American Diagnostic Radiology Moves Offshore: Surfing the Internet Wave to Worldwide Access and Quality Perspectives: American Diagnostic Radiology Moves Offshore: Where Is the Internet Wave Taking This Field

International reading of medical imaging studies, or offshore teleradiology, has been a successful, though limited, practice benefiting patients and physicians for over a decade. Domestic and international market forces will continue to expand the demand for teleradiology as an important complement to United States based diagnostic radiology, though a full exodus of diagnostic reading to offshore sites is unlikely and inappropriate. Considerable obstacles remain to taking the teleradiology market to scale; however, barriers related to licensure, liability, quality assurance, and reimbursement will likely yield to market forces to be resolved in recognition of the significant benefits teleradiology offers to consumers and providers. As in other aspects of the economy, the world of medicine is becoming flat as the necessity of physical proximity is becoming less essential in the doctor-patient relationship. Telemedicine, which is the use of electronic information and communication technologies to diagnose and manage medical care from a distance, is realistic, successful, and even preferred in several instances. Telemedicine has existed for decades with telephone and fax, but with the Internet and the ability to view large amounts of audio and visual data at increasingly faster and cheaper rates, the practices of telemedicine is rapidly expanding

Bias Dependence of the Depletion Layer Width in Semi-Insulating GaAs by Charge Collection Scanning Microscopy

A procedure for the evaluation of the depletion region width of a Schottky barrier diode made on semi-insulating materials has been assessed and applied to gallium arsenide nuclear detectors. This procedure, which makes use of the optical beam induced current method of charge collection scanning microscopy, allows the direct measurement of the depletion layer width. By taking into account the high resistivity of the material under examination and measuring the diode reverse current, it is possible to evaluate the actual voltage applied at the depletion layer boundaries. It was found that, at low actual bias values, the voltage dependence of the depletion layer follows the usual square root power law, while at increasing voltages, it changes into a linear behavior. An explanation in terms of deep trap effect and trap field-enhanced capture cross-section is proposed even though further work must be done to explain the space charge width dependence on bias applied in terms of the deep trap influence

imaging the coupling of terahertz radiation to a high electron mobility transistor in the near field

We used AlGaN/GaN high electron mobility transistors as room-temperature direct detectors of radiation at 0.15 THz from a free electron laser, hence 5 times higher than their cutoff frequency of 30 GHz. By near-field active mapping we investigated the antenna-like coupling of the radiation to the transistor channel. We formulate a model for the detection based on self-mixing in the transistor channel. The noise equivalent power is found in the range of 10^{-7} W/Hz^{0.5} without any optimization of the device responsivity. Present day AlGaN/GaN fabrication technology may provide operation at higher frequency, integration of amplifiers for improved responsivity and fast switches for multiplexing, which make the detector here described the basic element of a monolithic terahertz focal plane array

Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005

Medscape, LLC is pleased to provide online continuing medical education (CME) for this journal article, allowing clinicians the opportunity to earn CME credit. This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education through the joint sponsorship of Medscape, LLC and Emerging Infectious Diseases. Medscape, LLC is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide CME for physicians. Medscape, LLC designates this educational activity for a maximum of 0.5 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. All other clinicians completing this activity will be issued a certificate of participation. To participate in this journal CME activity: (1) review the learning objectives and author disclosures; (2) study the education content; (3) take the post-test and/or complete the evaluation at http://www.medscape.com/cme/eidExternal Web Site Icon; (4) view/print certificate.\ud Learning Objectives\ud \ud Upon completion of this activity, participants will be able to:\ud \ud Describe the mechanism of infection for adiaspiromycosis.\ud Identify the age group most susceptible to ocular adiaspiromycosis.\ud Describe presenting symptoms associated with ocular adiaspiromycosis.\ud Describe the frequency of ocular lesions associated with adiaspiromycosis.\ud Identify risk factors for ocular adiaspiromycosis

