Noise level reduction inside helicopter cabins

NASA Astrophysics Data System (ADS)

Laudien, Eckehard; Niesl, George

1990-09-01

A number of measures to reduce the noise level in helicopter cabins are discussed. Laboratory test results of various panellings are presented as well as the insulation capacities of different panel mounts. Experiments in acoustic facilities (anechoic chamber and reverberation room) with the original cabin door and its frame led to an optimization of the transmission losses of door components such as window, sealing, and frame. The reduction of the cabin noise level by adding absorption is illustrated in the case of a honeycomb bulkhead with Helmholtz resonators. These sound absorption elements were designed to damp discrete gearbox frequencies. Resonators were also used for noise attenuation of an oil cooler fan. Cabin noise comfort can be improved by eliminating discrete frequencies. This was achieved in an experimental set up where properly tuned resonators were placed as close as possible to the passenger's ear in the headrest of the seat. In order to reduce structureborne transmission system noise, ground and flight test data of gearbox strut impedance were used for the design of specially tuned vibration absorbers.

STS-65 Commander Cabana with SAREX-II on Columbia's, OV-102's, flight deck

NASA Technical Reports Server (NTRS)

1994-01-01

STS-65 Commander Robert D. Cabana is seen on the Space Shuttle Columbia's, Orbiter Vehicle (OV) 102's, aft flight deck with the Shuttle Amateur Radio Experiment II (SAREX-II) (configuration C). Cabana is equipped with the SAREX-II headset and holds a cable leading to the 2-h window antenna mounted in forward flight deck window W1 (partially blocked by the seat headrest). SAREX was established by NASA, the American Radio League/Amateur Radio Satellite Corporation and the Johnson Space Center (JSC) Amateur Radio Club to encourage public participation in the space program through a project to demonstrate the effectiveness of conducting short-wave radio transmissions between the Shuttle and ground-based radio operators at low-cost ground stations with amateur and digital techniques. As on several previous missions, SAREX was used on this flight as an educational opportunity for students around the world to learn about space firsthand by speaking directly to astronauts aboard the shuttle.

BabySQUID: A mobile, high-resolution multichannel magnetoencephalography system for neonatal brain assessment

NASA Astrophysics Data System (ADS)

Okada, Yoshio; Pratt, Kevin; Atwood, Christopher; Mascarenas, Anthony; Reineman, Richard; Nurminen, Jussi; Paulson, Douglas

2006-02-01

We developed a prototype of a mobile, high-resolution, multichannel magnetoencephalography (MEG) system, called babySQUID, for assessing brain functions in newborns and infants. Unlike electroencephalography, MEG signals are not distorted by the scalp or the fontanels and sutures in the skull. Thus, brain activity can be measured and localized with MEG as if the sensors were above an exposed brain. The babySQUID is housed in a moveable cart small enough to be transported from one room to another. To assess brain functions, one places the baby on the bed of the cart and the head on its headrest with MEG sensors just below. The sensor array consists of 76 first-order axial gradiometers, each with a pickup coil diameter of 6mm and a baseline of 30mm, in a high-density array with a spacing of 12-14mm center-to-center. The pickup coils are 6±1mm below the outer surface of the headrest. The short gap provides unprecedented sensitivity since the scalp and skull are thin (as little as 3-4mm altogether) in babies. In an electromagnetically unshielded room in a hospital, the field sensitivity at 1kHz was ˜17fT/√Hz. The noise was reduced from ˜400to200fT/√Hz at 1Hz using a reference cancellation technique and further to ˜40fT/√Hz using a gradient common mode rejection technique. Although the residual environmental magnetic noise interfered with the operation of the babySQUID, the instrument functioned sufficiently well to detect spontaneous brain signals from babies with a signal to noise ratio (SNR) of as much as 7.6:1. In a magnetically shielded room, the field sensitivity was 17fT/√Hz at 20Hz and 30fT/√Hz at 1Hz without implementation of reference or gradient cancellation. The sensitivity was sufficiently high to detect spontaneous brain activity from a 7month old baby with a SNR as much as 40:1 and evoked somatosensory responses with a 50Hz bandwidth after as little as four averages. We expect that both the noise and the sensor gap can be reduced further by approximately half with a gain in SNR of about four. Thus, we conclude from the performance of the prototype that it should be feasible to improve the babySQUID to detect cortical activity in infants in real time with high spatial resolution.

