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21 April 2023 Accepted: 03 June 2023 Published: 07 June 2023
## Ethics approval and consent to participate
The study was conducted in accordance with the ethical principles of the Declaration of Helsinki (2013). Ethical approval was obtained from Sakhiya Skin Clinic, Surat, Gujarat, India. (Approval No: 2023/06). Consent forms were signed by patient. He was informed that he had the right to withdraw from the study at any time without any consequences. All pictures reported in this case- report study belong to Sakhiya Skin Clinic, Surat- 395003, Gujarat, India.
## Consent for publication
Not applicable
## Competing interest
The authors declare that they have no competing interests.
## Open Access
This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article unless otherwise stated.
## Author Details
1Department of Dermatology, Sakhiya Skin Clinic, Surat, Gujarat, India. 2Department of Medical Writing, Sakhiya Skin Clinic, Surat, Gujarat, India
## Article Info
Received: 21 April 2023 Accepted: 03 June 2023 Published: 07 June 2023
## References
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2. Lever WF, Schaumburg-Lever G. Immunosuppressants and prednisone in pemphigus vulgaris: therapeutic results obtained in 63 patients between 1961 and 1975. Arch Dermatol. 1977 Sep;113(9):1236-41. doi: 10.1001/archderm.1977.016400900084013.
3. Pasricha JS, Gupta R. Pulse therapy with dexamethasonecyclophosphamide in pemphigus. Indian J Dermatol Venereol Leprol. 1984;50:199-203.
4. Bystryn JC, Steinman NM. The adjuvant therapy of pemphigus. An update. Arch Dermatol. 1996 Sep;132(2):203-12.
5. Heizmann M, Itin P, Wernli M, Borradori L, Bargetzi MJ. Successful treatment of paraneoplastic pemphigus in follicular NHL with rituximab: report of a case and review of treatment for paraneoplastic pemphigus in NHL and CLL. Am J Hematol. Feb 2001;66(2):142-4. doi: 10.1002/1096-8652(200102)66:2<142::AID-AJH1032>3.0.CO;2-0.
6. Food and Drug Administration. Rituxan label; 2012 [cited Feb 2, 2021]. Available from: http://www.accessdata.fda.gov/drugsatfda_docs/label/2012/103705s5373lbl.pdf.
7. Belgi AS, Azeze M, Hoyle C, Williams REA. Response of pemphigus vulgaris to anti-CD20 antibody therapy (rituximab) may be delayed. Clin Exp Dermatol. 2006 Jan;31(1):143. doi: 10.1111/j.1365-2230.2005.01941.x.
8. Schmidt E, Seitz CS, Benoit S, Brocker EB, Goebeler M. Rituximab in autoimmune bullous diseases: mixed responses and adverse effects. Br J Dermatol. 2007 Feb;156(2):352-6. doi: 10.1111/j.1365-2133.2006.07646.x.
9. Barrera MV, Mendiola MV, Bosch RJ, Herrera E. Prolonged treatment with rituximab in patients with refractory pemphigus vulgaris. J Dermatol Treat. 2007 Jan;18(5):312-4. doi: 10.1080/09546630701323988.
10. Faurschou A, Gniadecki R. Two courses of rituximab (anti-CD20 monoclonal antibody) for recalcitrant pemphigus vulgaris. Int J Dermatol. 2008 Mar;47(3):292-4. doi: 10.1111/j.1365-4632.2008.03423.x.
11. Craythorne EE, Mufti G, DuVivier AW. Rituximab used as a first-line single agent in the treatment of pemphigus vulgaris. J Am Acad Dermatol. 2011 Nov;65(5):1064-5. doi: 10.1016/j.jaad.2010.06.033.
12. Horvath B, Huizinga J, Pas HH, Mulder AB, Jonkman MF. Low-dose rituximab is effective in pemphigus. Br J Dermatol. 2012 Feb;166(2):405-12. doi: 10.1111/j.1365-2133.2011.10663.x.
