The Life of Don Shields: from Atmospheric Nuclear Tests to the Lunar Module.

INTRODUCTION: In this article, we recount some aspects of the tremendous life of Don Shields. As a young Air Force pilot, Don Shields flew the B57 aircraft through the actual nuclear cloud during nuclear weapons blast explosions in Operation Dominic. The data he collected was of vital importance to our country's nuclear weapons program. Don Shields knew of the tremendous risk of radiation but served our country at the call of duty. After his military service, Don Shields served as the subject matter expert for the Apollo lunar module and worked directly with Commander Neil Armstrong and lunar module pilot Buzz Aldrin in training them on the module. During the Apollo 11 mission, Don Shields was being interviewed by Walter Cronkite on the epic Moon landing coverage. Unfortunately, later in life Don Shields suffered from cataracts and leukemia, both of which are known to be related to high radiation exposures. During his old age, Don Shields volunteered at the NASA Ames Museum and inspired generations of young individuals towards the space mission.Douglas DB, Cagle Y. The life of Don Shields: from atmospheric nuclear tests to the lunar module. Aerosp Med Hum Perform. 2020; 91(1):56-58.

Meeting the World Health Organization Maternal Antenatal Care Guidelines Is Associated with Improved Early and Middle Childhood Cognition in Ethiopia.

OBJECTIVE: To assess the association between meeting the World Health Organization (WHO) maternal antenatal care attendance guidelines and early and middle childhood cognition among impoverished Ethiopian children. STUDY DESIGN: A total of 1914 impoverished Ethiopian children from the Young Lives longitudinal cohort study were included. Childhood cognition was assessed via the Cognitive Development Assessment (CDA) and Peabody Picture Vocabulary Test (PPVT) at ages 4-5 years; PPVT, Early Grade Reading Assessment (EGRA), and Math Test at ages 7-8 years; and PPVT, Math Test, and Reading Test at ages 11-12 years. Linear regression models were used to examine the association between maternal antenatal care attendance and childhood academic achievement test scores. RESULTS: In the univariable analysis, children of mothers who received the WHO recommended 4+ antenatal care visits or received the WHO recommended first antenatal care visit during the first trimester scored higher on all academic achievement tests. In the multivariable analysis, children of mothers who received 4+ antenatal care visits scored significantly higher on the CDA at ages 4-5 years and Math Test at ages 7-8 years. Children of mothers who received antenatal care in the first trimester scored higher on the CDA at ages 4-5 years and Math Test scores at ages 11-12 years. Children of mothers who received both antenatal care in the first trimester and 4+ antenatal care visits scored significantly higher on the CDA at ages 4-5 years and Math Test at both ages 7-8 and 11-12 years. CONCLUSIONS: Children of mothers who received the WHO recommended number and timing of antenatal care visits had significantly higher academic achievement scores across multiple domains during early and middle childhood. Promotion of antenatal care visit attendance may improve cognition through middle childhood.

Neuroimaging of Traumatic Brain Injury.

The purpose of this article is to review conventional and advanced neuroimaging techniques performed in the setting of traumatic brain injury (TBI). The primary goal for the treatment of patients with suspected TBI is to prevent secondary injury. In the setting of a moderate to severe TBI, the most appropriate initial neuroimaging examination is a noncontrast head computed tomography (CT), which can reveal life-threatening injuries and direct emergent neurosurgical intervention. We will focus much of the article on advanced neuroimaging techniques including perfusion imaging and diffusion tensor imaging and discuss their potentials and challenges. We believe that advanced neuroimaging techniques may improve the accuracy of diagnosis of TBI and improve management of TBI.

Neuroimaging of brain trauma.