Description of a Simple Method of Stoma Protection During Prone Positioning.

PubMed

Mackert, Gina A; Reid, Christopher M; Dobke, Marek K; Tenenhaus, Mayer

2016-06-01

Surgeries conducted with the patient in the prone position are frequent and can be lengthy. Abdominal stomas and su- prapubic catheters require protection for the complete duration of the procedure to avoid complications such as stomal ischemia, bleeding, or mucocutaneous separation. Standard protection strategies such as pillows and wedges can eas- ily fail. In the course of managing several patients who had sustained ostomy complications following surgery in a prone position, a simple method of stoma protection was devised. Instead of discarding the foam headrest typically used dur- ing induction by anesthesia staff, this device is placed with its central recess over the stoma and secured to the patient's abdominal wall with gentle tape just before turning the patient into a prone position. This method, used in more than 80 patients, has been found to effectively relieve pressure, and no complications have been observed. The foam shape also enables unobstructed drainage of fluids, facilitating collection and preventing leakage and contamination of the surgical field. Because the device is widely used by anesthesia, it is readily available and does not add any extra cost.

Active euthanasia in pre-modern society, 1500-1800: learned debates and popular practices.

PubMed

Stolberg, Michael

2007-08-01

Historians of medical ethics have found that active euthanasia, in the sense of intentionally hastening the death of terminally-ill patients, was considered unacceptable in the Christian West before the 1870s. This paper presents a range of early modern texts on the issue which reflect a learned awareness of practices designed to shorten the lives of dying patients which were widely accepted among the lay public. Depriving the dying abruptly of their head-rest or placing them flat on the cold floor may strike us as merely symbolic today, but early moderns associated such measures with very concrete and immediate effects. In this sense, the intentional hastening of death in agonising patients had an accepted place in pre-modern popular culture. These practices must, however, be put into their proper context. Death was perceived more as a transition to the after-life and contemporary notions of dying could make even outright suffocation appear as an act of compassion which merely helped the soul depart from the body at the divinely ordained hour of death. The paper concludes with a brief comparison of early modern arguments with those of today.

Ocular counterrolling measured during eight hours of sustained body tilt

NASA Technical Reports Server (NTRS)

Miller, E. F., II; Graybiel, A.

1972-01-01

Adaptation of otolith organ activity was investigated by monitoring the ocular counterrolling response of four normal individuals and three persons with severe bilateral loss of labyrinthine function. Several eye photographs were recorded every 30 minutes during a period of 8 hours in which the subject was held in a lateral tilt (60 deg) position. The recorded eye roll position varied to an expected small extent within each test session; this variation about a given mean roll position was similar among the test sessions for all subjects. The mean roll position, on the other hand, changed from session to session in substantial amounts, but these changes appeared to be random with respect to time and among subjects. Furthermore, the intersessional variation in the mean torsional eye position of the normal subjects was equivalent to that of the labyrinthine-defective subjects who displayed little or no counterrolling. These results suggest that the human counterrolling response is maintained either by essentially nonadapting macular receptors or by extremely fine movements of the head in the gravitational field, such as may have been allowed by the biteboard/headrest restraint system used in this study, which served as an everchanging accelerative stimulus.

Survey of the use of transport by recipients of a regional Electric Indoor/Outdoor Powered (EPIOC) wheelchair service.