13. Craythorne E, Du Vivier A, Mufti GJ, Warnakulasuriya S. Rituximab for the treatment of corticosteroid鈥攔efractory pemphigus vulgaris with oral and skin manifestations. J Oral Pathol Med. 2011 Sep;40(8):616-20. doi: 10.1111/j.1600-0714.2011.01017.x.
14. Kim JH, Kim YH, Kim MR, Kim SC. Clinical efficacy of different doses of rituximab in the treatment of pemphigus: a retrospective study of 27 patients. Br J Dermatol. 2011Sep;165(3):646-51. doi: 10.1111/j.1365-2133.2011.10411.x.
15. Kasperkiewicz M, Shimanovich I, Ludwig RJ, Rose C, Zillikens D, Schmidt E. Rituximab for treatment-refractory pemphigus and pemphigoid: a case series of 17 patients. J Am Acad Dermatol. 2011 Sep;65(3):552-8. doi: 10.1016/j.jaad.2010.07.032
16. Investor update. Basel; June 12, 2019. [cited Feb 5, 2021]. Available from: https://www.roche.com/investors/updates/inv-update-2019-06-12.htm.
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0.9mm 0.9mm 0.9mm 0.9mm 0.9mm 0.9mm 0.9mm
For more than a century, Xylem's pump technologies and solutions have satisfied customers all over the world. The e-SH pump continues that tradition, with higher efficiencies and proven performance. Here are just a few of the markets and applications in which we're helping customers solve their water and fluid management challenges.
## PUMPED FLUIDS
- Groundwater
- Potable water
- Process water
- Gray/used water
- Heat transfer fluids
- Produced water
## SPECIFICATIONS
<table><tr><td>Maximum flow</td><td>1,140 gpm</td></tr><tr><td>Maximum head</td><td>464 ft. TDH</td></tr><tr><td>Maximum working pressure</td><td>230 psi</td></tr><tr><td>Maximum temperature</td><td>250 掳F</td></tr><tr><td>Hydraulic performance</td><td>compliant with ANSI/HI 14.6 Grade 2B</td></tr><tr><td>Suction and discharge flanges</td><td>1" - 4" ANSI class 150 flanges</td></tr><tr><td>Motor</td><td>Standard 60 HZ NEMA premium efficient motors</td></tr></table>
## POWER GENERATION
## OIL AND GAS
## GENERAL MANUFACTURING
| null |
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622. 623. 624. 625. 626. 627. 628. 629. 630. 631. 632. 633. 634. 635. 636. 637. 638. 639. 640. 641. 642. 643. 644. 645. 646. 647. 648. 649. 650. 651. 652. 653. 654. 655. 656. 657. 658. 659. 660. 661. 662. 663. 664. 665. 666. 667. 668. 669. 670. 671. 672. 673. 674. 675. 676. 677. 678. 679. 680. 681. 682. 683. 684. 685. 686. 687. 688. 689. 690. 691. 692. 693. 694. 695. 696. 697. 698. 699. 700. 701. 702. 703. 704. 705. 706. 707. 708. 709. 710. 711. 712. 713. 714. 715. 716. 717. 718. 719. 720. 721. 722. 723. 724. 725. 726. 727. 728. 729. 730. 731. 732. 733. 734. 735. 736. 737. 738. 739. 740. 741. 742. 743. 744. 745. 746. 747. 748. 749. 750. 751. 752. 753. 754. 755. 756. 757. 758. 759. 760. 761. 762. 763. 764. 765. 766. 767. 768. 769. 770. 771. 772. 773. 774. 775. 776. 777. 778. 779. 780. 781. 782. 783. 784. 785. 786. 787. 788. 789. 790. 791. 792. 793. 794. 795. 796. 797. 798. 799. 800. 801. 802. 803. 804. 805. 806. 807. 808. 809. 810. 811. 812. 813. 814. 815. 816. 817. 818. 819. 820. 821. 822. 823. 824. 825. 826. 827. 828. 829. 