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On 22-Sep-12, at 12:20 PM, John Ballinger wrote: Help! (and thanks in advance for any that comes.) I have about 4 cues (out of 90) that are not advancing to the next cue after 'GO'. There seems to be no explanation that involves programming i.e. I have nearly identical cues that DO operate well relative to the ones that do not. The only difference between them are audio files. One thing that was suggested to me was to create a separate cue list, copy and paste the problematic cue into the new list, then copy and paste the cue from the new list into the 'show' list, erase the 'old' problematic cue and see if that fixes it. It did in one case but not in others.
I am updated to qlab 2.3.8 We have a preview tonight and I'm getting loads of fecal matter from the SM. Anyone out there have wisdom on this? (no video, using 6 channels of audio, mixing mp3's with AIFF's, very straightforward gig, no mics, no MIDI, ) john. On Sat, Sep 22, 2012 at 12:20 PM, John Ballinger wrote: Help! (and thanks in advance for any that comes.) I have about 4 cues (out of 90) that are not advancing to the next cue after 'GO'. There seems to be no explanation that involves programming i.e. I have nearly identical cues that DO operate well relative to the ones that do not.
The only difference between them are audio files. One thing that was suggested to me was to create a separate cue list, copy and paste the problematic cue into the new list, then copy and paste the cue from the new list into the 'show' list, erase the 'old' problematic cue and see if that fixes it. It did in one case but not in others. I am updated to qlab 2.3.8 We have a preview tonight and I'm getting loads of fecal matter from the SM. Anyone out there have wisdom on this? (no video, using 6 channels of audio, mixing mp3's with AIFF's, very straightforward gig, no mics, no MIDI, ) john -- Change your preferences or unsubscribe here: Follow Figure 53 on Twitter. (and thanks in advance for any that comes.) I have about 4 cues (out of 90) that are not advancing to the next cue after 'GO'.
There seems to be no explanation that involves programming i.e. I have nearly identical cues that DO operate well relative to the ones that do not. The only difference between them are audio files. One thing that was suggested to me was to create a separate cue list, copy and paste the problematic cue into the new list, then copy and paste the cue from the new list into the 'show' list, erase the 'old' problematic cue and see if that fixes it. It did in one case but not in others. I am updated to qlab 2.3.8 We have a preview tonight and I'm getting loads of fecal matter from the SM.
Anyone out there have wisdom on this? (no video, using 6 channels of audio, mixing mp3's with AIFF's, very straightforward gig, no mics, no MIDI, ) john -- Change your preferences or unsubscribe here: Follow Figure 53 on Twitter: ra byn (robin) taylor 11:58. On Sep 22, 2012, at 1:46 PM, John Ballinger wrote: >that really could be it.there are some long mp3's (tone, atmosphere). Heading to the theater now. >>thanks for the ideas.hope I can return the favor some day. I think this issue has bit way too many users to be a casual matter any more.
I'd be incline to think the following: Qlab should refuse to load a file that won't play correctly. If the mp3 issue is a moving target. Meaning that its not a fixed length but random, I'd be inclined to think that qlab should just refuse to play mp3s at some point. Better that than these sorts of emergencies that could of been avoided.
Obviously a first time warning is a start but not enough. Maybe the mp3 warning should show up any time qlab is started from scratch of it doesn't and any time an existing workspace file is loaded that contains any mp3s. DSP Quattro converts any mp3 I open into a aiff/wav automatically.
Maybe that is an option. As a hardcore fan and user of qlab, I'd be in complete support of qlab not supporting mp3s at all. Maybe provide a mp3 to aiff / wav file batch tool. Something besides this situation where a new user to qlab learns the hard way that some mp3s will play but not correctly. I think this makes it appear that qlab is flawed even though it's an apple issue. My 2 cents, Ra byn John Ballinger 12:53. [Drifting off-topic, responding to ra byn's suggestion to Figure 53] I do use mp3s as part of my workflow.
