Cohort of incident cases from 1955 to 2006.
To analyse acute and long-term mortality, estimate life expectancy and identify survival patterns of individuals experiencing traumatic spinal cord injury ...(SCI).
Specialised SCI unit in Australia.
Data for patients with traumatic SCI admitted to a spinal unit in Sydney, Australia between January 1955 and June 2006 were collated and deaths confirmed. Cumulative survival probability was estimated using life-table techniques and mortality rates were calculated from the number of deaths and aggregate years of exposure. Standardised mortality ratios (SMRs) were estimated from the ratio of observed to expected number of deaths. Life expectancy was then estimated using adjusted attained age-specific mortality rates.
From 2014 persons, 88 persons with tetraplegia (8.2%) and 38 persons with paraplegia (4.1%) died within 12 months of injury, most often with complete C1-4 tetraplegia. Among first-year survivors, overall 40-year survival rates were 47 and 62% for persons with tetraplegia and paraplegia, respectively. The most significant increases in mortality were seen in those with tetraplegia and American Spinal Injury Association Impairment Scale (AIS) grades A-C lesions, with SMRs between 5.4 and 9.0 for people <50 years, reducing with advancing attained age. Estimated life expectancies from 25 to 65 years ranged between 69-64%, 74-65%, 88-91% and 97-96% for C1-4 AIS A-C, C5-8 A-C, T1-S5 A-C and all AIS D lesions, respectively.
Survival related strongly to extent of neurological impairment. Future research should focus on identifying contextual factors, personal or environmental, that may contribute to the reduced life expectancy after SCI.
•We propose a new algorithm for correcting susceptibility distortions in high-resolution fMRI scans, using a T1 weighted image and two inverse phase-encoding EPI images.•The robustness of the ...proposed algorithm is increased by using regularization parameters that are automatically selected via Bayesian optimization.•Compared with two state-of-the-art methods (TOPUP and HySCO), the proposed method runs significantly faster while achieving a similar correction accuracy.•It also provides a better alignment of the BOLD responses to the T1w image, and produces less image blur compared to the existing methods.•The proposed method is suitable for several high-resolution fMRI applications, including retinotopic mapping and BOLD localization.
Functional magnetic resonance imaging (fMRI) enables non-invasive examination of both the structure and the function of the human brain. The prevalence of high spatial-resolution (sub-millimeter) fMRI has triggered new research on the intra-cortex, such as cortical columns and cortical layers. At present, echo-planar imaging (EPI) is used exclusively to acquire fMRI data; however, susceptibility artifacts are unavoidable. These distortions are especially severe in high spatial-resolution images and can lead to misrepresentation of brain function in fMRI experiments.
This paper presents a new method for correcting susceptibility artifacts by combining a T1-weighted (T1w) image and inverse phase-encoding (PE) based registration. The latter uses two EPI images acquired using identical sequences but with inverse-PE directions. In the proposed method, the T1w image is used to regularize the registration, and to select the regularization parameters automatically. The motivation is that the T1w image is considered to reflect the anatomical structure of the brain.
Our proposed method is evaluated on two sub-millimeter EPI-fMRI datasets, acquired using 3T and 7T scanners. Experiments show that the proposed method provides improved corrections that are well-aligned to the T1w image.
The proposed method provides more robust and sharper corrections and runs faster compared with two other state-of-the-art inverse-PE based correction methods, i.e. HySCO and TOPUP.
The proposed correction method used the T1w image as a reference in the inverse-PE registration. Results show its promising performance. Our proposed method is timely, as sub-millimeter fMRI has become increasingly popular.
Objective Depression and anxiety may be linked to poor surgical outcomes, but there has been a lack of attention to these comorbidities within total joint arthroplasty (TJA) cohorts. This study aims ...to define the prevalence of depressive and anxiety disorders prior to TJAs and assess their impact on risks of infection, revision, and reoperation. Methods Between 2000 and 2019, 21,469 TJAs (11,458 knee; 10,011 hip) performed at a single academic medical center were identified from a linked electronic medical record (EMR) system. Depressive and anxiety disorders were determined from EMR diagnoses or by an artificial intelligence method followed by manual chart review validation. Patients with other mental health diagnoses were excluded. Mean follow-up was 6 years. Results Combined depression/anxiety prevalence was 32% prior to primary knee surgery and 30% prior to primary hip surgery. 84% of patients undergoing knee surgery and 80% undergoing hip surgery had been treated with antidepressants and/or anxiolytics for a depression/anxiety indication. Presence of a depressive or anxiety disorder was associated with significantly increased risks of infection (HR= 1.6 knee; HR = 1.5 hip), revision (HR= 1.6 knee; HR= 1.7 hip), and reoperation (HR = 1.4 knee; HR = 1.6 hip), p< 0.001 for all. Similar prevalence of depressive and anxiety disorders, medication treatment, and associations with complications were observed following revision TJAs. Conclusion Depression and anxiety are common prior to TJAs and associated with significantly increased risk of infection, revision, and reoperation. Mental health optimization prior to TJA may be of similar importance to management of more commonly considered preoperative variables such as diabetes and hypertension.
