scholarly journals Automated patient positioning in CT using a 3D camera for body contour detection: accuracy in pediatric patients

2020 ◽  
Vol 31 (1) ◽  
pp. 131-138
Author(s):  
Ronald Booij ◽  
Marcel van Straten ◽  
Andreas Wimmer ◽  
Ricardo P.J. Budde
Keyword(s):  
Pediatric Patient ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Patient Positioning ◽  
Small Sample ◽  
Contour Detection ◽  
Body Contour ◽  
3D Camera ◽  
Thorax Ct ◽  
The Ideal

Abstract Objective To assess the accuracy of a 3D camera for body contour detection in pediatric patient positioning in CT compared with routine manual positioning by radiographers. Methods and materials One hundred and ninety-one patients, with and without fixation aid, which underwent CT of the head, thorax, and/or abdomen on a scanner with manual table height selection and with table height suggestion by a 3D camera were retrospectively included. The ideal table height was defined as the position at which the scanner isocenter coincides with the patient’s isocenter. Table heights suggested by the camera and selected by the radiographer were compared with the ideal height. Results For pediatric patients without fixation aid like a baby cradle or vacuum cushion and positioned by radiographers, the median (interquartile range) absolute table height deviation in mm was 10.2 (16.8) for abdomen, 16.4 (16.6) for head, 4.1 (5.1) for thorax-abdomen, and 9.7 (9.7) for thorax CT scans. The deviation was less for the 3D camera: 3.1 (4.7) for abdomen, 3.9 (6.3) for head, 2.2 (4.3) for thorax-abdomen, and 4.8 (6.7) for thorax CT scans (p < 0.05 for all body parts combined). Conclusion A 3D camera for body contour detection allows for automated and more accurate pediatric patient positioning than manual positioning done by radiographers, resulting in overall significantly smaller deviations from the ideal table height. The 3D camera may be also useful in the positioning of patients with fixation aid; however, evaluation of possible improvements in positioning accuracy was limited by the small sample size. Key Points • A 3D camera for body contour detection allows for automated and accurate pediatric patient positioning in CT. • A 3D camera outperformed radiographers in positioning pediatric patients without a fixation aid in CT. • Positioning of pediatric patients with fixation aid was feasible using the 3D camera, but no definite conclusions were drawn regarding the positioning accuracy due to the small sample size.

scholarly journals Influence of breathing state on the accuracy of automated patient positioning in thoracic CT using a 3D camera for body contour detection

2021 ◽  
Author(s):  
Ronald Booij ◽  
Marcel van Straten ◽  
Andreas Wimmer ◽  
Ricardo P. J. Budde
Keyword(s):  
Ct Scan ◽  
Patient Positioning ◽  
Contour Detection ◽  
Body Contour ◽  
Positioning Accuracy ◽  
Thoracic Ct ◽  
3D Camera ◽  
The Mean ◽  
Thoracic Ct Scan ◽  
The Ideal

Abstract Objective To assess the influence of breathing state on the accuracy of a 3D camera for body contour detection and patient positioning in thoracic CT. Materials and methods Patients who underwent CT of the thorax with both an inspiratory and expiratory scan were prospectively included for analysis of differences in the ideal table height at different breathing states. For a subgroup, an ideal table height suggestion based on 3D camera images at both breathing states was available to assess their influence on patient positioning accuracy. Ideal patient positioning was defined as the table height at which the scanner isocenter coincides with the patient’s isocenter. Results The mean (SD) difference of the ideal table height between the inspiratory and the expiratory breathing state among the 64 included patients was 10.6 mm (4.5) (p < 0.05). The mean (SD) positioning accuracy, i.e., absolute deviation from the ideal table height, within the subgroup (n = 43) was 4.6 mm (7.0) for inspiratory scans and 7.1 mm (7.7) for expiratory scans (p < 0.05) when using corresponding 3D camera images. The mean (SD) accuracy was 14.7 mm (7.4) (p < 0.05) when using inspiratory camera images on expiratory scans; vice versa, the accuracy was 3.1 mm (9.5) (p < 0.05). Conclusion A 3D camera allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state. Key Points • A 3D camera for body contour detection allows for accurate and precise patient positioning if the camera image and the subsequent CT scan are acquired in the same breathing state. • It is recommended to perform an expiratory planning image when acquiring a thoracic CT scan in both the inspiratory and expiratory breathing state.