For someone who knows that there is a bug with them and has a workflow that can incorporate that information into their process intelligently, it'd be a bummer to not have qlab support mp3s at all. The warning is enough. It sounds like the OP was using a version of QLab from before the warning was put in place, which is the problem with regards to mp3 support. [Specifically, because I know I'll get a lot of eye-rolls from saying that I use mp3s as part of my workflow — sometimes directors expect you to move quickly during tech. If the short sound cue that I throw together is composed of mp3 pieces, I'll flag them so I know to convert them later, but I at least want to be able to drop them in, take a listen, and start working with them without holding everybody else up by pausing to convert them. Of course, if the source material I'm working with is a long file and I know the bug is likely to rear its head, I won't use the mp3] I'd be bummed if QLab stopped supporting mp3s until it also has a quick and easy to use file conversion tool built in.
Sounds like all of this is coming down the road, so I'm happy to wait, but I wouldn't be happy to see another change prohibiting mp3s from qlab altogether in the meantime.
Methods and results The study population consisted of 40 non-selected patients (mean age 48 ± 18 year, 20 men) and 50 non-selected healthy volunteers (mean age 34 ± 12 year, 21 men). Feasibility and intra-observer reproducibility of the measurement of LV rotation parameters by STE were assessed for two different methods (Method A: six tracking points placed mid-myocardial and Method B: six tracking points placed endocardial and epicardial forming six myocardial segments). Subsequently, inter-observer and temporal reproducibility of the most robust method were assessed.
Complete LV rotation assessment was more feasible with Method A (60 out of 90 subjects, 67% vs. 50 out of 90 subjects, 56%). In the 49 subjects in whom both Methods A and B were feasible, intra-observer reproducibility of LV rotation parameters was better with Method A (variabilities 2 ± 3 to 10 ± 9% vs. 2 ± 4 to 21 ± 18%). With this method, inter-observer variability varied from 4 ± 4 to 13 ± 9% and temporal variability from 4 ± 6 to 19 ± 15%.
, The apex and base of the heart rotate in different directions, resulting in a twisting motion, which has an important role in left ventricular (LV) function., Assessment of LV rotation and twist may provide important insights into different types of myocardial dysfunction., Speckle tracking echocardiography (STE) is a new, emerging echocardiographic image modality that is able to quantify LV twist., In most clinical STE studies, the EchoPac software package (GE Medical Systems, Milwaukee, WI, USA) was used. The newer QLAB Advanced Quantification Software (Philips, Best, The Netherlands) was only recently validated against magnetic resonance imaging for assessment of LV twist by STE. This software allows a manual and flexible approach. However, information about the feasibility and the reproducibility of LV rotation parameters with this software package is still lacking. This study sought to find the most robust method for LV rotation measurements and to test intra-observer, inter-observer, and temporal reproducibility of LV rotation parameters. Methods Study participants The study population consisted of 40 non-selected patients in sinus rhythm [mean age 48 ± 18 year, 20 men, 31 with a cardiomyopathy (12 hypertrophic, 10 dilated, 7 ischaemic, 2 non-compaction), 6 with aortic stenosis, and 3 with mitral regurgitation] and 50 non-selected healthy volunteers (mean age 34 ± 12 year, 21 men) in sinus rhythm without hypertension or diabetes, and with normal left atrial dimensions, LV dimensions, and LV function. All subjects gave informed consent and the institutional review board approved the study.
Echocardiography Two-dimensional grey-scale harmonic images at a frame rate of 60–80 frames/s were obtained in the left lateral decubitus position using a commercially available system (iE33, Philips), equipped with a broadband S5-1 transducer (frequency transmitted 1.7 MHz, received 3.4 MHz). A single, experienced, sonographer (W.B.V.) performed all studies. Parasternal short-axis images at the LV basal level (showing the tips of the mitral valve leaflets) with the cross-section as circular as possible were obtained from the standard parasternal position, defined as the long-axis position in which the LV and aorta were most in-line with the mitral valve tips in the middle of the sector.