PURPOSE OF REVIEW: The purpose of this review is to provide an update on advanced neuroimaging techniques in traumatic brain injury (TBI). We will focus this review on recent literature published within the last 18 months and the advanced neuroimaging techniques of perfusion imaging and diffusion tensor imaging (DTI). RECENT FINDINGS: In the setting of a moderate or severe acute closed head injury (Glasgow Coma Scale <13), the most appropriate neuroimaging study is a noncontrast computed tomography (CT) scan. In the setting of mild TBI, the indication for neuroimaging can be determined using the New Orleans Criteria or Canadian CT Head Rules or National Emergency X-Ray Utilization Study-II clinical criteria. Two advanced neuroimaging techniques that are currently being researched in TBI include perfusion imaging and DTI. Perfusion CT has a higher sensitivity for detecting cerebral contusions than noncontrast CT examinations. DTI is a sensitive at detecting TBI at the group level (TBI-group versus control group), but there is insufficient evidence to suggest that DTI plays a clinical role for diagnosing mild TBI at the individual patient level. SUMMARY: Future research in advanced neuroimaging techniques including perfusion imaging and DTI may improve the accuracy of the diagnosis and prognosis as well as improve the management of TBI.

Hemispheric brain asymmetry differences in youths with attention-deficit/hyperactivity disorder.

Introduction: Attention-deficit hyperactive disorder (ADHD) is the most common neurodevelopmental disorder in children. Diagnosis is currently based on behavioral criteria, but magnetic resonance imaging (MRI) of the brain is increasingly used in ADHD research. To date however, MRI studies have provided mixed results in ADHD patients, particularly with respect to the laterality of findings. Methods: We studied 849 children and adolescents (ages 6-21 y.o.) diagnosed with ADHD (n = 341) and age-matched typically developing (TD) controls with structural brain MRI. We calculated volumetric measures from 34 cortical and 14 non-cortical brain regions per hemisphere, and detailed shape morphometry of subcortical nuclei. Diffusion tensor imaging (DTI) data were collected for a subset of 104 subjects; from these, we calculated mean diffusivity and fractional anisotropy of white matter tracts. Group comparisons were made for within-hemisphere (right/left) and between hemisphere asymmetry indices (AI) for each measure. Results: DTI mean diffusivity AI group differences were significant in cingulum, inferior and superior longitudinal fasciculus, and cortico-spinal tracts (p < 0.001) with the effect of stimulant treatment tending to reduce these patterns of asymmetry differences. Gray matter volumes were more asymmetric in medication free ADHD individuals compared to TD in twelve cortical regions and two non-cortical volumes studied (p < 0.05). Morphometric analyses revealed that caudate, hippocampus, thalamus, and amygdala were more asymmetric (p < 0.0001) in ADHD individuals compared to TD, and that asymmetry differences were more significant than lateralized comparisons. Conclusions: Brain asymmetry measures allow each individual to serve as their own control, diminishing variability between individuals and when pooling data across sites. Asymmetry group differences were more significant than lateralized comparisons between ADHD and TD subjects across morphometric, volumetric, and DTI comparisons.

Perfusion Imaging in Acute Traumatic Brain Injury.

Traumatic brain injury (TBI) is a significant problem worldwide and neuroimaging plays a critical role in diagnosis and management. Recently, perfusion neuroimaging techniques have been explored in TBI to determine and characterize potential perfusion neuroimaging biomarkers to aid in diagnosis, treatment, and prognosis. In this article, computed tomography (CT) bolus perfusion, MR imaging bolus perfusion, MR imaging arterial spin labeling perfusion, and xenon CT are reviewed with a focus on their applications in acute TBI. Future research directions are also discussed.

Augmented Reality Imaging System: 3D Viewing of a Breast Cancer.

OBJECTIVE: To display images of breast cancer from a dedicated breast CT using Depth 3-Dimensional (D3D) augmented reality. METHODS: A case of breast cancer imaged using contrast-enhanced breast CT (Computed Tomography) was viewed with the augmented reality imaging, which uses a head display unit (HDU) and joystick control interface. RESULTS: The augmented reality system demonstrated 3D viewing of the breast mass with head position tracking, stereoscopic depth perception, focal point convergence and the use of a 3D cursor and joy-stick enabled fly through with visualization of the spiculations extending from the breast cancer. CONCLUSION: The augmented reality system provided 3D visualization of the breast cancer with depth perception and visualization of the mass's spiculations. The augmented reality system should be further researched to determine the utility in clinical practice.

D3D augmented reality imaging system: proof of concept in mammography.