PubMed

Belcher, M J H; Frank, A O

2004-05-20

To determine the extent to which Electric Indoor/Outdoor Powered wheelchair (EPIOC) users travel in vehicles, their concerns about safety, any accidents occurring during transportation and difficulties with their equipment. All 268 EPIOC users on the departmental database were sent a purpose-designed postal questionnaire asking whether the respondent:--used the chair during transportation and in what type of vehicle; understood clamping processes; had a 'mishap' or an 'accident'; felt safe during transportation and wished to comment. Replies from two mailings resulted in 203 usable replies (76%). Responses and comments were entered into an Excel database. Thirty-seven (18%) users did not use any transport. Of the 170 (82%) who did: 51% used Dial-a-Ride, 44% taxis, 41% ambulances, 37% local authority transport, 34% cars and others 17%. Twenty-one (12%) experienced 'mishaps'--8 toppled out of their chairs and 6 reported clamping-related accidents. Headrests were only used by 69 (41%). Thirty-four (19%) of 182 expressing a view about 'feeling safe' felt unsafe sometimes. Wheelchair users often feel vulnerable when being transported by public providers. Risks of vehicular travel by wheelchair users could be reduced with appropriate equipment and regular review of NHS prescriptions, education of users, wheelchair services and transport providers.

Articulation at shoulder level--a pilot experimental study on car seat comfort.

PubMed

Coelho, Denis Alves; Dahlman, Sven

2012-01-01

This article reports on a pilot experimental study aimed at a first evaluation of the introduction of an articulation in the upper part of the seat backrest. The idea of introducing this articulation sprang from prevention of whiplash injuries and this study tentatively assesses its potential for improvement in comfort. This was done considering a pre-defined articulation height. A height for the articulation of 43.5 cm above the H-point of a reference seat was theoretically deduced based on a population with an average sitting height of 88 cm. Participants evaluated the articulated seat in comparison with the reference seat. Twelve participants were divided into three groups of sitting height. In a laboratory environment subjective comfort evaluations and preferred values of deployment of the articulation and of counter-tilting of the headrest were registered. Driving on the roads completed and validated the laboratory assessments. The reference seat was deemed less comfortable for the participants with short and medium sitting height than for the tall ones. There was a notable improvement in comfort for most of the medium and short sitting height participants when using the articulated seat. The articulation was fully deployed by most participants. Copyright © 2011 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Investigation of spherical loudspeaker arrays for local active control of sound.

PubMed

Peleg, Tomer; Rafaely, Boaz

2011-10-01

Active control of sound can be employed globally to reduce noise levels in an entire enclosure, or locally around a listener's head. Recently, spherical loudspeaker arrays have been studied as multiple-channel sources for local active control of sound, presenting the fundamental theory and several active control configurations. In this paper, important aspects of using a spherical loudspeaker array for local active control of sound are further investigated. First, the feasibility of creating sphere-shaped quiet zones away from the source is studied both theoretically and numerically, showing that these quiet zones are associated with sound amplification and poor system robustness. To mitigate the latter, the design of shell-shaped quiet zones around the source is investigated. A combination of two spherical sources is then studied with the aim of enlarging the quiet zone. The two sources are employed to generate quiet zones that surround a rigid sphere, investigating the application of active control around a listener's head. A significant improvement in performance is demonstrated in this case over a conventional headrest-type system that uses two monopole secondary sources. Finally, several simulations are presented to support the theoretical work and to demonstrate the performance and limitations of the system. © 2011 Acoustical Society of America

Exploring the design of a lightweight, sustainable and comfortable aircraft seat.

PubMed

Kokorikou, A; Vink, P; de Pauw, I C; Braca, A

2016-07-19

Making a lightweight seat that is also comfortable can be contradictory because usually comfort improvement means adding a feature (e.g. headrest, adjustable lumbar support, movable armrests, integrated massage systems, etc.), which makes seats heavier. This paper explores the design of an economy class aircraft seat that aims to be lightweight, comfortable and sustainable. Theory about comfort in seats, ergonomics, lightweight design, Biomimicry and Cradle to cradle was studied and resulted in a list of requirements that the new seat should satisfy. The design process resulted in a new seat that is 36% lighter than the reference seat, which showed that a significant weight reduction can be achieved. This was completed by re-designing the backrest and seat pan and integrating their functions into a reduced number of parts. Apart from the weight reduction that helps in reducing the airplane's environmental impact, the seat also satisfies most of the other sustainability requirements such as the use of recyclable materials, design for disassembly, easy to repair. A user test compared the new seat with a premium economy class aircraft seat and the level of comfort was similar. Strong points of the new design were identified such as the lumbar support and the cushioning material, as well as shortcomings on which the seat needs to be improved, like the seat pan length and the first impression. Long term comfort tests are still needed as the seat is meant for long-haul flights.

