Publications by authors named "Matthew D Wilson"

17 Publications

  • Page 1 of 1

Outcomes of Ankle Arthrodesis Conversion to Total Ankle Arthroplasty: A Systematic Review.

J Foot Ankle Surg 2021 Mar-Apr;60(2):362-367. Epub 2020 Aug 14.

Fellowship-Trained Foot and Ankle Surgeon, Bryan Health, Lincoln, NE; Member, Ohio Innovation Group, Columbus, OH.

Ankle arthrodesis (AA) provides reliable pain relief, good patient satisfaction scores, and improved overall function. However, this procedure has been associated with numerous complications and sequelae, such as pseudoarthrosis, malunion, gait abnormalities, increased demand on surrounding joints, and a long period of convalescence. Conversion to total ankle arthroplasty (TAA) is a potential option in the management of these complex and challenging situations. The purpose of this study is to investigate the outcomes of AA conversion to TAA. A systematic review of electronic databases was performed. Six studies involving 172 ankles met inclusion criteria. The weighted mean preoperative Visual Analogue Scale (VAS) score at the time of TAA conversion was 7.8 and the weighted mean postoperative VAS score at the time of final follow-up was 2.5. The weighted mean preoperative AOFAS score at the time of TAA conversion was 32 and the weighted mean postoperative AOFAS score at the time of final follow-up was 72.4. The rate of salvage tibiotalocalcaneal arthrodesis was 2.3% and rate of transtibial amputation was also 2.3% after attempted conversion from initial AA to TAA. Conversion of AA to TAA appears to be a viable option to improve patient outcomes and prevent extensive hindfoot arthrodesis and transtibial amputation. More prospective studies with consistent reporting of outcomes, complications, and revision rates with long-term follow-up are needed.
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http://dx.doi.org/10.1053/j.jfas.2020.06.025DOI Listing
August 2020

An spatially resolved study of alkaline battery discharge using a novel hyperspectral detector and X-ray tomography.

J Appl Crystallogr 2020 Dec 13;53(Pt 6):1434-1443. Epub 2020 Oct 13.

Rutherford Appleton Laboratory, Science and Technology Facilities Council, Harwell Campus, Didcot, Oxfordshire OX11 0QX, United Kingdom.

An experimental technique is described for the collection of time-resolved X-ray diffraction information from a complete commercial battery cell during discharging or charging cycles. The technique uses an 80 × 80 pixel 2D energy-discriminating detector in a pinhole camera geometry which can be used with a polychromatic X-ray source. The concept was proved in a synchrotron X-ray study of commercial alkaline Zn-MnO AA size cells. Importantly, no modification of the cell was required. The technique enabled spatial and temporal changes to be observed with a time resolution of 20 min (5 min of data collection with a 15 min wait between scans). Chemical changes in the cell determined from diffraction information were correlated with complementary X-ray tomography scans performed on similar cells from the same batch. The clearest results were for the spatial and temporal changes in the Zn anode. Spatially, there was a sequential transformation of Zn to ZnO in the direction from the separator towards the current collector. Temporally, it was possible to track the transformation of Zn to ZnO during the discharge and follow the corresponding changes in the cathode.
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http://dx.doi.org/10.1107/S1600576720012078DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7710487PMC
December 2020

Preliminary Assessment of a Telehealth Approach to Evaluating, Treating, and Discharging Low-Acuity Patients With Suspected COVID-19.

J Emerg Med 2020 12 7;59(6):957-963. Epub 2020 Aug 7.

MedStar Telehealth Innovation Center, MedStar Washington Hospital Center, Washington, DC.

Background: Telemedicine is uniquely positioned to address challenges posed to emergency departments (EDs) by the Coronavirus Disease 2019 (COVID-19) pandemic. By reducing in-person contact, it should decrease provider risk of infection and preserve personal protective equipment (PPE).

Objectives: To describe and assess the early results of a novel telehealth workflow in which remote providers collaborate with in-person nursing to evaluate and discharge well-appearing, low-risk ED patients with suspected COVID-19 infection.

Methods: Retrospective chart review was completed 3 weeks after implementation. Metrics include the number of patients evaluated, number of patients discharged without in-person contact, telehealth wait time and duration, collection of testing, ED length of stay (ED-LOS), 72-h return, number of in-person health care provider contacts, and associated PPE use.

