A Bayesian approach for energy-based estimation of acoustic aberrations in high intensity focused ultrasound treatment

High intensity focused ultrasound is a non-invasive method for treatment of diseased tissue that uses a beam of ultrasound to generate heat within a small volume. A common challenge in application of this technique is that heterogeneity of the biological medium can defocus the ultrasound beam. Here we reduce the problem of refocusing the beam to the inverse problem of estimating the acoustic aberration due to the biological tissue from acoustic radiative force imaging data. We solve this inverse problem using a Bayesian framework with a hierarchical prior and solve the inverse problem using a Metropolis-within-Gibbs algorithm. The framework is tested using both synthetic and experimental datasets. We demonstrate that our approach has the ability to estimate the aberrations using small datasets, as little as 32 sonication tests, which can lead to significant speedup in the treatment process. Furthermore, our approach is compatible with a wide range of sonication tests and can be applied to other energy-based measurement techniques

Lack of benefit of endoscopic ventriculoperitoneal shunt insertion: a multicenter randomized trial

Journal ArticleObject. Endoscopically assisted ventricular catheter placement has been reported to reduce shunt failure in uncontrolled series. The authors investigated the efficacy of this procedure in a prospective multicenter randomized trial. Methods. Children younger than 18 years old who were scheduled for their first ventriculoperitoneal (VP) shunt placement were randomized to undergo endoscopic or nonendoscopic insertion of a ventricular catheter. Eligibility and primary outcome (shunt failure) were decided in a blinded fashion. An intention-to-treat analysis was performed. The sample size offered 80% power to detect a 10 to 15% absolute reduction in the 1-year shunt failure rate. The authors studied 393 patients from 16 pediatric neurosurgery centers between May 1996 and November 1999. Median patient age at shunt insertion was 89 days. The baseline characteristics of patients within each group were similar: 54% of patients treated with endoscopy were male and 55% of patients treated without endoscopy were male; 30% of patients treated with and 26% of those without endoscopy had myelomeningocele; a differential pressure valve was used in 51% of patients with and 49% of those treated without endoscopy; a Delta valve was inserted in 38% of patients in each group; and a Sigma valve was placed in 9% of patients treated with and 12% of those treated without endoscopy. Median surgical time lasted 40 minutes in the group treated with and 35 minutes in the group treated without endoscopy. Ventricular catheters, which during surgery were thought to be situated away from the choroid plexus, were demonstrated to be in it on postoperative imaging in 67% of patients who had undergone endoscopic insertion and 61% of those who had undergone nonendoscopic shunt placements. The incidence of shunt failure at 1 year was 42% in the endoscopic insertion group and 34% in the nonendoscopic group. The time to first shunt failure was not different between the two groups (log rank = 2.92, p = 0.09). Conclusions. Endoscopic insertion of the initial VP shunt in children suffering from hydrocephalus did not reduce the incidence of shunt failure

Determining the best cerebrospinal fluid shunt valve design: the pediatric valve design trial

Journal ArticleMyriad cerebrospinal fluid shunt valve designs are available (17, IS). None has ever been shown to be superior to another, although claims by neurosurgeons and shunt manufacturers of the merits of particular designs are numerous. Such is the case with two recent shunt valve designs, the Orbis-Sigma valve (Cordis Corporation, Miami, FL) and the Delta valve (PS Medical, Gofetta, CA). Both reduce the siphoning effect when the patient is in the upright position by different mechanisms. Reports of reduced complication rates in uncontrolled series have been attributed to diminished shunt overdrainage (13, 19, 20, 22)

Randomized trial of cerebrospinal fluid shunt valve design in pediatric hydrocephalus

Journal ArticleOBJECTIVE: Forty percent of standard cerebrospinal fluid shunts implanted for the treatment of pediatric hydrocephalus fail within the first year. Two new shunt valves designed to limit excess flow, particularly in upright positions, were studied to compare treatment failure rates with those for standard differential-pressure valves. METHODS: Three hundred-forty-four hydrocephalic children (age, birth to 18 yr) undergoing their first cerebrospinal fluid shunt insertion were randomized at 12 North American or European pediatric neurosurgical centers. Patients received one of three valves, i.e., a standard differential-pressure valve; a Delta valve (Medtronic PS Medical, Goleta, CA), which contains a siphon-control component designed to reduce siphoning in upright positions; or an Orbis-Sigma valve (Cordis, Miami, FL), with a variable-resistance, flow-limiting component. Patients were monitored for a minimum of 1 year. Endpoints were defined as shunt failure resulting from shunt obstruction, overdrainage, loculations of the cerebral ventricles, or infection. Outcome events were assessed by blinded independent case review. RESULTS: One hundred-fifty patients reached an endpoint; shunt obstruction occurred in 108 (31.4%), overdrainage in 12(3.5%), loculated ventricles in 2(0.6%), and infection in 28 (8.1%). Sixty-one percent were shunt failure-free at 1 year and 47% at 2 years, with a median shunt failure-free duration of 656 days. There was no difference in shunt failure-free duration among the three valves (P = 0.24)

