Minimizing radiation injury and neoplastic effects during pediatric fluoroscopy: what should we know?

Radiation-induced injuries from fluoroscopic procedures in pediatric patients have occurred, and young patients are at greatest risk of many radiation-induced neoplasms. Some fluoroscopists have been injured from their use of fluoroscopy, and they are known to be at risk of radiation-induced neoplasm when radiation is not well-controlled. This article reviews the circumstances that lead to radiation injury and delineates some procedural methods to avoid injury and limit radiation exposure to both the patient and the fluoroscopist

Synthesizing Speech from Intracranial Depth Electrodes using an Encoder-Decoder Framework

Speech Neuroprostheses have the potential to enable communication for people with dysarthria or anarthria. Recent advances have demonstrated high-quality text decoding and speech synthesis from electrocorticographic grids placed on the cortical surface. Here, we investigate a less invasive measurement modality in three participants, namely stereotactic EEG (sEEG) that provides sparse sampling from multiple brain regions, including subcortical regions. To evaluate whether sEEG can also be used to synthesize high-quality audio from neural recordings, we employ a recurrent encoder-decoder model based on modern deep learning methods. We find that speech can indeed be reconstructed with correlations up to 0.8 from these minimally invasive recordings, despite limited amounts of training data

Hydrodynamic bubble coarsening in off-critical vapour-liquid phase separation

Late-stage coarsening in off-critical vapour-liquid phase separation is re-examined. In the limit of bubbles of vapour distributed throughout a continuous liquid phase, it is argued that coarsening proceeds via inertial hydrodynamic bubble collapse. This replaces the Lifshitz-Slyozov-Wagner mechanism seen in binary liquid mixtures. The arguments are strongly supported by simulations in two dimensions using a novel single-component soft sphere fluid.Comment: 5 pages, 3 figures, revtex3.

Criteria for Removing Traffic Signals, Technical Report

DOT-FH-11-9524The report presents the results of a study to develop criteria that may be adopted as warrants for the removal of existing traffic control signals. The development of the signal removal criteria was based largely, as in a legal argument, on precedent. Those cases where positive impacts were realized by removing signals served to identify the criteria and conditions under which other signals should be removed. Likewise, cases involving negative impacts or unsuccessful removal attempts were reviewed to identify those conditions where signal removal should not be pursued. The methodology employed in this research was to compile the traffic signal removal experiences at over 200 intersections in 31 political entities, and to summarize and analyze this information to provide an objective base for the development of signal removal criteria. The decision process is designed to allow the traffic engineer to predict the expected impacts that will result from the removal of a traffic signal at a particular intersection. Knowing these probable impacts on intersection safety, traffic flow, energy consumption and costs, the traffic engineer can then make a sound decision concerning the removal of a signal. This volume documents the details of the signal removal criteria. A User's Guide is presented in another volume

Capacitance spectroscopy in quantum dots: Addition spectra and decrease of tunneling rates

A theoretical study of single electron capacitance spectroscopy in quantum dots is presented. Exact diagonalizations and the unrestricted Hartree-Fock approximation have been used to shed light over some of the unresolved aspects. The addition spectra of up to 15 electrons is obtained and compared with the experiment. We show evidence for understanding the decrease of the single electron tunneling rates in terms of the behavior of the spectral weight function. (To appear in Phys. Rev. B (Rapid Comm.))Comment: 10 pages, Revtex, hard copy or PostScript Figures upon request on [email protected]

Decoding executed and imagined grasping movements from distributed non-motor brain areas using a Riemannian decoder

