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Damcott M.,Kessler Foundation Research Center | Blochlinger S.,Specialized Tech | Foulds R.,New Jersey Institute of Technology
Pediatric Physical Therapy | Year: 2013

Purpose: To investigate the effectiveness of a novel dynamic standing intervention compared with a conventional passive standing intervention on bone health in children with cerebral palsy who are nonambulatory. Methods: Four children in passive standers and 5 in dynamic standers were followed for 15 months (standing 30 min/d, 5 d/wk). Dual-energy X-ray absorptiometry scans of the distal femur were obtained at 3-month intervals to measure changes in bone mineral density (BMD), bone mineral content, and area. Results: Increases in BMD were observed during dynamic standing (P <.001), whereas passive standing appeared to maintain the baseline BMD. Increases in bone mineral content were observed in each standing intervention (P <.001), with dynamic standing inducing greater increases. Increases in area were comparable between interventions (P =.315). Conclusions: Dynamic standing demonstrated the potential of moderate-magnitude, low-frequency loading to increase cortical BMD. Further investigations could provide insight into the mechanisms of bone health induced through loading interventions. Copyright © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins and Section on Pediatrics of the American Physical Therapy Association.


Maruzzelli L.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Parr A.J.,University of Pittsburgh | Miraglia R.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Tuzzolino F.,Specialized Tech | Luca A.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT
Academic Radiology | Year: 2014

Rationale and Objectives: To evaluate, in a group of candidates for liver donation, the role of unenhanced computed tomography (CT) and magnetic resonance (MR) as noninvasive means to measure hepatic steatosis (HS). Materials and Methods: Sixty-one consecutive candidates underwent CT and MR evaluation for liver donation within 3weeks of liver biopsy. On CT, three methods of HS quantification were evaluated: the measurement of hepatic attenuation (CT L), the ratio of hepatic attenuation to splenic attenuation (CT L/S), and the difference between the hepatic and splenic attenuation (CT L-S). On MR, HS was reported in terms of fat signal fraction (FSF) using in-phase/opposed-phase and fat/non-fat- saturated images, with and without normalization with the spleen (T1W IP/OP FSF, T1W IP/OP FSF spleen and T2W±FS FSF, TW2±FS FSF spleen). The accuracy of each imaging index in the diagnosis of HS, according to various thresholds, was assessed using receiver operating characteristic analysis. Results: On biopsy, 35 donors showed no significant HS (<5%); the remaining 26 showed HS ranging from 5% to 40%. With all CT and MR indices, there was a trend toward increasing diagnostic accuracy as the threshold levels of HS increased. When comparing all the indices, TW2±FS FSF(spl) showed higher accuracy at threshold levels of 5% and 10% of steatosis but without reaching statistical significance. Conclusions: In candidates for living donation, MR and CT indices are similar in estimating liver-fat content; however, MR with T2W±FS FSF(spl) sequences shows higher accuracy when low threshold levels of steatosis (≤5% and ≤10% HS) are selected. © 2014 AUR.


Luca A.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Caruso S.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Milazzo M.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Marrone G.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | And 6 more authors.
Radiology | Year: 2012

Purpose: To define the natural course of extrahepatic nonmalignant partial portal vein thrombosis (PVT), including the progression from partial to complete PVT, in patients with cirrhosis who had undergone multidetector computed tomography (CT). Materials and Methods: This study was institutional review board and ethics committee approved. Written informed consent was obtained for each procedure. Forty-two consecutive patients with cirrhosis and untreated extrahepatic, nonmalignant partial PVT were followed up until the final clinical evaluation, liver transplantation, or death. Multidetector CT was used to evaluate the thrombus lumen occlusion, patent lumen area, thrombus area, total lumen area, and diameter of main portal vein, superior mesenteric vein, and splenic vein. Statistical analysis was performed with the Wilcoxon Mann-Whitney U test, χ2 test, Wilcoxon matched-pairs signed-rank test, life-table analysis, Kaplan-Meier method, and log-rank test, as appropriate. Results: After a mean follow-up period of 27 months, partial PVT worsened in 20 (48%) patients, improved in 19 (45%), and was stable in three (7%). The Kaplan-Meier probability of episodes of hepatic decompensation at 1 and 2 years was 41% and 57%; probability of hospital admission for hepatic decompensation, 37% and 54%; and survival rates, 77% and 57%, respectively. There was no clear association between progression or regression of partial PVT and clinical outcome. Multivariate analysis showed that the Child-Pugh score at diagnosis was the only independent predictor of survival (hazard ratio, 1.97; 95% confidence interval: 1.19, 3.23; P = .007) and hepatic decompensation (hazard ratio, 1.51; 95% confidence interval: 1.18, 1.19; P = .001). Conclusion: Extrahepatic nonmalignant partial PVT improved spontaneously in 45% of patients with cirrhosis, and the progression of partial PVT was not associated with clinical outcome, which appeared to be dependent on the severity of cirrhosis. © RSNA, 2012.


