Editorial: Oral Health: luxury or a fundamental human right? The necessity of introducing a dedicated oral health budget and Proportionate Universalism in Greece

Oral health is an integral part of overall health and critically affects quality of life as well as personal and social well-being. Poor oral health negatively influences general health and creates medical, financial and social burdens for individuals, families and health systems. The US Office of Disease Prevention and Health Promotion (2021) sees use of the oral health care system as a leading health indicator. Oral health improvement is an important step to reduce socioeconomic inequalities and promote the UN Sustainable Development Strategy (Wang et al., 2020, Huang and Chang 2022). Moreover, "achieving the highest attainable standard of oral health is a fundamental human right of every human being" (WHO 2022a).

First observations of core-transiting seismic phases on Mars

We present the first observations of seismic waves propagating through the core of Mars. These observations, made using seismic data collected by the InSight geophysical mission, have allowed us to construct the first seismically constrained models for the elastic properties of Mars' core. We observe core-transiting seismic phase SKS from two farside seismic events detected on Mars and measure the travel times of SKS relative to mantle traversing body waves. SKS travels through the core as a compressional wave, providing information about bulk modulus and density. We perform probabilistic inversions using the core-sensitive relative travel times together with gross geophysical data and travel times from other, more proximal, seismic events to seek the equation of state parameters that best describe the liquid iron-alloy core. Our inversions provide constraints on the velocities in Mars' core and are used to develop the first seismically based estimates of its composition. We show that models informed by our SKS data favor a somewhat smaller (median core radius = 1,780 to 1,810 km) and denser (core density = 6.2 to 6.3 g/cm³) core compared to previous estimates, with a P-wave velocity of 4.9 to 5.0 km/s at the core-mantle boundary, with the composition and structure of the mantle as a dominant source of uncertainty. We infer from our models that Mars' core contains a median of 20 to 22 wt% light alloying elements when we consider sulfur, oxygen, carbon, and hydrogen. These data can be used to inform models of planetary accretion, composition, and evolution.

Digitally designed reduction guide to correct proclined anterior teeth: An aid before fabricating trial restorations

Restoring teeth with ceramic laminate veneers is most often an additive procedure. However, when proclined anterior teeth are being treated, a misfitting silicone matrix will lead to inaccurate trial restorations, affecting evaluation of the definitive esthetic result and leading to inaccurate definitive preparations. Using the digital technology, a 3-dimensionally printed reduction guide can be used to remove the proclined areas as the first step before trial restorations. Then, the trial restorations and made and then the definitive preparations made through them.

Surface waves and crustal structure on Mars

We detected surface waves from two meteorite impacts on Mars. By measuring group velocity dispersion along the impact-lander path, we obtained a direct constraint on crustal structure away from the InSight lander. The crust north of the equatorial dichotomy had a shear wave velocity of approximately 3.2 kilometers per second in the 5- to 30-kilometer depth range, with little depth variation. This implies a higher crustal density than inferred beneath the lander, suggesting either compositional differences or reduced porosity in the volcanic areas traversed by the surface waves. The lower velocities and the crustal layering observed beneath the landing site down to a 10-kilometer depth are not a global feature. Structural variations revealed by surface waves hold implications for models of the formation and thickness of the martian crust.

Largest recent impact craters on Mars: Orbital imaging and surface seismic co-investigation

Two >130-meter-diameter impact craters formed on Mars during the later half of 2021. These are the two largest fresh impact craters discovered by the Mars Reconnaissance Orbiter since operations started 16 years ago. The impacts created two of the largest seismic events (magnitudes greater than 4) recorded by InSight during its 3-year mission. The combination of orbital imagery and seismic ground motion enables the investigation of subsurface and atmospheric energy partitioning of the impact process on a planet with a thin atmosphere and the first direct test of martian deep-interior seismic models with known event distances. The impact at 35°N excavated blocks of water ice, which is the lowest latitude at which ice has been directly observed on Mars.

