Computed tomography of the cervical spine: comparison of image quality between a standard-dose and a low-dose protocol using filtered back-projection and iterative reconstruction.

OBJECTIVE: To compare image quality of a standard-dose (SD) and a low-dose (LD) cervical spine CT protocol using filtered back-projection (FBP) and iterative reconstruction (IR). MATERIALS AND METHODS: Forty patients investigated by cervical spine CT were prospectively randomised into two groups: SD (120 kVp, 275 mAs) and LD (120 kVp, 150 mAs), both applying automatic tube current modulation. Data were reconstructed using both FBP and sinogram-affirmed IR. Image noise, signal-to-noise (SNR) and contrast-to-noise (CNR) ratios were measured. Two radiologists independently and blindly assessed the following anatomical structures at C3-C4 and C6-C7 levels, using a four-point scale: intervertebral disc, content of neural foramina and dural sac, ligaments, soft tissues and vertebrae. They subsequently rated overall image quality using a ten-point scale. RESULTS: For both protocols and at each disc level, IR significantly decreased image noise and increased SNR and CNR, compared with FBP. SNR and CNR were statistically equivalent in LD-IR and SD-FBP protocols. Regardless of the dose and disc level, the qualitative scores with IR compared with FBP, and with LD-IR compared with SD-FBP, were significantly higher or not statistically different for intervertebral discs, neural foramina and ligaments, while significantly lower or not statistically different for soft tissues and vertebrae. The overall image quality scores were significantly higher with IR compared with FBP, and with LD-IR compared with SD-FBP. CONCLUSION: LD-IR cervical spine CT provides better image quality for intervertebral discs, neural foramina and ligaments, and worse image quality for soft tissues and vertebrae, compared with SD-FBP, while reducing radiation dose by approximately 40 %.

Back to the patient, l'information dans les soins

La relation thérapeutique jour un rôle primordial dans le processus du rétablissement des patients. Il est important que les outils probants soient suffisamment bien ajustés pour faciliter le travail thérapeutique. Le projet Back to the patient, développé en collaboration étroite avec l'équipe de TECAPP technologies applications (www.tecapp.ch), vise à offrir des outils informatiques utilisables sur la tablette ou téléphone portable pour soutenir la relation thérapeutique dans le cadre de l'évaluation des besoins de santé et des soins.

Maria-Mercè Marçal en el mirall : sobre l'imaginari femení i el llenguatge poètic

Per Maria-Mercè Marçal, la poeta no es pot trobar, no es pot veure, en el «mirall del bell», que sempre han fomentat els discursos dominants. El seu és una altra mena de mirall trencat que reflecteix un ésser complex, híbrid i contaminat que lluita «entre un jo que es vol fer i els múltiples personatges que, des del mirall, li retornen una imatge múltiple». En aquest article, per explorar el tema de l’imaginari femení i el llenguatge poètic, hem escollit dialogar amb Maria- Mercè Marçal i examinar tres dels múltiples bocins que conformen la seva imatge en el mirall. Conversem amb dues mares i un pare simbòlics de l’altre cantó del seu espill, tots tres proveïdors de material ideològic i eixos vertebradors dels assaigs marçalians. Es tracta d’intel·lectuals ben diversos: l’escriptora anglesa Virginia Woolf, el filòsof francès Jacques Derrida i la poeta catalana Maria-Antònia Salvà. En definitiva, dividim la investigació en tres apartats, que volen coincidir amb el diàleg que Marçal suposem que hi mantingué. De primer, amb Virginia Woolf, explorem la necessitat de la poeta de descobrir el sentiment de «fúria» que porta a dins per tal d’assumir la irracionalitat del seu llenguatge. Després, ens endinsem en les teories derridianes sobre la dona i l’escriptura, en un intent de demostrar que ambdues són espècies híbrides que viuen en el llindar, en un espai d’entremig. A l’últim, amb Maria-Antònia Salvà, revisem la imatge de la dona-monstre amb la certesa que «el salvatge» i «l’incert » són el motor del llenguatge poètic femení.

Timber Abutment Piling and Back Wall Rehabilitation and Repair, TR-616, 2012

Based on previous National Bridge Inventory data, the state of Iowa has nearly 20,000 bridges on low-volume roads (LVRs). Thus, these bridges are the responsibility of the county engineers. Of the bridges on the county roads, 24 percent are structurally deficient and 5 percent are functionally obsolete. A large number of the older bridges on the LVRs are built on timber piling with timber back walls. In many cases, as timber abutments and piers age, the piling and back wall planks deteriorate at a rate faster than the bridge superstructure. As a result, a large percentage of the structurally deficient bridges on LVRs are classified as such because of the condition of the timber substructure elements. As funds for replacing bridges decline and construction costs increase, effective rehabilitation and strengthening techniques for extending the life of the timber substructures in bridges with structurally sound superstructures has become even more important. Several counties have implemented various techniques to strengthen/repair damaged piling, however, there is minimal data documenting the effectiveness of these techniques. There are numerous instances where cracked and failed pilings have been repaired. However, there are no experimental data on the effectiveness of the repairs or on the percentage of load transferred from the superstructure to the sound pile below. To address the research needs, a review and evaluation of current maintenance and rehabilitation methods was completed. Additionally, a nationwide survey was conducted to learn the methods used beyond Iowa. Field investigation and live-load testing of bridges with certain Iowa methods was completed. Lastly, laboratory testing of new strengthening and rehabilitation methods was performed.

