Search

Objective: The purpose of this mixed-methods study was to gather benchmark data on curricular content related to imaging of transgender patients. In addition, the intent was to explore program directors’ opinions on the need to include this content in the curriculum. Material and Methods: An online survey was emailed to all directors (n = 982) of accredited imaging programs in the United States. Results: In total, 331 (34%) program directors participated in the survey. Fifty-six percent currently do not include this content in their curriculum and 67% reported no discussion of adding the material. There was a modest and significant positive correlation between the program directors’ perceived level of knowledge, regarding imaging transgender patients, and their perceived importance of including this material in the curriculum ( r = 0.370; P < .001). Positive (55%), negative (7%), and neutral themes (38%) emerged from the qualitative data analysis. Conclusion: These findings were consistent with literature regarding a lack of curriculum specific to transgender patients. Program directors recognized the need to include this content, although barriers exist related to readiness to implement, limited faculty knowledge with the material, and lack of educational resources. Program directors are seeking strategies and resources to guide the integration of this material into the curriculum.

Objective: The practice of mindfulness has many reported benefits. The purpose of this mixed-methods study was to investigate the effect of a three-minute, instructor-led Mindful Pause Practice (MPP) in the sonography classroom over a two-semester period. Methods: Participants were students enrolled in programs accredited by the Commission on Accreditation of Allied Health Education Programs from four universities. Instructors provided MPP, and then students completed the Mindful Attention Awareness Scale. Results: A statistically significant increase in mindfulness as was seen from pre- to poststudy (3.3 vs. 3.9, P < .001). The majority of students described the MPP as a positive experience (>70%) and reported improved classroom attention and awareness (>78%). Qualitative themes of stress reduction/relaxation, improved focus/attention, and self-care were noted each semester. Self-directed MPP outside the classroom was low but did improve over time. Conclusion: The addition of a short MPP to sonography classes has positive benefits and improves student mindfulness. These findings support current literature on classroom mindfulness and add information specific to sonography education.

The rising share of distributed energy sources and the application of voltage control strategies lead to a significantly change in reactive power demand of distribution grids. High voltage grid operators need to adequately estimate this change in reactive power demand for effective reactive power planning and securing voltage control. For modelling this demand, the often limited information on exact parameters of the underlying medium and low voltage grids presents a significant challenge for high voltage grid operators. In this paper, we therefore present a simplified approach for reactive power modelling based on functional correlations between the reactive power demand and aggregated grid parameters. We identify these correlations based on simulations on a generic distribution grid model applied to structurally different grid regions in Germany. The results indicate, that even though the simplified reactive power demand model applies significant simplifications, the reactive power flow between high and medium voltage grid can be estimated with reasonable accuracy in most situations.

The installation of distributed power generation from renewable energy sources (DRES) leads to a rising need for grid extension in German distribution grids. Congestion management can be applied to avoid cost-intensive grid expansion measures due to rare feed-in peaks from fluctuating DRES. In this paper the market-based provision of flexibility for congestion management is assessed and compared to conventional grid extension measures. The method is based on a contribution margin maximization approach for marketing flexibility options on spot and control reserve markets under consideration of technical constraints. The results show that flexibility provision for congestion management in a mix with conventional grid extensions measures can be a cost efficient provision for congestion management

Fournier’s gangrene is a rare type of necrotizing fasciitis specific to the superficial fascia and subcutaneous tissues of the external genitalia, perineum, perirectal, and ischiorectal regions. It is usually diagnosed clinically, and imaging is used to support the diagnosis, assess the extent of the necrosis, and aid in surgical planning. Computed tomography (CT) is the primary imaging modality to diagnose Fournier’s gangrene, usually after symptoms are severe. Sonography may be used to diagnose early stages of this disease and to differentiate it from intrascrotal pathology or benign cellulitis. A case of Fournier’s gangrene is presented that discusses sonographic findings of Fournier’s gangrene and the disease process.

