Enhanced Video-Oculography System

A previously developed video-oculography system has been enhanced for use in measuring vestibulo-ocular reflexes of a human subject in a centrifuge, motor vehicle, or other setting. The system as previously developed included a lightweight digital video camera mounted on goggles. The left eye was illuminated by an infrared light-emitting diode via a dichroic mirror, and the camera captured images of the left eye in infrared light. To extract eye-movement data, the digitized video images were processed by software running in a laptop computer. Eye movements were calibrated by having the subject view a target pattern, fixed with respect to the subject s head, generated by a goggle-mounted laser with a diffraction grating. The system as enhanced includes a second camera for imaging the scene from the subject s perspective, and two inertial measurement units (IMUs) for measuring linear accelerations and rates of rotation for computing head movements. One IMU is mounted on the goggles, the other on the centrifuge or vehicle frame. All eye-movement and head-motion data are time-stamped. In addition, the subject s point of regard is superimposed on each scene image to enable analysis of patterns of gaze in real time

The Paradox of Filamented Coronal Hole Flow but Uniform High Speed Wind

Plumes and rays in coronal holes are nearly radially aligned density striations that follow the ambient magnetic field. They have long been known, but have gained new interest with growing awareness that coronal hole flow is inherently filamentary. In retrospect, filamentary flow should have been no surprise. This is because,Beta much less than 1 in coronal holes inside approximately 10 Solar radius, allowing the flow to be filamentary down to the smallest scale of photospheric magnetic activity. While the magnetic field itself is locally smooth across any height above ca. 50,000 km, SOHO/MDI has shown that the photospheric magnetic field is a complex array of rapidly evolving small bipoles that are constantly emerging, evolving, and cancelling. The resulting activity is manifested in microflares, concentrated in the magnetic network, that produce Impulsive injections at the footpoints of coronal field lines. The uneven distribution of this activity in space and time is the source of coronal hole filamentation. What is surprising is that the radial flow speed also exhibits filamentary structure. It is not well described as smooth, spherically symmetric, diverging flow, but instead ranges from 300 to over 1000 km/s at 5.5 Solar radius among field-aligned filaments like those seen in plumes and rays [Feldman et al., JGR, Dec. 1997]. This is completely unlike the constant high speed solar wind reported beyond 0.3 AU. Consequently, plumes and filamentary structure must be strongly mixed, and the mixing must be far along by 0.3 AU to be consistent with Helios observations. The paradox is what causes the mixing? Existing models of coronal heating and solar wind acceleration hardly address this issue. One possibility we are investigating is the MHD Kelvin-Helmholtz instability, to which the shear between plumes and interplume corona is expected to become unstable at 5-10 Solar radius. This instability can be simulated and followed far into the nonlinear regime and may lead to Alfvenic fluctuations like those seen at 1 AU

The Width of a Solar Coronal Mass Ejection and the Source of the Driving Magnetic Explosion

We show that the strength of the magnetic field in the area covered by the flare arcade following a CME-producing ejective solar eruption can be estimated from the final angular width of the CME in the outer corona and the final angular width of the flare arcade. We assume (1) the flux-rope plasmoid ejected from the flare site becomes the interior of the CME plasmoid, (2) in the outer corona (R greater than 2R(sub Sun)) the CME is roughly a spherical plasmoid with legs shaped like a light bulb, and (3) beyond some height in or below the outer corona the CME plasmoid is in lateral pressure balance with the surrounding magnetic field. The strength of the nearly radial magnetic field in the outer corona is estimated from the radial component of the interplanetary magnetic field measured by Ulysses. We apply this model to three well-observed CMEs that exploded from flare regions of extremely different size and magnetic setting. One of these CMEs is an over-and-out CME that exploded from a laterally far offset compact ejective flare. In each event, the estimated source-region field strength is appropriate for the magnetic setting of the flare. This agreement (1) indicates that CMEs are propelled by the magnetic field of the CME plasmoid pushing against the surrounding magnetic field, (2) supports the magnetic-arch-blowout scenario for over-and-out CMEs, and (3) shows that a CME s final angular width in the outer corona can be estimated from the amount of magnetic flux covered by the source-region flare arcade

New Evidence that CMEs are Self-Propelled Magnetic Bubbles

We briefly describe the "standard model" for the production of coronal mass ejections (CMEs), and our view of how it works. We then summarize pertinent recent results that we have found from SOHO observations of CMEs and the flares at the sources of these magnetic explosions. These results support our interpretation of the standard model: a CME is basically a self-propelled magnetic bubble, a low-beta plasmoitl, that (1) is built and unleashed by the tether-cutting reconnection that builds and heats the coronal flare arcade, (2) can explode from a flare site that is far from centered under the full-blown CME in the outer corona, and (3) drives itself out into the solar wind by pushing on the surrounding coronal magnetic field