Writing for the contemporany naturalistic stage: a personal process of creation

El objetivo principal de este proyecto es desarrollar más a fondo y consolidar los objetivos formativos y competencias del grado en Estudios Ingleses a través de un trabajo de escritura creativa, en concreto, la creación de una obra teatral original. Este trabajo consiste en, por un lado, una introducción al Naturalismo, como género literario en un marco cultural y metodológico, y por otro lado, la creación personal de una obra naturalista que incluye la primera parte del manuscrito. Este proyecto incluye un proceso completo de creatividad justificado gracias a las principales teorías de algunos escritores naturalistas, como: Émile Zola – como precursor del Naturalismo – y August Strindberg como uno de los mayores mentores de este género literario. Los resultados obtenidos en este trabajo son: la creación de una obra teatral original, una especialización en el movimiento Naturalista aplicado al teatro contemporáneo, y un profundo conocimiento de la lengua inglesa a través de la perspectiva de un dramaturgo.

Surgical results in patients with chronic low back pain who failed multidisciplinary rehabilitation with cognitive intervention

Introduction¦Surgery for chronic low back pain (CLBP) is a controversial topic. One randomized controlled¦trial (RCT) showed superiority of surgery to physiotherapy only, whereas two more RCTs¦failed to show that surgery was better than multidisciplinary rehabilitation including cognitive¦intervention. The latter is therefore regarded as the golden standard of conservative¦treatment and in our unit it is whenever possible offered to patients prior to lumbar surgery¦for CLBP.¦The objective of this study was to compare results of lumbar surgery between one group of¦patients who failed to improve despite such rehabilitation and a second group of patients who¦underwent surgery following usual conservative therapies. Our hypothesis is that patients¦who failed such a comprehensive treatment would respond poorly to surgery.¦Patients and Methods¦43 patients (age 41.2±8.1 years, number of men 20) were operated between 2003 and 2009¦by a single surgeon for CLBP due to degenerative disc disease (36) or isthmic¦spondylolisthesis (7). Patients with sciatica or neurological abnormalities were excluded.¦Seventeen (40%) patients were operated having failed to improve following the¦aforementioned rehabilitation programme (Surgery following rehabilitation group) whereas¦the remaining 26 (60%) were operated having failed to improve with physiotherapy of varying¦intensity (Surgery following physiotherapy group). Oswestry disability index (ODI) pre¦operatively and at 2 years following surgery was prospectively evaluated. Fisher's exact test¦was used to compare groups.¦Results¦At two years following surgery, with an average follow up of 22 month, a 15 points ODI¦improvement was achieved for 9 (53%) patients of the surgery following rehabilitation group¦and in 15 (58%) patients of the surgery following physiotherapy group (p=1.0). A 50% ODI¦improvement was observed for 6 (35%) and 12 (46%) patients respectively (p=0.54).¦Discussion¦The main finding of this study was that surgery following failed multidisciplinary rehabilitation¦yields similar results to those of patients who only received usual physiotherapy treatment for¦CLBP prior to surgery. But surprisingly we found that it is possible with surgery to improve¦the quality of life of those CLBP sufferers who failed to respond to a comprehensive¦rehabilitation program and with a similar success rate to those reported in other series.¦But rehabilitation should still be offered as a treatment option in all CLBP patients prior to¦surgery, given that it is devoid of complications and that it will spare the need of surgery to a¦significant proportion of CLBP patients while not compromising surgical results in the¦remaining subjects who failed to improve.

Selective ablation of photovoltaic materials with UV laser sources for monolithic interconnection of devices based on a-Si:H

Lasers are essential tools for cell isolation and monolithic interconnection in thin-film-silicon photovoltaic technologies. Laser ablation of transparent conductive oxides (TCOs), amorphous silicon structures and back contact removal are standard processes in industry for monolithic device interconnection. However, material ablation with minimum debris and small heat affected zone is one of the main difficulty is to achieve, to reduce costs and to improve device efficiency. In this paper we present recent results in laser ablation of photovoltaic materials using excimer and UV wavelengths of diode-pumped solid-state (DPSS) laser sources. We discuss results concerning UV ablation of different TCO and thin-film silicon (a-Si:H and nc-Si:H), focussing our study on ablation threshold measurements and process-quality assessment using advanced optical microscopy techniques. In that way we show the advantages of using UV wavelengths for minimizing the characteristic material thermal affection of laser irradiation in the ns regime at higher wavelengths. Additionally we include preliminary results of selective ablation of film on film structures irradiating from the film side (direct writing configuration) including the problem of selective ablation of ZnO films on a-Si:H layers. In that way we demonstrate the potential use of UV wavelengths of fully commercial laser sources as an alternative to standard backscribing process in device fabrication.