Results: Among 302 patients evaluated by telehealth, 153 patients were evaluated and discharged by a telehealth provider with reductions in ED-LOS, PPE use, and close contact with health care personnel. These patients had a 62.5% shorter ED-LOS compared with other Emergency Severity Index level 4 patients seen over the same time period. Telehealth use for these 153 patients saved 413 sets of PPE. We observed a 3.9% 72-h revisit rate. One patient discharged after telehealth evaluation was hospitalized on a return visit 9 days later.

Conclusion: Telehealth can be safely and efficiently used to evaluate, treat, test, and discharge ED patients suspected to have COVID-19. This workflow reduces infection risks to health care providers, PPE use, and ED-LOS. Additionally, it allows quarantined but otherwise well clinicians to continue working.
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http://dx.doi.org/10.1016/j.jemermed.2020.08.007DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7413125PMC
December 2020

Development of a multi-detector readout circuitry for ultrahigh energy resolution single-photon imaging applications.

Nucl Instrum Methods Phys Res A 2020 Nov 14;981. Epub 2020 Aug 14.

Bioengineering, University of Illinois at Urbana-Champaign, United States of America.

In this paper, we present the design and preliminary performance evaluation of a novel external multi-channel readout circuitry for small-pixel room-temperature semiconductor detectors, namely CdZnTe (CZT) and CdTe, that provide an excellent intrinsic spatial (250 and 500 μm pixel size) and an ultrahigh energy resolution (~1% at 122 keV) for X-ray and gamma-ray imaging applications. An analog front-end printed circuit board (PCB) was designed and developed for data digitization, data transfer and ASIC control of pixelated CZT or CdTe detectors. Each detector unit is 2 cm × 2 cm in size and 1 or 2 mm in thickness, being bump-bonded onto a HEXITEC ASIC, and wire-bonded to a readout detector module PCB. The detectors' front-end is then connected, through flexible cables of up to 10 m in length, to a remote data acquisition system that interfaces with a PC through USB3.0 connection. We present the design and performance of a prototype multi-channel readout system that can read out up to 24 detector modules synchronously. Our experimental results demonstrated that the readout circuitry offers an ultrahigh spectral resolution (0.8 keV at 60 keV and 1.05 keV at 122 keV) with the Cd(Zn)Te/HEXITEC ASIC modules tested. This architecture was designed to allow easy expansion to accommodate a larger number of detector modules, and the flexibility of arranging the detector modules in a large and deformable detector array without degrading the excellent energy resolution.
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http://dx.doi.org/10.1016/j.nima.2020.164531DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7505227PMC
November 2020

Central Adjudication Identified Additional and Prognostically Important Myocardial Infarctions in Patients Undergoing Percutaneous Coronary Intervention.

Circ Cardiovasc Interv 2019 07 12;12(7):e007342. Epub 2019 Jul 12.

Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, CA (C.B.O., K.W.M.).

Background: In the CHAMPION PHOENIX trial, cangrelor reduced the primary composite end point of death, myocardial infarction (MI), ischemia-driven revascularization, or stent thrombosis at 48 hours. This study aimed to explore the impact of event adjudication and the prognostic importance of MI reported by a clinical events committee (CEC) or site investigators (SIs).

Methods And Results: Data from the CHAMPION PHOENIX trial of patients undergoing elective or nonelective percutaneous coronary intervention were analyzed. A CEC systematically identified and adjudicated MI using predefined criteria, a computer algorithm to identify suspected events, and semilogarithmic plots to review biomarker changes. Thirty-day death was modeled using baseline characteristics. Of 10 942 patients, 462 (4.2%) patients had at least 1 MI by 48 hours identified by the CEC (207 [3.8%] cangrelor; 255 [4.7%] clopidogrel; odds ratio [OR] 0.80; 95% CI, 0.67-0.97; P=0.022), and 143 patients had at least 1 MI by 48 hours reported by the SI (60 [1.1%] cangrelor; 83 [1.5%] clopidogrel; OR, 0.72; 95% CI, 0.52-1.01; P=0.053). Of the 462 MIs identified by the CEC, 92 (20%) were reported by SI, and 370 (80%) were not. Of the 143 MI reported by the SI, 51 (36%) were not confirmed by CEC. All categories were associated with an increased adjusted risk for 30-day death (CEC: OR, 5.35; 95% CI, 2.56-11.2; P<0.001; SI: 9.08 [4.01-20.5]; P<0.001; CEC and SI: 10.9 [3.23-36.6]; P<0.001; CEC but not SI: 4.69 [1.94-11.3]; P<0.001; SI but not CEC: 15.4 [5.26-44.9]; P<0.001).