830. 831. 832. 833. 834. 835. 836. 837. 838. 839. 840. 841. 842. 843. 844. 845. 846. 847. 848. 849. 850. 851. 852. 853. 854. 855. 856. 857. 858. 859. 860. 861. 862. 863. 864. 865. 866. 867. 868. 869. 870. 871. 872. 873. 874. 875. 876. 877. 878. 879. 880. 881. 882. 883. 884. 885. 886. 887. 888. 889. 890. 891. 892. 893. 894. 895. 896. 897. 898. 899. 900. 901. 902. 903. 904. 905. 906. 907. 908. 909. 910. 911. 912. 913. 914. 915. 916. 917. 918. 919. 920. 921. 922. 923. 924. 925. 926. 927. 928. 929. 930. 931. 932. 933. 934. 935. 936. 937. 938. 939. 940. 941. 942. 943. 944. 945. 946. 947. 948. 949. 950. 951. 952. 953. 954. 955. 956. 957. 958. 959. 960. 961. 962. 963. 964. 965. 966. 967. 968. 969. 970. 971. 972. 973. 974. 975. 976. 977. 978. 979. 980. 981. 982. 983. 984. 985. 986. 987. 988. 989. 990. 991. 992. 993. 994. 995. 996. 997. 998. 999. 1000. 1001. 1002. 1003. 1004. 1005. 1006. 1007. 1008. 1009. 1010. 1011. 1012. 1013. 1014. 1015. 1016. 1017. 1018. 1019. 1020. 1021. 1022. 1023. 1024. 1025. 1026. 1027. 1028. 1029. 1030. 1031. 1032. 1033. 1034. 1035. 1036. 1037. 1038. 1039. 1040. 1041. 1042. 1043. 1044. 1045. 1046. 1047. 1048. 1049. 1050. 1051. 1052. 1053. 1054. 1055. 1056. 1057. 1058. 1059. 1060. 1061. 1062. 1063. 1064. 1065. 1066. 1067. 1068. 1069. 1070. 1071. 1072. 1073. 1074. 1075. 1076. 1077. 1078. 1079. 1080. 1081. 1082. 1083. 1084. 1085. 1086. 1087. 1088. 1089. 1090. 1091. 1092. 1093. 1094. 1095. 1096. 1097. 1098. 1099. 1100. 1101. 1102. 1103. 1104. 1105. 1106. 1107. 1108. 1109. 1110. 1111. 1112. 1113. 1114. 1115. 1116. 1117. 1118. 1119. 1120. 1121. 1122. 1123. 1124. 1125. 1126. 1127. 1128. 1129. 1130. 1131. 1132. 1133. 1134. 1135. 1136. 1137. 1138. 1139. 1140. 1141. 1142. 1143. 1144. 1145. 1146. 1147. 1148. 1149. 1150. 1151. 1152. 1153. 1154. 1155. 1156. 1157. 1158. 1159. 1160. 1161. 1162. 1163. 1164. 1165. 1166. 1167. 1168. 1169. 1170. 1171. 1172. 1173. 1174. 1175. 1176. 1177. 1178. 1179. 1180. 1181. 1182. 1183. 1184. 1185. 1186. 1187. 1188. 1189. 1190. 1191. 1192. 1193. 1194. 1195. 1196. 1197. 1198. 1199. 1200. 1201. 1202. 1203. 1204. 1205. 1206. 1207. 1208. 1209. 1210. 1211. 1212. 1213. 1214. 1215. 1216. 1217. 1218. 1219. 1220. 1221. 1222. 1223. 1224. 1225. 1226. 1227. 1228. 1229. 1230. 1231. 1232. 1233. 1234. 1235. 1236. 1237. 1238. 1239. 1240. 1241. 1242. 1243. 1244. 1245. 1246. 1247. 1248. 1249. 1250. 1251. 1252. 1253. 1254. 1255. 1256. 1257. 1258. 1259. 1260. 1261. 1262. 1263. 1264. 1265. 1266. 1267. 1268. 1269. 1270. 1271. 1272. 1273. 127
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| 3
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To build and operate an efficient water system, you need both the right products and experts who know the application. Aquavar庐 IPC and Hydrovar庐 controllers have been designed by Xylem's engineers with these things in mind. The Aquavar庐 IPC or Hydrovar庐 variable speed controller provide built in pump protection controls and monitoring to help you optimize pump operations and increase energy savings up to 70% (vs. fixed speed) while reducing installation time.