Miraglia R.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Maruzzelli L.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Tuzzolino F.,Specialized Tech | Indovina P.L.,Medical Physic ISMETT Consultant | Luca A.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT
CardioVascular and Interventional Radiology | Year: 2013

Purpose: The aim of this study was to estimate radiation exposure in pediatric liver transplants recipients who underwent biliary interventional procedures and to compare radiation exposure levels between biliary interventional procedures performed using an image intensifier-based angiographic system (IIDS) and a flat panel detector-based interventional system (FPDS). Materials and Methods: We enrolled 34 consecutive pediatric liver transplant recipients with biliary strictures between January 2008 and March 2013 with a total of 170 image-guided procedures. The dose-area product (DAP) and fluoroscopy time was recorded for each procedure. The mean age was 61 months (range 4-192), and mean weight was 17 kg (range 4-41). The procedures were classified into three categories: percutaneous transhepatic cholangiography and biliary catheter placement (n = 40); cholangiography and balloon dilatation (n = 55); and cholangiography and biliary catheter change or removal (n = 75). Ninety-two procedures were performed using an IIDS. Seventy-eight procedures performed after July 2010 were performed using an FPDS. The difference in DAP between the two angiographic systems was compared using Wilcoxon rank-sum test and a multiple linear regression model. Results: Mean DAP in the three categories was significantly greater in the group of procedures performed using the IIDS compared with those performed using the FPDS. Statistical analysis showed a p value = 0.001 for the PTBD group, p = 0.0002 for the cholangiogram and balloon dilatation group, and p = 0.00001 for the group with cholangiogram and biliary catheter change or removal. Conclusion: In our selected cohort of patients, the use of an FPDS decreases radiation exposure. © 2013 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE).


Luca A.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Miraglia R.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Caruso S.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | Milazzo M.,Mediterranean Institute for Transplantation and Advanced Specialized Therapies ISMETT | And 6 more authors.
Gut | Year: 2011

Background and aims: Portal vein thrombosis (PVT) negatively impacts the prognosis in patients with cirrhosis. The aim of our study was to evaluate the effects of transjugular intrahepatic portosystemic shunt (TIPS) placement in patients with cirrhosis complicated by PVT. Methods: Seventy consecutive cirrhotic patients with non-tumoural PVT treated with TIPS for portal hypertension complications from January 2003 to February 2010 in a tertiary-care centre were followed until last clinical evaluation, liver transplantation, or death. Results: TIPS was successfully placed without major procedure-related complications. After TIPS, the portal venous system was completely recanalised in 57% of patients, a marked decrease in thrombosis was observed in 30%, and no improvement was seen in 13%. 95% of patients with complete recanalisation after TIPS maintained a patent portal vein. Predictors of complete recanalisation were a less severe and extensive PVT, de novo diagnosis of PVT, and absence of gastrooesophageal varices. At follow-up, 1 patient had recurrence of bleeding, and 2 had spontaneous bacterial peritonitis. The rate of TIPS dysfunction at 12 and 24 months was 38% and 85% for bare stent and 21% and 29% for covered stent (p=0.001), respectively. Occurrence of encephalopathy at 12 and 24 months was 27% and 32%, respectively. Fifteen patients underwent liver transplantation. Survival at 1, 12 and 24 months was 99%, 89% and 81%, respectively. Conclusion: Long-term outcome of non-tumoural PVT in patients with cirrhosis treated with TIPS placement is excellent. Prospective randomised studies should investigate whether TIPS placement is the best therapeutic option in patients with cirrhosis who develops non-tumoural PVT.


This paper discusses a method developed for the construction of logical structures and its mathematical description with use of objective functions (quality functions). The mentioned method can be applied to describe radwaste repositories, radwaste itself, and any processes in the field of radwaste management. The paper also discusses the extension of the list of quality indices groups in the objective function construction.


Patent
Specialized Tech | Date: 2012-12-19

A particulate-accommodating fluid flow directing apparatus comprises a failure detection housing containing a flow directing insert, the housing serving as a pressure boundary; failure at any location along the insert being detectable by means associated with the housing. The insert can be manufactured of erosion resistant materials, including non-ductile materials such as ceramics. The insert is sealed to the housing at an inlet and a discharge forming a pressure chamber between the insert and housing. The pressure chamber can be maintained at a pad pressure complementary to the process pressure, the pad pressure being maintained and monitored for indication of insert failure.


Patent
Specialized Tech | Date: 2012-02-13

A desanding system has an elongated vessel that is tilted at a non-zero inclination angle. A fluid inlet at the vessels upper end discharges a gas stream having entrained liquids and particulates and a fluid outlet into a freeboard portion formed adjacent an upper portion of the vessel above a gas/liquid interface formed below the fluid outlet. A belly storage portion is formed below the interface. The freeboard portion of the vessel has a freeboard cross-sectional area that diminishes along the interface from the fluid inlet to a fluid outlet spaced away from and lower than the fluid inlet. The cross-sectional are of the freeboard portion causes precipitation of the entrained liquids and particulates therefrom and collect in the belly portion of the vessel. A desanded gas stream, being free of a substantial portion of the particulates is removed from the vessel through the fluid outlet.


Patent
Specialized Tech | Date: 2016-03-09

This invention describes the incorporation of printed conductive elements (2, 3), as conductive tracks for interconnecting photovoltaic cells (4), in a polymeric encapsulating film or layer (1) for photovoltaic modules, the film comprising at least one olefinic co-polymer of ethylene including mono-carboxylic acids, di-carboxylic acids, esters of carboxylic acids (including vinyl esters), alkyl acrylates, alpha-olefins, and combinations thereof. It also describes methods for making photovoltaic modules that incorporate a polymeric encapsulating film (1) with printed conductive elements (2, 3), as well as the photovoltaic modules themselves.


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