Conclusions: In patients undergoing percutaneous coronary intervention, CEC procedures identified 3 times as many MIs as the SI reported. Compared with clopidogrel, cangrelor significantly reduced MIs identified by the CEC with a qualitatively similar relative risk reduction in MIs reported by the SI. MIs identified by CEC or reported by SI were independently associated with worse 30-day death. Central adjudication identified additional, prognostically important events.

Clinical Trial Registration: URL: https://www.clinicaltrials.gov . Unique identifier: NCT01156571.
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http://dx.doi.org/10.1161/CIRCINTERVENTIONS.118.007342DOI Listing
July 2019

The Incidence of Nonunion of the Naviculocuneiform Joint Arthrodesis:A Systematic Review.

J Foot Ankle Surg 2019 May 13;58(3):545-549. Epub 2019 Mar 13.

Faculty, Grant Medical Center, Columbus, OH; Fellowship-Trained Foot and Ankle Surgeon, Orthopedic Foot and Ankle Center, Westerville, OH; Residency Program Director, Grant Medical Center, Columbus, OH.

Naviculocuneiform (NC) joint arthrodesis is an effective procedure to treat pain and provide stability to the medial column. Various forms of fixation have been described for NC arthrodesis. Despite this, the available literature is scant and questions remain regarding nonunion rate and contributory factors. A systematic review of the literature was undertaken to determine the rate of nonunion for NC joint arthrodesis. Seven studies involving 139 NC joint arthrodeses met inclusion criteria. The nonunion rate was 6.5% at a weighted mean follow-up of 73.2 months. There is insufficient evidence to provide a practice guideline based on the current literature. Adequately powered prospective clinical trials comparing well-matched patient groups with long-term follow-up are required to limit systematic error and enhance external validity. Specific outcomes measures should include union, functional assessment, complications, and cost-benefit analysis.
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http://dx.doi.org/10.1053/j.jfas.2018.09.014DOI Listing
May 2019

Bedside End-tidal Carbon Dioxide in Evaluation for Pulmonary Embolism.

Acad Emerg Med 2019 02 17;26(2):263-266. Epub 2018 Sep 17.

Emergency Department, Medstar Washington Hospital Center, Georgetown University School of Medicine, Washington, DC.

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http://dx.doi.org/10.1111/acem.13546DOI Listing
February 2019

Incidence of Nonunion of the Hallux Interphalangeal Joint Arthrodesis: A Systematic Review.

J Foot Ankle Surg 2018 Jul - Aug;57(4):776-780. Epub 2018 May 11.

Attending Physician, Orthopedic Foot and Ankle Center, Westerville, OH. Electronic address:

Hallux interphalangeal joint arthrodesis is an effective procedure to treat pain and provide stability and is often performed for intrinsic pain to the hallux interphalangeal joint. Additionally, this procedure is typically used in concert with the Jones tenosuspension. Although this as an accepted technique, the available data are scant, and questions remain regarding nonunion rates and contributory factors to poor healing. A systematic review of the reported data were undertaken to determine the rate of nonunion for hallux interphalangeal joint arthrodesis. Seven studies involving 313 hallux interphalangeal joint arthrodeses met the inclusion criteria. The nonunion rate was 28.3% at a weighted mean follow-up period of 8.4 months. The overall complication rate was 33.0%. Considering the increased rate of complications and nonunion rate for this commonly used procedure, additional prospective comparative analyses are needed regarding this topic to identify important patient demographic data and determine superior fixation constructs.
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http://dx.doi.org/10.1053/j.jfas.2018.01.002DOI Listing
December 2018

Antithrombotic Reversal Agents.