To obtain a short-axis image at the LV apical level (just proximal to the level with end-systolic LV luminal obliteration), the transducer was positioned 1 or 2 intercostal spaces more caudal, as previously described by us. From each short-axis level, three consecutive end-expiratory cardiac cycles were acquired and transferred to a QLAB workstation (Philips) for off-line analysis. Data analysis Analysis of the data sets was performed using QLAB Advanced Quantification Software version 6.0 (Philips). Data analysis started with a search for the best STE method with the least need for changes in tracking point position and best intra-observer variability in LV rotation measurements. In Method A, six tracking points were placed manually on an end-diastolic frame in the mid-myocardium in each parasternal short-axis image. Tracking points were separated ∼60° from each other and placed on 1 (30°, anteroseptal insertion into the LV of the right ventricle), 3 (90°), 5 (150°), 7 (210°), 9 (270°, inferoseptal insertion into the LV of the right ventricle), and 11 (330°) o'clock to fit the total LV circumference ( Figure A ). In Method B, six tracking points were placed manually on an end-diastolic frame in the endocardium in each parasternal short-axis image with the same partitioning as described for Method A.
By increasing myocardial transit, six secondary tracking points were placed on the epicardium. As shown in Figure B, the resultant 12 tracking points formed six LV segments. After positioning the tracking points, the programme tracks these points on a frame-by-frame basis by using a least squares global affine transformation. The rotational component of this affine transformation is then used to generate rotational profiles.
The time necessary to complete analysis, for both methods, was calculated from 20 randomly selected studies. ( A ) Example of positioning of tracking points using Method A and ( B ) Method B. If a tracking point showed poor speckle tracking by visual assessment, the position of the tracking point was changed manually on the end-diastolic frame, in both methods in a circumferential direction towards one of the other tracking points, but not >1 h (30°). When speckle tracking was still insufficient, the position of the mid-myocardial tracking points in Method A and the epicardial tracking points in Method B could be changed additionally in the direction of the endocardium. All necessary positional changes in tracking points were noted.
Because all tracking points are needed for optimal measurement of global LV rotation, a subject was considered insufficient for analysis of global LV rotation by STE and excluded from further analysis when despite these changes, one or more tracking points still did not track well. In the remaining subjects, good image quality was defined as an image in which all segments were well visualized, whereas in moderate image quality one or more segments were not well visualized (but all tracking points visually tracked well). The influence of necessary changes in tracking point position on LV rotation measurements was assessed in a stepwise manner in three subjects (one healthy volunteer, one patient with aortic stenosis, and one patient with a dilated cardiomyopathy) with excellent image quality. First, one mid-myocardial tracking point was moved in a circumferential direction by 1 h. Subsequently, the same tracking point was moved towards the endocardium. Finally, these manipulations were repeated for an additional (second) tracking point.
In subjects in whom complete STE analysis was possible with both Methods A and B, intra-observer reproducibility for Methods A and B was assessed 4 weeks apart by one observer (B.M.van D.) on the same echocardiographic loop in all subjects in whom both methods were feasible. A second observer (M.L.G.) who was unaware of the results of the first examination also assessed inter-observer reproducibility of the most robust method for assessment of LV rotation parameters (in terms of feasibility and intra-observer reproducibility, assessed by the first observer). Finally, the temporal reproducibility of LV rotation measurements was assessed. In 10 clinically stable patients and 10 healthy volunteers, two additional echocardiograms were made 27 ± 18 days after the first examination (Study 2) and 1 h after this second echocardiogram (Study 3). Data were exported to a spreadsheet program (Excel, Microsoft Corporation, Redmond, WA, USA) to determine LV peak systolic rotation (Rot max ), time to Rot max (from R wave to Rot max ), instantaneous LV peak systolic twist (Twist max, defined as the maximal value of instantaneous apical LV systolic rotation − basal LV systolic rotation), time to Twist max, and LV untwisting at 5, 10, and 15% of diastole. The degree of untwisting was expressed as a percentage of maximum systolic twist: untwisting = (Twist max − Twist t )/Twist max × 100%, where Twist t is twist at time t.
To adjust for intra- and inter-subject differences in heart rate, the time sequence was normalized to the percentage of systolic duration. The end of systole was defined as the point of aortic valve closure. In each study, it was verified that the heart rate for the cardiac cycle in which the timing of aortic valve closure was assessed was the same as that used for analysis of the LV rotation parameters. Statistical analysis Continuous variables were presented as mean ± SD and compared using Student's t -test or ANOVA when appropriate. The need to adjust the intended position of a tracking point was compared using the Pearson χ 2 test. A P -value of.
