The tool allowed surgeons to take an allograft reconstruction and fuse it to a patient’s CT or MR medical image for virtual fit assessment. The allograft is either a reconstruction of the donor’s actual heart (from CT or MR images) or an analogue from a health heart library. The analogue allograft geometry is identified from gross donor parameters using a regression model build herein. The need for the regression model is donor images may not exist or they may not become available within the time-window clinicians have to make a provisional acceptance of an offer.
The tool’s assessment suggested > 20% of upper DRBW listings could have been increased at Phoenix Children’s Hospital (PCH). Upper DRBW listings in the UNOS national database was statistically smaller than at PCH (p-values: < 0.001). Delayed sternal closure and surgeon perceived complication variables had an association (p-value: 0.000016) with 9 of the 11 cases that surgeons had perceived fit-related complications had delayed closures (p-value: 0.034809).
A tool to assess allograft size-match has been developed. Findings warrant future preclinical and clinical prospective studies to further assess the tool’s clinical utility.
grass) offers unique opportunities to mitigate climate change through avoided fossil fuel use and associated greenhouse gas reduction. Although conversion of existing agriculturally intensive lands (e.g., maize and soy) to perennial bioenergy cropping systems has been shown to reduce near-surface temperatures, unintended consequences on natural water resources via depletion of soil moisture may offset these benefits. In the effort of the cross-fertilization across the disciplines of physics-based modeling and spatio-temporal statistics, three topics are investigated in this dissertation aiming to provide a novel quantification and robust justifications of the hydroclimate impacts associated with bioenergy crop expansion. Topic 1 quantifies the hydroclimatic impacts associated with perennial bioenergy crop expansion over the contiguous United States using the Weather Research and Forecasting Model (WRF) dynamically coupled to a land surface model (LSM). A suite of continuous (2000–09) medium-range resolution (20-km grid spacing) ensemble-based simulations is conducted. Hovmöller and Taylor diagrams are utilized to evaluate simulated temperature and precipitation. In addition, Mann-Kendall modified trend tests and Sieve-bootstrap trend tests are performed to evaluate the statistical significance of trends in soil moisture differences. Finally, this research reveals potential hot spots of suitable deployment and regions to avoid. Topic 2 presents spatio-temporal Bayesian models which quantify the robustness of control simulation bias, as well as biofuel impacts, using three spatio-temporal correlation structures. A hierarchical model with spatially varying intercepts and slopes display satisfactory performance in capturing spatio-temporal associations. Simulated temperature impacts due to perennial bioenergy crop expansion are robust to physics parameterization schemes. Topic 3 further focuses on the accuracy and efficiency of spatial-temporal statistical modeling for large datasets. An ensemble of spatio-temporal eigenvector filtering algorithms (hereafter: STEF) is proposed to account for the spatio-temporal autocorrelation structure of the data while taking into account spatial confounding. Monte Carlo experiments are conducted. This method is then used to quantify the robustness of simulated hydroclimatic impacts associated with bioenergy crops to alternative physics parameterizations. Results are evaluated against those obtained from three alternative Bayesian spatio-temporal specifications.
2D fetal echocardiography (ECHO) can be used for monitoring heart development in utero. This study’s purpose is to empirically model normal fetal heart growth and function changes during development by ECHO and compare these to fetuses diagnosed with and without cardiomyopathy with diabetic mothers. There are existing mathematical models describing fetal heart development but they warrant revalidation and adjustment. 377 normal fetuses with healthy mothers, 98 normal fetuses with diabetic mothers, and 37 fetuses with cardiomyopathy and diabetic mothers had their cardiac structural dimensions, cardiothoracic ratio, valve flow velocities, and heart rates measured by fetal ECHO in a retrospective chart review. Cardiac features were fitted to linear functions, with respect to gestational age, femur length, head circumference, and biparietal diameter and z-scores were created to model normal fetal growth for all parameters. These z-scores were used to assess what metrics had no difference in means between the normal fetuses of both healthy and diabetic mothers but differed from those diagnosed with cardiomyopathy. It was found that functional metrics like mitral and tricuspid E wave and pulmonary velocity could be important predictors for cardiomyopathy when fitted by gestational age, femur length, head circumference, and biparietal diameter. Additionally, aortic and tricuspid annulus diameters when fitted to estimated gestational age showed potential to be predictors for fetal cardiomyopathy. While the metrics overlapped over their full range, combining them together may have the potential for predicting cardiomyopathy in utero. Future directions of this study will explore creating a classifier model that can predict cardiomyopathy using the metrics assessed in this study.
