Brachial plexus injury mimicking a spinal-cord injury.

Objective High-energy impact to the head, neck, and shoulder can result in cervical spine as well as brachial plexus injuries. Because cervical spine injuries are more common, this tends to be the initial focus for management. We present a case in which the initial magnetic resonance imaging (MRI) was somewhat misleading and a detailed neurological exam lead to the correct diagnosis.Clinical presentation A 19-year-old man presented to the hospital following a shoulder injury during football practice. The patient immediately complained of significant pain in his neck, shoulder, and right arm and the inability to move his right arm. He was stabilized in the field for a presumed cervical-spine injury and transported to the emergency department.Intervention Initial radiographic assessment (C-spine CT, right shoulder x-ray) showed no bony abnormality. MRI of the cervical-spine showed T2 signal change and cord swelling thought to be consistent with a cord contusion. With adequate pain control, a detailed neurological examination was possible and was consistent with an upper brachial plexus avulsion injury that was confirmed by CT myelogram. The patient failed to make significant neurological recovery and he underwent spinal accessory nerve grafting to the suprascapular nerve to restore shoulder abduction and external rotation, while the phrenic nerve was grafted to the musculocutaneous nerve to restore elbow flexion.Conclusion Cervical spinal-cord injuries and brachial plexus injuries can occur by the same high energy mechanisms and can occur simultaneously. As in this case, MRI findings can be misleading and a detailed physical examination is the key to diagnosis. However, this can be difficult in polytrauma patients with upper extremity injuries, head injuries or concomitant spinal-cord injury. Finally, prompt diagnosis and early surgical renerveration have been associated with better long-term recovery with certain types of injury

Deep Markov Random Field for Image Modeling

Markov Random Fields (MRFs), a formulation widely used in generative image modeling, have long been plagued by the lack of expressive power. This issue is primarily due to the fact that conventional MRFs formulations tend to use simplistic factors to capture local patterns. In this paper, we move beyond such limitations, and propose a novel MRF model that uses fully-connected neurons to express the complex interactions among pixels. Through theoretical analysis, we reveal an inherent connection between this model and recurrent neural networks, and thereon derive an approximated feed-forward network that couples multiple RNNs along opposite directions. This formulation combines the expressive power of deep neural networks and the cyclic dependency structure of MRF in a unified model, bringing the modeling capability to a new level. The feed-forward approximation also allows it to be efficiently learned from data. Experimental results on a variety of low-level vision tasks show notable improvement over state-of-the-arts.Comment: Accepted at ECCV 201

Empirically Constrained Color-Temperature Relations. II. uvby

(Abriged) A new grid of theoretical color indices for the Stromgren uvby photometric system has been derived from MARCS model atmospheres and SSG synthetic spectra for cool dwarf and giant stars. At warmer temperatures this grid has been supplemented with the synthetic uvby colors from recent Kurucz atmospheric models without overshooting. Our transformations appear to reproduce the observed colors of extremely metal-poor turnoff and giant stars (i.e., [Fe/H]<-2). Due to a number of assumptions made in the synthetic color calculations, however, our color-temperature relations for cool stars fail to provide a suitable match to the uvby photometry of both cluster and field stars having [Fe/H]>-2. To overcome this problem, the theoretical indices at intermediate and high metallicities have been corrected using a set of color calibrations based on field stars having accurate IRFM temperature estimates and spectroscopic [Fe/H] values. Encouragingly, isochrones that employ the transformations derived in this study are able to reproduce the observed CMDs (involving u-v, v-b, and b-y colors) for a number of open and globular clusters (including M92, M67, the Hyades, and 47Tuc) rather well. Moreover, our interpretations of such data are very similar, if not identical, with those given by VandenBerg & Clem (2003, AJ, 126, 778) from a consideration of BV(RI)c observations for the same clusters. In the present investigation, we have also analyzed the observed Stromgren photometry for the classic Population II subdwarfs, compared our "final" (b-y)-Teff relationship with those derived empirically in a number of recent studies, and examined in some detail the dependence of the m1 index on [Fe/H].Comment: 70 pages, 26 figures. Accepted for publication in AJ (Feb 2004). Postscript version with high resolution figures and complete Table 3 available at http://astrowww.phys.uvic.ca/~jclem/uvb