scholarly journals Accuracy of automated patient positioning in CT using a 3D camera for body contour detection

2018 ◽  
Vol 29 (4) ◽  
pp. 2079-2088 ◽  
Author(s):  
Ronald Booij ◽  
Ricardo P.J. Budde ◽  
Marcel L. Dijkshoorn ◽  
Marcel van Straten
Keyword(s):  
Patient Positioning ◽  
Contour Detection ◽  
Body Contour ◽  
3D Camera

scholarly journals Impact of antibiotic pretreatment on cultures in children with osteomyelitis and septic arthritis: a retrospective review

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Lansell ◽  
Yasasvi Vasili ◽  
Parminder S. Suchdev ◽  
Janet Figueroa ◽  
Anjali Kirpalani
Keyword(s):  
Septic Arthritis ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Positive Culture ◽  
Small Sample ◽  
Blood Cultures ◽  
Pathogen Identification ◽  
Culture Positivity ◽  
Antibiotic Duration ◽  
Bone Cultures

Abstract Background In the management of pediatric osteomyelitis or septic arthritis, delay in treatment may affect outcome, while receipt of antibiotics prior to culture may affect culture results. We aimed to determine if pathogen identification decreased in cultures that were pretreated with antibiotics. Methods We conducted a retrospective cohort study of 584 hospitalized children between 30 days and 18 years of age admitted to two tertiary children’s hospitals. Logistic regression assessed the effect of antibiotic duration on blood, bone, joint aspirate, and “other” culture positivity. Results Overall, 42% of blood cultures, 70% of bone cultures, 39% of joint cultures, and 70% of “other” cultures were positive. Compared with children who did not receive antibiotics prior to culture, there were no significant differences in odds of a positive culture in children whose cultures were pretreated with antibiotics for any of the culture types [OR (95% CI) 0.90 (0.56–1.44) for blood cultures, 0.77 (0.25–2.34) for bone cultures, 0.71 (0.39–1.28) for joint cultures, 1.18 (0.58–2.41) “for other” cultures; all p > 0.05]. Furthermore, the duration (hours) of antibiotics in the pretreated cultures was also not a significant predictor of culture positivity (OR ranged from 0.99–1.00 for all cultures, p > 0.05). Conclusions Culture positivity was not associated with antibiotic pretreatment in any of the samples, even for longer duration of antibiotics prior to culture, though the small sample size of subgroups is an important limitation. In pediatric patients hospitalized with osteomyelitis and/or septic arthritis, early initiation of antibiotics may not affect culture positivity.

Focal Seizures in Patients With SCN1A Mutations

2016 ◽  
Vol 32 (2) ◽  
pp. 170-176 ◽  
Author(s):  
Christopher L. McDonald ◽  
Russell P. Saneto ◽  
Lionel Carmant ◽  
Márcio A. Sotero de Menezes
Keyword(s):  
Clinical Practice ◽  
Time Course ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Genetic Mutation ◽  
Small Sample ◽  
Focal Seizures ◽  
Clinical Considerations ◽  
New Research ◽  
Scn1a Gene

The SCN1A gene has been implicated in the etiology of various forms of epilepsy. New research has linked this gene to specific types of epilepsy, all of which present in infancy or early childhood. This study examines the time course and pathology of pediatric patients who have a mutation in the SCN1A gene in order to open a discussion regarding the key trends of this form of epilepsy as well as important clinical considerations in management for patients who present with symptoms relating to the SCN1A mutations. We retrospectively examined 20 patients who presented to the clinic with focal seizures, as well as were positive for an SCN1A genetic mutation. Despite the small sample size, we were able to find important trends in the time course of the disorder as well as important areas of clinical practice that must be taken into consideration for these patients.

scholarly journals Feature selection by higher criticism thresholding achieves the optimal phase diagram