Acute Conjunctivitis with Episcleritis and Anterior Uveitis Linked to Adiaspiromycosis and Freshwater Sponges, Amazon Region, Brazil, 2005

An epidemiologic investigation of an ocular disease outbreak among children was linked to the unusual fungus Emmonsia sp., an agent of adiaspiromycosis

Factors associated with chest injuries to front seat occupants in frontal impacts

Objective: Improving crash protection for older car occupants is a matter of urgency since the number of older car users is forecast to grow dramatically over the next two decades. The thorax is particularly vulnerable in older occupants, and this study aimed to provide real-world in-depth analysis of factors contributing to chest injuries in frontal impacts involving European cars. Methods: Real world crash injury data were interrogated, focusing on cars with current restraint components. The research examined belted front-seat occupants in frontal impacts where air bags, pretensioners and load limiters were present. Results: The chest was the most often injured body region at AIS 2+, 3+ and 4+ injury levels. The rate of AIS 2+ and AIS 3+ chest injuries was highest among elderly occupants and lowest among young occupants, and elderly occupants sustained proportionally more severe chest injuries in low/moderate speed impacts compared to young and middle-aged occupants. However, it should be noted that rates of AIS 2 chest injury were also significantly higher for middle-aged occupants compared to the young. The front passenger seat was shown to be more often associated with significant chest injury than the driver seat. The higher proportion of elderly female occupants was postulated as a reason for this. Skeletal injury was the most frequent type of AIS 2+ chest injury and the rate of injury for elderly occupants with such injuries was higher than for young and middle-aged occupants. With the increase in the number of rib fractures, the risk of pulmonary complications and organ injuries tended to increase. The major cause of chest injury was identified as restraining loads transmitted to the chest via the seat belt. The absence of intrusion in the majority of cases, suggests an opportunity for the restraint system to better manage the crash pulse. Not only for elderly occupants but for those who are middle-aged as well. Conclusions: This study shows the necessity for safety interventions, through new vehicle crashworthiness systems to improve chest protection especially for middle aged and elderly car occupants. Deployment of appropriate injury risk criteria, use of an appropriate dummy thorax, development of a low energy restraint test, and the development of more adaptive restraints have been discussed as possible solutions to the problem

Periodic fever syndromes in Eastern and Central European countries: results of a pediatric multinational survey

<p>Abstract</p> <p>Objective</p> <p>To analyze the prevalence of diagnosed and suspected autoinflammatory diseases in Eastern and Central European (ECE) countries, with a particular interest on the diagnostic facilities in these countries.</p> <p>Methods</p> <p>Two different strategies were used to collect data on patients with periodic fever syndromes from ECE countries- the Eurofever survey and collection of data with the structured questionnaire.</p> <p>Results</p> <p>Data from 35 centers in 14 ECE countries were collected. All together there were 11 patients reported with genetically confirmed familial Mediterranean fever (FMF), 14 with mevalonate-kinase deficiency (MKD), 11 with tumor necrosis factor receptor associated periodic syndrome (TRAPS) and 4 with chronic infantile neurological cutaneous and articular syndrome (CINCA). Significantly higher numbers were reported for suspected cases which were not genetically tested. All together there were 49 suspected FMF patients reported, 24 MKD, 16 TRAPS, 7 CINCA and 2 suspected Muckle-Wells syndrome (MWS) patients.</p> <p>Conclusions</p> <p>The number of genetically confirmed patients with periodic fever syndromes in ECE countries is very low. In order to identify more patients in the future, it is important to organize educational programs for increasing the knowledge on these diseases and to establish a network for genetic testing of periodic fever syndromes in ECE countries.</p

Decline in Diarrhea Mortality and Admissions after Routine Childhood Rotavirus Immunization in Brazil: A Time-Series Analysis

A time series analysis by Manish Patel and colleagues shows that the introduction of rotavirus vaccination in Brazil is associated with reduced diarrhea-related deaths and hospital admissions in children under 5 years of age