Coupled Replicator Equations for the Dynamics of Learning in Multiagent Systems

Starting with a group of reinforcement-learning agents we derive coupled replicator equations that describe the dynamics of collective learning in multiagent systems. We show that, although agents model their environment in a self-interested way without sharing knowledge, a game dynamics emerges naturally through environment-mediated interactions. An application to rock-scissors-paper game interactions shows that the collective learning dynamics exhibits a diversity of competitive and cooperative behaviors. These include quasiperiodicity, stable limit cycles, intermittency, and deterministic chaos--behaviors that should be expected in heterogeneous multiagent systems described by the general replicator equations we derive.Comment: 4 pages, 3 figures, http://www.santafe.edu/projects/CompMech/papers/credlmas.html; updated references, corrected typos, changed conten

Evolutionary conservation of regulated longevity assurance mechanisms

Short abstract: A multi-level cross-species comparative analysis of gene-expression changes accompanying increased longevity in mutant nematodes, fruit flies and mice with reduced insulin/IGF-1 signaling revealed candidate conserved mechanisms

Offshore Radiation Observations for Climate Research at the CERES Ocean Validation Experiment

When radiometers on a satellite are pointed towards the planet with the goal of understanding a phenomenon quantitatively, rather than just creating a pleasing image, the task at hand is often problematic. The signal at the detector can be affected by scattering, absorption, and emission; and these can be due to atmospheric constituents (gases, clouds, and aerosols), the earth's surface, and subsurface features. When targeting surface phenomena, the remote sensing algorithm needs to account for the radiation associated with the atmospheric constituents. Likewise, one needs to correct for the radiation leaving the surface, when atmospheric phenomena are of interest. Rigorous validation of such remote sensing products is a real challenge. In visible and near infrared wavelengths, the jumble of effects on atmospheric radiation are best accomplished over dark surfaces with fairly uniform reflective properties (spatial homogeneity) in the satellite instrument's field of view (FOV). The ocean's surface meets this criteria; land surfaces - which are brighter, more spatially inhomogeneous, and more changeable with time - generally do not. NASA's Clouds and the Earth's Radiant Energy System (CERES) project has used this backdrop to establish a radiation monitoring site in Virginia's coastal Atlantic Ocean. The project, called the CERES Ocean Validation Experiment (COVE), is located on a rigid ocean platform allowing the accurate measurement of radiation parameters that require precise leveling and pointing unavailable from ships or buoys. The COVE site is an optimal location for verifying radiative transfer models and remote sensing algorithms used in climate research; because of the platform's small size, there are no island wake effects; and suites of sensors can be simultaneously trained both on the sky and directly on ocean itself. This paper describes the site, the types of measurements made, multiple years of atmospheric and ocean surface radiation observations, and satellite validation results

Short-Term Impact of Bracing in Multi-Level Posterior Lumbar Spinal Fusion

Background: Clinical practice in postoperative bracing after posterior lumbar spine fusion (PLF) is inconsistent between providers. This paper attempts to assess the effect of bracing on short-term outcomes related to safety, quality of care, and direct costs. Methods: Retrospective cohort analysis of consecutive patients undergoing multilevel PLF with or without bracing (2013-2017) was undertaken (n = 980). Patient demographics and comorbidities were analyzed. Outcomes assessed included length of stay (LOS), discharge disposition, quality-adjusted life years (QALY), surgical-site infection (SSI), total cost, readmission within 30 days, and emergency department (ED) evaluation within 30 days. Results: Amongst the study population, 936 were braced and 44 were not braced. There was no difference between the braced and unbraced cohorts regarding LOS (P = .106), discharge disposition (P = .898), 30-day readmission (P = .434), and 30-day ED evaluation (P = 1.000). There was also no difference in total cost (P = .230) or QALY gain (P = .740). The results indicate a significantly lower likelihood of SSI in the braced population (1.50% versus 6.82%, odds ratio = 0.208, 95% confidence interval = 0.057-0.751, P = .037). There was no difference in relevant comorbidities (P = .259-1.000), although the braced cohort was older than the unbraced cohort (63 versus 56 y, P = .003). Conclusion: Bracing following multilevel posterior lumbar fixation does not alter short-term postoperative course or reduce the risk for early adverse events. Cost analysis show no difference in direct costs between the 2 treatment approaches. Short-term data suggest that removal of bracing from the postoperative regimen for PLF will not result in increased adverse outcomes