Elevated serum CC chemokine ligand (CCL)18 reflects lung fibrosis activity in systemic sclerosis (SSc) and could be an early marker of lung function worsening. Therefore, we sought to evaluate ...whether serum CCL18 levels at baseline could predict worsening of lung disease in SSc. In this prospective study, 83 SSc patients were analysed longitudinally over a 4-yr observation period for the risk of occurrence of combined deleterious events, defined as a 10% decrease from baseline of total lung capacity or forced vital capacity % predicted, or death, according to serum CCL18 at inclusion. Receiver operating characteristic (ROC) curve analysis was performed for prediction of events during the first year after inclusion. The best cut-off level of serum CCL18 for prediction of a combined event within the follow-up period was 187 ng · mL(-1), with 53% sensitivity and 96% specificity (area under the ROC curve 0.86; p < 0.001). After a mean ± SD follow-up of 33.7 ± 10.8 months, a higher rate of disease progression occurred in the group with serum CCL18 levels >187 ng · mL(-1). The adjusted hazard ratio was 5.36 (95% CI 2.44-11.75; p < 0.001). In summary, serum CCL18 is an accurate predictive biomarker for the identification of patients with a higher risk of subsequent scleroderma lung disease worsening.
This paper describes an experimental program that was designed to quantify the rate of spray water evaporation into a warm, dry airstream with application to a proposed inflatable fabric duct cooling ...tower. The inflatable nature of the fabric duct cooling tower promotes rapid deployment, and provides low energy cooling for human comfort in hot, arid environments. The test apparatus measured the mass transfer coefficient for dispersed water droplets flowing parallel to a heated air stream. The data reduction approach employed the analogy between forced convection heat transfer and evaporation mass transfer. For a specific misting nozzle used in a prototype inflatable fabric evaporative cooling tower, the experiments demonstrated that the average test section Sherwood number was a power-law function of the water-to-air mass flow rate ratio, with the exponent equal to 0.70. Likewise the resulting Sherwood number was inversely proportional to the downstream distance from the spray water injection.
An uncertainty analysis of a numerical performance model of a downdraft evaporative fabric cooling tower was conducted. Such a cooling tower can be rapidly deployed and can improve living conditions ...in hot, arid environments where temporary structures are needed for emergency shelters or special events. Previous experiments to verify the numerical performance model took place under nonideal ambient conditions. The downdraft flow was driven by very small density differences for the given ambient conditions and in the absence of wind pressure effects. For those test conditions, the predicted moist air volume flow rate uncertainty was approximately equal to the magnitude of the measured value, and the moist air density uncertainty dominated the calculated volume flow rate uncertainty. The present investigation confirmed that uncertainties associated with the volume flow measurements were insufficient to account for the discrepancies observed between model predictions and experimentally determined values. A parametric study was performed where quantities such as the minor loss coefficients, spray water temperature, ambient dry-bulb temperature, ambient relative humidity, and ambient cross flow wind velocity were varied individually to facilitate comparison to a baseline case. It was shown that the inaccuracy in the spray water temperature measurements was insufficient to entirely account for the discrepancies between measured and predicted moist airflow rates. Furthermore, this study demonstrated that the performance of the fabric evaporative cooling tower was enhanced in situations where steady wind conditions existed using a wind capture device.
The fortification of milk with phytosterols is an increasingly common practice to enhance the sterol profile and offer consumers potential health benefits. This study investigated whether cattle feed ...can influence the profile of phytosterols and cholesterol in the milk produced as an alternative to direct fortification of milk. Five experiments were performed using feeds commonly used by Australian dairy farmers and selected formulated rumen-protected feeds. Statistical significances were observed for some individual plant sterols and cholesterol in milk under these differing feeding regimens compared with the respective controls. In the case of the phytosterols, where the daily recommended consumption is typically 2 g per day, the total phytosterols were <0.12 mg/100 mL of milk. An experiment using a rumen-protected feed with high phytosterol levels suggested a decreased transfer of cholesterol to the milk by as much as 20%, although further work is required to confirm these preliminary results. Overall, the study suggests that different feeding practices have minimal effect on the resulting sterol profile of the milk.
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