Using brain activity directly as input for assistive tool control can circumventmuscular dysfunction and increase functional independence for physically impaired people. The motor cortex is commonly targeted for recordings, while growing evidence shows that there exists decodable movement-related neural activity outside of the motor cortex. Several decoding studies demonstrated significant decoding from distributed areas separately. Here, we combine information from all recorded non-motor brain areas and decode executed and imagined movements using a Riemannian decoder. We recorded neural activity from 8 epilepsy patients implanted with stereotactic-electroencephalographic electrodes (sEEG), while they performed an executed and imagined grasping tasks. Before decoding, we excluded all contacts in or adjacent to the central sulcus. The decoder extracts a low-dimensional representation of varying number of components, and classified move/no-move using a minimum-distance-to-geometric-mean Riemannian classifier. We show that executed and imagined movements can be decoded from distributed non-motor brain areas using a Riemannian decoder, reaching an area under the receiver operator characteristic of 0.83 ± 0.11. Furthermore, we highlight the distributedness of the movement-related neural activity, as no single brain area is the main driver of performance. Our decoding results demonstrate a first application of a Riemannian decoder on sEEG data and show that it is able to decode from distributed brain-wide recordings outside of the motor cortex. This brief report highlights the perspective to explore motor-related neural activity beyond the motor cortex, as many areas contain decodable information.</p

Phase separation in a chaotic flow

The phase separation between two immiscible liquids advected by a bidimensional velocity field is investigated numerically by solving the corresponding Cahn-Hilliard equation. We study how the spinodal decomposition process depends on the presence -or absence- of Lagrangian chaos. A fully chaotic flow, in particular, limits the growth of domains and for unequal volume fractions of the liquids, a characteristic exponential distribution of droplet sizes is obtained. The limiting domain size results from a balance between chaotic mixing and spinodal decomposition, measured in terms of Lyapunov exponent and diffusivity constant, respectively.Comment: Minor changes - Version accepted for publication - Physical Review Letter

Short- and long-term effects of a quality improvement collaborative on diabetes management

Introduction: This study examined the short- and long-term effects of a quality improvement collaborative on patient outcomes, professional performance, and structural aspects of chronic care management of type 2 diabetes in an integrated care setting.Methods: Controlled pre- and post-intervention study assessing patient outcomes (hemoglobin A1c, cholesterol, blood pressure, weight, blood lipid levels, and smoking status), professional performance (guideline adherence), and structural aspects of chronic care management from baseline up to 24 months. Analyses were based on 1,861 patients with diabetes in six intervention and nine control regions representing 37 general practices and 13 outpatient clinics.Results: Modest but significant improvement was seen in mean systolic blood pressure (decrease by 4.0 mm Hg versus 1.6 mm Hg) and mean high density lipoprotein levels (increase by 0.12 versus 0.03 points) at two-year follow up. Positive but insignificant differences were found in hemoglobin A1c (0.3%), cholesterol, and blood lipid levels. The intervention group showed significant improvement in the percentage of patients receiving advice and instruction to examine feet, and smaller reductions in the percentage of patients receiving instruction to monitor blood glucose and visiting a dietician annually. Structural aspects of self-management and decision support also improved significantly.Conclusions: At a time of heightened national attention toward diabetes care, our results demonstrate a modest benefit of participation in a multi-institutional quality improvement collaborative focusing on integrated, patient-centered care. The effects persisted for at least 12 months after the intervention was completed.Trial number: http://clinicaltrials.gov Identifier: NCT 00160017

Syndromic Surveillance and Bioterrorism-related Epidemics

To facilitate rapid detection of a future bioterrorist attack, an increasing number of public health departments are investing in new surveillance systems that target the early manifestations of bioterrorism-related disease. Whether this approach is likely to detect an epidemic sooner than reporting by alert clinicians remains unknown. The detection of a bioterrorism-related epidemic will depend on population characteristics, availability and use of health services, the nature of an attack, epidemiologic features of individual diseases, surveillance methods, and the capacity of health departments to respond to alerts. Predicting how these factors will combine in a bioterrorism attack may be impossible. Nevertheless, understanding their likely effect on epidemic detection should help define the usefulness of syndromic surveillance and identify approaches to increasing the likelihood that clinicians recognize and report an epidemic