Multiple osteochondromas were detected during a lower extremity sonographic examination of a child with a palpable mass. An osteochondroma is a benign bone tumor that typically arises from the long bones, especially around the knee. Diagnosis is usually made during adolescence when a mass is palpated. Those affected are typically asymptomatic, but some experience pain, swelling, and possible pseudoaneurysm depending on the size and location of the lesion. Treatment is unnecessary unless symptomatic. Annual monitoring is necessary because a small percentage undergo malignant transformation. Sonography is not the modality of choice when imaging bone tumors, but it is important for sonographers to understand that bony abnormalities can be found in patients referred for evaluation of a palpable mass.

Congenital adrenal hyperplasia is an autosomal recessive disorder that impairs the production of two essential hormones, cortisol and aldosterone. This deficiency results in the overproduction of adrenocorticotropic hormone and overgrowth of the adrenal tissue. Specific forms of congenital adrenal hyperplasia can result in ambiguous genitalia, precocious puberty, short stature, and testicular adrenal rest tumors. Common sonographic findings of testicular rest tissue are multifocal hypoechoic lesions and a spokelike vascularity with multiple peripheral vessels. The sonographer needs to understand the correlation between congenital adrenal hyperplasia and testicular adrenal rest tumors so the testicular masses are not misdiagnosed.

When using electric power steering systems in sports cars there are additional requirements concerning steering feel and road feedback. Here off-the-shelf steering mechanics quickly maxes out. Also the software of many manufacturers of steering systems does not entirely cover these requirements. To fulfil these requirements, regardless of the steering system supplier, Porsche has developed an own control approach to increase road feedback as well as additional software modules for optimized tuning ability of steering feel.

Femoral hypoplasia—unusual facies syndrome is an extremely rare form of skeletal malformations with both femoral and facial abnormalities. Insulin-dependent diabetes mellitus has been reported as the main contributing factor to its development. Common sonographic findings include bilateral femoral hypoplasia and facial dysmorphism. Aside from complications due to physical limitations, most patients are able to live relatively normal lives. Several differential diagnoses can be made from sonographic findings; therefore, complete and thorough examinations must be performed by the sonographer.

Although there are many causes of an irritable hip in children, transient synovitis and septic arthritis are the two most common etiologies. Both present with inability or difficulty to bear weight on the affected leg, pain, stiffness, limp, and fluid within the synovium. Because of potential serious complications associated with septic arthritis, accurate and early differentiation between the two processes is important. The workup for pediatric hip pain includes a thorough history and physical examination, appropriate laboratory studies, pelvis/hip radiography, hip sonography, and possible arthrocentesis.

A pseudoaneurysm, also termed a false aneurysm, is a leakage of blood from an artery into the surrounding tissue with persistent communication between the originating artery and the terminating blood-filled cavity. Pseudoaneurysms involving the uterine arteries are rare and can be a complication of pregnancy, pelvic surgery, or pelvic trauma. Presenting symptoms include persistent vaginal bleeding and pelvic pain. The detection and diagnosis of a uterine artery pseudoaneurysm is important because of the potential for rupture and hemorrhage, which could be lethal. A variety of treatment options are available, with embolization being the most common.

Medullary sponge kidney (MSK) is a developmental anomaly that occurs in the medullary pyramids of the kidney. MSK is characterized by cystic dilation of the distal collecting tubules and ducts in one or more renal pyramids. Many patients remain asymptomatic, but patients with symptoms of nephrolithiasis, hematuria, and infection should be carefully evaluated for medullary sponge kidney disease. A case is presented in which sonography is used to diagnose MSK.

Anomalies of the branchial cleft form during early embryonic head and neck development. Many of these anomalies are asymptomatic, but when symptoms occur, the only definitive method of treatment is surgical excision. Sonography is a useful imaging modality for assessment of neck masses. A case of branchial cleft cyst evaluated by sonography is presented, and differential diagnoses are discussed.

A ureterocele is a congenital disorder of the terminal ureter. Although ureteroceles may be asymptomatic, there is an associated sequela of hydronephrosis and reflux that can lead to permanent renal damage. This case study involves the sonographic diagnosis of a ureterocele in utero and associated urinary tract abnormalities. These findings are then correlated with postnatal imaging studies.

