Beyond California: States in Fiscal Peril

Analyzes the causes of fiscal stress in nine states facing issues similar to California's: high foreclosure rates, increasing joblessness, loss of state revenues, large budget gaps, legal obstacles to balanced budgets, and poor money management practices

State of the States 2009

Highlights state election results and policy developments in 2008 and projects trends for 2009. Considers how the recession and the new administration's policies may affect states on energy, education, Medicaid, the social safety net, and other issues

Monopolelike probes for quantitative magnetic force microscopy: calibration and application

A local magnetization measurement was performed with a Magnetic Force Microscope (MFM) to determine magnetization in domains of an exchange coupled [Co/Pt]/Co/Ru multilayer with predominant perpendicular anisotropy. The quantitative MFM measurements were conducted with an iron filled carbon nanotube tip, which is shown to behave like a monopole. As a result we determined an additional in-plane magnetization component of the multilayer, which is explained by estimating the effective permeability of the sample within the \mu*-method.Comment: 3 pages, 3 figure

State of the States 2006

Summarizes major state policy developments in 2005, and projects likely trends for 2006. Focuses on public education, affordable health care, aging, taxes, homeland security, immigration, and energy. Profiles newly elected governors

Protective Embolization of the Gastroduodenal Artery with a One-HydroCoil Technique in Radioembolization Procedures

Purpose: Protective occlusion of the gastroduodenal artery (GDA) is required to avoid severe adverse effects and complications in radioembolization procedures. Because of the expandable features of HydroCoils, our goal was to occlude the GDA with only one HydroCoil to provide particle reflux protection. Methods: Twenty-three subjects with unresectable liver tumors, who were scheduled for protective occlusion of the GDA before radioembolization therapy, were included. The primary end point was to achieve a proximal occlusion of the GDA with only one detachable HydroCoil. Evaluated parameters were duration of deployment, and early (during the intervention) and late (7-21days) occlusion rates of GDA. Secondary end points included complete duration of the intervention, amount of contrast medium used, fluoroscopy rates, and adverse effects. Results: In all cases, the GDA was successfully occluded with only one HydroCoil. The selected diameter/length range was 4/10mm in 2 patients, 4/15mm in 6 patients, and 4/20mm in 15 patients. HydroCoils were implanted, on average, 3.75mm from the origin of the GDA (range 1.5-6.8mm), with an average deployment time of 2:47 (median 2:42, range 2:30-3:07) min. In 21 (91%) of 23 patients, a complete occlusion of the GDA was achieved during the first 30min after the coil implantation; however, in all patients, a late occlusion of the GDA was present after 6 to 29days. No clinical or technical complications were reported. Conclusion: We demonstrated that occlusion of the GDA with a single HydroCoil is a safe procedure and successfully prevents extrahepatic embolization before radioembolizatio

SEVERE OSTEOPOROSIS DUE TO SYSTEMIC MAST CELL DISEASE: SUCCESSFUL TREATMENT WITH INTERFERON ALPHA-2B

We describe a 33-yr-old man suffering from severe vertebral osteoporosis and urticaria pigmentosa due to systemic mast cell disease (SMCD). Because i.v. clodronate therapy could not prevent further vertebral fractures, an additional treatment with interferon alpha-2b was initiated. During 24 months of treatment, our patient had no further pain episodes, no new vertebral fractures were discovered, trabecular bone mineral density (BMD) increased significantly and urticarial symptoms improved. Nevertheless, the extent of skin lesions remained unchanged. On histological examination, a remarkable decrease of mast cells was observed in the bone marrow, but not in the skin. Five months after discontinuation of interferon alpha-2b, trabecular BMD decreased and urticarial symptoms deteriorated. These findings illustrate a beneficial effect of interferon alpha-2b on SMCD-induced osteoporosis as well as urticarial symptoms, and raise the question whether this treatment may have a diverse impact on mast cell populations in different tissue

