Search

The study of individuals’ skills and their various social and conversational competencies at early ages, enables us to predict collective and psychological performance and social, behavioral and emotional compatibility in advanced stages, with the increase in violence phenomena in its various forms in Jordanian universities, and in light of the recommendations of previous studies on the need to intensify research on student parliaments school and its role in enhancing and developing students’ competence and social skills in the pre-university stage, as well as in light of the recommendations of the political leadership on the need to strengthen and support the youth category and enable them to participate in decision-making and build the future of the state and prepare them for that through school student parliaments, so the researcher began to seek to identify and define Philosophy and foundations of a proposed program that can be an entry point for the development of social competence among high school students, based on the philosophical foundations of each of the school student parliament, social competence, social skills and metacognitive strategies, as well as the social, mental, behavioral and cultural characteristics of high school students. Methodology: It follows the quasi-experimental curriculum and design for its relevance to the intentional samples, and a measure of social efficiency that he built and presented to a group of specialized arbitrators, to suit the intended age stage, and a proposed program that he built and implemented during the academic year 2018-2019, and it consists of 10 training sessions with two training sessions per week. The duration of one session is one hour, and two quasi-experimental and one control groups, with 24 individuals in each group, 12 males and 12 females, with two measurements before and after the other.

Background:The natural history of gallstone formation after bariatric surgery, the incidence of symptomatic gallstones, and timing of cholecystectomy are not well established.This research is being done to bring awareness to one particular postoperative consequence of bariatric surgery: gallstone development. Methods:This study was retrospective cross-sectional study to achieve the objectives of the study. A cross-sectional study because of the capture information based on data gathered for a specific point in time. Obese population who were surgically managed aby one of the bariatric surgeries. The sampling type was a non-probability convenient sample. Sample size was determined according to 95% confidence level using Epi Info software. Results:Researches filled the questionnaire from 843 participants. Among them, 15.5% had bariatric surgery (n= 131). Age at time of bariatric surgery was more than 25 years among most of participants.Male to female ratio was almost 1:1 among study participants who underwent bariatric surgery. The mean body mass index among study participants was 39.18 + 11.77 kg/m2while the median BMI was 40.74 kg/m2. This indicates that most of study participants are morbidly obese. The most frequent type of bariatric surgery was gastrectomy operation (n= 101, 77.1%). There were a number of participants who reported having gallstone after the surgery (n= 24, 18.3%). The timing of gallstone formation varied among study participants Conclusion:The incidence of gallstone formation following bariatric surgery was relatively less that other literature. All of study participants who underwent bariatric surgery reported having complications following the surgery. &nbsp

We propose a deep learning based method for classification of commonly occurring pathologies in chest X-ray images. The vast number of publicly available chest X-ray images provides the data necessary for successfully employing deep learning methodologies to reduce the misdiagnosis of thoracic diseases. We applied our method to the classification of two example pathologies, pulmonary nodules and cardiomegaly, and we compared the performance of our method to three existing methods. The results show an improvement in AUC for detection of nodules and cardiomegaly compared to the existing methods., Comment: 4 pages, 4 figures, 2 tables, conference , SSIAI 2020

Our large single-center study demonstrates the safety of performing contrast-enhanced MR imaging with gadobenate dimeglumine in patients with severe chronic kidney disease, with no patients having developed nephrogenic systemic fibrosis at follow-up.

The authors have requested to withdraw this manuscript from publication because the study was not conducted in full accordance with the relevant institutional IRB protocol.

