Objectives: Small field of view gamma detection and imaging technologies for monitoring in vivo tracer uptake are rapidly expanding and being introduced for bed-side imaging and image guided surgical procedures. The Hybrid Gamma Camera (HGC) has been developed to enhance the localization of targeted radiopharmaceuticals during surgical procedures; for example in sentinel lymph node (SLN) biopsies and for bed-side imaging in procedures such as lacrimal drainage imaging and thyroid scanning. In this study, a prototype anthropomorphic head and neck phantom has been designed, constructed, and evaluated using representative modelled medical scenarios to study the capability of the HGC to detect SLNs and image small organs. Methods: An anthropomorphic head and neck phantom has been designed to mimic the adult head and neck including some internal organs and tissues of interest, such as the thyroid gland and sentinel lymph nodes. The design of the head and neck phantom included an adjustable inner jig holding the simulated SLNs and thyroid gland. The simulated thyroid gland was designed and 3D printed taking into consideration the size and the shape of a healthy adult thyroid gland. The inner sealed space of the thyroid was filled with 15MBq of 99mTc through two upper filling valves. Sealed micro-tubes (0.2ml) have been employed to simulate SLNs containing various 99mTc activity concentrations ranging between 0.1MBq and 1MBq, and can be positioned at any desired place in the head and neck region. An active background was simulated through mixing 10MBq of 99mTc solution with the water used to fill the outer shell of the head and neck phantom. Results: The head and neck phantom was employed to simulate a situation where there are four SLNs distributed at two different vertical levels and at two depths within the neck. Contrast to noise ratio (CNR) calculations were performed for the detected SLNs at an 80mm distance between both pinhole collimators (i.e. 0.5mm and 1.0mm diameters) and the surface of the head and neck phantom with a 100s acquisition time. The recorded CNR values for the simulated SLNs are higher when the HGC was fitted with the 1.0mm diameter pinhole collimator. For instance, the recorded CNR values for the superficially simulated SLN containing 0.1MBq of 99mTc using 0.5mm and 1.0mm diameter pinhole collimators are 6.48 and 16.42, respectively (~87% difference). The anatomical context provided by the hybrid imaging aided the localization process of radioactivity accumulation in simulated SLNs. Gamma and hybrid optical images were acquired using the HGC with both available pinhole collimators for the simulated thyroid gland. The thyroid images produced varied in terms of spatial resolution and detectability. The count profiles through the middle of the simulated thyroid gland images provided by both pinhole collimators were obtained. The HGC could clearly differentiate the individual peaks of both thyroid lobes in the gamma image produced by the 0.5mm pinhole collimator. In contrast, the recorded count profile for the acquired image using the 1.0mm diameter pinhole collimator showed broader peaks for both lobes, reflecting the degradation of the spatial resolution with increasing the diameter of the pinhole collimator. Conclusion: The capability of the HGC has been evaluated utilizing a prototype anthropomorphic head and neck phantom, and the gamma and hybrid images obtained demonstrate that it is ideally suited for intraoperative SLNs detection and small organ imaging. The standardization of test phantoms and protocols for SFOV portable gamma systems will provide an opportunity to collect data across various medical centers and research groups. Moreover, it will provide a technical baseline for researchers and clinical practitioners to consider when assessing their SFOV gamma imaging systems. The anthropomorphic head and neck phantom described is cost effective, reproducible, flexible and anatomically representative.
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Objective: An efficient solution for stabilization is the mobilization of the joints for the arthrokinematics affected by the positional defect of the CAI (i.e. chronic ankle instability). This study put to comparison the impacts of ankle dorsi flexion range of motion (DFROM) as well as dynamic balance ability (DBA) in the patients who have CAI using PJM (i.e. passive joint mobilization), a technique typically been used in previous works, and active joint mobilization (AJM), a technique which could have a greater impact on cortical excitability with the spontaneous movement. Design: rehabilitation program to treat recurrent ankle. Methods: A total of 10 players from the Iraqi clubs Muay Thai team were registered, 5 from each of
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This paper proposes a self organizing fuzzy controller as an enhancement level of the fuzzy controller. The adjustment mechanism provides explicit adaptation to tune and update the position of the output membership functions of the fuzzy controller. Simulation results show that this controller is capable of controlling a non-linear time varying system so that the performance of the system improves so as to reach the desired state in a less number of samples.
A multivariate multisite hydrological data forecasting model was derived and checked using a case study. The philosophy is to use simultaneously the cross-variable correlations, cross-site correlations and the time lag correlations. The case study is of two variables, three sites, the variables are the monthly rainfall and evaporation; the sites are Sulaimania, Dokan, and Darbandikhan.. The model form is similar to the first order auto regressive model, but in matrices form. A matrix for the different relative correlations mentioned above and another for their relative residuals were derived and used as the model parameters. A mathematical filter was used for both matrices to obtain the elements. The application of this model indicates i
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Background: Nursing interventions tailored to the smoking triggers in patients with non-communicable chronic diseases are essential. However, these interventions are scant due to the nature of factors associated with smoking cessation and the poor understanding of the effect of nurse-led intervention in Iraq.Purpose: This study aimed to determine the dominant smoking triggers and examine the effects of a tailored nursing intervention on smoking behavior in patients with non-communicable chronic diseases.Methods: Convenience samples of 128 patients with non-communicable chronic diseases, male and female patients, who were 18-70 years old, were recruited in this quasi-experimental, randomized comparative trial in the outpatient clinic
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Abstract
The research aims to build a training program to develop some executive functions for kindergarten children. To achieve this goal, the two researchers built the program according to the following steps:
1. Determining the general objective of the program.
2. Determining the behavioral objectives of the program.
3. Determining the included content in the program.
4. Implementing the content of the activities of the program.
5. Evaluating the Program.
The program included (12) training activities, the training activities included several items: the title of the activity, the time of implementation of the activity, the general objective of the activity, the procedural behavioral objective, the means and tools u
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In this article, we aim to define a universal set consisting of the subscripts of the fuzzy differential equation (5) except the two elements and , subsets of that universal set are defined according to certain conditions. Then, we use the constructed universal set with its subsets for suggesting an analytical method which facilitates solving fuzzy initial value problems of any order by using the strongly generalized H-differentiability. Also, valid sets with graphs for solutions of fuzzy initial value problems of higher orders are found.
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