Seismic detection of the martian core

Clues to a planet's geologic history are contained in its interior structure, particularly its core. We detected reflections of seismic waves from the core-mantle boundary of Mars using InSight seismic data and inverted these together with geodetic data to constrain the radius of the liquid metal core to 1830 ± 40 kilometers. The large core implies a martian mantle mineralogically similar to the terrestrial upper mantle and transition zone but differing from Earth by not having a bridgmanite-dominated lower mantle. We inferred a mean core density of 5.7 to 6.3 grams per cubic centimeter, which requires a substantial complement of light elements dissolved in the iron-nickel core. The seismic core shadow as seen from InSight's location covers half the surface of Mars, including the majority of potentially active regions-e.g., Tharsis-possibly limiting the number of detectable marsquakes.

Upper mantle structure of Mars from InSight seismic data

For 2 years, the InSight lander has been recording seismic data on Mars that are vital to constrain the structure and thermochemical state of the planet. We used observations of direct (P and S) and surface-reflected (PP, PPP, SS, and SSS) body-wave phases from eight low-frequency marsquakes to constrain the interior structure to a depth of 800 kilometers. We found a structure compatible with a low-velocity zone associated with a thermal lithosphere much thicker than on Earth that is possibly related to a weak S-wave shadow zone at teleseismic distances. By combining the seismic constraints with geodynamic models, we predict that, relative to the primitive mantle, the crust is more enriched in heat-producing elements by a factor of 13 to 20. This enrichment is greater than suggested by gamma-ray surface mapping and has a moderate-to-elevated surface heat flow.

Analog-digital hybrid impression technique in an elderly patient: A case report

The hybrid impression technique consists of an initial alginate impression that provides a preoperative cast upon which a diagnostic wax-up and a silicone index are made. The wax-up is digitized; thus, the final altered digital impression is limited to absolute minimum time, effort and ensures comfort for the patient.

Assessment of InSight Landing Site Predictions

Comprehensive analysis of remote sensing data used to select the Interior Exploration using Seismic Investigations, Geodesy and Heat Transport (InSight) landing site correctly predicted the atmospheric temperature and pressure profile during entry and descent, the safe landing surface, and the geologic setting of the site. The smooth plains upon which the InSight landing site is located were accurately predicted to be generally similar to the Mars Exploration Rover Spirit landing site with relatively low rock abundance, low slopes, and a moderately dusty surface with a 3-10 m impact fragmented regolith over Hesperian to Early Amazonian basaltic lava flows. The deceleration profile and surface pressure encountered by the spacecraft during entry, descent, and landing compared well (within 1σ) of the envelope of modeled temperature profiles and the expected surface pressure. Orbital estimates of thermal inertia are similar to surface radiometer measurements, and materials at the surface are dominated by poorly consolidated sand as expected. Thin coatings of bright atmospheric dust on the surface were as indicated by orbital albedo and dust cover index measurements. Orbital estimates of rock abundance from shadow measurements in high-resolution images and thermal differencing indicated very low rock abundance and surface counts show 1-4% area covered by rocks. Slopes at 100 to 5 m length scale measured from orbital topographic and radar data correctly indicated a surface comparably smooth and flat as the two smoothest landing sites (Opportunity and Phoenix). Thermal inertia and radar data indicated the surface would be load bearing as found.

Scientific Observations With the InSight Solar Arrays: Dust, Clouds, and Eclipses on Mars

Records of solar array currents recorded by the InSight lander during its first 200 sols on Mars are presented. In addition to the geometric variation in illumination on seasonal and diurnal timescales, the data are influenced by dust suspended in the atmosphere and deposited on the solar panels. Although no dust devils have been detected by InSight's cameras, brief excursions in solar array currents suggest that at least some of the vortices detected by transient pressure drops are accompanied by dust. A step increase in array output (i.e., a "cleaning event") was observed to be directly associated with the passage of a strong vortex. Some quasiperiodic variations in solar array current are suggestive of dust variations in the planetary boundary layer. Nonzero array outputs before sunrise and after sunset are indicative of scattering in the atmosphere: A notable increase in evening twilight currents is observed associated with noctilucent clouds, likely of water or carbon dioxide ice. Finally, although the observations are intermittent (typically a few hours per sol) and at a modest sample rate (one to two samples per minute), three single-sample light dips are seen associated with Phobos eclipses. These results demonstrate that engineering data from solar arrays provide valuable scientific situational awareness of the Martian environment.