Bakgrunn: En viktig målsetting for det offentlige helsevesenet er å tilby tjenester av høy kvalitet. Kvalitet kan måles på flere måter; én måte er ved å undersøke hvor tilfreds pasientene er med helsetjenestene. Det er viktig å studere hvordan tilfredshet varierer med sosioøkonomiske faktorer for å danne et bilde av hvordan ulike befolkningsgrupper oppfatter det offentlige helsetilbudet. Formål: Denne studien undersøker hvorvidt tilfredsheten pasienter uttrykker med fastlegen påvirkes av helsetilstand og sosioøkonomisk status. Metode: Multivariat logistisk regresjon benyttes for å undersøke om det foreligger en sammenheng mellom pasienters helsetilstand eller sosioøkonomiske status og deres vurdering av fastlegen. Studien anvender data fra Statistisk sentralbyrås levekårsundersøkelse om helse fra 2012. Pasienters tilfredshet ble undersøkt ved deres vurdering av fem påstander om fastlegen. Resultater: Analysene viste en statistisk signifikant sammenheng mellom pasientenes egenvurderte helse og deres vurdering av fastlegen. Individer med dårlig helse hadde lavere sannsynlighet for å uttrykke tilfredshet med påstandene om fastlegen. For de sosioøkonomiske faktorene var resultatene tvetydige; studien fant ingen klar sammenheng. Konklusjon: Pasienttilfredshet er et komplekst begrep som påvirkes av flere faktorer; også faktorer utenfor helsetjenesten. Denne studien har avdekket at det foreligger en sammenheng mellom pasientenes egenvurderte helse og deres vurdering av fastlegen. Effekten av helse var robust i alle modellene.

Purpose: To evaluate intrinsic hepatic enhancement patterns on multiphase, gadolinium-enhanced, fat-suppressed, 3D T1-weighted, gradient echo magnetic resonance imaging (MRI) as a quantitative correlate for severity of pathological changes in chronic liver disease (CLD). Materials and Methods: This study was HIPAA-compliant and Institutional Review Board-approved. In all, 75 patients were studied by contrast-enhanced multiphase abdominal MRI. CLD patients had liver histology correlation derived from right lobe liver biopsies. Contrast-enhanced arterial- and delayed-phase 3D gradient recalled echo (GRE) liver MRI were scored using feature categorization templates to quantify enhancement patterns by three independent readers. Liver histopathology was staged/graded for fibrosis/inflammation using the Scheuer system. Statistical testing for MRI histology correlates used a Pearson's product moment correlation and a Wilcoxon–Mann–Whitney two-sample rank-sum test. Reader agreement was analyzed by a modified Fleiss' kappa test. Results: MRI histology correlation was high for delayed-phase MRI versus fibrosis stage (95% confidence interval [CI] 0.941 < r < 0.976, P = 5 × 10−7), but lower for all other comparisons (delayed-phase vs. inflammation and arterial-phase vs. inflammation or fibrosis all showed a CI no greater than 0.64). Paired testing between delayed-phase MRI score and histology fibrosis staging incremental levels was significant (from P < 10−2 to P < 10−5). Conclusion: A standard gadolinium-enhanced liver MRI may provide a correlate measure of hepatic fibrosis over a spectrum of severity. J. Magn. Reson. Imaging 2012;36:422–429. © 2012 Wiley Periodicals, Inc.

Purpose: To measure contrast agent enhancement kinetics in the liver and to further evaluate and develop an optimized gadolinium enhanced MRI using a single injection real-time bolus-tracking method for reproducible imaging of the transient arterial-phase. Materials and Methods: A total of 18 subjects with hypervascular liver lesions were imaged with four dimensional (4D) perfusion scans to measure time-to-peak (TTP) delays of arterial (aorta-celiac axis), liver parenchyma, liver lesion, portal, and hepatic veins. Time delays were calculated from the TTP-aorta signal, and then related to the gradient echo (GRE) k-space acquisition design, to determine optimized timing for real-time bolus-track triggering methodology. As another measure of significance, 200 clinical patients were imaged with 3D-GRE using either a fixed time-interval or by individualized arterial bolus real-time triggering. Bolus TTP-aorta was calculated and arterial-phase acquisitions were compared for accuracy and reproducibility using specific vascular enhancement indicators. Results: The mean bolus transit-time to peak-lesion contrast was 8.1 ± 2.7 seconds following arterial detection, compared to 32.1 ± 5.4 seconds from contrast injection, representing a 62.1% reduction in the time-variability among subjects (N = 18). The real-time bolus-triggered technique more consistently captured the targeted arterial phase (94%), compared to the fixed timing technique (73%), representing an expected improvement of timing accuracy in 28% of patients (P = 0.0001389). Conclusion: Our results show detailed timing window analysis required for optimized arterial real-time bolus-triggering acquisition of transient arterial phase features of liver lesions, with optimized arterial triggering expected to improve reproducibility in a significant number of patients. J. Magn. Reson. Imaging 2011;33:110–118. © 2010 Wiley-Liss, Inc.