Impaired positioning of the gape in whiplash-associated disorders.

PubMed

Zafar, Hamayun; Nordh, Erik; Eriksson, Per-Olof

2006-01-01

We have previously introduced a new concept for natural jaw function suggesting that "functional jaw movements" are the result of coordinated jaw and neck muscle activation, leading to simultaneous movements in the temporomandibular, atlanto-occipital and cervical spine joints. Thus, jaw function requires a healthy state of both the jaw and the neck motor systems. The aim of this study was to examine the positioning of the gape in space during maximal jaw opening at fast and slow speed in healthy as well as whiplash-associated disorders (WAD) individuals. A wireless optoelectronic technique for three-dimensional movement recording was used. Subjects were seated in an upright position, with back support up to the mid-scapular level without headrest. The position of the gape in space was defined as the vertical midpoint position of the gape at maximal jaw opening (MP). In healthy, the MP generally coincided with the reference position at the start of jaw opening. In the WAD group, the MP was significantly lower than the reference position. No sex or speed related differences were found. The results suggest that both the width and orientation of the gape in space relies on coordinated jaw and neck muscle activation and mandibular and head-neck movements. This study also suggests an association between neck pain and dysfunction following trauma, and reduced width and impaired positioning of the gape in space. Finally, the MP seems to be a useful marker in evaluation of the functional state of the jaw-neck motor system.

Novel Hybrid Operating Table for Neuroendovascular Treatment.

PubMed

Jong-Hyun, Park; Jonghyeon, Mun; Dong-Seung, Shin; Bum-Tae, Kim

2017-03-25

The integration of interventional and surgical techniques is requiring the development of a new working environment equipped for the needs of an interdisciplinary neurovascular team. However, conventional surgical and interventional tables have only a limited ability to provide for these needs. We have developed a concept mobile hybrid operating table that provides the ability for such a team to conduct both endovascular and surgical procedures in a single session. We developed methods that provide surgeons with angiography-guided surgery techniques for use in a conventional operating room environment. In order to design a convenient device ideal for practical use, we consulted with mechanical engineers. The mobile hybrid operating table consists of two modules: a floating tabletop and a mobile module. In brief, the basic principle of the mobile hybrid operating table is as follows: firstly, the length of the mobile hybrid operating table is longer than that of a conventional surgical table and yet shorter than a conventional interventional table. It was designed with the goal of exhaustively meeting the intensive requirements of both endovascular and surgical procedures. Its mobile module allows for the floating tabletop to be moved quickly and precisely. It is important that during a procedure, a patient can be moved without being repositioned, particularly with a catheter in situ. Secondly, a slim-profile headrest facilitates the mounting of a radiolucent head cramp system for cranial stabilization and fixation. We have introduced a novel invention, a mobile hybrid operating table for use in an operating suite.

Central retinal artery occlusion - rethinking retinal survival time.