The impacts of land-cover composition on urban temperatures, including temperature extremes, are well documented. Much less attention has been devoted to the consequences of land-cover configuration, most of which addresses land surface temperatures. This study explores the role of both composition and configuration—or land system architecture—of residential neighborhoods in the Phoenix metropolitan area, on near-surface air temperature. It addresses two-dimensional, spatial attributes of buildings, impervious surfaces, bare soil/rock, vegetation and the “urbanscape” at large, from 50 m to 550 m at 100 m increments, for a representative 30-day high sun period. Linear mixed-effects models evaluate the significance of land system architecture metrics at different spatial aggregation levels. The results indicate that, controlling for land-cover composition and geographical variables, land-cover configuration, specifically the fractal dimension of buildings, is significantly associated with near-surface temperatures. In addition, statistically significant predictors related to composition and configuration appear to depend on the adopted level of spatial aggregation.
The relationship between the characteristics of the urban land system and land surface temperature (LST) has received increasing attention in urban heat island and sustainability research, especially for desert cities. This research generally employs medium or coarser spatial resolution data and primarily focuses on the effects of a few classes of land-cover composition and pattern at the neighborhood or larger level using regression models. This study explores the effects of land system architecture—composition and configuration, both pattern and shape, of fine-grain land-cover classes—on LST of single family residential parcels in the Phoenix, Arizona (southwestern USA) metropolitan area. A 1 m resolution land-cover map is used to calculate land architecture metrics at the parcel level, and 6.8 m resolution MODIS/ASTER data are employed to retrieve LST. Linear mixed-effects models quantify the impacts of land configuration on LST at the parcel scale, controlling for the effects of land composition and neighborhood characteristics. Results indicate that parcel-level land-cover composition has the strongest association with daytime and nighttime LST, but the configuration of this cover, foremost compactness and concentration, also affects LST, with different associations between land architecture and LST at nighttime and daytime. Given information on land system architecture at the parcel level, additional information based on geographic and socioeconomic variables does not improve the generalization capability of the statistical models. The results point the way towards parcel-level land-cover design that helps to mitigate the urban heat island effect for warm desert cities, although tradeoffs with other sustainability indicators must be considered.
Five immunocompetent C57BL/6-cBrd/cBrd/Cr (albino C57BL/6) mice were injected with GL261-luc2 cells, a cell line sharing characteristics of human glioblastoma multiforme (GBM). The mice were imaged using magnetic resonance (MR) at five separate time points to characterize growth and development of the tumor. After 25 days, the final tumor volumes of the mice varied from 12 mm3 to 62 mm3, even though mice were inoculated from the same tumor cell line under carefully controlled conditions. We generated hypotheses to explore large variances in final tumor size and tested them with our simple reaction-diffusion model in both a 3-dimensional (3D) finite difference method and a 2-dimensional (2D) level set method. The parameters obtained from a best-fit procedure, designed to yield simulated tumors as close as possible to the observed ones, vary by an order of magnitude between the three mice analyzed in detail. These differences may reflect morphological and biological variability in tumor growth, as well as errors in the mathematical model, perhaps from an oversimplification of the tumor dynamics or nonidentifiability of parameters. Our results generate parameters that match other experimental in vitro and in vivo measurements. Additionally, we calculate wave speed, which matches with other rat and human measurements.
Atypical brainstem modulation of pain might contribute to changes in sensory processing typical of migraine. The study objective was to investigate whether migraine is associated with brainstem structural alterations that correlate with this altered pain processing. MRI T1-weighted images of 55 migraine patients and 58 healthy controls were used to: (1) create deformable mesh models of the brainstem that allow for shape analyses; (2) calculate volumes of the midbrain, pons, medulla and the superior cerebellar peduncles; (3) interrogate correlations between regional brainstem volumes, cutaneous heat pain thresholds, and allodynia symptoms. Migraineurs had smaller midbrain volumes (healthy controls = 61.28 mm3, SD = 5.89; migraineurs = 58.80 mm3, SD = 6.64; p = 0.038), and significant (p < 0.05) inward deformations in the ventral midbrain and pons, and outward deformations in the lateral medulla and dorsolateral pons relative to healthy controls. Migraineurs had a negative correlation between ASC-12 allodynia symptom severity with midbrain volume (r = − 0.32; p = 0.019) and a positive correlation between cutaneous heat pain thresholds with medulla (r = 0.337; p = 0.012) and cerebellar peduncle volumes (r = 0.435; p = 0.001). Migraineurs with greater symptoms of allodynia have smaller midbrain volumes and migraineurs with lower heat pain thresholds have smaller medulla and cerebellar peduncles. The brainstem likely plays a role in altered sensory processing in migraine and brainstem structure might reflect severity of allodynia and hypersensitivity to pain in migraine.