# SPECIFICATIONS
<table><tr><td>Indoor enclosures</td><td>IP20 Open, TYPE 1, TYPE 12</td></tr><tr><td>Outdoor enclosures</td><td>TYPE 3R, TYPE 4X</td></tr><tr><td>Input supply</td><td>1.5-600 hp (frame A-D) wall or base mounted</td></tr><tr><td>Ambient<br>temperature</td><td>14掳F-113掳F(-10掳C-45掳C)</td></tr><tr><td></td><td>Higher temperatures can be achieved by derating the output amperage of the drive 10% for up to 122掳F (50掳C)</td></tr><tr><td>Communication</td><td>Modbus庐 RTU, Metasys N2, FLN, and BACnet standard<br>Others available with option cards</td></tr><tr><td></td><td>At altitudes from 0 to 1,000 meters<br>(0 to 3,300 ft)<br>Nameplate rated current is available<br>Derate for altitudes above 1,000<br>(3,300 ft) with a maximum operating<br>altitude of 3,000 m (9,900 ft)<br>Consult factory for applications above 3,000 m (9,900 ft)</td></tr><tr><td>Altitudes</td><td></td></tr><tr><td></td><td>Lower than 95% without condensation</td></tr><tr><td>Electrical -<br>input power</td><td>3 phase 380 V to 480 V 卤10%<br>1 phase 200 V to 240 V 卤10%<br>3 phase 200 V to 240 V 卤10%<br>3 phase 525 V to 600 V 卤10%<br>Frequency 50 or 60 Hz,卤2 Hz</td></tr><tr><td>Electrical -<br>output power</td><td>3 phase from 0 to V supply</td></tr></table>
# AQUAVAR庐 IPC VARIABLE SPEED CONTROLLER
# FEATURES
路Easier start-up and programming with Start-Up Genie
路Wide range of standard and permanent magnet motors with power up to 600 hp
路Multi-pump configuration for up to four (4) pumps - no need for programmable logic controller (PLC)
路Remote commissioning and monitoring with USB connectivity and software
路Two wire multi-pump connection for faster installation
路Hand on, off, and auto-on buttons available for easy pump operation at the keypad. No toggling between local and remote operation
路System redundancy with multi-master control in case of drive failure
路BACnet and Modbus as a standard for seamless BMS integration
路Submersible and above ground applications
路Wide range of voltage and enclosure options
路True 208 V coverage
路Dedicated single phase input
路Remote commissioning and monitoring with USB connectivity and software
路In-panel or handheld keypad with backlit display
路Alarm Log for last 5 alarms and maintenance events
路EMC/RFI filters and dual DC-link reactors to reduce drive noise emissions and interference
路I/O expansion cards, factory installed or field configured
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2645-9248 Journal homepage: www.jidhealth.com Open Access Original Article A case report on generalized pemphigus vulgaris treated with rituximaba J agdish J adavbhai Sakhiya1\\*, Dhruv J agdish Sakhiya1, J ashmine Mukeshbhai Gandhi1, Feral Ravi Daruwala2 Abstract Background: Pemphigus vulgaris has an obscure etiology; the presence of autoantibodies is coherent with an autoimmune disease. Rituximab a monoclonal antibody that specifically targets the CD20 antigen of B lymphocytes, has arisen as a novel treatment approach for pemphigus vulgaris. Case presentation: A 39-year-old male patient presented with a three-month history of mouth ulcers, poor oral hygiene accompanied with heavy tobacco smoking and alcohol consumption. He was diagnosed with pemphigus vulgaris. The disease gradually progressed to involve other body parts. The patient had shown partial improvement after conventional therapy (oral cefuroxime, oral prednisolone with azathioprine) and was later on successfully treated with rituximab. After 90 days of follow-up, no future recurrence was observed. Conclusion: With this case, the authors would like to aware other clinicians of the potential use of rituximab in treating pemphigus vulgaris, especially when the conventional therapy fails. Keywords: Autoantibodies; Pemphigus, Rituximab, Oral Hygiene, Ulceration, Tobacco Smoking, Alcohol consumption, India Background The term pemphigus implies a group of autoimmune, mucocutaneous blistering diseases, in which the keratinocyte antigens are the target of the autoantibodies, prompting