2009 ◽  
Vol 367 (1906) ◽  
pp. 4449-4470 ◽  
Author(s):  
David Donoho ◽  
Jiashun Jin
Keyword(s):  
Phase Diagram ◽  
Phase Space ◽  
Order Statistic ◽  
Small Sample Size ◽  
Forthcoming Paper ◽  
Small Sample ◽  
Classification Error ◽  
Two Dimensional ◽  
Higher Criticism ◽  
The Ideal

We consider two-class linear classification in a high-dimensional, small-sample-size setting. Only a small fraction of the features are useful, these being unknown to us, and each useful feature contributes weakly to the classification decision. This was called the rare/weak (RW) model in our previous study ( Donoho, D. & Jin, J. 2008 Proc. Natl Acad. Sci. USA 105 , 14 790–14 795). We select features by thresholding feature Z -scores. The threshold is set by higher criticism (HC). For 1≤ i ≤ N , let π i denote the p -value associated with the i th Z -score and π ( i ) denote the i th order statistic of the collection of p -values. The HC threshold (HCT) is the order statistic of the Z -score corresponding to index i maximizing . The ideal threshold optimizes the classification error. In that previous study, we showed that HCT was numerically close to the ideal threshold. We formalize an asymptotic framework for studying the RW model, considering a sequence of problems with increasingly many features and relatively fewer observations. We show that, along this sequence, the limiting performance of ideal HCT is essentially just as good as the limiting performance of ideal thresholding. Our results describe two-dimensional phase space , a two-dimensional diagram with coordinates quantifying ‘rare’ and ‘weak’ in the RW model. The phase space can be partitioned into two regions—one where ideal threshold classification is successful, and one where the features are so weak and so rare that it must fail. Surprisingly, the regions where ideal HCT succeeds and fails make exactly the same partition of the phase diagram. Other threshold methods, such as false (feature) discovery rate (FDR) threshold selection, are successful in a substantially smaller region of the phase space than either HCT or ideal thresholding. The FDR and local FDR of the ideal and HC threshold selectors have surprising phase diagrams, which are also described. Results showing the asymptotic equivalence of HCT with ideal HCT can be found in a forthcoming paper ( Donoho, D. & Jin, J. In preparation ).

scholarly journals Comparison of Morphine- and Hydromorphone-Containing Patient-Controlled Epidural Analgesia Solutions in Pediatric Postoperative Patients

2019 ◽  
Vol 24 (1) ◽  
pp. 22-26
Author(s):  
Jesse Cramer
Keyword(s):  
Postoperative Pain ◽  
Epidural Analgesia ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Small Sample ◽  
Serious Adverse Events ◽  
On Demand ◽  
Pain Scores ◽  
Number Of Patients ◽  
Maximum Pain

OBJECTIVE The use of patient-controlled epidural analgesia (PCEA) in pediatric patients has been shown to be safe and effective in managing postoperative pain in children. However, the optimal opioid to use in the epidural regimen remains undetermined. Morphine, hydromorphone, and fentanyl have been the agents most often used, but comparison of effectiveness across studies is difficult. The goal of this study was to compare postoperative pain scores in patients receiving PCEA solutions that contained either ropivicaine plus morphine or ropivicaine plus hydromorphone. METHODS Retrospective chart review was used at a single center to identify pediatric patients between the ages of 5 and 17 years who used a morphine- or hydromorphone-containing PCEA solution postoperatively during an 18-month period. Maximum pain scores were recorded during 2 consecutive 24-hour periods postoperatively. The primary outcome was the number of patients who had a maximum pain score of ≤4 on postoperative day zero and postoperative day 1. RESULTS Forty-six patients met the inclusion criteria and were analyzed. Patients prescribed morphine-containing PCEAs had a significantly higher incidence of maximal pain scores ≤4 in the 48 hours immediately after surgery compared with those patients prescribed hydromorphone-containing PCEAs (p = 0.03). Ropivicaine dosing in the epidural solution did not have a significant effect on pain scores and was not statistically different between opioid groups. Pediatric patients were able to effectively use the PCEA on-demand dose, with patients having pain scores &gt;4 demanding significantly more on-demand doses from the PCEA than those patients with pain scores ≤4 (p ≤ 0.002). No serious adverse events were reported. CONCLUSIONS Morphine-containing PCEAs may have an advantage in controlling postoperative pain in pediatric patients compared with hydromorphone-containing PCEAs. However, the heterogeneous nature of the procedures performed and the small sample size limit the generalizability of this study.