A pessary is a device similar to the outer ring of a diaphragm that is placed into the vagina to help reposition and support the uterus or bladder. It is a common method for the treatment of pelvic organ prolapse and stress urinary incontinence. Numerous pessaries are available, and selection is based on pathologic condition and patient comfort. After a pessary is placed, patient follow-up is necessary to determine if it is working correctly.

Testicular epidermoid cysts are benign tumors that represent only 1% of all testicular tumors. This tumor presents as a palpable mass within the testicle. High-resolution sonography can help provide a presurgical diagnosis due to the tumor’s unique sonographic appearance of a “bow tie” echogenicity. This bow tie pattern is formed by the deposition of keratin in layers by the lining of the cyst. A preoperative sonographic diagnosis of a testicular epidermoid cyst can lead to testicle-sparing surgery in healthy, young males due to the benign nature of this tumor.

Niemann-Pick disease type C (NPC) is an autosomal, recessive lipid storage disease that can present in infants, children, and adults. Harmful quantities of lipids accumulate in the spleen, liver, lungs, bone marrow, and, in some patients, the brain. Infiltration of the lipid component can cause organs, vessels, and surrounding tissues to lose their function with advancement of the disease. The elevated levels of lipids lead to irreversible damage of the organs and organ failure, resulting in death. Sonographic evaluation of patients with NPC provides valuable information on the progression of this disease.

An arrhythmia is a disturbance in the normal rhythm of the heart. Heart rhythms are generated by the sinoatrial (SA) node and travel through the heart’s conduction system, causing the atrial and ventricular myocardium to contract and relax at a regular rate. If there is a disturbance in the electrical system of the heart, it can be detected in utero by using M-mode sonography. It is important to diagnose a fetal arrhythmia early in pregnancy. If the arrhythmia persists, it can lead to congestive heart failure and hydrops.

Lissencephaly is a neural disorder characterized by lack of sulcations in the brain. In lissencephaly, the normal migration of the neuron does not occur due to an insult to the fetus early in gestation. This causes a “smooth brain” appearance. Lissencephaly is associated with syndromes such as Walker-Warburg and Miller-Dieker syndromes. Sonographic findings of lissencephaly include agenesis of the corpus collosum, dilated third ventricle, and lack of sulcations. Patients diagnosed with lissencephaly do not usually de-velop intellectually past the three- to five-month age level.

Ultrasonography has been shown to be a reliable technique for measurement of kidney length in pediatric patients. Ultrasound was used in this study to evaluate normal variation in kidney size in healthy pediatric patients. The data also were used for comparison of kidney size in solitary kidneys to evaluate compensatory hypertrophy in pediatric patients. The authors also compared renal size in pediatric patients with chronic liver disease against those with healthy kidneys. A correlation was found in younger pediatric patients.

Inflammation of the scrotum is a rare complication of acute pancreatitis with few reported cases in the literature. Pain, scrotal swelling, and hydroceles occur when the inflammatory process spreads along tissue planes to the scrotum. The testes are typically not affected. Sonography is the modality of choice for imaging the scrotum and determining the cause of acute scrotal swelling and pain.

The authors discuss research in the use of virtual-reality technology as a new interface paradigm for monitoring and controlling networks. They describe the prototype system that has been built in support. >

The present paper is concerned with catalytic pollution abatement of sulfur and nitrogen oxides in flue gases from industrial sources. Especially fundamental and applied research on industrial catalysts and their model systems is presented with regards to cleaning of flue gases from fossil fuel based power plants and plants producing sulfuric acid. Combined DeSOx and DeNOx processes are very common installations in power plants in the industrialized world since both contaminants cause “acid rain”, leading to destruction of forests and lakes as well as corrosion of ancient and modern constructions. In most cases SOX is removed by wet limestone scrubbing of power plant flue gases, but new waste is produced. However, catalytic conversion by reaction (1): and finally absorption of SO3 to obtain H2SO4 of commercial grade, is an attractive alternative. The technology has been developed [1] by Haldor Tops0e A/S, as the so called SNOX process, where NOX is removed as well by catalytic conversion upstream of the SO2/SO3 converter.

The problem of picking up single cylindrical objects using a robot equipped with a vision system is investigated. Explanation of how the robot defines the position of objects located within the workcell is provided. Image analysis, camera calibration, and algorithm specification are also defined.