OBJECTIVES To determine whether the degree of enhancement of pancreatic adenocarcinoma visualized on arterial phase gadolinium-enhanced magnetic resonance imaging (MRI) correlates with the histopathological tumor grade. METHODS Thirty-nine patients with pancreatic adenocarcinoma had MRI within 14 days before tumor resection. Gadolinium-chelate-enhanced (Gd) 3-dimensional gradient echo images were acquired including the arterial phase. Tumor imaging patterns on the arterial phase images were classified for low, moderate, or high degree of enhancement and compared against conventional histological grading. RESULTS Based on histological grading, there were 12 poorly differentiated, 2 poorly to moderately differentiated, 22 moderately differentiated, and 3 well-differentiated adenocarcinomas. There was agreement between the MRI arterial enhancement pattern and histological grading in 30 of 39 cases. The mean size of tumors grouped by enhancement pattern or grade was not significantly different between groups. Although minor discordance was found in 9 of the 39 cases, statistical analysis showed agreement between the degree of arterial enhancement on MRI and histological tumor differentiation; the Cohen's kappa value was 0.64 with a 95% confidence interval of 0.46-0.83. CONCLUSIONS Pancreatic adenocarcinoma arterial phase enhancement correlates with the histological grade of differentiation.

Chronic kidney disease is a significant public health problem, and a comprehensive evaluation of renal disease often requires accurate evaluation of both kidney structure and function. Magnetic resonance (MR) nephrourography refers to newly developed imaging techniques that have the ability to provide a quantitative assessment of renal function, especially glomerular filtration rate and renal blood flow. Our review outlines several different methodologies that are present in the literature and also details the specifics of our own methods for renal imaging. Though varied, all MR imaging methods use the common steps of image acquisition, image postprocessing, and tracer kinetics modeling of the processed image data. The optimal methodology should be practical and based primarily on simplicity, speed, and reproducibility. The combination of anatomic and quantitative functional information of the kidneys provided by MR imaging allows for a safe, comprehensive evaluation of renal disease, with particular utility in the settings of urinary tract obstruction and renal transplantation.

The purpose of this study was to evaluate prospectively acquired institutional results to determine the accuracy of gadolinium-enhanced MRI in liver tumor surveillance before transplantation.One hundred fifteen patients underwent MRI of the abdomen within 90 days before liver transplantation. Images were acquired with gadolinium-enhanced 3D gradient-echo sequences in the arterial, venous, and delayed phases. Detection of hepatocellular carcinoma (HCC) was based on the imaging criteria arterial phase enhancement, delayed phase hypointensity, and development of an enhancing outer margin capsule. Imaging findings were compared with findings at histopathologic evaluation of the explanted liver.Thirty-six HCCs in 27 patients were detected at histopathologic evaluation. Patient-based analysis showed the sensitivity of MRI was 88.9% (24/27); specificity, 97.7% (false-positive findings in two patients); and accuracy, 95.7%. MRI depicted 28 of 36 HCCs, resulting in a lesion-based sensitivity of 77.8%. Although all 18 HCCs 2 cm or larger were depicted with MRI, only 10 of 18 HCCs smaller than 2 cm were correctly diagnosed. However, two HCCs measuring smaller than 2 cm at pathologic examination were rated as dysplastic nodules on MRI.Contrast-enhanced MRI can be used as a primary diagnostic method for accurate detection and characterization of HCC 2 cm or larger as required by the criteria of the Model for End-Stage Liver Disease used by the United Network for Organ Sharing. MRI can be considered a standard tool for surveillance before liver transplantation. Reduction in cost and risk may be derived from the diminished need for other diagnostic imaging studies and biopsy and the avoidance of use of iodinated contrast agents in imaging of patients with cirrhosis, many of whom have impaired renal function.