Image quality First observer Second observer Method A Method B Method A Endocardium Epicardium All All New Basal n (%) All ( n = 294) 22 (7%) 32 (11%) 47 (16%) 79 (27%) 20 (7%) 2 (1%) Good ( n = 162) 6 (4%) 9 (6%) 17 (10%) 26 (16%) 4 (3%) 0 (0%) Moderate ( n = 132) 16 (12%) 23 (17%) 30 (22%) 53 (39%) 16 (12%) 2 (1%) Apical n (%) All ( n = 294) 24 (8%) 5 (2%) 48 (16%) 53 (18%) 26 (9%) 5 (2%) Good ( n = 162) 6 (4%) 1 (1%) 18 (11%) 19 (12%) 7 (5%) 1 (1%) Moderate ( n = 132) 18 (14%) 4 (3%) 30 (23%) 34 (26%) 19 (14%) 4 (2%). Image quality First observer Second observer Method A Method B Method A Endocardium Epicardium All All New Basal n (%) All ( n = 294) 22 (7%) 32 (11%) 47 (16%) 79 (27%) 20 (7%) 2 (1%) Good ( n = 162) 6 (4%) 9 (6%) 17 (10%) 26 (16%) 4 (3%) 0 (0%) Moderate ( n = 132) 16 (12%) 23 (17%) 30 (22%) 53 (39%) 16 (12%) 2 (1%) Apical n (%) All ( n = 294) 24 (8%) 5 (2%) 48 (16%) 53 (18%) 26 (9%) 5 (2%) Good ( n = 162) 6 (4%) 1 (1%) 18 (11%) 19 (12%) 7 (5%) 1 (1%) Moderate ( n = 132) 18 (14%) 4 (3%) 30 (23%) 34 (26%) 19 (14%) 4 (2%). Subject Standard Adjustment 1 Adjustment 2 Adjustment 3 Adjustment 4 Basal Rot max (°) 1 −4.0 −4.1 −4.8 −4.8 −6.1 2 −3.6 −3.7 −4.0 −4.0 −4.4 3 −4.6 −4.3 −4.9 −4.8 −5.3 Mean −4.1 −4.0 −4.6 −4.5 −5.3 Apical Rot max (°) 1 5.3 5.0 6.6 6.7 7.1 2 12.4 12.3 13.0 13.1 14.2 3 8.5 8.4 9.9 9.8 12.4 Mean 8.7 8.6 9.8 9.9 11.2 Time to basal Rot max (%) 1 90 90 93 93 93 2 87 87 87 87 87 3 92 92 92 92 92 Mean 90 90 91 91 91 Time to apical Rot max (%) 1 88 88 88 88 88 2 92 92 92 92 92 3 90 88 85 90 90 Mean 90 89 88 90 90.
Subject Standard Adjustment 1 Adjustment 2 Adjustment 3 Adjustment 4 Basal Rot max (°) 1 −4.0 −4.1 −4.8 −4.8 −6.1 2 −3.6 −3.7 −4.0 −4.0 −4.4 3 −4.6 −4.3 −4.9 −4.8 −5.3 Mean −4.1 −4.0 −4.6 −4.5 −5.3 Apical Rot max (°) 1 5.3 5.0 6.6 6.7 7.1 2 12.4 12.3 13.0 13.1 14.2 3 8.5 8.4 9.9 9.8 12.4 Mean 8.7 8.6 9.8 9.9 11.2 Time to basal Rot max (%) 1 90 90 93 93 93 2 87 87 87 87 87 3 92 92 92 92 92 Mean 90 90 91 91 91 Time to apical Rot max (%) 1 88 88 88 88 88 2 92 92 92 92 92 3 90 88 85 90 90 Mean 90 89 88 90 90. Intra-observer reproducibility For both Methods A and B, significantly less intra-observer variability of basal Rot max, apical Rot max, and Twist max was seen in subjects with good image quality ( Table ). Regardless of image quality, all parameters, apart from time to basal Rot max, time to apical Rot max, and time to Twist max, showed significantly less intra-observer variability when measured with Method A. With Method A, all parameters showed acceptable intra-observer variabilities, in both good and moderate image quality (variabilities 2 ± 3 to 10 ± 9%) ( Table ). A Bland–Altman analysis confirmed the better intra-observer reproducibility of Method A for Twist max measurements by demonstrating 95% limits of agreement of ± 1.2° vs.