PURPOSE: The purpose of this article is to present images from simulated breast microcalcifications and assess the pattern of the microcalcifications with a technical development called "depth 3-dimensional (D3D) augmented reality". MATERIALS AND METHODS: A computer, head display unit, joystick, D3D augmented reality software, and an in-house script of simulated data of breast microcalcifications in a ductal distribution were used. No patient data was used and no statistical analysis was performed. RESULTS: The D3D augmented reality system demonstrated stereoscopic depth perception by presenting a unique image to each eye, focal point convergence, head position tracking, 3D cursor, and joystick fly-through. CONCLUSION: The D3D augmented reality imaging system offers image viewing with depth perception and focal point convergence. The D3D augmented reality system should be tested to determine its utility in clinical practice.

Diffusion Tensor Imaging of TBI: Potentials and Challenges.

Neuroimaging plays a critical role in the setting in traumatic brain injury (TBI). Diffusion tensor imaging (DTI) is an advanced magnetic resonance imaging technique that is capable of providing rich information on the brain's neuroanatomic connectome. The purpose of this article is to systematically review the role of DTI and advanced diffusion techniques in the setting of TBI, including diffusion kurtosis imaging (DKI), neurite orientation dispersion and density imaging, diffusion spectrum imaging, and q-ball imaging. We discuss clinical applications of DTI and review the DTI literature as it pertains to TBI. Despite the continued advancements in DTI and related diffusion techniques over the past 20 years, DTI techniques are sensitive for TBI at the group level only and there is insufficient evidence that DTI plays a role at the individual level. We conclude by discussing future directions in DTI research in TBI including the role of machine learning in the pattern classification of TBI.

Effects of breath-hold and cardiac cycle on the MRI appearance of the aorta and inferior vena cava in t2 abdominal imaging.

OBJECTIVE: The purpose of this article is to review the MR principles of blood signal and normal flow-related phenomena seen in the aorta and inferior vena cava (IVC) on T2-weighted images of the abdomen and to discuss the physiologic and physical basis of signal alterations with breath-hold imaging. We define time-of-flight (TOF) loss and list the factors that affect it; explain the physiologic effects of breath-hold imaging on both aortic and IVC waveforms and velocity; state which abdominal T2 imaging techniques are most susceptible to variable TOF effects and explain why based on physiologic effects and MR principles; and describe three trouble-shooting techniques to confirm that unexpected signal does not reflect pathology. CONCLUSION: T2 images customarily result in TOF loss and dark blood signal. Abdominal MRI relies extensively on breath-hold imaging techniques that may alter markedly the flow velocity in normal vessels. This marked flow change results in signal heterogeneity and variable TOF loss especially with faster sequences filling k-space in shorter time frames. Breath-hold imaging decreases k-space fill time, and of the breath-hold T2 techniques, single-shot fast spin-echo decreases k-space fill time the most. Atypical blood signal during breath-hold imaging may mimic pathology, but abnormal findings can be verified by review of other sequences and planes of imaging.

Preparing for pandemic influenza and its aftermath: mental health issues considered.

In November of 2005, President George W Bush requested $7.1 billion dollars for a global influenza epidemic preparedness initiative (Brown, 2005). Preparation measures for a biological threat or influenza pandemic focus on rapid quarantine, vaccines, developing antiviral treatments, and economic concerns (Brown, 2005; Ferguson et al., 2006; Reina, 2008). Although these public health measures are vital, they do not consider the acute mental health consequences that could develop during a pandemic and its aftermath. The most recent H1N1 swine flu has now spread to more than 70 countries (CDC, June 2009), and as of June 11, 2009, is considered a Phase 6 pandemic by the World Health Organization, indicative of ongoing community level outbreaks in multiple parts of the globe. Following recent cases of swine flu, global concern of an influenza pandemic has risen, and it is critical that metal health considerations become an integrated part of the pandemic response. Here, potential mental health consequences and high risk populations are identified and reviewed. Mental health professionals, communities, businesses, and organizations can create an infrastructure to help mitigate mental health consequences. These issues, as well as familial stressors and coping methods, are reviewed.