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The free version of Concepts is a sketchbook on steroids. Use an infinite canvas, gorgeous brushes, 5 layers, and a whole lot of creative freedom. No account or signup required - just download the app and start sketching.
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Diffusion tensor imaging (DTI) is a magnetic resonance imaging (MRI) technique used for evaluating changes in the white matter in brain parenchyma. The reliability of quantitative DTI analysis is influenced by several factors, such as the imaging protocol, pre-processing and post-processing methods, and selected diffusion parameters. The region-of-interest (ROI) method is most widely used of the post-processing methods because it is found in commercial software. The focus of our research was to study the reliability of the freehand ROI method using various intra- and inter-observer analyses.
This study included 40 neurologically healthy participants who underwent diffusion MRI of the brain with a 3 T scanner. The measurements were performed at nine different anatomical locations using a freehand ROI method. The data extracted from the ROIs included the regional mean values, intra- and inter-observer variability and reliability. The used DTI parameters were fractional anisotropy (FA), the apparent diffusion coefficient (ADC), and axial (AD) and radial (RD) diffusivity.
The quantitative freehand ROI method can be considered highly reliable for the average ICC and mostly adequate for the single ICC. The freehand method is suitable for research work with a well-experienced observer. Measurements should be performed at least twice in the same region to ensure that the results are sufficiently reliable. In our study, reliability was slightly undermined by artifacts in some regions such as the cerebral peduncle and centrum semiovale. From a clinical point of view, the results are most reliable in adults under the age of 30, when age-related changes in brain white matter have not yet occurred.
The main objective of this study was to investigate the reliability of the freehand ROI method, by intra- and inter-observer variation and repeatability measurements. The aim was also to examine the effects of different parameters (FA, ADC, AD and RD) and artifacts on the reliability of the results. In addition, the effects of age on white matter changes were studied in group comparisons.
Two experienced observers, a medical physicist (UH) and a neuroradiologist (AB), performed the freehand measurements on a workstation using commercially available software Neuro3D (Siemens Healthcare, Malvern, USA). The freehand ROIs were manually placed on the axial images of the color-coded FA maps and automatically transferred to the ADC, AD, and RD maps as well as the non-diffusion weighted b0 images. The ROIs were centered in the region using color-coded directions. The measurements were aimed to avoid border areas, such as areas overlapping with cerebrospinal fluid spaces, partial volume effects, and neighboring tracts. The thalamus was drawn to the grayscale FA map, because the border areas were more clearly distinguishable in this manner than in the color map.
Slices containing artefacts were avoided. If this was not possible, the artefact areas were excluded by omitting them from the ROI regions (Figs. 1 and 2). The sizes of the ROIs were chosen using the anatomical knowledge of brain regions and a tract-based atlas of human white matter anatomy [43]. The ROI size ranged from 10 mm2 (min, cerebral peduncle) to 430 mm2 (max, centrum semiovale). The time between the first and repeated freehand ROI measurements was at least four weeks.
Axial FA color maps with the measured freehand ROIs (regions-of-interest) (ROIs marked in white): A cerebral peduncle, B posterior limb of the internal capsule, C corona radiata, D centrum semiovale, E uncinate fasciculus, F forceps minor, G thalamus, and H genu and splenium of the corpus callosum
The intra-observer reliability was high according to the average measures of the ICC analysis. In our study, average ICC refers to the repeatability obtained as the average of two measurements from a single region. Overall, the average ICC results were excellent for all four parameters. The repeatability result was also excellent (above 0.8) in eight out of nine regions for FA and all regions for the ADC. The repeatability of the freehand method was significantly improved compared to our previous study [40]. The average ICC increase was 0.4 (37%) in terms of the FA and ADC parameters.
According to our results, the intra-observer repeatability of the quantitative freehand ROI method can be considered at least adequate. The quantitative freehand ROI method can be considered highly reliable for the average ICC and mostly adequate for the single ICC. The reliability of the single measurements was excellent or moderate in 80% of the regions, including all DTI parameters. In the comparison of parameters, for the single ICCs, most of the repeatability results were excellent in terms of the ADC and RD while only moderate in terms of the FA and AD parameters.
Although many techniques of circumcision have been described, there are few reports determining which technique is associated with the least complications [3]. Conventional dissection surgery (freehand) or Plastibell technique is the most frequently employed method for circumcision [4].
The patients were randomized assigned into two groups. The samples were allocated into two groups by a simple randomization technique using computer generated random numbers. The choice of procedure was determined based on whether the number falls into either group A or B. Group A had freehand circumcision, while Group B had Plastibell circumcision. The cost implication per patient was noted. All the surgeries were performed by the same surgeon.
One neonate in the freehand group had adhesion at 1 month. The skin of the distal penal shaft was adherent to the corona. This was separated via blunt dissection. No adhesion occurred in those that had Plastibell circumcision.
In the freehand group, three boys had prolonged penile swelling which persisted till day 7. These swellings subsided before the next follow-up at 1 month. No patient in the Plastibell group had penile swelling on day 7 and beyond.
One neonate in the freehand group represented at 1 month with adhesion of the skin of the penile shaft to the corona. Even though this adhesion was released via blunt dissection, most postcircumcision adhesions require no treatment, they usually resolve with time. The chance of postcircumcision adhesion decreases with ageing [19]. Adhesions are generally commoner in freehand technique compared to Plastibell [13].
Plastibell circumcision has the obvious advantage of being faster than freehand circumcision. The total cost implication per procedure is also far cheaper as compared to freehand technique. These are quite beneficial to high-volume centers. Plastibell has the best outcome in infants. Older children are at risk of bleeding and delayed separation of the residual plastic ring. Close follow-up should be enforced following Plastibell circumcision.
FreeHand was created by Altsys in 1988, which was later bought by Macromedia and finally purchased by Adobe in 2005. The software was discontinued in 2007. While you can no longer get it from Adobe's website, there are some FreeHand updates you can download from Adobe if you need v11.0.2 (the last version released).
Save time and edit faster by doing more touchups and photo corrections in AfterShot Pro 3, rather than jumping to PaintShop Pro or Adobe Photoshop. The new Blemish Remover offers circle, brush, polygon and freehand tools for detailed editing, making portrait editing faster and easier. Remove dust, spots, smudges and a variety of imperfections on any photo.
Now it's easier to tap into the power of presets to automate more of your repetitive processing jobs or quickly reproduce a look that would otherwise be tedious to replicate. The new Image Preset Library^ lets you browse, preview and download free and for-purchase presets.
Formerly known as realtimeboard, Miro is a virtual whiteboard where teams can collaborate and design in real time. With realistic sticky notes, a built-in wireframe library as well as a mind-mapping tool, it is a supercharged whiteboard. It has several built-in templates, integrations (Slack, Dropbox, Creative Cloud, Trello and Zapier, among others) and allows unlimited users for up to 3 boards in its free version. To create more than 3 boards and get access to the Kanban framework, you can upgrade to the team plan starting at $8 per member/month.
InVision Studio is a desktop application that you can use to create screens and animations. Originally known for its browser-based prototyping application, the desktop application Studio is not as popular as the other tools listed above, partly because it came after the other tools. With the free version, you can create 3 documents and include a generous 10 active users. The Pro account lets you create unlimited documents but still limits active users to 15.
MockFlow allows you to collaboratively create user interfaces. Its free version is good for a single project and limited to 3 pages, so you are almost certainly going to have to upgrade to get all the functionality that you need. That starts at $12 per editor/month, in which you get access to UI templates and desktop applications for you to work offline, along with unlimited UI projects, team component libraries and business app integrations. 2ff7e9595c
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