Validation of 24-hour ambulatory gait assessment in Parkinson's disease with simultaneous video observation

<p>Abstract</p> <p>Background</p> <p>Parkinson's disease (PD) is a neurodegenerative disorder resulting in motor disturbances that can impact normal gait. Although PD initially responds well to pharmacological treatment, as the disease progresses efficacy often fluctuates over the course of the day, and clinical management would benefit from long-term objective measures of gait. We have previously described a small device worn on the shank that uses acceleration and angular velocity sensors to calculate stride length and identify freezing of gait in PD patients. In this study we extend validation of the gait monitor to 24-h using simultaneous video observation of PD patients.</p> <p>Methods</p> <p>A sleep laboratory was adapted to perform 24-hr video monitoring of patients while wearing the device. Continuous video monitoring of a sleep lab, hallway, kitchen and conference room was performed using a 4-camera security system and recorded to hard disk. Subjects (3) wore the gait monitor on the left shank (just above the ankle) for a 24-h period beginning around 5 pm in the evening. Accuracy of stride length measures were assessed at the beginning and end of the 24-h epoch. Two independent observers rated the video logs to identify when subjects were walking or lying down.</p> <p>Results</p> <p>The mean error in stride length at the start of recording was 0.05 m (SD 0) and at the conclusion of the 24 h epoch was 0.06 m (SD 0.026). There was full agreement between observer coding of the video logs and the output from the gait monitor software; that is, for every video observation of the subject walking there was a corresponding pulse in the monitor data that indicated gait.</p> <p>Conclusions</p> <p>The accuracy of ambulatory stride length measurement was maintained over the 24-h period, and there was 100% agreement between the autonomous detection of locomotion by the gait monitor and video observation.</p

Real-time flood inundation forecasting and mapping for key railway infrastructure: a UK case study

Flooding events that impede railway infrastructure can cause severe travel delays for the general public and large fines in delayed minutes for the rail industry. Early warnings of flood inundation can give more time to implement mitigation measures which help reduce cancellations, delays and fines. Initial work is reported on the development of a real-time flood inundation forecasting and mapping system for the Cowley Bridge track area near Exeter, UK. This location is on one of the main access routes to South West England and has suffered major floods in the past resulting in significant transport impacts. Flood forecasting systems in the UK mainly forecast river level/flow rather than extent and depth of flood inundation. Here, the development of a chain of coupled models is discussed that link rainfall to river flow, river level and flood extent for the rail track area relating to Cowley Bridge. Historical events are identified to test model performance in predicting inundation of railway infrastructure. The modelling system will operate alongside a series of in-situ sensors chosen to enhance the flood mapping forecasting system. Sensor data will support offline model calibration/verification and real-time data assimilation as well as monitoring flood conditions to inform track closure decisions

Safety Recommendations for Evaluation and Surgery of the Head and Neck During the COVID-19 Pandemic

Importance The rapidly expanding novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has challenged the medical community to an unprecedented degree. Physicians and health care workers are at added risk of exposure and infection during the course of patient care. Because of the rapid spread of this disease through respiratory droplets, health care workers who come in close contact with the upper aerodigestive tract during diagnostic and therapeutic procedures, such as otolaryngologists–head and neck surgeons, are particularly at risk. A set of safety recommendations was created based on a review of the literature and communications with physicians with firsthand knowledge of safety procedures during the COVID-19 pandemic. Observations A high number of health care workers were infected during the first phase of the pandemic in the city of Wuhan, China. Subsequently, by adopting strict safety precautions, other regions were able to achieve high levels of safety for health care workers without jeopardizing the care of patients. The most common procedures related to the examination and treatment of upper aerodigestive tract diseases were reviewed. Each category was reviewed based on the potential risk imposed to health care workers. Specific recommendations were made based on the literature, when available, or consensus best practices. Specific safety recommendations were made for performing tracheostomy in patients with COVID-19. Conclusions and Relevance Preserving a highly skilled health care workforce is a top priority for any community and health care system. Based on the experience of health care systems in Asia and Europe, by following strict safety guidelines, the risk of exposure and infection of health care workers could be greatly reduced while providing high levels of care. The provided recommendations, which may evolve over time, could be used as broad guidance for all health care workers who are involved in the care of patients with COVID-19

