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The primary method used to assess the left ventricle is steady state free precession (SSFP) technique at 1.5 Tesla. Steady-state free precession (SSFP) technique yields significantly improved blood-myocardium contrast compared to conventional fast gradient echo (FGRE). However, at 3 Tesla, fast gradient echo CMR may also be used. To date however, no studies have presented normal data at 3 Tesla. The derived cardiac volumes and ventricular mass are known to differ for SSFP and FGRE CMR, so that normal ranges are different for each method .
Three- dimensional contrast enhanced MR Angiography (MRA) has gained broad acceptance and is widely used for assessment and follow-up of thoracic aortic diameter in clinical setting. The multi-planar reformation of MRA images leads to an accurate measurement perpendicular to the lumen of the vessel. However, the need of a contrast injection is a limitation for the use of this technique in patients who need multiple follow up examinations and in population based study settings . Alternatively non-contrast techniques such as ECG gated non contrast 3D (2D) balanced steady state free precession (SSFP) CMR can be applied. The modulus image of phase contrast CMR has also been used to measure diameters of the aorta . 2D Black blood CMR is used for a more detailed aortic wall assessment. In 2D acquisitions, the imaging plane needs to be acquired correctly at the time of the scan; thus any alterations in the imaging plane will result in a higher variability and lower accuracy of measurements. Another limitation for ascending thoracic aorta diameter measurement is the through plane motion during the cardiac cycle which can be minimized with ECG gating . Potthast and colleagues compared the diameter of the ascending aorta obtained by different CMR sequences to ECG-triggered CT angiography as the gold standard and reported that ECG gated navigator triggered 3D SSFP sequence showed the best agreement with CT .
The free electronic diploma and transcript download links will be e-mailed to the e-mail address associated with your GED® account once you have passed all GED® test subjects and earned your diploma.
The thermal physiology of most birds and mammals is characterised by considerable spatial and temporal variation in body temperature. Body temperature is, therefore, a key parameter in physiological, behavioural and ecological research. Temperature measurements on freely moving or free-ranging animals in the wild are challenging but can be undertaken using a range of techniques. Internal temperature may be sampled using thermometry, surgically implanted loggers or transmitters, gastrointestinal or non-surgically placed devices. Less invasive approaches measure peripheral temperature with subcutaneous passive integrated transponder tags or skin surface-mounted radio transmitters and data loggers, or use infrared thermography to record surface temperature. Choice of technique is determined by focal research question and region of interest that reflects appropriate physiological or behavioural causal mechanisms of temperature change, as well as welfare and logistical considerations. Particularly required are further studies that provide opportunities of continuously sampling from multiple sites from within the body. This will increase our understanding of thermoregulation and temperature variation in different parts of the body and how these temperatures may change in response to physiological, behavioural and environmental parameters. Technological advances that continue to reduce the size and remote sensing capability of temperature recorders will greatly benefit field research.
Intra-peritoneal (and sometimes also intra-abdominal) implants are commonly used when continuous long-term body temperature profiles are desirable, such as when studying the functional characteristics of thermoregulation. Implantable temperature-sensitive devices have been used for this purpose in a wide range of species (see references in ), and have provided considerable insights into the thermal biology of a large number of free-ranging animals. The devices basically come in two forms; data loggers and radio transmitters. Common to all implants is the need for surgery, which requires anaesthesia. Sedation itself is often unproblematic, but mortality may occur despite proper dosage  so care must be taken to monitor vital signs and provide post-surgical recovery. Although surgical implantation is logistically demanding, it has been successfully used on wild animals by either transporting animals to temporary surgical facility  or directly undertaking surgery in the field . Implantation of devices may actually be preferable to externally attached loggers in long-term studies .
When subjects cannot or need not be captured, there are possibilities to study body temperature patterns using infrared thermography (IRT). IRT involves the detection of infrared radiation, which is emitted from all surfaces with a temperature above 0 K . An obvious strength of IRT as compared to other means of temperature sampling is that it allows for an integrated measure of the thermal properties of different surfaces of the body in freely moving animals and functional variation in heat loss from the surface of different body regions [91, 92]. In endotherms with a relatively thin pelage or plumage, thermal imaging could also be optimised to investigate regional heterothermy. This would allow assessment of the extent to which animals strategically alter blood flow to the body periphery to control heat loss. However, IRT only determines surface temperature and, therefore, changes in internal temperature must be measured using other techniques (e.g. ). Attempts have been made to correlate IRT surface temperature measurements with core body temperature. For example, by removing a small area of plumage from the head of ducklings, scalp temperature was shown to be within 1 °C of cloacal measurements over a range of ambient temperatures . Similarly, facial skin temperature measured via thermal imaging explained more than 80 % of the variation in core body temperature in domestic fowl . Due to the lack of insulation around the eye, the temperature of this region is often closest to core temperature compared to other peripheral regions. The surface temperature of the eye region is not a reliable predictor of core temperature . However, measurement of temperature of the eye region or other bare skin areas may be useful for detecting stress responses [97, 98].
This review was the outcome of WS1 Body temperature measurement in free-ranging animals on 24 September 2014 at The 5th Bio-logging Science Symposium (BLS5), Strasbourg, France. The workshop was supported and funded by IBAHCM, University of Glasgow. We thank speakers A. Gleiss, B. Cresswell, E. Hohtola, K. Herborn, N. Weissenböck, P. Jerem, P. Ponganis, P-Y. Henry and S. Annaheim and all participants for very useful discussion of techniques. R. Dwyer kindly provided insights into acoustic temperature measurement. DM was supported in this work by a grant from the Carnegie Trust for the Universities of Scotland. AN was funded by the Royal Physiographic Society in Lund and the Swedish Research Council (Grant No. 637-2013-7442).
The ability to download medical apps on mobile devices has made a wealth of mobile clinical resources available to HCPs.15 Medical apps for many purposes are available, including ones for electronic prescribing, diagnosis and treatment, practice management, coding and billing, and CME or e-learning.9,10 A broad choice of apps that assist with answering clinical practice and other questions at the point of care exist, such as: drug reference guides, medical calculators, clinical guidelines and other decision support aids, textbooks, and literature search portals.7,13,15 There are even mobile apps that simulate surgical procedures or that can conduct simple medical exams, such as hearing or vision tests.6,7 Many mobile apps are not intended to replace desktop applications, but are meant to complement them in order to provide a resource that has the potential to improve outcomes at the point of care.7 The use of medical apps has become frequent and widespread; 70% of medical school HCPs and students reported using at least one medical app regularly, with 50% using their favorite app daily.1,9
Cloud-based storage and file-sharing services that can be accessed using a mobile device are also useful for information management, since they allow users to store, update, and share documents or photographs with others without exchanging a flash drive or CD.2,5,6 Most cloud-based storage systems provide users with a few gigabytes of memory for free; additional space often requires payment of an annual subscription.2 Cloud-based information storage provides the additional advantage of permitting information to be accessed instantaneously from multiple devices, which allows people who are collaborating together to share materials quickly.2,5,6
An additional advantage provided by information management apps is that they can be used in combination. For example, GoodReader can be connected to a cloud service, allowing PDF files to be downloaded from the cloud into the reader app.5 Evernote, as well as some other information management apps, can be used in conjunction with a cloud service and reader.5 This enables a PDF downloaded from the cloud to be viewed with a reader, then sections of the document can be cut and pasted into the information management app.5 2b1af7f3a8