Pelvic MR imaging using the combination of motion-insensitive T2-weighted single-shot fast spin echo and high soft tissue resolution standard T2-weighted fast spin echo techniques has helped to identify soft tissue abnormalities that directly correlate with the clinical and intraoperative findings related to pelvic floor prolapse. In particular, the authors have shown that pelvic MR imaging has the ability to identify changes related to uterosacral ligament disruption and to document the corrective changes after surgical repair of this ligament. In the future, pelvic MR imaging is expected to play a progressively larger role in preoperative planning for complex or uncertain cases and for more detailed evaluation of repair in cases that do not show good symptomatic response. Pelvic MR imaging should also help to document and advance knowledge of surgical repair methodology.

Purpose To assess a possible correlation between active acute hepatitis and the development of abnormal liver perfusion demonstrated as heterogeneous enhancement on arterial phase gadolinium-enhanced MRI. Dynamically-enhanced MRI of the liver can detect reversible perfusion abnormalities that correlate with acute hepatitis. Materials and Methods Six patients presenting with symptoms and clinical findings in keeping with transient acute hepatitis underwent serial MRI of the liver throughout the course of the disease. Serial liver enzyme analysis was performed for all six patients, and histopathology was assessed for three patients. Imaging included gadolinium-enhanced arterial and venous-phase gradient-echo sequences. Results Arterial phase gadolinium-enhanced MRI showed abnormal irregular liver perfusion in the setting of acute hepatitis, and the degree of irregularity, as well as the persistence of irregular enhancement into the venous phase, correlated with the clinical severity of the disease. Conclusion Acute hepatitis can cause irregular enhancement of the liver on arterial-phase, gadolinium-enhanced, gradient-echo MRI, a reversible finding that improves with clinical improvement of the disease. J. Magn. Reson. Imaging 2004;20:838–842. © 2004 Wiley-Liss, Inc.

Kidney disease represents a leading cause of morbidity, with high healthcare costs. The existing methods used to evaluate renal function include measures of glomerular filtration rate (GFR), yet the clinical methods are generally inaccurate and poorly reproducible. A method that improves measures of renal function as part of a comprehensive examination that also evaluates renal structure represents an important unmet clinical need. Use of dynamic contrast-enhanced magnetic resonance imaging (MRI) for the evaluation of renal function has been undergoing development by several groups. The methodology has been referred to as MR Urography (MRU) or MR Nephro-urography (MRNU). MRU/MRNU shows promise for providing new insights into the evaluation of renal structure and function in relation to important disease processes, including urinary obstruction and in relation to renal transplantation. MRU/MRNU generally requires consideration of imaging acquisition technique, image postprocessing strategies, and subsequent kinetic mathematical modeling of the data in reference to specific physiological renal processes, such as renal blood flow and GFR. Here we review the specifics of proposed methods in light of the overall strengths and limitations of each of these strategies. The overall objective is to provide a roadmap for future developments in this evolving field of novel MRI applications.

Acute flank pain is a frequent clinical presentation encountered in emergency departments, and a work-up for obstructive urolithiasis in this setting is a common indication for computed tomography (CT). However, imaging alternatives to CT for the evaluation of renal colic are warranted in some clinical situations, such as younger patients, pregnancy, patients that have undergone multiple prior CT exams and also patients with vague clinical presentations. MRI, although relatively insensitive for the direct detection of urinary calculi, has the ability to detect the secondary effects of obstructive urolithiasis. Using rapid, single shot T2-weighted sequences without and with fat saturation provides an abdominopelvic MR examination that can detect the sequelae of clinically active stone disease, in addition to alternate inflammatory processes that may mimic the symptoms of renal colic. In addition, MR nephro-urography (MRNU) has the ability to provide quantitative analysis of renal function that has the potential to direct clinical management in the setting of obstructing calculi. This review describes the potential utility and limitations of MRI in the emergency setting for diagnosing causes of flank pain and renal colic, particularly in patients with unusual presentations or when an alternative to CT may be warranted. J. Magn. Reson. Imaging 2010;32:1012–1023. © 2010 Wiley-Liss, Inc.

