r > 0.7) with the estimated shear wave arrival times both in simulations and in phantoms. Lateral weighting of the swept-receive pattern improved the correlation between arrival time estimates and speckle position. The simulations indicate that high RF echo correlation does not equate to an accurate shear wave arrival time estimate-a high correlation coefficient indicates that motion is being tracked with high precision, but the location tracked is uncertain within the tracking beam width. The presence of a strong on-axis speckle is seen to imply high RF correlation and low bias. The converse does not appear to be true-highly correlated RF echoes can still produce biased arrival time estimates. The shear wave arrival time bias is relatively stable with variations in shear wave amplitude and sign (-20 μm to 20 μm simulated) compared with the variation with different speckle realizations obtained along a given tracking vector. We show that the arrival time bias is weakly dependent on shear wave amplitude compared with the variation with axial position/ local speckle pattern. Apertures of f/3 to f/8 on transmit and f/2 and f/4 on receive were simulated. Arrival time error and correlation with speckle pattern are most strongly determined by the receive aperture.
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http://dx.doi.org/10.1109/TUFFC.2015.007171 | DOI Listing |
Trials
December 2024
Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA.
Background: Vancomycin, an antibiotic with activity against methicillin-resistant Staphylococcus aureus (MRSA), is frequently included in empiric treatment for community-acquired pneumonia (CAP) despite the fact that MRSA is rarely implicated in CAP. Conducting polymerase chain reaction (PCR) testing on nasal swabs to identify the presence of MRSA colonization has been proposed as an antimicrobial stewardship intervention to reduce the use of vancomycin. Observational studies have shown reductions in vancomycin use after implementation of MRSA colonization testing, and this approach has been adopted by CAP guidelines.
View Article and Find Full Text PDFBMC Microbiol
December 2024
College of Agriculture and Forestry, Linyi University, Linyi, 276005, Shandong, China.
Avian pathogenic Escherichia coli (APEC) is a significant pathogen infecting poultry that is responsible for high mortality, morbidity and severe economic losses to the poultry industry globally, posing a substantial risk to the health of poultry. APEC encounters reactive oxygen species (ROS) during the infection process and thus has evolved antioxidant defense mechanisms to protect against oxidative damage. The imbalance of ROS production and antioxidant defenses is known as oxidative stress, which results in oxidative damage to proteins, lipids and DNA, and even bacterial cell death.
View Article and Find Full Text PDFAnn Vasc Surg
December 2024
Section of Vascular Surgery, Department of Surgery, Michigan Medicine, Ann Arbor, MI; Jobst Vascular Institute, Toledo, OH.
Objectives: The COVID-19 epidemic introduced significant systems- and disease-based uncertainty into Abdominal Aortic Aneurysm (AAA) rupture management. The goal of this work was to evaluate whether short-term AAA rupture outcomes during COVID-19 were comparable to pre-COVID era outcomes and to explore the impact of COVID status and COVID era healthcare systems restrictions on AAA rupture outcomes.
Methods: The Vascular Quality Initiative (VQI) database was queried for all ruptured AAAs that underwent intervention from January 1, 2019 to August 31, 2022.
Am J Emerg Med
December 2024
Department of Internal Medicine (Section of General Internal Medicine, Program for Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA; Department of Pediatrics (Section of Hospital Medicine), Yale University School of Medicine, New Haven, CT, USA.
Boarding of admitted patients in the Emergency Department (ED) changes both the setting and teams providing care during the initial phase of admissions. We measured the waiting time from ED door arrival to inpatient floor arrival for 17,944 admissions to internal medicine services over a 5-year period from 2018 to 2023 and propose this as a metric for the total delay in care associated with ED boarding, termed "Door to Floor" (DTF) time. We find a sustained increase as well as significant seasonal and day-of-the-week variation in DTF times.
View Article and Find Full Text PDFInterdiscip Cardiovasc Thorac Surg
December 2024
Department of Cardiovascular Surgery, University Hospital Freiburg Heart Centre, Freiburg, Germany, University of Freiburg, Faculty of Medicine, Freiburg, Germany.
Objectives: Evidence for different surveillance protocols following aortic treatment is still lacking. Aim of this study was to analyze the clinical relevance of a first follow-up visit after 6 months.
Methods: Between 01/2018 and 12/2019, 464 patients treated for non-emergent aortic pathologies were retrospectively analysed.
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