Hematol Oncol Clin North Am 2017 12;31(6):1147-1157

Department of Emergency Medicine, Georgetown University Hospital, Washington Hospital Center, 110 Irving Street, NA 1177, Washington, DC 20010, USA. Electronic address:

The actively bleeding anticoagulated patient presenting to the emergency department requires rapid evaluation and treatment, which is made increasingly complicated by the ever-evolving antithrombotic treatment options used in medicine. Even with excellent supportive care, the timeliness with which reversal decisions need to be made continues to demand of the emergency practitioner a familiarity with the properties and general characteristics of a variety of antithrombotic agents. Reversal options vary and may include vitamin K, FFP, PCC, rFVIIa, platelets, and desmopressin, among others.
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http://dx.doi.org/10.1016/j.hoc.2017.08.013DOI Listing
December 2017

Cardiovascular adverse events in the drug-development program of bupropion for smoking cessation: A systematic retrospective adjudication effort.

Clin Cardiol 2017 Oct 12;40(10):899-906. Epub 2017 Jun 12.

Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, California.

Background: In 2011, the US Food and Drug Administration requested that GlaxoSmithKline perform retrospective adjudication of cardiovascular (CV) events reported in the bupropion drug-development trials for smoking cessation.

Hypothesis: Retrospective adjudication of clinical trial data will not increase the identification of adverse events.

Methods: We performed a comprehensive retrospective analysis of adverse events in 19 previously completed controlled US clinical trials of bupropion marketed for the treatment of smoking cessation, yielding 9479 subjects (5290 bupropion, 2927 placebo, 1018 active control [ACT], and 244 treated concurrently with bupropion and ACT). All adverse events were sent to the Duke Clinical Research Institute for adjudication by Clinical Events Classification (CEC) physician reviewers. The primary endpoint was a composite of major adverse CV events: CV death, nonfatal myocardial infarction (MI), and nonfatal stroke.

Results: Overall, 416 nonfatal CV events in 366 subjects, and 22 deaths, were identified and processed for adjudication. Of these, 7 nonfatal MIs (4 bupropion, 3 placebo, 0 ACT), 5 nonfatal strokes (1 bupropion, 3 placebo, 1 ACT), and 9 CV deaths (4 bupropion, 4 placebo, 1 ACT) were confirmed by the CEC Committee. The primary endpoint occurred in 3/4297 (0.07%) subjects in the bupropion group and in 4/2927 (0.14%) subjects in the placebo group (log-rank P value: 0.613).

Conclusions: CV events in bupropion clinical trials for smoking cessation were uncommon, with no observed increase among subjects assigned to bupropion vs placebo. However, this effort was limited by a paucity of quality data.
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http://dx.doi.org/10.1002/clc.22744DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6490529PMC
October 2017

High Energy Resolution Hyperspectral X-Ray Imaging for Low-Dose Contrast-Enhanced Digital Mammography.

IEEE Trans Med Imaging 2017 09 18;36(9):1784-1795. Epub 2017 May 18.

Contrast-enhanced digital mammography (CEDM) is an alternative to conventional X-ray mammography for imaging dense breasts. However, conventional approaches to CEDM require a double exposure of the patient, implying higher dose, and risk of incorrect image registration due to motion artifacts. A novel approach is presented, based on hyperspectral imaging, where a detector combining positional and high-resolution spectral information (in this case based on Cadmium Telluride) is used. This allows simultaneous acquisition of the two images required for CEDM. The approach was tested on a custom breast-equivalent phantom containing iodinated contrast agent (Niopam 150®). Two algorithms were used to obtain images of the contrast agent distribution: K-edge subtraction (KES), providing images of the distribution of the contrast agent with the background structures removed, and a dual-energy (DE) algorithm, providing an iodine-equivalent image and a water-equivalent image. The high energy resolution of the detector allowed the selection of two close-by energies, maximising the signal in KES images, and enhancing the visibility of details with the low surface concentration of contrast agent. DE performed consistently better than KES in terms of contrast-to-noise ratio of the details; moreover, it allowed a correct reconstruction of the surface concentration of the contrast agent in the iodine image. Comparison with CEDM with a conventional detector proved the superior performance of hyperspectral CEDM in terms of the image quality/dose tradeoff.
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http://dx.doi.org/10.1109/TMI.2017.2706065DOI Listing
September 2017

Acute Kidney Injury as a Risk Factor for Delirium and Coma during Critical Illness.

Am J Respir Crit Care Med 2017 06;195(12):1597-1607

12 Clinical Research, Investigation, and Systems Modeling of Acute Illness Center, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Rationale: Acute kidney injury may contribute to distant organ dysfunction. Few studies have examined kidney injury as a risk factor for delirium and coma.

Objectives: To examine whether acute kidney injury is associated with delirium and coma in critically ill adults.

