Resorbable Mesh Cranioplasty Repair of Bilateral Cerebrospinal Fluid Leaks Following Pediatric Simultaneous Bilateral Auditory Brainstem Implant Surgery

OBJECTIVE: To present a child with cochlear nerve deficiency (CND) who received simultaneous bilateral simultaneous auditory brainstem implants (BS-ABI) and subsequently presented with bilateral cerebrospinal fluid (CSF) leaks unresponsive to standard treatments. To propose a novel rigid retrosigmoid cranioplasty for treating and preventing CSF leaks in children at high risk for this complication. PATIENT: A 3.5-year-old child with CND, vertebral defects, anal atresia, cardiac defects, tracheo-esophageal fistula, renal anomalies, and limb abnormalities, coloboma, heart defect, atresia choanae, retarded growth and development, genital abnormality, and ear abnormality, Arnold Chiari malformation, previous treated tracheo-esophageal fistula underwent BS-ABI. Postoperatively, the child had recurrent bilateral retroauricular fluid collections. A standard revision procedure revealed breaches in the dural closure, migration of the auditory brainstem implantation (ABI) receiver stimulator on both sides and was unsuccessful in stopping the leak. INTERVENTIONS: Bilateral repair with free fat grafting filling the craniectomy space and two absorbable meshes of poly-L-D-lactic (PLDL) acid stabilized with PLDL pins on the surrounding cranium, one to stabilize the fat graft and one to fix the ABI receiver stimulators inside the subperiosteal pockets. MAIN OUTCOME MEASURE: CSF leak recurrence, postoperative computed tomographic (CT) scans, intra- and postoperative simultaneous electrically evoked auditory brainstem responses (EABRs). Subjective and objective assessment of ABI function. RESULTS: No postoperative CSF leaks at 60 days follow-up. EABRs and consistent behavioral responses obtained at initial mapping on both sides. CONCLUSIONS: The use of BS-ABI likely contributed to bilateral CSF leaks requiring revision surgeries in this child. Simultaneous bilateral craniotomies can put patients at risk for CSF leak. A novel cranioplasty technique employed finally proved successful in stopping the CSF leak in this case

Subtotal petrosectomy and cerebrospinal fluid leakage in unilateral anacusis

Objective This study presents a group of patients experiencing recurrent cerebrospinal fluid (CSF) leakage associated with ipsilateral anacusis who underwent subtotal petrosectomies with the goal of stopping the CSF leak and preventing meningitis. Materials and Methods Eight patients with CSF leakage were enrolled: three patients with giant vestibular schwannomas had CSF leakage after gamma knife failure and subsequent removal via a retrosigmoid approach; two patients had malformations at the level of the inner ear with consequent translabyrinthine fistulas; two had posttraumatic CSF leakages; and one had a CSF leakage coexisting with an encephalocele. Two patients developed meningitis that resolved with antibiotic therapy. Each patient had preoperative anacusis and vestibular nerve areflexia on the affected side. Results The patients with congenital or posttraumatic CSF leaks had undergone at least one unsuccessful endaural approach to treat the fistula. All eight patients were treated successfully with a subtotal petrosectomy. The symptoms disappeared within 2 months postoperatively. No meningitis, signs of fistula, or other symptoms occurred during the follow-up. Conclusion A subtotal petrosectomy should be the first choice of treatment in patients with recurrent CSF leakage whenever there is associated unilateral anacusis

Hydrogen leak detection device Patent

Development of device for detecting hydrogen in ambient environment

Stopping The Presses: Evaluating The Effectiveness Of The 2013 Justice Department’s New Protections For Journalists

The Obama Administration ushered in a new era of accountability and communication between the government and those it governs. With the rise of social media and the creation of White House accounts on various platforms it seemed as if the Obama administration was taking his pledge to have the most transparent presidency of all time to serious heights. However, during the first term of the Obama administration, the justice department under Attorney General Eric Holder set some dangerous precedents. The justice department pursued several prosecutions of people who had leaked government secrets and developed a successful formula for these cases by way of the Espionage Act. Out of this behavior, a new landscape for the relationship between the government and the media was formed. After backlash, they conducted a review and used experts from outside the Whitehouse in the media, and academia to provide feedback. They then released a list of protections and new policies to protect journalists to undo the precedents they may have set and encourage future due diligence in the prosecutorial process regarding the role of media in leaks. I am evaluating how effective those protections are and whether they accomplish the goals they set out to meet.Plan II Honors Progra

Poking fun at the surface: exploring touch-point overloading on the multi-touch tabletop with child users

In this paper a collaborative game for children is used to explore touch-point overloading on a multi-touch tabletop. Understanding the occurrence of new interactional limitations, such as the situation of touch-point overloading in a multi-touch interface, is highly relevant for interaction designers working with emerging technologies. The game was designed for the Microsoft Surface 1.0 and during gameplay the number of simultaneous touch-points required gradually increases to beyond the physical capacity of the users. Studies were carried out involving a total of 42 children (from 2 different age groups) playing in groups of between 5-7 and all interactions were logged. From quantitative analysis of the interactions occurring during the game and observations made we explore the impact of overloading and identify other salient findings. This paper also highlights the need for empirical evaluation of the physical and cognitive limitations of interaction with emerging technologies

Industrial Energy Efficiency: Using New Technologies to Reduce Energy Use in Industry and Manufacturing

Key facts: -Industry uses over one-third of the energy consumed in the United States.- Oil and natural gas provide nearly four-fifths of industrial energy; the rest comes mostly from electricity and coal. - Between 1990 and 2003, US industrial output has grown 25 percent but industrial energy use has increased only by 2 percent

Area and Length Minimizing Flows for Shape Segmentation

©1997 IEEE. Personal use of this material is permitted. However, permission to reprint/republish this material for advertising or promotional purposes or for creating new collective works for resale or distribution to servers or lists, or to reuse any copyrighted component of this work in other works must be obtained from the IEEE. This material is presented to ensure timely dissemination of scholarly and technical work. Copyright and all rights therein are retained by authors or by other copyright holders. All persons copying this information are expected to adhere to the terms and constraints invoked by each author's copyright. In most cases, these works may not be reposted without the explicit permission of the copyright holder.Presented at the 1997 IEEE Computer Society Conference on Computer Vision and Pattern Recognition, June 17-19, 1997, San Juan, Puerto Rico.DOI: 10.1109/CVPR.1997.609390Several active contour models have been proposed to unify the curve evolution framework with classical energy minimization techniques for segmentation, such as snakes. The essential idea is to evolve a curve (in 20) or a surface (in 30) under constraints from image forces so that it clings to features of interest in an intensity image. Recently the evolution equation has. been derived from first principles as the gradient flow that minimizes a modified length functional, tailored io features such as edges. However, because the flow may be slow to converge in practice, a constant (hyperbolic) term is added to keep the curve/surface moving in the desired direction. In this paper, we provide a justification for this term based on the gradient flow derived from a weighted area functional, with image dependent weighting factor. When combined with the earlier modified length gradient flow we obtain a pde which offers a number of advantages, as illustrated by several examples of shape segmentation on medical images. In many cases the weighted area flow may be used on its own, with significant computational savings