PubMed

Tobalem, Stephan; Schutz, James S; Chronopoulos, Argyrios

2018-04-18

The critical time from onset of complete occlusion of the central retinal artery (CRA) to functionally significant inner retinal infarction represents a window of opportunity for treatment and also has medical-legal implications, particularly when central retinal artery occlusion (CRAO) complicates therapeutic interventions. Here, we review the evidence for time to infarction from complete CRAO and discuss the implications of our findings. A Medline search was performed using each of the terms "central retinal artery occlusion", "retinal infarction", "retinal ischemia", and "cherry red spot" from 1970 to the present including articles in French and German. All retrieved references as well as their reference lists were screened for relevance. An Internet search using these terms was also performed to look for additional references. We find that the experimental evidence showing that inner retinal infarction occurs after 90-240 min of total CRAO, which is the interval generally accepted in the medical literature and practice guidelines, is flawed in important ways. Moreover, the retinal ganglion cells, supplied by the CRA, are part of the central nervous system which undergoes infarction after non-perfusion of 12-15 min or less. Retinal infarction is most likely to occur after only 12-15 min of complete CRAO. This helps to explain why therapeutic maneuvers for CRAO are often ineffective. Nevertheless, many CRAOs are incomplete and may benefit from therapy after longer intervals. To try to avoid retinal infarcton from inadvertent ocular compression by a headrest during prone anesthesia, the eyes should be checked at intervals of less than 15'.

Refinement of the Hybrid Neuroendovascular Operating Suite: Current and Future Applications.

PubMed

Ashour, Ramsey; See, Alfred P; Dasenbrock, Hormuzdiyar H; Khandelwal, Priyank; Patel, Nirav J; Belcher, Bianca; Aziz-Sultan, Mohammad Ali

2016-07-01

In early-generation hybrid biplane endovascular operating rooms, switching from surgical to angiographic position is cumbersome. In this report, we highlight the unique design of a new hybrid neuroendovascular operating suite that allows surgical access to the head while keeping the biplane system over the lower body of the patient. Current and future hybrid neuroendovascular operating suite applications are discussed. We collaborated with engineers to implement the following modifications to the design of the angiographic system: translation of the bed toward the feet to allow biplane cerebral imaging in the head-side position and the biplane left-side position; translation of the base of the A-plane C-arm away from the feet to allow increased operator space at the head of the bed and to allow cerebral imaging in both the head-side and left-side positions; use of a specialized boom mount for the display panel to increase mobility; and use of a radiolucent tabletop with attachments for the headrest or radiolucent head clamp system. The modified hybrid neuroendovascular operating suite allows for seamless transition between surgical and angiographic positions within seconds, improving workflow efficiency and decreasing procedure time as compared with early-generation hybrid rooms. Combined endovascular and surgical applications are facilitated by co-locating their respective technologies and refining the ergonomics of the system to ease transition between both sets of technologies. In so doing, hybrid neuroendovascular operating suites can be anticipated to improve patient outcomes, generate novel treatment paradigms, and improve time and cost efficiency. Copyright © 2016. Published by Elsevier Inc.

Slit lamps and lenses: a potential source of nosocomial infections?

PubMed

Sobolewska, Bianka; Buhl, Michael; Liese, Jan; Ziemssen, Focke

2018-01-30

The aim of the study was to evaluate the bacterial contamination level of contact surfaces on slit lamps and the grip areas of lenses. Within unannounced audits, two regions of the slit lamps (headrest and joystick), indirect ophthalmoscopy devices, and ultrasound probes were obtained with rayon-tipped swab. Non-contact lenses used for indirect fundoscopy were pressed on RODAC (Replicate Organism Detection and Counting) plates. One hundred and eighty-one surfaces were sampled. The total number of colony-forming units was assessed and bacterial species were identified. Spa-typing and antimicrobial susceptibility testing were performed from Staphylococcus aureus isolates. Among the total bacterial isolates from ophthalmological equipment (lenses: 51 of 78, slit lamps: 43 of 88, ophthalmoscopy helmets: 3 of 8, ultrasound probes: 2 of 7), coagulase-negative staphylococci (CNS) was most frequently found, followed by Micrococcus spp. (lenses vs. slit lamps: P < 0.001 and P = 0.01, respectively). The bacterial contamination of lenses (76%) was significantly higher than that of slit lamps (54%) (P < 0.003). A significantly higher contamination with CNS was observed on lenses from residents vs. from consultants (78% vs. 35%, P = 0.01). A total of seven different spa-types of S. aureus were isolated. No correlation was found between S. aureus contamination of different ophthalmological equipments (Spearman's rank correlation coefficient, ρ = 0.04, P = 0.75). Methicillin-resistant S. aureus was not detected. Bacterial species of the normal skin flora were isolated from the ophthalmological equipment. The bacterial contamination of the portable devices was significantly higher than that of slit lamps. Therefore, proper hygiene of the mobile instruments should be monitored in order to prevent transmission of bacteria in residents and consultants.

