Concern over Confidentiality in Mediation - An in-Depth Look at the Protection Provided by the Proposed Uniform Mediation Act, The

This Comment will investigate the historical problems with confidentiality in mediation and evaluate the Proposed Uniform Mediation Act\u27s (hereinafter U.M.A. or Act ) approaches to remedying confidentiality issues. The reader should carefully note that the Uniform Mediation Act is in an on-going drafting phase at this time, and the content of the Act\u27s drafts discussed herein are not final and are for discussion purposes only. This Comment\u27s discussion will cover confidentiality in disclosure with respect to parties, waiver, and a mediator\u27s duty of non-disclosure. This Comment will also compare the mechanisms the U.M.A. has put in place to govern confidentiality to mechanisms utilized in other fields, such as the attorney-client privilege and rules of evidence regulating the admission of compromise negotiations at trial

Intracranial Stents Being Modeled as a Porous Medium: Flow Simulation in Stented Cerebral Aneurysms

Intracranial aneurysms may be treated by flow diverters, alternatively to stents and coils combination. Numerical simulation allows the assessment of the complex nature of aneurismal flow. Endovascular devices present a rather dense and fine strut network, increasing the complexity of the meshing. We propose an alternative strategy, which is based on the modeling of the device as a porous medium. Two patient-specific aneurysm data sets were reconstructed using conventional clinical setups. The aneurysms selection was done so that intra-aneurismal flow was shear driven in one and inertia driven in the other. Stents and their porous medium analog were positioned at the aneurysm neck. Physiological flow and standard boundary conditions were applied. The comparison between both approaches was done by analyzing the velocity, vorticity, and shear rate magnitudes inside the aneurysm as well as the wall shear stress (WSS) at the aneurysm surface. Simulations without device were also computed. The average flow reduction reaches 76 and 41% for the shear and inertia driven flow models, respectively. When comparing the two approaches, results show a remarkable similarity in the flow patterns and magnitude. WSS, iso-velocity surfaces and velocity on a trans-sectional plane are in fairly good agreement. The root mean squared error on the investigated parameters reaches 20% for aneurysm velocity, 30.6% for aneurysm shear rate, and 47.4% for aneurysm vorticity. It reaches 20.6% for WSS computed on the aneurysm surface. The advantages of this approach reside in its facility to implement and in the gain in computational time. Results predicted by the porous medium approach compare well with the real stent geometry model and allow predicting the main effects of the device on intra-aneurismal flow, facilitating thus the analysi

Double-lumen balloon microcatheter-assisted occlusion of cerebral vessels with coils: a technical note

The purpose of this study was to describe a balloon-assisted double-lumen microcatheter technique to perform a controlled and tight coil packing of a vascular segment for vessel occlusion. This technique can be performed immediately after a test occlusion with the balloon kept in place and was, as illustrated in six cases, in our experience safe, straight forward to use and fas

Intracranial Stents Being Modeled as a Porous Medium: Flow Simulation in Stented Cerebral Aneurysms

Intracranial aneurysms may be treated by flow diverters, alternatively to stents and coils combination. Numerical simulation allows the assessment of the complex nature of aneurismal flow. Endovascular devices present a rather dense and fine strut network, increasing the complexity of the meshing. We propose an alternative strategy, which is based on the modeling of the device as a porous medium. Two patient-specific aneurysm data sets were reconstructed using conventional clinical setups. The aneurysms selection was done so that intra-aneurismal flow was shear driven in one and inertia driven in the other. Stents and their porous medium analog were positioned at the aneurysm neck. Physiological flow and standard boundary conditions were applied. The comparison between both approaches was done by analyzing the velocity, vorticity, and shear rate magnitudes inside the aneurysm as well as the wall shear stress (WSS) at the aneurysm surface. Simulations without device were also computed. The average flow reduction reaches 76 and 41% for the shear and inertia driven flow models, respectively. When comparing the two approaches, results show a remarkable similarity in the flow patterns and magnitude. WSS, iso-velocity surfaces and velocity on a trans-sectional plane are in fairly good agreement. The root mean squared error on the investigated parameters reaches 20% for aneurysm velocity, 30.6% for aneurysm shear rate, and 47.4% for aneurysm vorticity. It reaches 20.6% for WSS computed on the aneurysm surface. The advantages of this approach reside in its facility to implement and in the gain in computational time. Results predicted by the porous medium approach compare well with the real stent geometry model and allow predicting the main effects of the device on intra-aneurismal flow, facilitating thus the analysis

The Role of Computational Fluid Dynamics in the Management of Unruptured Intracranial Aneurysms: A Clinicians' View

Objective. The importance of hemodynamics in the etiopathogenesis of intracranial aneurysms (IAs) is widely accepted. Computational fluid dynamics (CFD) is being used increasingly for hemodynamic predictions. However, alogn with the continuing development and validation of these tools, it is imperative to collect the opinion of the clinicians. Methods. A workshop on CFD was conducted during the European Society of Minimally Invasive Neurological Therapy (ESMINT) Teaching Course, Lisbon, Portugal. 36 delegates, mostly clinicians, performed supervised CFD analysis for an IA, using the @neuFuse software developed within the European project @neurIST. Feedback on the workshop was collected and analyzed. The performance was assessed on a scale of 1 to 4 and, compared with experts' performance. Results. Current dilemmas in the management of unruptured IAs remained the most important motivating factor to attend the workshop and majority of participants showed interest in participating in a multicentric trial. The participants achieved an average score of 2.52 (range 0–4) which was 63% (range 0–100%) of an expert user. Conclusions. Although participants showed a manifest interest in CFD, there was a clear lack of awareness concerning the role of hemodynamics in the etiopathogenesis of IAs and the use of CFD in this context. More efforts therefore are required to enhance understanding of the clinicians in the subject