Methods: In a prospective cohort study of intensive care unit patients with respiratory failure and/or shock, we examined the association between acute kidney injury and daily mental status using multinomial transition models adjusting for demographics, nonrenal organ failure, sepsis, prior mental status, and sedative exposure. Acute kidney injury was characterized daily using the difference between baseline and peak serum creatinine and staged according to Kidney Disease Improving Global Outcomes criteria. Mental status (normal vs. delirium vs. coma) was assessed daily with the Confusion Assessment Method for the ICU and Richmond Agitation-Sedation Scale.

Measurements And Main Results: Among 466 patients, stage 2 acute kidney injury was a risk factor for delirium (odds ratio [OR], 1.55; 95% confidence interval [CI], 1.07-2.26) and coma (OR, 2.04; 95% CI, 1.25-3.34) as was stage 3 injury (OR for delirium, 2.56; 95% CI, 1.57-4.16) (OR for coma, 3.34; 95% CI, 1.85-6.03). Daily peak serum creatinine (adjusted for baseline) values were also associated with delirium (OR, 1.35; 95% CI, 1.18-1.55) and coma (OR, 1.44; 95% CI, 1.20-1.74). Renal replacement therapy modified the association between stage 3 acute kidney injury and daily peak serum creatinine and both delirium and coma.

Conclusions: Acute kidney injury is a risk factor for delirium and coma during critical illness.
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http://dx.doi.org/10.1164/rccm.201603-0476OCDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5476907PMC
June 2017

Antithrombotic reversal agents.

Emerg Med Clin North Am 2014 Aug 7;32(3):715-25. Epub 2014 Jun 7.

Department of Emergency Medicine, Georgetown University Hospital, Washington Hospital Center, 110 Irving Street, NA 1177, Washington, DC 20010, USA. Electronic address:

The actively bleeding anticoagulated patient presenting to the emergency department requires rapid evaluation and treatment, which is made increasingly complicated by the ever-evolving antithrombotic treatment options used in medicine. Even with excellent supportive care, the timeliness with which reversal decisions need to be made continues to demand of the emergency practitioner a familiarity with the properties and general characteristics of a variety of antithrombotic agents. Reversal options vary and may include vitamin K, FFP, PCC, rFVIIa, platelets, and desmopressin, among others.
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http://dx.doi.org/10.1016/j.emc.2014.04.013DOI Listing
August 2014

Dark-field hyperspectral X-ray imaging.

Proc Math Phys Eng Sci 2014 May;470(2165):20130629

School of Materials , University of Manchester , Manchester M13 9PL, UK.

In recent times, there has been a drive to develop non-destructive X-ray imaging techniques that provide chemical or physical insight. To date, these methods have generally been limited; either requiring raster scanning of pencil beams, using narrow bandwidth radiation and/or limited to small samples. We have developed a novel full-field radiographic imaging technique that enables the entire physio-chemical state of an object to be imaged in a single snapshot. The method is sensitive to emitted and scattered radiation, using a spectral imaging detector and polychromatic hard X-radiation, making it particularly useful for studying large dense samples for materials science and engineering applications. The method and its extension to three-dimensional imaging is validated with a series of test objects and demonstrated to directly image the crystallographic preferred orientation and formed precipitates across an aluminium alloy friction stir weld section.
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http://dx.doi.org/10.1098/rspa.2013.0629DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3973392PMC
May 2014

Communicating in the pre-hospital emergency environment.

Aust Health Rev 2013 May;37(2):140-6

Queensland Ambulance Service, Lutwyche, Australia.

Aim: To develop and evaluate the implementation of a communication board for paramedics to use with patients as an augmentative or alternative communication tool to address communication needs of patients in the pre-hospital setting.

Method: A double-sided A4-size communication board was designed specifically for use in the pre-hospital setting by the Queensland Ambulance Service and Disability and Community Care Services. One side of the board contains expressive messages that could be used by both the patient and paramedic. The other side contains messages to support patients' understanding and interaction tips for the paramedic. The communication board was made available in every ambulance and patient transport vehicle in the Brisbane Region.

Results: A total of 878 paramedics completed a survey that gauged which patient groups they might use the communication board with. The two most common groups were patients from culturally and linguistically diverse backgrounds and children. Staff reported feeling confident in using the board, and 72% of interviewed paramedics agreed that the communication board was useful for aiding communication with patients. Feedback from paramedics suggests that the board is simple to use, reduces patient frustration and improves communication.