Performance of the Universal Vital Assessment (UVA) Mortality Risk Score in Hospitalized Adults with Infection in Rwanda: A Retrospective External Validation Study

BACKGROUND: We previously derived a Universal Vital Assessment (UVA) score to better risk-stratify hospitalized patients in sub-Saharan Africa, including those with infection. Here, we aimed to externally validate the performance of the UVA score using previously collected data from patients hospitalized with acute infection in Rwanda. METHODS: We performed a secondary analysis of data collected from adults ≥18 years with acute infection admitted to Gitwe District Hospital in Rwanda from 2016 until 2017. We calculated the UVA score from the time of admission and at 72 hours after admission. We also calculated quick sepsis-related organ failure assessment (qSOFA) and modified early warning scores (MEWS). We calculated amalgamated qSOFA scores by inserting UVA cut-offs into the qSOFA score, and modified UVA scores by removing the HIV criterion. The performance of each score determined by the area under the receiver operator characteristic curve (AUC) was the primary outcome measure. RESULTS: We included 573 hospitalized adult patients with acute infection of whom 40 (7%) died in-hospital. The admission AUCs (95% confidence interval [CI]) for the prediction of mortality by the scores were: UVA, 0.77 (0.68-0.85); modified UVA, 0.77 (0.68-0.85); qSOFA, 0.66 (0.56-0.75), amalgamated qSOFA, 0.71 (0.61-0.80); and MEWS, 0.74 (0.64, 0.83). The positive predictive values (95% CI) of the scores at commonly used cut-offs were: UVA \u3e4, 0.35 (0.15-0.59); modified UVA \u3e4, 0.35 (0.15-0.59); qSOFA \u3e1, 0.14 (0.07-0.24); amalgamated qSOFA \u3e1, 0.44 (0.20-0.70); and MEWS \u3e5, 0.14 (0.08-0.22). The 72 hour (N = 236) AUC (95% CI) for the prediction of mortality by UVA was 0.59 (0.43-0.74). The Chi-Square test for linear trend did not identify an association between mortality and delta UVA score at 72 hours (p = 0.82). CONCLUSIONS: The admission UVA score and amalgamated qSOFA score had good predictive ability for mortality in adult patients admitted to hospital with acute infection in Rwanda. The UVA score could be used to assist with triage decisions and clinical interventions, for baseline risk stratification in clinical studies, and in a clinical definition of sepsis in Africa

Metal Abundances in the Magellanic Stream

We report on the first metallicity determination for gas in the Magellanic Stream, using archival HST GHRS data for the background targets Fairall 9, III Zw 2, and NGC 7469. For Fairall 9, using two subsequent HST revisits and new Parkes Multibeam Narrowband observations, we have unequivocally detected the MSI HI component of the Stream (near its head) in SII1250,1253 yielding a metallicity of [SII/H]=-0.55+/-0.06(r)+/-0.2(s), consistent with either an SMC or LMC origin and with the earlier upper limit set by Lu et al. (1994). We also detect the saturated SiII1260 line, but set only a lower limit of [SiII/H]>-1.5. We present serendipitous detections of the Stream, seen in MgII2796,2803 absorption with column densities of (0.5-1)x10^13 cm^-2 toward the Seyfert galaxies III Zw 2 and NGC 7469. These latter sightlines probe gas near the tip of the Stream (80 deg down-Stream of Fairall 9). For III Zw 2, the lack of an accurate HI column density and the uncertain MgIII ionization correction limits the degree to which we can constrain [Mg/H]; a lower limit of [MgII/HI]>-1.3 was found. For NGC 7469, an accurate HI column density determination exists, but the extant FOS spectrum limits the quality of the MgII column density determination, and we conclude that [MgII/HI]>-1.5. Ionization corrections associated with MgIII and HII suggest that the corresponding [Mg/H] may range lower by 0.3-1.0 dex. However, an upward revision of 0.5-1.0 dex would be expected under the assumption that the Stream exhibits a dust depletion pattern similar to that seen in the Magellanic Clouds. Remaining uncertainties do not allow us to differentiate between an LMC versus SMC origin to the Stream gas.Comment: 30 pages, 8 figures, LaTeX (aaspp4), also available at http://casa.colorado.edu/~bgibson/publications.html, accepted for publication in The Astronomical Journa

Orchidopexy for Testicular Torsion : A Systematic Review of Surgical Technique

Peer reviewedPostprin