9,030 research outputs found
Interventions to improve the labour market situation of adults with physical and/or sensory disabilities in low- and middle-income countries
Large-eddy simulation of buoyant plane plumes
In the present study a turbulent plane plume is examined by means of numerical simulations. Results are compared with experiments and results from integral models based on an entrainment assumption. The objective of this research is to determine wheter a large-eddy simulation can be applied in this case and what subgrid scale model performs best
The bright optical afterglow of the nearby gamma-ray burst of 29 March 2003
Many past studies of cosmological gamma-ray bursts (GRBs) have been limited
because of the large distance to typical GRBs, resulting in faint afterglows.
There has long been a recognition that a nearby GRB would shed light on the
origin of these mysterious cosmic explosions, as well as the physics of their
fireballs. However, GRBs nearer than z=0.2 are extremely rare, with an
estimated rate of localisation of one every decade. Here, we report the
discovery of bright optical afterglow emission from GRB 030329. Our prompt
dissemination and the brilliance of the afterglow resulted in extensive
followup (more than 65 telescopes) from radio through X-ray bands, as well as
measurement of the redshift, z=0.169. The gamma-ray and afterglow properties of
GRB 030329 are similar to those of cosmological GRBs (after accounting for the
small distance), making this the nearest known cosmological GRB. Observations
have already securely identified the progenitor as a massive star that exploded
as a supernova, and we anticipate futher revelations of the GRB phenomenon from
studies of this source.Comment: 13 pages, 4 figures. Original tex
Prognostic implications of immunohistochemically detected YKL-40 expression in breast cancer
BACKGROUND: YKL-40 has been implicated as a mediator of collagen synthesis and extracellular matrix re-modeling as well as mitogenesis. Elevated serum levels of YKL-40 have been associated with worse survival in a variety of malignancies including breast cancer. We wished to determine if immunohistochemically detected expression had prognostic implications in breast cancer. METHODS: A prospectively collected database of breast cancer patients treated at the University Hospital of Newark was used for analysis. Immunohistochemistry was performed on archived tumor tissue from 109 patients for whom full clinical information and follow up was available. RESULTS: YKL-40 expression was noted in 37 patients (34%). YKL-40 immunoreactivity significantly correlated with larger tumor size, poorer tumor differentiation, and a greater likelihood of being estrogen and/or progesterone receptor negative. No significant correlation was demonstrated between YKL-40 status and nodal stage. At a mean follow up of 3.2 years, disease-free survival was significantly worse in the subset of patients whose tumors demonstrated YKL-40 expression compared to the non-expressors. In multivariate analysis, YKL-40 status was independent of T-stage and N-stage in predicting disease recurrence. CONCLUSION: Immunoreactivity for YKL-40 was a significant predictor of breast cancer relapse in this subset of patients. This was independent of T or N-stage and suggests that tumor immunohistochemistry for this protein may be a valuable prognostic marker in breast cancer
Browser-based Data Annotation, Active Learning, and Real-Time Distribution of Artificial Intelligence Models: From Tumor Tissue Microarrays to COVID-19 Radiology.
BACKGROUND: Artificial intelligence (AI) is fast becoming the tool of choice for scalable and reliable analysis of medical images. However, constraints in sharing medical data outside the institutional or geographical space, as well as difficulties in getting AI models and modeling platforms to work across different environments, have led to a "reproducibility crisis" in digital medicine. METHODS: This study details the implementation of a web platform that can be used to mitigate these challenges by orchestrating a digital pathology AI pipeline, from raw data to model inference, entirely on the local machine. We discuss how this federated platform provides governed access to data by consuming the Application Program Interfaces exposed by cloud storage services, allows the addition of user-defined annotations, facilitates active learning for training models iteratively, and provides model inference computed directly in the web browser at practically zero cost. The latter is of particular relevance to clinical workflows because the code, including the AI model, travels to the user's data, which stays private to the governance domain where it was acquired. RESULTS: We demonstrate that the web browser can be a means of democratizing AI and advancing data socialization in medical imaging backed by consumer-facing cloud infrastructure such as Box.com. As a case study, we test the accompanying platform end-to-end on a large dataset of digital breast cancer tissue microarray core images. We also showcase how it can be applied in contexts separate from digital pathology by applying it to a radiology dataset containing COVID-19 computed tomography images. CONCLUSIONS: The platform described in this report resolves the challenges to the findable, accessible, interoperable, reusable stewardship of data and AI models by integrating with cloud storage to maintain user-centric governance over the data. It also enables distributed, federated computation for AI inference over those data and proves the viability of client-side AI in medical imaging. AVAILABILITY: The open-source application is publicly available at , with a short video demonstration at
Delivering reform in English healthcare: an ideational perspective
A variety of perspectives has been put forward to understand reform across healthcare systems. Recently, some have called for these perspectives to give greater recognition to the role of ideational processes. The purpose of this article is to present an ideational approach to understanding the delivery of healthcare reform. It draws on a case of English healthcare reform – the Next Stage Review led by Lord Darzi – to show how the delivery of its reform proposals was associated with four ideational frames. These frames built on the idea of “progress” in responding to existing problems; the idea of “prevailing policy” in forming part of a bricolage of ideas within institutional contexts; the idea of “prescription” as top-down structural change at odds with local contexts; and the idea of “professional disputes” in challenging the notion of clinical engagement across professional groups. The article discusses the implications of these ideas in furthering our understanding of policy change, conflict and continuity across healthcare settings