Postmortem imaging of blood and its characteristics using MSCT and MRI

The rapid development of computed tomography (CT) and magnetic resonance imaging (MRI) led to the introduction and establishment in postmortem investigations. The objectives of this preliminary study were to describe the imaging appearances of the early postmortem changes of blood after cessation of the circulation, such as sedimentation, postmortem clotting, and internal livores, and to give a few first suggestions on how to differentiate them from other forensic findings. In the Virtopsy project, 95 human corpses underwent postmortem imaging by CT and MRI prior to traditional autopsy and therefore 44 cases have been investigated in this study. Postmortem alterations as well as the forensic relevant findings of the blood, such as internal or subcutaneous bleedings, are presented on the basis of their imaging appearances in multislice CT and MR

Strategien zur Reduktion der CT-Strahlendosis

Zusammenfassung: Die rasante technische Weiterentwicklung der CT hat in den letzten Jahren zu einer deutlichen Zunahme der diagnostischen Möglichkeiten geführt, mit dem Resultat, dass die CT-Untersuchungszahlen weltweit angestiegen sind. Dies hat ebenfalls Auswirkung auf die Strahlenexposition der Bevölkerung. Bis heute sind zahlreiche Publikationen erschienen, die gezeigt haben, dass eine Dosisreduktion erreicht werden kann, ohne dadurch die Bildqualität und Sensitivität der CT zu beeinträchtigen. Die Mehrzahl der Strategien zur Dosisoptimierung sind einfach anzuwenden und unabhängig von der Detektorkonfiguration des CT-Scanners. Im vorliegenden Übersichtsartikel werden die wichtigsten Methoden vorgestellt: indikationsabhängige Methoden (z.B. rechtfertigende Indikation, Reduktion der Röhrenspannung für die CT-Angiographie, Wahl von Kollimation und Pitchfaktor, Minimierung der Untersuchungsphasen, Senkung der Röhrenspannung und des -stroms für die Nativphase), herstellerabhängige Methoden (z.B. automatische Röhrenstrommodulation, adaptive Filter zur Reduktion des Bildrauschens, iterative Bildrekonstruktion) und allgemeine Methoden (z.B. Patientenzentrierung im Isozentrum der CT-Gantry, Reduktion der Scanlänge, Anwendung von Röntgenschutzmitteln, Reduktion der Röhrenspannung und/oder des -stroms für den CT-Planungsscan

How to set up and apply reference levels in fluoroscopy at a national level

A nationwide survey was launched to investigate the use of fluoroscopy and establish national reference levels (RL) for dose-intensive procedures. The 2-year investigation covered five radiology and nine cardiology departments in public hospitals and private clinics, and focused on 12 examination types: 6 diagnostic and 6 interventional. A total of 1,000 examinations was registered. Information including the fluoroscopy time (T), the number of frames (N) and the dose-area product (DAP) was provided. The data set was used to establish the distributions of T, N and the DAP and the associated RL values. The examinations were pooled to improve the statistics. A wide variation in dose and image quality in fixed geometry was observed. As an example, the skin dose rate for abdominal examinations varied in the range of 10 to 45mGy/min for comparable image quality. A wide variability was found for several types of examinations, mainly complex ones. DAP RLs of 210, 125, 80, 240, 440 and 110Gy cm2 were established for lower limb and iliac angiography, cerebral angiography, coronary angiography, biliary drainage and stenting, cerebral embolization and PTCA, respectively. The RL values established are compared to the data published in the literatur

Cohort-based T-SSIM Visual Computing for Radiation Therapy Prediction and Exploration

We describe a visual computing approach to radiation therapy (RT) planning, based on spatial similarity within a patient cohort. In radiotherapy for head and neck cancer treatment, dosage to organs at risk surrounding a tumor is a large cause of treatment toxicity. Along with the availability of patient repositories, this situation has lead to clinician interest in understanding and predicting RT outcomes based on previously treated similar patients. To enable this type of analysis, we introduce a novel topology-based spatial similarity measure, T-SSIM, and a predictive algorithm based on this similarity measure. We couple the algorithm with a visual steering interface that intertwines visual encodings for the spatial data and statistical results, including a novel parallel-marker encoding that is spatially aware. We report quantitative results on a cohort of 165 patients, as well as a qualitative evaluation with domain experts in radiation oncology, data management, biostatistics, and medical imaging, who are collaborating remotely.Comment: IEEE VIS (SciVis) 201