± 2.2° for Method B ( Figure ). Inter-observer reproducibility As described in the Methods section, inter-observer reproducibility was only assessed for Method A, because this was the most feasible method with the best intra-observer reproducibility. All parameters assessed with Method A showed acceptable inter-observer variability (variabilities 4 ± 4 to 13 ± 9%) ( Table ). Significantly less variability of basal Rot max, apical Rot max, and Twist max was seen in subjects with good image quality (all P. Temporal reproducibility Variabilities of LV end-systolic and end-diastolic volume, LV ejection fraction, and heart rate between studies were small (between Studies 1 and 2, 10 ± 6, 9 ± 6, 8 ± 7, and 8 ± 9%, respectively, between Studies 1 and 3, 11 ± 6, 8 ± 7, 8 ± 9, and 9 ± 10%, respectively, and between Studies 2 and 3, 9 ± 6, 7 ± 5, 8 ± 6, and 6 ± 6%, respectively).
Variabilities of these parameters were comparable in patients and healthy volunteers (7 ± 7 to 12 ± 5% and 6 ± 6 to 11 ± 6%, respectively, P = NS). With the exception of LV untwisting at 5, 10, and 15% of diastole (variabilities 9 ± 11 to 19 ± 15%), all parameters showed acceptable temporal variability (variabilities 4 ± 6 to 13 ± 6%). The majority of parameters showed less variability in subjects with good image quality compared with those with moderate image quality, and between Studies 2 and 3 compared with Studies 1 and 3 or 1 and 2 ( Table ). Discussion This is the first study in which the reproducibility (intra-observer, inter-observer, and temporal) of LV rotation parameters measured by STE is extensively investigated.
The main findings of this study are (i) the most robust method to assess global LV twist with QLAB software is from the mid-myocardium and (ii) global LV twist measurements with this method are possible in approximately two-thirds of subjects with good intra-observer, inter-observer, and temporal reproducibility. Influence of tracking points' position STE is an angle-independent technique as the movement of speckles can be followed in any two-dimensional direction. The QLAB Advanced Quantification Software allows a manual and flexible approach for positioning of tracking points.
This manual approach might improve the feasibility of speckle tracking in general and the clinical utility in, for example, hypertrophic cardiomyopathy patients with asymmetrical myocardial wall thickness, because with conventional speckle tracking software packages, it is not possible to appropriately include the entire myocardium in these patients. Worsening reproducibility can be a potential consequence of a flexible measurement method. Intra-observer variability of all LV rotation parameters was better when rotation was measured in the LV mid-myocardium compared with measurement in segments including the complete myocardial wall.
This might be explained by the higher need to adjust the position of tracking points in the basal endocardium and the basal or apical epicardium with the latter method. The imaged epicardium is sometimes too bright, causing signal saturation. This precludes discrimination of the subtleties of image contrast that allows STE to work. Also, the size of the actual tracking point is about twice as large as the one that is displayed. Therefore, placement of a tracking point in the epicardium can potentially result in stationary artefacts by tracking of non-moving speckles outside the heart. To avoid this, adjustment of the position of the tracking point towards the mid-myocardium can be helpful, but this can result in overestimation of rotation.
If adjustment of the position of these tracking points is unsuccessful, the stationary artefacts can cause underestimation of rotation. Motion of the mitral valve leaflets in the area of tracking points placed on the endocardium will potentially interfere with proper speckle tracking as well, making adjustment of the position of a tracking point in a circumferential direction sometimes mandatory. These adjustments seem less influential because they do not necessarily result in different rotation values. Nevertheless, in prior studies, it has been demonstrated that rotational components do differ between segments., Interference of the mitral valve leaflets can potentially limit the ability of STE to obtain rotation values of the endocardium for specific LV segments. Temporal reproducibility The assessment of temporal reproducibility is an important consideration in the expansion of STE to evaluate serial studies of LV rotation in the same patient. Temporal reproducibility of LV rotation parameters tended to be better for LV basal measurements compared with apical measurements.