Conclusion: These results suggest that a communication board can be applied in the pre-hospital setting to support communication success with patients. WHAT IS KNOWN ABOUT THE TOPIC? It is imperative that communication between patient and paramedic is clear and effective. Research has shown that communication boards have been effective with people with temporary or permanent communication difficulties. WHAT DOES THIS PAPER ADD? This is the first paper outlining the development and use of a communication board by paramedics in the pre-hospital setting in Australia. The paper details the design of the communication board for the unique pre-hospital environment. The paper provides some preliminary data on the use of the communication board with certain patient groups and its effectiveness as an alternative communication tool. WHAT ARE THE IMPLICATIONS FOR PRACTITIONERS? The findings support the use of the tool as a viable option in supporting the communication between paramedics and a range of patients. It is not suggested that this communication board will meet the complete communication needs of any individual in this environment, but it is hoped that the board's presence within the Queensland Ambulance Service may result in paramedics introducing the board on occasions where communication with a patient is challenging.
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http://dx.doi.org/10.1071/AH12155DOI Listing
May 2013

A laboratory system for element specific hyperspectral X-ray imaging.

Analyst 2013 Feb;138(3):755-9

School of Materials, The University of Manchester, Manchester, M13 9PL, UK.

X-ray tomography is a ubiquitous tool used, for example, in medical diagnosis, explosives detection or to check structural integrity of complex engineered components. Conventional tomographic images are formed by measuring many transmitted X-rays and later mathematically reconstructing the object, however the structural and chemical information carried by scattered X-rays of different wavelengths is not utilised in any way. We show how a very simple; laboratory-based; high energy X-ray system can capture these scattered X-rays to deliver 3D images with structural or chemical information in each voxel. This type of imaging can be used to separate and identify chemical species in bulk objects with no special sample preparation. We demonstrate the capability of hyperspectral imaging by examining an electronic device where we can clearly distinguish the atomic composition of the circuit board components in both fluorescence and transmission geometries. We are not only able to obtain attenuation contrast but also to image chemical variations in the object, potentially opening up a very wide range of applications from security to medical diagnostics.
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http://dx.doi.org/10.1039/c2an36157dDOI Listing
February 2013

Monitoring trends in dextromethorphan abuse using the National Poison Data System: 2000-2010.

Clin Toxicol (Phila) 2011 Jun;49(5):409-15

University of Virginia School of Medicine, Charlottesville, VA, USA.

Context: Dextromethorphan (DXM) abuse persists among US youth and should be closely monitored because of the risks of severe medical complications, addiction, and psychiatric sequelae. Prior investigations have demonstrated DXM to be an emerging drug of abuse with increasing national prevalence through 2004.

Objective: To extend existing substance abuse survey results by describing demographic, geographic, product, and outcome trends in medically significant DXM abuse cases (those reported to US poison centers).

Methods: National Poison Data System (NPDS) data are collected and compiled in real time by all 57 US poison centers. Demographic, geographic, product, and outcome data for all intentional DXM abuse cases reported to the NPDS between 2000 and 2010 were analyzed.

Results: A total of 44,206 DXM abuse cases met inclusion criteria, 34,755 of which were single-substance exposures. The mean annual prevalence of DXM cases reported to poison control centers was 13.4 cases per million population for all ages and 113.0 cases per million for 15-19 year olds. The prevalence of DXM cases for all ages increased steadily (p = 0.002, Cochran-Armitage trend test) until 2006 to a peak of 17.6 calls/million and has subsequently plateaued at 15.7 cases per million in 2010. This trend is also seen in the most commonly abused brand of DXM products, Coricidin(®). A preponderance of male adolescents was noted throughout the study period. The odds of a severe outcome are increased for a multi-substance exposure (OR: 2.53; 95% CI: 2.14-2.99, logistic regression); odds were not significantly increased for any of the most commonly abused product brands.

Conclusion: The increasing trend of DXM abuse cases noted in the first half of the decade by previous studies seems to have peaked at 17.6 calls per million population in 2006. It is likely that a combination of legislative, educational, and economic initiatives are responsible for the observed plateau.
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http://dx.doi.org/10.3109/15563650.2011.585429DOI Listing
June 2011