Purpose: To retrospectively determine the incidence of nephrogenic systemic fibrosis (NSF) in patients on dialysis administered either a lower dose high-relaxivity linear gadolinium-chelate, gadobenate dimeglumine (MultiHance, MH), compared to a standard dose linear gadolinium chelate, gadodiamide (Omniscan, OM). Materials and Methods: This study was Health Insurance Portability and Accountability Act (HIPAA)-compliant and Institutional Review Board (IRB)-approved. As per institution standardized contrast-enhanced magnetic resonance imaging (MRI) protocols, patients on dialysis were imaged using either MH, between 2/2007 to 9/2008, or OM between 10/2003 and 1/2007. Rates of NSF were compared using 95% score-based confidence intervals (CI). The Wilcoxon rank sum test was used to test similarity/difference between contrast doses given to each patient group. Results: Overall, 312 patients on dialysis received OM and eight (2.6%) developed NSF (95% CI: 1.30%–4.98%). In all, 784 patients on dialysis received MH at a mean cumulative dose of 0.11 mmol/kg (0.05–0.75 mmol/kg) and no cases of NSF were identified (upper 95% confidence bound of 0.45%). The mean cumulative dose of OM was 0.16 mmol/kg (0.1–0.9 mmol/kg) for all patients and 0.28 mmol/kg (0.1–0.8 mmol/kg) for the patients with NSF. The median OM dose was greater in patients who developed NSF (P = 0.03), and was greater than the median MH dose (P < 0.005). Conclusion: NSF incidence in at-risk patients receiving contrast-enhanced MRI can be reduced after changing contrast administration protocols that includes changing the type and dose of contrast agent. J. Magn. Reson. Imaging 2010; 31: 440–446. © 2010 Wiley-Liss, Inc.

End-stage-renal disease (ESRD) is a major health issue in the United States, and the Medicare costs of ESRD totaled nearly $21 billion in 2005. Renal transplantation has emerged as the treatment of choice in this patient population, providing improved quality of life and lower healthcare costs compared with other treatment options. Imaging evaluation of a graft kidney plays a critical role in the postoperative care of the renal transplant patient. In the past, diagnostic evaluation of the transplant kidney has depended upon a combination of ultrasonography, computed tomography, MRI, and biopsy, used in conjunction with the patient's clinical presentation. However, new and developing advances in MR technology has lead to the development of MR Nephro-Urography (MRNU), which provides both anatomic and functional evaluation of the kidney in a single examination. It is expected that the increasing use of MRNU will have a significant impact on the management of renal transplant patients. This review describes MRNU methodology, examines known posttransplant complications, and highlights the utility of MRNU as a comprehensive imaging examination to diagnose both surgical and medical complications of the transplant kidney. J. Magn. Reson. Imaging 2008;28:805–822. © 2008 Wiley-Liss, Inc.

MR nephrourography (MRNU) makes it possible to obtain structural and functional data within a single imaging examination without using ionizing radiation. The functional data available with MRNU allows renal physiology to be examined in ways that were not possible previously. Coupled with the exquisite soft-tissue contrast provided by standard MR images, MRNU can provide a comprehensive study that yields critical diagnostic information on structural diseases of the kidneys and collecting system, including congenital and acquired diseases, and also on the full range of the causes of dysfunction in the transplanted kidney.