scholarly journals Children’s Dental Anxiety during the COVID-19 Pandemic: Polish Experience

2020 ◽  
Vol 9 (9) ◽  
pp. 2751
Author(s):  
Aneta Olszewska ◽  
Piotr Rzymski
Keyword(s):  
Pediatric Patients ◽  
Emotional State ◽  
Small Sample Size ◽  
Dental Anxiety ◽  
Small Sample ◽  
Anxiety Level ◽  
Control Group ◽  
Dental Intervention ◽  
Anxiety Levels ◽  
Children’S Dental Anxiety

Dental fear and anxiety is a significant issue that affects pediatric patients and creates challenges in oral health management. Considering that the coronavirus disease 2019 (COVID-19) pandemic, along with its associated sanitary regime, social distancing measures and nationwide quarantines, could itself induce public fears, including in children, it is of great interest to explore whether this situation and the necessity of reorganizing dental care could potentially affect the emotional state of pediatric patients facing a need for urgent dental intervention. The present study assessed the emotional state of children ≤ seven years old (n = 25) requiring dental healthcare during a nationwide quarantine in Poland, as well as the anxiety levels of their caregivers. The Faces Anxiety Scale was adopted, and the evaluation was independently performed by the dentist, caregivers and children themselves. The level of anxiety in caregivers was also measured. As demonstrated, children requiring dental intervention during the nationwide quarantine did not reveal a significantly higher anxiety level as compared to the age- and indication-matched pre-pandemic control group (n = 20), regardless of whether their emotional state was evaluated by the dentist, caregivers, or by themselves. However, the share of children scoring the lowest anxiety level in all assessments was smaller in the pandemic group. Boys in the pandemic group had a higher anxiety level, as indicated by a caregiver assessment, and displayed a negative correlation with age in all three types of evaluation. Moreover, caregiver anxiety levels were higher in the pandemic group as compared to the pre-pandemic subset and revealed stronger correlations with the dental anxiety in children. The results suggest that the reorganization of oral healthcare under the pandemic scenario did not have a profound effect on children’s dental anxiety. Nevertheless, findings in young boys highlight that they may be more vulnerable and require special care to mitigate their anxiety and decrease the risk of dentophobia in the future—these observations must be, however, treated with caution due to the small sample size and require further confirmation. Moreover, it is important to reassure caregivers of the safety of the dental visit during the pandemic to minimize the effect of their own anxiety on dental fears in children.

Ultrasound-detected venous changes associated with peripheral intravenous placement in children

2020 ◽  
Vol 29 (8) ◽  
pp. S44-S49
Author(s):  
Dewansh Goel ◽  
Anilawan Smitthimedhin ◽  
Bhupender Yadav ◽  
Ranjith Vellody ◽  
Meenal Lele ◽  
...  
Keyword(s):  
Blood Flow ◽  
Pediatric Patients ◽  
Small Sample Size ◽  
Medical Center ◽  
Small Sample ◽  
Physical Exam ◽  
High Rate ◽  
Wall Thickening ◽  
Branch Points ◽  
Luminal Narrowing