Short-axis images of the LV apex were obtained by moving the transducer one or two intercostal spaces more caudal as previously described by us. Relative inexperience with this new method, causing more variability in the recording, compared with the well-known technique of assessing a short-axis image at LV basal level, might have caused this finding. Also, temporal reproducibility was better when the temporal interval between the studies was less. This might be explained by recall bias. The influence of small haemodynamic changes in stable individuals on LV rotation parameters is unknown. In the current study, the variabilities of LV volumes and heart rate between studies were relatively independent of the time interval between the studies.
However, there still might have been small, but more extensive, haemodynamic changes between the studies with the largest time interval, which could potentially explain this finding as well. Nevertheless, with the exception of LV untwisting parameters, the temporal variability of all measurements was within acceptable limits. Repeatability In the current study, repeatability was used as a surrogate for reproducibility as well. A repeatability value indicates that in 95% of repeated cases, the deviation of the second measurement with respect to the first measurement will be less than this repeatability value.
For all parameters, repeatability of Method A and good image quality was better than that of Method B and moderate image quality, respectively. It should be determined in clinical studies whether the repeatability values found in the current study are acceptable. Previous studies reporting data on feasibility and reproducibility of left ventricular rotation parameters by speckle tracking echocardiography Previous studies investigating LV rotation parameters using the EchoPac software package only reported limited information about intra- and inter-observer variability without providing data on temporal reproducibility.,, Feasibility of obtaining LV rotation parameters in these studies varied widely. Notomi et al. And Takeuchi et al., excluded subjects because of a poor track score, an automated reliability parameter based on the degree of decorrelation of the block-matching.
This resulted in exclusion of maximal 13% of the subjects. In contrast, in the software version used by Kim et al., the track score was eliminated and replaced by ‘pass or fail’. This, in combination with defining assessment of LV rotation not feasible when theoretically unacceptable values were obtained, resulted in the exclusion of 65% of the subjects. In the study by Kim et al., in particular the high rate of failure to obtain reliable LV basal rotation was blamed to the prominent through-plane motion observed at this level and dropouts of ultrasound data in the anterolateral and inferolateral segments. Motion of the mitral valve leaflets in the area of the tracking points placed on the endocardium may also have contributed to failure of tracking at the LV basal level. In our study, the failure rate was comparable at the LV basal (37%) and apical levels (31%).
The software used in our study allows a manual and thus flexible approach. Positioning of the tracking points on the mid-myocardium will prevent interference of mitral valve motion in the area of the tracking points, which might to some extent explain the higher feasibility of measurement of LV rotation parameters by STE in the current study compared with the study by Kim et al. However, proper comparison of the speckle tracking software used in previous studies and our study would require a direct comparison. Limitations The echocardiographic window is the Achilles' heel of echocardiography. Therefore, a relatively large amount of the subjects had to be excluded from analysis because image quality in one or more segments was insufficient for STE analysis.
Even the best feasible method —mid-myocardial speckle tracking used in Method A— resulted in exclusion of one-third of the subjects. In our experience, for reliable complete speckle tracking of all LV myocardial segments using QLAB Advanced Quantification Software, at least moderate image quality is mandatory. Therefore, the clinical utility of this new technique might currently be hampered by this limitation, in particular when regional functional information is required (requiring complete LV assessment). Positioning of the tracking points on an end-systolic frame might improve reproducibility because of a clearer delineation of the myocardial borders.
However, in the current version of QLAB Advanced Quantification Software, it is only possible to position the tracking points on an end-diastolic frame. Unfortunately, we did not include patients with atrial fibrillation. It may be anticipated that also in such patients, the mid-myocardial tracking method will be more reproducible. However, temporal reproducibility may be lower because of comparing loops with relatively large dissimilarities in RR intervals, of which the influence on LV twist is currently unknown. Finally, a proper evaluation of distinctions in feasibility and reproducibility of different speckle tracking software packages from different vendors would require a direct comparison of these techniques, which is not performed in the current study. Conclusion The most robust method to assess LV rotation with QLAB software is from the mid-myocardium.
This method is feasible in approximately two-thirds of subjects and has good intra-observer, inter-observer, and temporal reproducibility, allowing to study changes over time in LV rotation in an individual patient. Minitab 17 Product Key Keygen For Mac. Conflict of interest: none declared.