A new strategy for the treatment of atherothrombosis - inhibition of inflammation

Improvement in the prognosis of patients at risk of atherothrombotic events is based on three pillars - slowing down the process of atherogenesis (i.e. the development of atherosclerotic plaque), stabilizing the current atherosclerotic plaque, and reducing the risk of thrombotic occlusion in cases with unstable atherosclerotic plaque. The current prophylaxis has so far taken into consideration the adjustment of several risk factors, including dyslipidemia, arterial hypertension, smoking, and diabetes through lifestyle changes or pharmacological therapies. An essential part of prophylaxis is the anti-thrombotic strategy, especially anti-platelet therapy. Recently, a new pathway has been developed, based on reducing the activity of the inflammatory process with NLRP3 inflammasome, specifically a monoclonal antibody against interleukin 1beta (canakinumab). The efficacy and safety of this treatment, in secondary prevention, were documented in the CANTOS study. Other therapeutic procedures, including suppression of the inflammatory component of atherogenesis, are at the stage of clinical assessment.

SEIS: Insight's Seismic Experiment for Internal Structure of Mars

By the end of 2018, 42 years after the landing of the two Viking seismometers on Mars, InSight will deploy onto Mars' surface the SEIS (Seismic Experiment for Internal Structure) instrument; a six-axes seismometer equipped with both a long-period three-axes Very Broad Band (VBB) instrument and a three-axes short-period (SP) instrument. These six sensors will cover a broad range of the seismic bandwidth, from 0.01 Hz to 50 Hz, with possible extension to longer periods. Data will be transmitted in the form of three continuous VBB components at 2 sample per second (sps), an estimation of the short period energy content from the SP at 1 sps and a continuous compound VBB/SP vertical axis at 10 sps. The continuous streams will be augmented by requested event data with sample rates from 20 to 100 sps. SEIS will improve upon the existing resolution of Viking's Mars seismic monitoring by a factor of ∼ 2500 at 1 Hz and ∼ 200 000 at 0.1 Hz. An additional major improvement is that, contrary to Viking, the seismometers will be deployed via a robotic arm directly onto Mars' surface and will be protected against temperature and wind by highly efficient thermal and wind shielding. Based on existing knowledge of Mars, it is reasonable to infer a moment magnitude detection threshold of M w ∼ 3 at 40 ∘ epicentral distance and a potential to detect several tens of quakes and about five impacts per year. In this paper, we first describe the science goals of the experiment and the rationale used to define its requirements. We then provide a detailed description of the hardware, from the sensors to the deployment system and associated performance, including transfer functions of the seismic sensors and temperature sensors. We conclude by describing the experiment ground segment, including data processing services, outreach and education networks and provide a description of the format to be used for future data distribution.

ELECTRONIC SUPPLEMENTARY MATERIAL

The online version of this article (10.1007/s11214-018-0574-6) contains supplementary material, which is available to authorized users.

Fast and selective separation of carbon dioxide from dilute streams by pressure swing adsorption using solid ionic liquids

The need to create a new approach to carbon capture processes that are economically viable has led to the design and synthesis of sorbents that selectively capture carbon dioxide by physisorption. Solid Ionic Liquids (SoILs) were targeted because of their tunable properties and solid form under operational conditions. Molecular modelling was used to identify candidate SoILs and a number of materials based on the low cost, environmentally friendly acetate anion were selected. The materials showed excellent selectivity for carbon dioxide over nitrogen and oxygen and moderate sorption capacity. However, the rate of capture was extremely fast, in the order of a few seconds for a complete adsorb-desorb cycle, under pressure swing conditions from 1 to 10 bar. This showed the importance of rate of sorption cycling over capacity and demonstrates that smaller inventories of sorbents and smaller process equipment are required to capture low concentration CO₂ streams. Concentrated CO₂ was isolated by releasing the pressure back to atmospheric. The low volatility and thermal stability of SoILs mean that both plant costs and materials costs can be reduced and plant size considerably reduced.

Transient subdiffusion from an Ising environment

We introduce a model in which a particle performs a continuous-time random walk (CTRW) coupled to an environment with Ising dynamics. The particle shows locally varying diffusivity determined by the geometrical properties of the underlying Ising environment, that is, the diffusivity depends on the size of the connected area of spins pointing in the same direction. The model shows anomalous diffusion when the Ising environment is at critical temperature. We show that any finite scale introduced by a temperature different from the critical one, or a finite size of the environment, cause subdiffusion only during a transient time. The characteristic time, at which the system returns to normal diffusion after the subdiffusive plateau depends on the limiting scale and on how close the temperature is to criticality. The system also displays apparent ergodicity breaking at intermediate time, while ergodicity breaking at longer time occurs only under the idealized infinite environment at the critical temperature.