acantholysis and the formation of blisters. Main variants of pemphigus include pemphigus vulgaris (PV) and pemphigus foliaceus (PF). PV is the most common subtype and represents well over 80% of cases. As being a serious and potentially life-threatening condition, early treatment is of utmost importance [1]. The advent of corticosteroids in the amelioration of pemphigus has dramatically changed the outlook of this perpetually disastrous disease; thus, corticosteroids have become the cornerstone of pemphigus therapy. One case reported favorable outcomes with combined therapy of high-dose corticosteroids and other immunosuppressants. However, such a high dose of corticosteroids can cause serious adverse events such as several metabolic problems, global reduction of immune system efficacy, antecedent risk of serious infections, and mortality [2]. To overcome these long-term events, Pasricha and Gupta introduced dexamethasone cyclophosphamide pulse (DCP) therapy in 1984 [3]. Later on, DCP and oral corticosteroids with or without adjuvant immunosuppressants (azathioprine, cyclophosphamide, mycophenolate mofetil, and cyclosporine) have emerged as the backbone of pemphigus treatment, however, they are associated with the high death rate in pemphigus [4]. With these conventional treatments, some patients fail to improve or some have contraindications for their usage, or some encounter relapse. Hence, advanced research has continuously been going on for finding newer molecules in pemphigus. In 2001, Heizmann et al. [5] first used rituximab for the therapy of autoimmune bullous diseases. He reported a case of paraneoplastic pemphigus favorably managed with rituximab, since then there was a drastic development in the pemphigus treatment era. Rituximab chimeric monoclonal antibody selectively acts on the CD20 expressing B cells, which are known to secrete auto-antibodies targeting the epidermal desmogleins (DSG). It has been used nearly in one million patients for treating lymphoma worldwide. Recently, rituximab has been approved for rheumatoid arthritis that is unresponsive
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1,000 mg given at least 30 min prior to injection) to prevent possible thyroid uptake of free radioactive iodine.
## Information Pertinent to Performance of the Procedure
- Patient history with particular focus on previous surgery and/or radiation therapy as well as current and past neurological or psychiatric status.- History of diabetes, fasting state.- Information regarding recent morphological imaging studies (CT, MRI).- Current medication and when last taken, especially psychotropic pharmaceuticals. These may influence regional metabolic rate of glucose (rCMRGI).- Patient's ability to lie still for 20-40 min for PET to \(\sim 1\) h for SPECT.
## Precautions and Conscious Sedation
- Continuous supervision of the patients during the whole scanning procedure is necessary. This is especially important for patients with tumor associated seizures.- In uncooperative patients, it may be worthwhile to apply conscious sedation (e.g., by a short acting benzodiazepine such as i.v., midazolam). For FDG, administration should take place at least 20 min after tracer injection, preferably starting only a few minutes before data acquisition.- Appropriate monitoring (pulse-oximetry) should be performed to recognize the possibility of cardiopulmonary depression and appropriate antidote/emergency backup should be foreseen. Doses of sedation should be reduced in elderly patients.
## Radiopharmaceutical
## Radiopharmaceutical
- \(^{[18}\mathrm{F}]\mathrm{Fluoro-2-deoxyglucose}\) (FDG).
- \(3 - [^{123}\mathrm{I}]\) Iodo- \(\alpha\) -methyl-L-tyrosine (IMT).
- [Methyl-\(^{11}\mathrm{C}\) ]-L-methionine (MET).
- \(O - (2 - [^{18}\mathrm{F}]\) Fluoroethyl)-L-tyrosine (FET).
## Recommended Dosage
The dose recommendations for FDG, MET, and FET mentioned here are valid for full ring dedicated PET- cameras with BGO- crystals in 3D- mode.
