Emergency radiology without the radiologist: the forensic perspective

Purpose. The aim of this paper is to describe two cases from the authors\u27 forensic archive database in which teleradiology was related to unfavourable outcomes. Material and methods. Two patients underwent autopsy after unexpected death following road accidents. In one case, death was caused by multiple cervical fractures following minor neck injury in the presence of diffuse idiopathic skeletal hyperostosis. In the other case, death was due to delayed isthmic aortic rupture occurring after thoracic blunt trauma in a young adult. Both conditions were diagnosed at autopsy only. Results. In both cases, the lethal outcome was due to the failure to obtain radiological reports of the X-rays performed in the emergency department. Radiological diagnoses could have been established by activating the teleradiology service which, according to the hospitals\u27 teleradiology protocols, is available on demand in cases of emergency only, as selected by the physician requesting the service. Conclusions. These cases suggest the high risk of excluding the radiologist from the management of patients whose images are transmitted via a teleradiology system.Obiettivo. Gli autori intendono descrivere due casi tratti dal proprio archivio autoptico medico-legale nei quali l\u27esito sfavorevole ? connesso all\u27uso della teleradiologia. Materiali e metodi. Sono descritte le risultanze dell\u27indagine autoptica eseguita su due soggetti deceduti in maniera inattesa dopo incidente della strada. In un caso la morte ? dipesa da fratture cervicali multiple determinatesi, in soggetto affetto da DISH (iperostosi scheletrica idiopatica diffusa), per un trauma minore del collo. Nel secondo caso un giovane adulto riportava una contusione del torace con "rottura in due tempi" dell\u27istmo aortico. Entrambe le patologie traumatiche sono state diagnosticate solo in sede di esame autoptico. Risultati. La mancata diagnosi in vita ha tratto origine, in entrambi i casi, dalla "non refertazione" degli esami radiologici eseguiti in urgenza; la diagnosi radiologica avrebbe potuto effettuarsi mediante attivazione del sistema di teleradiologia, utilizzabile, secondo il protocollo gestionale della struttura, solo in casi urgenti, selezionati dal medico richiedente la prestazione. Conclusioni. Questi due casi suggeriscono che l\u27esclusione del radiologo dalla gestione dei pazienti le cui immagini sono trasmesse in teleradiologia comporta un rischio molto elevato di prestazioni inadeguate

School Composition Effects in Spain: Accounting for Interceptand Slope Effects

Drawing on PISA 2012 data, in this paper we study the impact of school's socio-economic composi-tion on the science test scores for Spanish lower-secondary education students. We adopt a semi-para-metric methodology that enables spillovers to affect all the parameters in the educational productionfunction. We also deal with the issue of endogenous students' sorting into schools with better socio-economic composition. The positive effect of school's socio-economic composition is stronger whencomputed using the semi-parametric approach, suggesting the relevance of slope effects of school com-position. However, the spillovers are substantially reduced when the endogenous sorting of students iscontrolled for

Updates on the INFN High Power Ka-band klystron amplifier design program

In the framework of the "Compact Light XLS" project, a short ultra-high gradient linearizer working on the third harmonic of the main linac frequency is requested. Increasing gradients and reducing dimensions are requirements for XLS and all next generation linear accelerators. Actually, ultra-compact normal conducting accelerating structures, operating in the Ka-band regime ranging from 100 to 150 MV/m are required to achieve ultra-high gradients for research, industrial and medical applications. To fulfill these strong requirements, the R&D of a proper Ka-band klystron with RF power output and a high efficiency is mandatory. This contribution reports the design of a possible klystron amplifier tube operating on the TM010 mode at 36 GHz, the third harmonic of the 12 GHz linac frequency, with an efficiency of 42% and a 20 MW RF power output. This contribution discusses also the high-power DC gun, the beam focusing channel and the RF beam dynamics

The Ka-band high power klystron amplifier design program of INFN

In the framework of the Compact Light XLS project, a short ultra-high gradient linearizer working on the third harmonic of the main linac frequency is requested. Increasing gradients and reducing dimensions are requirements for XLS and all next generation linear accelerators. Actually, ultra-compact normal conducting accelerating structures, operating in the Ka-band are required to achieve ultra-high gradients for research, industrial and medical applications, with electric field ranging from 100 to 150 MV/m. To fulfill these strong requirements, the R&D of a proper Ka-band klystron with high RF power output and a high efficiency is mandatory. This contribution reports the design of a possible klystron amplifier tube operating on the 010 mode at 36 GHz, the third harmonic of the 12 GHz linac frequency, with an efficiency of 42% and a 20 MW RF power output. This contribution discusses also the high-power DC gun, the beam focusing channel and the RF beam dynamics

Spatially embedded random networks

Many real-world networks analyzed in modern network theory have a natural spatial element; e.g., the Internet, social networks, neural networks, etc. Yet, aside from a comparatively small number of somewhat specialized and domain-specific studies, the spatial element is mostly ignored and, in particular, its relation to network structure disregarded. In this paper we introduce a model framework to analyze the mediation of network structure by spatial embedding; specifically, we model connectivity as dependent on the distance between network nodes. Our spatially embedded random networks construction is not primarily intended as an accurate model of any specific class of real-world networks, but rather to gain intuition for the effects of spatial embedding on network structure; nevertheless we are able to demonstrate, in a quite general setting, some constraints of spatial embedding on connectivity such as the effects of spatial symmetry, conditions for scale free degree distributions and the existence of small-world spatial networks. We also derive some standard structural statistics for spatially embedded networks and illustrate the application of our model framework with concrete examples

Testosterone insulin-like effects: an in vitro study on the short-term metabolic effects of testosterone in human skeletal muscle cells

Testosterone by promoting different metabolic pathways contributes to short-term homeostasis of skeletal muscle, the largest insulin-sensitive tissue and the primary site for insulin-stimulated glucose utilization. Despite evidences indicate a close relationship between testosterone and glucose metabolism, the molecular mechanisms responsible for a possible testosterone-mediated insulin-like effects on skeletal muscle are still unknown

Advanced Design of a Low Energy Electron Source

A multiphysics-based modeling design of a low energy electron source using a thermionic cathode is described in this paper. The proposed device produces a narrow beam employable in delicate applications where dimensions are critical. The effects of multiple physics influencing factors due to the cathode heating over the beam dynamics have been predicted through a multiphysics design approach. This paper would provide the needed knowledge for virtual prototyping of such devices. For this aim, several strategies have been adopted to obtain a simple model, which shows clearly the investigated mechanisms. According to this study, the appropriate materials and shapes can be chosen

Electron Gun and Magnetic Systems Studies for a 36 GHz Klystron Amplifier

Self consistent analytic and numeric design for a set of innovative electron guns suitable for Ka-band klystrons is proposed in this paper. The proposed electron sources are designed to produces narrow beam with high currents that can be used in devices with critical dimensions. The proposed set of electron gun is destined to high power klystrons to be used as power sources for accelerating structures operating in Ka-Band. This family of accelerators is foreseen to achieve energy gradients around 150 MV/m. A klystron amplifier is being investigated in order to feed a linearizer structure. In this paper different electron gun and beam focusing channel designs are presented