Loss of motivation and frustration for visitor surgeons in provincial health centers or psychiatric hospitals in Greece

Introduction

The core workplace for a surgeon is the operating theatre. Secondary duties may include visits to small health centers for outpatient examinations and visitor work to psychiatric hospitals.

Objective

The objective of our study is to highlight the mistakes of management that lead to half-empty provincial health centers and psychiatric hospitals.

Methods

Presentation of the 2-year-experience of a surgeon visitor in provincial health centers and in a large psychiatric hospital in Greece.

Results

The provincial health center of Lagada needs at least 4 surgeons to serve; too many patients to be examined or/and operated in 2–3 hours only. Subsequently problems arise, as simultaneously in the emergencies department a surgical eye for an abdominal pain or a bad looking leg is needed every 15 minutes. The health center of Koufalia needs 3 hours of driving per day for 3–8 surgical patients only. The psychiatric hospital offered work for 3 surgeons 5 days a week for a long period of time. During 2012–2014, only one surgeon visited the hospital once a week. The work needed to be done may kill the surgeon or force him to receive antidepressants in order to keep his functions alive.

Conclusions

Not a hint of scientific motivation for two years is a strong reason for a surgeon to avoid the duty to provincial health centers and psychiatric hospitals which is obligatory according to our national health system Laws until two years are completed for newly appointed surgeons. Managers might encourage surgeons if some balancing convenience was offered.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Nonergodic subdiffusion from transient interactions with heterogeneous partners

Spatiotemporal disorder has been recently associated to the occurrence of anomalous nonergodic diffusion of molecular components in biological systems, but the underlying microscopic mechanism is still unclear. We introduce a model in which a particle performs continuous Brownian motion with changes of diffusion coefficients induced by transient molecular interactions with diffusive binding partners. In spite of the exponential distribution of waiting times, the model shows subdiffusion and nonergodicity similar to the heavy-tailed continuous time random walk. The dependence of these properties on the density of binding partners is analyzed and discussed. Our work provides an experimentally testable microscopic model to investigate the nature of nonergodicity in disordered media.

Optimal selection policies for a sequence of candidate drugs

Pharmaceutical companies have to face huge risks and enormous costs of production before they can produce a drug. Efficient allocation of resources is essential to help in maximizing profits. Yu and Gittins (2007) described a model and associated software for determining efficient allocations for a preclinical research project. This is the starting point for this paper. We provide explicit optimal policies for the selection of successive candidate drugs for two restricted versions of the Yu and Gittins (2007) model. To some extent these policies are likely to be applicable to the unrestricted model.

A maximally sensitive clinical decision rule to reduce the need for radiography in mandibular trauma

INTRODUCTION

To identify clinical symptoms and signs that exclude the presence of mandibular fracture in patients presenting with mandibular trauma and thus devise a clinical decision rule that will rule out the need for radiography in some patients.

PATIENTS AND METHODS

A prospective study was conducted of consecutive patients with a possible diagnosis of mandibular fracture who attended a city-centre emergency department between July 2000 and December 2001. Clinical symptoms and signs were recorded for each patient using a predesigned proforma. Radiographic evaluation of a suspected mandibular fracture consisted of lateral-oblique and postero-anterior mandibular views. The presence of a fracture was based on the interpretation of the X-rays by a radiologist who was blinded to the clinical probability of a fracture. Data were initially analysed using the chi-square test. Recursive partitioning was then performed to create a maximally sensitive decision tree.

RESULTS

280 patients were included in the study, 65 of whom had a mandibular fracture. A maximally sensitive decision rule was found that identified 5 parameters (malocclusion, trismus, broken teeth, pain with mouth closed, step deformity) whose absence excluded mandibular fracture. This rule has a sensitivity of 100% and specificity of 39% in identifying patients with mandibular fracture. If applied to our patient cohort, this rule would have saved 83 radiographs without missing any fractures.

CONCLUSIONS

A simple decision rule is presented that can be used to exclude the need for radiography in a subset of patients with mandibular trauma.