- FDG: in adults, 125-250 MBq (typically 150 MBq) in 3D-mode. In children, 2-4 MBq/kg in 3D-mode with a minimum of 10 MBq in newborn infants.- IMT: 100-400 MBq (typically 185 MBq).- MET: 200-250 MBq.- FET: 200-250 MBq.
The administered dose may increase using 2D- mode and vary for other systems according to differences in sensitivity. For the radiolabeled amino acids, the activity to be administered to children should be a fraction of the adult activity calculated from body weight according to the factors given by the EANM Pediatric Task Group.
## Radiation Dosimetry (Table 2.1)
## Radiation Dosimetry of Brain Transmission Scans
Based on transmission scans of 10 min and CT- based scans of 5- 10 s, the effective doses per scan are: 20- 30 渭Sv for Germanium- based transmission, \(\sim 20\) 渭Sv for low- dose high- speed CT, and between 220 and 450 渭Sv for high- quality CT.
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1? (X)
Entry for the Engineers Ireland Biomedical Research Medal? (X)
Mature Researcher (Beyond PhD Year 1?)
Post- Doctoral Researcher/Senior Researcher/PI
# LOAD INDUCED CHANGES IN COLLAGEN FIBRE ARCHITECTURE IN ARTERIES CHARACTERISED BY SMALL ANGLE LIGHT SCATTERING
Gaul, R.1,2, Lally, C.1,2 1Trinity Centre for Bioengineering, Trinity College Dublin, Dublin, Ireland. 2School of Engineering, Trinity College Dublin, Dublin, Ireland. email: [email protected]
## INTRODUCTION
The structural strength of arteries is governed by reinforcing collagen fibres present in the vessel wall. Although healthy vessels are capable of fibre remodelling, unhealthy fibre remodelling patterns may be associated with disease [1]. A greater understanding of the remodelling of these fibres may provide greater insight into arteries at risk of disease and how arterial repair may be induced.
Small angle light scattering (SALS) is a technique which has previously been used to determine the structure of thin, highly organised tissue structures, such as bovine pericardium and porcine aortic valve tissue [2].
The aim of the present study is to design and develop a fully automated SALS system capable of determining the changes in arterial fibre architecture in response to strain.
## MATERIALS AND METHODS
An in- house SALS system has been developed making use of an unpolarised 5mW HeNe laser \((\lambda = 632.8 \mathrm{nm})\) and two focusing lenses in order to pass light through a tissue sample held in an automated sample positioner. The sample positioner incorporates two stepper motors controlled by LabVIEW to allow movement of the sample in the x and y plane with a resolution of \(5\mu \mathrm{m}\) . The sample is interrogated sequentially in \(250 \mathrm{x} 250 \mu \mathrm{m}\) regions. The resulting scattered light pattern is recorded by a CMOS camera and analysed through a custom Matlab code to determine predominant collagen fibre directions.
To validate the system, testing was conducted on test plates with known printed configurations. Once validated, SALS testing was carried out on flat porcine carotid artery wall sections fixed at different stretch ratios. Carotid artery samples were fixed and processed using a standard histological tissue sectioning protocol. Validation of the results was achieved through histological staining of the sections.
## RESULTS
Figure 1a displays the collagen fibre directions in an unstretched carotid artery section, as predicted by SALS, overlaid on picrosirius red stained histological images. Figure 1b shows the reorganisation of the constituent collagen fibres under circumferential stretch \((\lambda = 1.25)\)
Collagen fibre patterns in the artery were also obtained through the thickness of the artery wall using SALS, for both strained and unstrained configurations.
<center>Figure 1 Fibre orientation as determined by SALS overlaid on histological carotid wall images. a) unstretched \((\lambda = 1)\) and b) stretched circumferentially \((\lambda = 1.25)\) </center>
## DISCUSSION
Results shown in Figure 1 highlight the dependence of fibre orientation on the levels of stretch experienced by the artery wall. A clear realignment of collagen fibres in the direction of loading is visible from Figure 1a and 1b. Although these results are widely known and shown in literature, this is the first time they have been resolved through SALS.
Although SALS is limited to thin samples, time consuming staining protocols are not required for fibre characterisation. The speed, accuracy and ease of use of this system make it a powerful system for providing insights into the response of arterial tissue to load.