Exploring How Eruption Source Parameters Affect Volcanic Radiative Forcing Using Statistical Emulation
The radiative forcing caused by a volcanic eruption is dependent on several eruption source parameters such as the mass of sulfur dioxide (SO2) emitted, the eruption column height, and the eruption latitude. General circulation models with prognostic aerosol and chemistry schemes can be used to investigate how each parameter influences the volcanic forcing. However, the range of multidimensional parameter space that can be explored is restricted because such simulations are computationally expensive. Here we use statistical emulation to explore the radiative impact of eruptions over a wide covarying range of SO2 emission magnitudes, injection heights, and eruption latitudes based on only 30 simulations. We use the emulators to build response surfaces to visualize and predict the sulfate aerosol e-folding decay time, the stratospheric aerosol optical depth, and net radiative forcing of thousands of different eruptions. We find that the volcanic stratospheric aerosol optical depth and net radiative forcing are primarily determined by the mass of SO2 emitted, but eruption latitude is the most important parameter in determining the sulfate aerosol e-folding decay time. The response surfaces reveal joint effects of the eruption source parameters in influencing the net radiative forcing, such as a stronger influence of injection height for tropical eruptions than high-latitude eruptions. We also demonstrate how the emulated response surfaces can be used to find all combinations of eruption source parameters that produce a particular volcanic response, often revealing multiple solutions
Flow-distributed spikes for Schnakenberg kinetics
This is the post-print version of the final published paper. The final publication is available at link.springer.com by following the link below. Copyright @ 2011 Springer-Verlag.We study a system of reaction–diffusion–convection equations which combine a reaction–diffusion system with Schnakenberg kinetics and the convective flow equations. It serves as a simple model for flow-distributed pattern formation. We show how the choice of boundary conditions and the size of the flow influence the positions of the emerging spiky patterns and give conditions when they are shifted to the right or to the left. Further, we analyze the shape and prove the stability of the spikes. This paper is the first providing a rigorous analysis of spiky patterns for reaction-diffusion systems coupled with convective flow. The importance of these results for biological applications, in particular the formation of left–right asymmetry in the mouse, is indicated.RGC of Hong Kon
Intraocular pressure and ocular pulse amplitude using dynamic contour tonometry and contact lens tonometry
BACKGROUND: The new Ocular Dynamic Contour Tonometer (DCT), investigational device supplied by SMT (Swiss Microtechnology AG, Switzerland) allows simultaneous recording of intraocular pressure (IOP) and ocular pulse amplitude (OPA). It was the aim of this study to compare the IOP results of this new device with Goldmann tonometry. Furthermore, IOP and OPA measured with the new slitlamp-mounted DCT were compared to the IOP and OPA measured with the hand-held SmartLens(®), a gonioscopic contact lens tonometer (ODC Ophthalmic Development Company AG, Switzerland). METHODS: Nineteen healthy subjects were included in this study. IOP was determined by three consecutive measurements with each of the DCT, SmartLens(®), and Goldmann tonometer. Furthermore, OPA was measured three times consecutively by DCT and SmartLens(®). RESULTS: No difference (P = 0.09) was found between the IOP values by means of DCT (mean: 16.6 mm Hg, median: 15.33 mm Hg, SD: +/- 4.04 mm Hg) and Goldmann tonometry (mean: 16.17 mm Hg, median: 15.33 mm Hg, SD: +/- 4.03 mm Hg). The IOP values of SmartLens(® )(mean: 20.25 mm Hg, median: 19.00 mm Hg, SD: +/- 4.96 mm Hg) were significantly higher (P = 0.0008) both from Goldmann tonometry and DCT. The OPA values of the DCT (mean: 3.08 mm Hg, SD: +/- 0.92 mm Hg) were significantly lower (P = 0.0003) than those obtained by SmartLens(® )(mean: 3.92 mm Hg, SD: +/- 0.83 mm Hg). CONCLUSIONS: DCT was equivalent to Goldmann applanation tonometry in measurement of IOP in a small group of normal subjects. In contrast, SmartLens(® )(contact lens tonometry) gave IOP readings that were significantly higher compared with Goldmann applanation tonometer readings. Both devices, DCT and SmartLens(® )provide the measurement of OPA which could be helpful e.g. for the management of glaucoma
Kypho-IORT - a novel approach of intraoperative radiotherapy during kyphoplasty for vertebral metastases
<p>Abstract</p> <p>Background</p> <p>Instable and painful vertebral metastases in patients with progressive visceral metastases present a common therapeutic dilemma. We developed a novel approach to deliver intraoperative radiotherapy (IORT) during kyphoplasty and report the first treated case.</p> <p>Methods/Results</p> <p>60 year old patient with metastasizing breast cancer under chemotherapy presented with a newly diagnosed painful metastasis in the 12<sup>th </sup>thoracic vertebra. Under general anaesthesia, a bipedicular approach into the vertebra was chosen with insertion of specially designed metallic sleeves to guide the electron drift tube of the miniature X-ray generator (INTRABEAM, Carl Zeiss Surgical, Oberkochen, Germany). This was inserted with a novel sheet designed for this approach protecting the drift tube. A radiation dose of 8 Gy in 5 mm distance (50 kV X-rays) was delivered. The kyphoplasty balloons (KyphX, Kyphon Inc, Sunnyvale) were inflated after IORT and polymethylmethacrylate cement was injected. The whole procedure lasted less than 90 minutes.</p> <p>Conclusion</p> <p>In conclusion, this novel, minimally invasive procedure can be performed in standard operating rooms and may become a valuable option for patients with vertebral metastases providing immediate stability and local control. A phase I/II study is under way to establish the optimal dose prescription.</p
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