HIGHLIGHTS Ultrasound shows several venous changes in pediatric PIV-containing veins. Changes were visualized by ultrasound in the absence of physical exam findings. Venous luminal narrowing, wall thickening, and thrombosis may explain PIV failure. Background: Peripheral intravenous catheters (PIVs) are routinely used for venous access in hospitalized pediatric patients to administer fluids and medications and to aspirate blood. Unfortunately, PIVs do not remain functional for the entire duration of intravascular need. We hypothesized that PIV malfunction may be related to venous changes that can be visualized with ultrasound (US) imaging. The purpose of this study was to describe and document such changes in pediatric patients. Methods: This Institutional Review Board-approved study was performed at a tertiary pediatric medical center. Patients underwent US scans of their PIV-containing veins, documenting venous characteristics such as depth, diameter, wall thickness, blood flow, valves, branch points, and presence of thrombus. Patient demographics and PIV characteristics were also recorded. Results: Data from 30 patients including 12 males and 18 females with a mean age of 11 years were analyzed. Mean venous depth and diameter were 2.07 ± 0.13 and 2.02 ± 0.18 mm, respectively. Mean PIV dwell time at time of evaluation was 3.3 days. PIV-associated venous changes were seen in 73% of accessed veins and included lumen narrowing (47%), wall thickening (33%), presence of thrombus (20%), and absence of blood flow around the PIV tip (40%). Conclusion: PIV-associated venous changes are seen with US in the majority of pediatric patients with indwelling PIVs but are not necessarily appreciated on physical exam. These changes may help explain the high rate of pediatric PIV device failure. Given the small sample size, further investigation is needed to better characterize PIV-associated venous changes in children.

Probing the ultrastructure of the mitotic and meiotic spindle in eggs: An expeditious approach based on semi-thin (0.25 μm) serial sections

1983 ◽  
Vol 41 ◽  
pp. 552-555
Author(s):  
Conly L. Rieder ◽  
S. Bowser ◽  
R. Nowogrodzki ◽  
K. Ross ◽  
G. Sluder
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Meiotic Spindle ◽  
Serial Sections ◽  
Mitotic Apparatus ◽  
Thin Sections ◽  
Cell Cycles ◽  
Ultrastructural Studies

Eggs have long been a favorite material for studying the mechanism of karyokinesis in-vivo and in-vitro. They can be obtained in great numbers and, when fertilized, divide synchronously over many cell cycles. However, they are not considered to be a practical system for ultrastructural studies on the mitotic apparatus (MA) for several reasons, the most obvious of which is that sectioning them is a formidable task: over 1000 ultra-thin sections need to be cut from a single 80-100 μm diameter egg and of these sections only a small percentage will contain the area or structure of interest. Thus it is difficult and time consuming to obtain reliable ultrastructural data concerning the MA of eggs; and when it is obtained it is necessarily based on a small sample size.We have recently developed a procedure which will facilitate many studies concerned with the ultrastructure of the MA in eggs. It is based on the availability of biological HVEM's and on the observation that 0.25 μm thick serial sections can be screened at high resolution for content (after mounting on slot grids and staining with uranyl and lead) by phase contrast light microscopy (LM; Figs 1-2).

Validating the Factor Structure of the Stigma of Suicide Scale–Short Form Spanish Version Among Healthcare Students

Crisis ◽  
2020 ◽  
pp. 1-5
Author(s):  
Ruthmarie Hernández-Torres ◽  
Paola Carminelli-Corretjer ◽  
Nelmit Tollinchi-Natali ◽  
Ernesto Rosario-Hernández ◽  
Yovanska Duarté-Vélez ◽  
...  
Keyword(s):  
Factor Structure ◽  
Structural Equation ◽  
Short Form ◽  
Small Sample Size ◽  
Small Sample ◽  
Spanish Version ◽  
Equation Modeling ◽  
Cross Sectional ◽  
Healthcare Students ◽  
Spanish Speaking

Abstract. Background: Suicide is a leading cause of death among Spanish-speaking individuals. Suicide stigma can be a risk factor for suicide. A widely used measure is the Stigma of Suicide Scale-Short Form (SOSS-SF; Batterham, Calear, & Christensen, 2013 ). Although the SOSS-SF has established psychometric properties and factor structure in other languages and cultural contexts, no evidence is available from Spanish-speaking populations. Aim: This study aims to validate a Spanish translation of the SOSS-SF among a sample of Spanish-speaking healthcare students ( N = 277). Method: We implemented a cross-sectional design with quantitative techniques. Results: Following a structural equation modeling approach, a confirmatory factor analysis (CFA) supported the three-factor model proposed by Batterham and colleagues (2013) . Limitations: The study was limited by the small sample size and recruitment by availability. Conclusion: Findings suggest that the Spanish version of the SOSS-SF is a valid and reliable tool with which to examine suicide stigma among Spanish-speaking populations.

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