Foot pump prophylaxis for deep venous thrombosis-rate of effective usage following knee and hip arthroplasty

We recorded the usage of foot pumps during the post-operative period in 29 patients undergoing knee or hip arthroplasty and made 621 recordings. Effective utilisation of foot pumps was seen in 37.2% of cases. There was a gradual reduction in correct utilisation with each day that passed post-operatively (day 1, 60.4%; day 2, 48.8%; day 3, 28.8%; day 4, 21.4%; day 5, 23%). This gradual reduction was statistically significant ( P=0.001) and mainly occurred between the second and third post-operative days. Effective usage was 60.2% overall at night and 36.4% during the day. Our results question the efficiency of foot pumps in deep venous thrombosis prophylaxis in the context of a true clinical setting.

Comparison of peripheral and central venous pressures in critically Ill patients

We conducted a prospective study to determine the relationship between central (CVP) and peripheral (PVP) venous pressures in critically ill patients. CVP and PVP were measured on five different occasions in 20 critically ill patients in the intensive care unit. Results showed that the mean difference between PVP and CVP was 4.4 mmHg (95% CI = 3.7 to 5.0). However, PVP might be 1.9 mmHg below (95% CI = 0.7 to 3.1) or 10.6 mmHg above (95% CI = 9.4 to 11.8) the CVP. The mean difference between changes in PVP and corresponding changes in CVP was 0.3 mmHg (95% CI = -0.1 to 0.7). The actual change in PVP could be 3.0 mmHg below (95% CI = 2.3 to 3.7) or 3.6 mmHg above (95% CI = 2.9 to 4.3) the change in CVP. Overall, the direction of change in PVP (rise or drop) predicted a same direction of change in CVP with an accuracy of 78%. Changes in PVP > or = 2 mmHg predicted a change in same direction of CVP with an accuracy of 90%. The direction of changes in CVP > or = 2 mmHg were predicted by the direction of change in PVP with an accuracy of 91%. We conclude that PVP measurement does not give an accurate estimate of the absolute value of CVP in individual patients. However, as changes in PVP parallel, in direction, changes in CVP, serial measurements of PVP may have a value in determining volume status and guiding fluid therapy in critically ill patients.

Weight bearing following intra-articular steroid injection of the knee: survey of current practice and review of the available evidence

INTRODUCTION

Intra-articular steroid therapy is one of the most common clinical procedures performed by rheumatologists. There is wide variation in the postoperative instructions given to patients following such injections.

AIM

The aim of this study was to determine what advice is given with regards to non-weight-bearing following steroid injections of the knee by rheumatologists, orthopaedic surgeons, and general practitioners (GPs).

METHOD

A questionnaire examining advice on non-weight-bearing following knee steroid injections was posted to 100 rheumatologists, 100 orthopaedic surgeons, and 50 GPs.

RESULTS

A significant proportion of respondents advised patients to avoid weight bearing after injection (42.4%). Most of these advised patients to do so for one (16.3%) or two (25.1%) days. As compared to 57.1% of general practitioners and 2.8% of orthopaedic surgeons, 70.7% of rheumatologists advised patients to avoid weight bearing (P < 0.05).

CONCLUSION

A significant proportion of rheumatologists and general practitioners performing steroid injections of the knee advise patients not to weight-bear postinjection. Examination of the available literature fails to reveal strong evidence to support such a practice, which has potentially significant implications with regards to loss of working days, costs of mobility aids, and patient inconvenience.

Gastric adenocarcinoma metastatic to the skin: a report

Metastases to the skin from internal tumours are uncommon, yet they may be the first presentation of such malignancies. They usually arise from the breast, lung and large bowel. Skin metastases from gastric adenocarcinoma are extremely rare. We report a case of a patient with gastric adenocarcinoma who at presentation had multiple, clinically benign-looking skin nodules. Biopsy of these revealed metastatic deposits.

Risk factors and clinical impact of central line infections in the surgical intensive care unit

OBJECTIVE

To determine the risk factors and clinical impact of central line infections in critically ill surgical patients.

DESIGN

Retrospective study.

SETTING

The surgical intensive care unit of a large tertiary care university hospital.

PATIENTS

A total of 232 consecutive central line catheters sent for culture from patients in a surgical intensive care unit during 1996 and 1997. Catheters were sent for microbiologic analysis when the patient was clinically infected and the central line was a possible source.