Screening of DUB activity and specificity by MALDI-TOF mass spectrometry

Deubiquitylases (DUBs) are key regulators of the ubiquitin system which cleave ubiquitin moieties from proteins and polyubiquitin chains. Several DUBs have been implicated in various diseases and are attractive drug targets. We have developed a sensitive and fast assay to quantify in vitro DUB enzyme activity using matrix-assisted laser desorption/ionization time-of-flight (MALDI-TOF) mass spectrometry. Unlike other current assays, this method uses unmodified substrates, such as diubiquitin topoisomers. By analyzing 42 human DUBs against all diubiquitin topoisomers we provide an extensive characterization of DUB activity and specificity. Our results confirm the high specificity of many members of the OTU and JAMM DUB families and highlight that all USPs tested display low linkage selectivity. We also demonstrate that this assay can be deployed to assess the potency and specificity of DUB inhibitors by profiling 11 compounds against a panel of 32 DUBs

Not all cows are epidemiologically equal:quantifying the risks of bovine viral diarrhoea virus (BVDV) transmission through cattle movements

International audienceMany economically important cattle diseases spread between herds through livestock movements. Traditionally, most transmission models have assumed that all purchased cattle carry the same risk of generating outbreaks in the destination herd. Using data on bovine viral diarrhoea virus (BVDV) in Scotland as a case example, this study provides empirical and theoretical evidence that the risk of disease transmission varies substantially based on the animal and herd demographic characteristics at the time of purchase. Multivariable logistic regression analysis revealed that purchasing pregnant heifers and open cows sold with a calf at foot were associated with an increased risk of beef herds being seropositive for BVDV. Based on the results from a dynamic within-herd simulation model, these findings may be partly explained by the age-related probability of animals being persistently infected with BVDV as well as the herd demographic structure at the time of animal introductions. There was also evidence that an epidemiologically important network statistic, "betweenness centrality" (a measure frequently associated with the potential for herds to acquire and transmit disease), was significantly higher for herds that supplied these particular types of replacement beef cattle. The trends for dairy herds were not as clear, although there was some evidence that open heifers and open lactating cows were associated with an increased risk of BVDV. Overall, these findings have important implications for developing simulation models that more accurately reflect the industry-level transmission dynamics of infectious cattle diseases

HEVC-EPIC: Fast Optical Flow Estimation from Coded Video via Edge-Preserving Interpolation

This paper presents a method leveraging coded motion information to obtain fast, high quality motion field estimation. The method is inspired by a recent trend followed by a number of top-performing optical flow estimation schemes that first estimate a sparse set of features between two frames, and then use an edge-preserving interpolation scheme (EPIC) to obtain a piecewise-smooth motion field that respects moving object boundaries. In order to skip the time-consuming estimation of features, we propose to directly derive motion seeds from decoded HEVC block motion; we call the resulting scheme 'HEVC-EPIC'. We propose motion seed weighting strategies that account for the fact that some motion seeds are less reliable than others. Experiments on a large variety of challenging sequences and various bit-rates show that HEVC-EPIC runs significantly faster than EPIC flow, while producing motion fields that have a slightly lower average endpoint error. HEVC-EPIC opens the door of seamlessly integrating HEVC motion into video analysis and enhancement tasks. When employed as input to a framerate upsampling scheme, the average Y-PSNR of the interpolated frames using HEVC-EPIC motion slightly outperforms EPIC flow across the tested bit-rates, while running an order of magnitude faster

Progressive melorheostosis in the peripheral and axial skeleton with associated vascular malformations: imaging findings over three decades

A 28-year old woman presented with Leri's disease (melorheostosis) and the rare combination of complex vascular malformations and lymphatic anomalies. Multifocal melorheostosis was segmental and unilateral, located in the left axial and peripheral skeleton, fifth thoracic vertebral body, fifth rib. left upper limb and lumbosacral spine (third lumbar body to first sacral segment). Sacral involvement was associated with spinal canal stenosis. Additionally the patient had multiple nevi and had suffered from left hemiplegia since birth. Lymphangiectasia of the mesentery and thorax led to chylothorax resistant to therapy for which the patient underwent a pleuropericardiectomy. Death ensued due to respiratory failur

Multisensor and multidimensional biomedical imaging (including volumetric electro-magnetic tomography) for the visualization and assessment of neurological (dys-)function

We have implemented a global system consisting of techniques and protocols for the combination (registration, visualization, navigation and processing) of various multidimensional biomedical imaging sensors, including all current modalities and also Electro-Magnetic Tomography (EMT), to study, assess, and localize neurological (dys-)function for both clinical and research applications. The already well described interest for this combination stems from the broad variety of complementary information brought out by modern biomedical imaging modalities. In this context, the input of volumetric EMT permits direct sighting, in near real-time, of any EM (dys-)functional behavior. Besides allowing morphology, metabolism and function to be studied simultaneously and from different points of view, the global combination permitted by our approach is expected to show its best value when studying pathologies reflected by metabolic or electromagnetic dysfunctions such as drug-resistant epilepsy