Simulation of fluid flows during growth of organic crystals in microgravity

Several counter diffusion type crystal growth experiments were conducted in space. Improvements in crystal size and quality are attributed to reduced natural convection in the microgravity environment. One series of experiments called DMOS (Diffusive Mixing of Organic Solutions) was designed and conducted by researchers at the 3M Corporation and flown by NASA on the space shuttle. Since only limited information about the mixing process is available from the space experiments, a series of ground based experiments was conducted to further investigate the fluid dynamics within the DMOS crystal growth cell. Solutions with density differences in the range of 10 to the -7 to 10 to the -4 power g/cc were used to simulate microgravity conditions. The small density differences were obtained by mixing D2O and H2O. Methylene blue dye was used to enhance flow visualization. The extent of mixing was measured photometrically using the 662 nm absorbance peak of the dye. Results indicate that extensive mixing by natural convection can occur even under microgravity conditions. This is qualitatively consistent with results of a simple scaling analysis. Quantitave results are in close agreement with ongoing computational modeling analysis

Reconstructing Salmon Abundance in Rivers: An Initial Dendrochronological Evaluation

Decision-makers concerned with salmon or their stream habitats are faced with many persistent, difficult questions including: how large and variable were these populations before European settlement? Here, we examine the feasibility of reconstructing salmon abundance using links between marine nutrients carried upstream by Pacific salmon ( Oncorhynchus spp.) and growth of dominant riparian trees in two Alaskan systems. We employ standard dendrochronology methods and regression models to quantify relationships between annual tree-ring growth, salmon escapement, and the climate pattern that affects oceanic production of Northeast Pacific salmon stocks, the Pacific Decadal Oscillation (PDO). We find that known, annual salmon escapement is significantly related to tree-ring growth at two sites in the Pacific coastal rainforest (PCRF) (r2 = 0.23, P \u3c 0.05 at each site), but not at two sites in the boreal forest. We then use relationships established at PCRF sites to reconstruct preliminary salmon spawning abundances to 1820 A.D. The PDO was not correlated with local 19-yr salmon escapement records and could not be used in re­constructions. Reconstructions compare favorably to southeastern Alaska fisheries catch data from 1924 to 1994 (Pearson correlation = 0.301 [P = 0.02] and 0.401 [P \u3c 0.01]). This study demonstrates the promise and utility of dendrochronology for reconstructing salmon returns to streams

How fluent is the fluent speech of people who stutter? A new approach to measuring kinematics with ultrasound

AM deposited 2020-06-22We present a new approach to the investigation of dynamic ultrasound tongue imaging (UTI) data, applied here to analyse the subtle aspects of the fluency of people who stutter (PWS). Fluent productions of CV syllables (C = /k/; V = /, i, /) from three PWS and three control speakers (PNS) were analysed for duration and peak velocity relative to articulatory movement towards (onset) and away from (offset) the consonantal closure. The objective was to apply a replicable methodology for kinematic investigation to speech of PWS in order to test Wingate's Fault-Line hypothesis. As was hypothesised, results show comparable onset behaviours for both groups. Regarding offsets, groups differ in peak velocity. Results suggest that PWS do not struggle initiating consonantal closure (onset). In transition from consonantal closure into the vowel, however, groups appear to employ different strategies expressed in increased variation (PNS) versus decreased mean peak velocity (PWS).casl30pub4219pub3-

Transits and secondary eclipses of HD 189733 with Spitzer

We present limits on transit timing variations and secondary eclipse depth variations at 8 microns with the Spitzer Space Telescope IRAC camera. Due to the weak limb darkening in the infrared and uninterrupted observing, Spitzer provides the highest accuracy transit times for this bright system, in principle providing sensitivity to secondary planets of Mars mass in resonant orbits. Finally, the transit data provides tighter constraints on the wavelength- dependent atmospheric absorption by the planet.Comment: 7 pages, 7 figures, submitted to proceedings of IAU Symposium No. 253 "Transiting Planets

The use of high frequency oscillations to guide neocortical resections in children with medically-intractable epilepsy: How do we ethically apply surgical innovations to patient care?

AbstractPurposeResective surgical strategies are increasingly applied to treat medically-intractable epilepsy in children as uncontrolled seizures are associated with poor cognitive, developmental and behavioral outcomes. Innovative surgical strategies are, however, needed to improve outcomes and minimize the morbidity of such procedures.MethodThe current article utilizes an axiological approach to explore and highlight ethical issues in the use of high frequency oscillations (HFOs) to guide surgical resections in children with medically-intractable epilepsy. We frame our discussion in the context of the broader challenges in the application of surgical innovation to patient care.ResultsDespite a paucity of knowledge regarding their pathogenesis, limited evidence suggests the use of HFOs as biomarkers of epileptogenicity in resective procedures can improve seizure outcome. Clinicians must therefore weigh deficiencies in knowledge against the limited evidence supporting the utility of HFOs and make ethical decisions for the treatment of individual patients. Important ethical considerations for clinicians include the extent of deviation from established practice, the extent of evidence required to establish clinical validity, and the impact of technique implementation on equitable distribution of healthcare.ConclusionThe use of HFO signatures to guide neocortical resections represents a novel approach for the treatment of epilepsy. It is hoped that the issues discussed herein will contribute to and advance meaningful dialog on the ethical application of this surgical innovation to the treatment of a very vulnerable patient population