INTERVENTIONS

None.

MAIN OUTCOME MEASURES

Risk factors associated and clinical impact of a positive catheter culture.

RESULTS

Of 232 consecutive catheters from 93 patients sent for microbiologic analysis, 114 catheters (49%) had no growth, 40 (17%) were colonized (<15 colonies), and 78 (34%) were considered infected (> or =15 colonies). Univariate analysis showed that site (internal jugular vs subclavian, P<.001), catheter use (monitoring > dialysis > fluid > nutrition, P=.006), placement in the operating room vs the intensive care unit (P=.02), and placement of a new catheter (> guide wire, > new site, P=.003) were all significant factors. Surprisingly, neither the number of lunmens nor the duration of the catheter in situ were predictors when a catheter was suspected and not proved infected compared with a suspected and proved catheter infection. In the multiple regression model, the placement of the catheter in the internal jugular position was the single most important predictor of a catheter infection (P<.001; odds ratio, 1.83; 95% confidence interval [CI], 1.41-2.37). The presence or absence of a specific clinical sign of infection was not predictive of a proved catheter infection. Eighty-six percent of patients had gram-positive bacteria identified on the culture, while the remaining patients had gram-negative bacteria or Candida identified. Of the catheter infections, 68% were monomicrobial, whereas 32% were polymicrobial. Of the catheters sent for microbiologic analysis, 209 (90%) had concurrent peripheral blood cultures for analysis. Nineteen (32%) with no growth from the catheter, and 14 (23%) of colonized catheters had concurrent bacteremia; all had another identifiable cause of infection. Twenty-seven (45%) of infected catheters had a concurrent bacteremia, and 9 of 27 had a second site positive for the same organism. Death related to the infection occurred in 15 patients, 2 in the first 72 hours and 13 in the following 14 days.

CONCLUSIONS

Central line infections remain an important cause of morbidity and mortality. Comprehensive review of hospital practices may show a directed focus for performance improvement practices. At our institution, internal jugular catheters have the highest rate of infection. This may suggest breaks in technique during catheter insertion or during catheter maintenance and care.

Immunohistochemical analysis of Hodgkin's disease using microwave heating

AIMS

To assess the effect of microwave heating on immunohistochemical staining of CD15 and CD30 antigens in Hodgkin's disease tissue samples.

METHODS

Formalin fixed, paraffin wax embedded sections from 20 cases of Hodgkin's disease (six mixed cellularity, 14 nodular sclerosis) were immunostained for CD15, using two antibodies (DAKO-M1 and Leu-M1) and for CD30 using the antibody Ber-H2. The staining was carried out by conventional techniques which included pretreatment of sections with trypsin and on untreated sections following heating with microwaves. With antibody Leu-M1 an additional method, using a specific antimouse IgM bridge both with and without microwave heating, was also included. The results for each method were compared by counting positively stained Reed-Sternberg cells and estimating the staining intensity.

RESULTS

Microwave heating resulted in a substantial increase in the number of cells stained with antibodies to CD15 and also in the staining intensity. The best results were obtained using Leu-M1 with specific rabbit anti-mouse IgM bridge and microwave heating. Dramatic enhancement of the staining of Reed-Sternberg cells for CD30 was achieved following microwave heating, together with disappearance of the non-specific staining of plasma cells.

CONCLUSION

Microwave heating is strongly recommended for the immunohistochemical staining of CD15 and CD30 expressed by Reed-Sternberg cells in Hodgkin's disease.

Two iterative image restoration algorithms with applications to nuclear medicine

Two methods for recovering an image that has been degraded while being processed are presented. The restoration problem is formulated as a constrained optimization problem in which a measure of smoothness based on the second derivatives of the restored image is maximized subject to the constraint that noise energy is equal to the energy in the difference between the distorted and blurred images. The approach is based on the Lagrange multiplier method. The first algorithm reduces the problem to the computation of few discrete Fourier transforms and allows control of the degree of sharpness and smoothness of the restored image. The second algorithm with weight matrices included allows the handling of edges and flat regions in the image in a pleasing manner for the human visual system. In this case the iterative conjugate gradient method is used in conjunction with the discrete Fourier transform to minimize the Lagrangian function. The application of these algorithms to nuclear medicine images is presented.