Ziele: Ziel dieser Studie war es, (a) retrospektiv Faelle von Nephrogener Systemischer Fibrose (NSF) an unserer Klinik zu identifizieren und (b) praedisponierende Faktoren fuer das Auftreten von NSF bei Dialysepatienten zu bestimmen. Methode: Datenbanken von Pathologie, MRT-Untersuchungen, Dialyse und medizinischen Krankenakten wurden zur Identifizierung von NSF-Faellen an unserer Klinik herangezogen. Die Krankengeschichte der Patienten wurde hinsichtlich potentieller Co-Faktoren ueberprueft, wie z.B. das Vorliegen einer venoesen Thrombose, chrirugische Eingriffe oder Infektionserkrankungen. Zudem wurden Laborwerte (Kreatinin, Anionen-Gap, Calcium, Phosphor, Albumin) und verabreichte Medikationen bei Patienten mit NSF analysiert. Die Ergebnisse wurden mit einer Kontrollgruppe von Dialyse-Patienten verglichen, die keine NSF Erkrankung entwickelten. Ergebnis: Zwischen Oktober 2003 und April 2007 konnten 9 NSF-Faelle an unserer Klinik festgestellt warden. Bei allen Patienten war vor Auftreten der Symptome eine oder mehrere Kontrastmittel-gestuetzte MRT-Untersuchung durchgefuehrt worden. In diesem Zeitraum wurde ausschlieslich Gadodiamide (Omniscan®, GE Healthcare) als paramagnetisches MRT-Kontrastmittel eingesetzt. 8 der 9 Patienten wurden zum Zeitpunkt der letzten MRT-Untersuchung dialysiert. Ein weiterer Patient zeigte nach Nierentransplantation eine deutlich eingeschraenkte Nierenfunktion (GFR

Purpose To retrospectively analyze nephrogenic systemic fibrosis (NSF) cases at our center, to determine prior gadolinium based contrast agent (GBCA) administration and to evaluate possible common risk factors for the development of NSF by reviewing laboratory data and concurrent medications. Materials and Methods A total of four data bases (pathology, MRI, dialysis, and medical records) were cross-referenced for identification and evaluation of NSF patients. Medical history of NSF patients was assessed as for previous deep venous thrombosis (DVT), surgery, or infections. Laboratory data (creatinine, anion gap, calcium, phosphorus, and albumin) as well as concurrent medication were evaluated. Findings were compared to those of a control group of non-NSF dialysis patients. Results Between October 2003 and February 2007 a total of nine NSF cases were identified. All patients had undergone contrast-enhanced MRI prior to the diagnosis of NSF. Only one gadolinium chelate had been used at our MRI center (Omniscan®, gadodiamide; GE Healthcare). Of nine patients, eight were receiving dialysis at the time of the MRI scan. During the same time 312 dialysis patients received gadodiamide. Thus, the prevalence of NSF within dialysis patients exposed to gadodiamide was 2.6%. NSF patients presented with a higher creatinine and anion gap than the control patients. Other laboratory values as well as medication did not show a significant difference. There were no patterns regarding previous history of DVT, surgery, or infection in the NSF group. Conclusion Our findings are consistent with the previously reported association between gadodiamide exposure and NSF. All NSF patients had severe renal insufficiency with glomerular filtration rate (GFR) < 30 (highest GFR = 25 mL/minute) at the time of last gadodiamide administration, and on average had received 71 mL of gadodiamide over an average of 2.9 administrations. J. Magn. Reson. Imaging 2007;26:1198–1203. © 2007 Wiley-Liss, Inc.

Detection and characterization of liver lesions often present a diagnostic challenge to the radiologists. Liver lesions may be classified as hypovascular and hypervascular based on degree of hepatic arterial blood supply. Common hypervascular liver lesions include hemangioma, focal nodular hyperplasia, hepatocellular adenoma, hepatocellular carcinoma, fibrolamellar carcinoma, and metastases from primary tumors such as islet cell tumor, carcinoid, renal cell carcinoma, melanoma, and thyroid carcinoma. In this review article, we discuss the spectrum of imaging features of hypervascular liver lesions.