Future work aims to fully identify load induced tissue changes in healthy and diseased arterial tissue using SALS.
## REFERENCES
[1] Creane et al., Biomech Model Mechanobiol., 10: 831- 843, 2011 [2] Billiar, K., and Sacks, M., J. Biomech. 30: 753- 7 56, 1997
## ACKNOWLEDGEMENTS
This research was part funded by Science Foundation Ireland (SFI/13/ERC/B2775) and the Irish Research Council (GOIPG/2014/515).
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2011, XLVI, 394 p., HardcoverISBN: 978-90-481-8664-8
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The parametric equations for a projectile with constant gravity g:
\[x = \nu_{0}t\cos \theta +x_{0}\]
\[y = -\frac{1}{2} gt^{2} + \nu_{0}t\sin \theta +y_{0}\]
ex. A shell is fired from ground level with an initial speed of 768 ft/sec. at an angle of 30掳. Find:
1. \(\vec{r} (t)\)
2. the maximum altitude attained
3. the range of the shell
4. the speed on impact
5. the horizontal distance when \(y = 2240\) ft.
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purpose of attenuation correction. The scanning parameters may vary according to the type of CT scanner. Usually the tube voltage is set at \(140 \text{kV}\) , which permits the conversion of the Hounsfield units into attenuation coefficients at 511 keV. The CT scan can be performed after the injection of FDG and has the advantage to significantly reduce the total scan time (usual duration is \(<10 \text{s}\) ). However, the dose of the CT scan to the patient can be reduced by lowering the tube current (see radiation dosimetry above) if anatomical information is not needed. When performing PET-CT of the brain it is recommended to check for movements between the CT and the PET sessions, which might produce artefacts in the attenuation correction.
- Emission scan. As semiquantitative estimates of tumor-to-background uptake ratios are typically used, it is recommended to use a standardized acquisition protocol with a fixed time for start of acquisition to make the data of different patients or repeated scans comparable. If data are acquired in 3-D mode, appropriate scatter correction is mandatory. The duration of emission image acquisition should be related to the minimum required number of counts. For FDG, typically data are acquired over \(15-30 \text{min}\) aiming to collect \(50-200 \text{million counts}\). Even though shorter acquisition times can still be used for diagnostic pattern evaluation (Chen et al. 2005), a minimum of 15 min in 3D mode is advocated. For MET and FET typically data are acquired for 20 min (20-40 min p.i.), often supplemented by dynamic data starting directly with tracer injection.
## IMT Single Photon Emission Tomography
- Multiple detectors (triple or dual head) or other dedicated SPECT cameras for brain imaging should be used for acquisition. Single detector units cannot generally be recommended. They may only be used if scan time is prolonged appropriately, a dose in the upper suggested range is applied, and meticulous care is taken to produce high-quality images.
- LEHR or LEUHR parallel-hole collimators are the mostly available collimator sets for brain imaging. All purpose collimators are not suitable. The use of medium energy collimators could be advantageous; however, usually they are hampered by a low sensitivity. They may only be used if acceptable count rates are obtained. If available, collimator sets specifically adapted to the characteristics of \(^{123}\text{I}\) may be used. Fanbeam collimators may be generally preferred over parallel-hole collimators due to the advantageous trade-off between resolution and count rate capability. The acquisition parameters are summarized in Table 2.2.
TABLE 2.2. Acquisition parameters for IMT-SPECT
- Rotational radius: smallest possible with appropriate patient safeguard
- Matrix: \(128 \times 128\)
- Angular sampling: \(\leq 3^\circ\) (360掳 rotation)
- Zoom: acquisition pixel size should be \(1/3-1/2\) of the expected resolution; therefore it may be necessary to use a hardware zoom to achieve an appropriate pixel size
- Acquisition mode: Step and shoot mode is predominantly used. Continuous mode acquisition may provide shorter total scan time, reduce mechanical wear to the system and improve patient comfort
- Total scan time: depending on the imaging device, typical scan time for a triple head camera is about 30-50 min (e.g., 120 projections; 40 projections per head; 60 s/projection)
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