A Randomized Study Comparing the Sniffing Position with Simple Head Extension for Glottis Visualization and Difficulty in Intubation during Direct Laryngoscopy.

PubMed

Akhtar, Mehmooda; Ali, Zulfiqar; Hassan, Nelofar; Mehdi, Saqib; Wani, Gh Mohammad; Mir, Aabid Hussain

2017-01-01

Proper positioning of the head and neck is important for an optimal laryngeal visualization. Traditionally, sniffing position (SP) is recommended to provide a superior glottic visualization, during direct laryngoscopy, enhancing the ease of intubation. Various studies in the last decade of this belief have challenged the need for sniffing position during intubation. We conducted a prospective study comparing the sniffing head position with simple head extension to study the laryngoscopic view and intubation difficulty during direct laryngoscopy. Five-hundred patients were included in this study and randomly distributed to SP or simple head extension. In the sniffing group, an incompressible head ring was placed under the head to raise its height by 7 cm from the neutral plane followed by maximal extension of the head. In the simple extension group, no headrest was placed under the head; however, maximal head extension was given at the time of laryngoscopy. Various factors as ability to mask ventilate, laryngoscopic visualization, intubation difficulty, and posture of the anesthesiologist during laryngoscopy and tracheal intubation were noted. In the incidence of difficult laryngoscopy (Cormack Grade III and IV), Intubation Difficulty Scale (IDS score) was compared between the two groups. There was no significant difference between two groups in Cormack grades. The IDS score differed significantly between sniffing group and simple extension group ( P = 0.000) with an increased difficulty during intubation in the simple head extension. Patients with simple head extension needed more lifting force, increased use of external laryngeal manipulation, and an increased use of alternate techniques during intubation when compared to SP. We conclude that compared to the simple head extension position, the SP should be used as a standard head position for intubation attempts under general anesthesia.

SU-E-T-633: Preparation and Planning of a VMAT Multi - Arc Radiation Therapy Technique for Full Scalp Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Araujo, C; Bardock, A; Berkelaar, S

2015-06-15

Purpose: The target volume for angiosarcoma of the scalp encompasses the entire scalp. Full scalp radiotherapy (FSRT) requires careful design of required bolus, immobilization and marking of the field before the patient CT is acquired. A VMAT multi-arc technique was designed to deliver FSRT for a patient with angiosarcoma of the scalp to a dose of 6000cGy in 25 fractions. Methods: A custom bolus helmet was fabricated from a 0.5 cm thick sheet of aquaplast material, which was molded to the patient’s head. With the bolus helmet in place the patient was then positioned supine on a H&N immobilization board.more » A custom vaclock bag positioned on a standard headrest and a thermoplastic mask were used to immobilize the patient. Additional bolus to cover the remaining treatment area was attached to the mask. We acquired two CT scans of the patient’s head, one in treatment position and an additional scan without the immobilization mask with wires marking the treatment area that the oncologist had delineated on the patient’s skin. The second scan was registered to the first and used to define the treatment CTV. A four-arc VMAT treatment planned using Varian-Eclipse was optimized to cover the skin with a PTV margin while sparing the brain and limiting the dose to the optic apparatus and lacrimal glands. Daily treatment setup was verified using anterior and lateral kV on-board-imaging. To verify the treated dose, TLDs were positioned on the patient’s scalp during one fraction. Results: With full dose coverage to the PTV, the mean dose to the brain was less than 24 Gy. The dose measured by the TLDs (mean difference 1%, standard deviation 4%)showed excellent agreement with the treatment planning calculation. Conclusion: FSRT delivered with a bolus helmet and a VMAT multi-arc technique can be accurately delivered with high dose uniformity and conformality.« less

SU-F-T-642: Sub Millimeter Accurate Setup of More Than Three Vertebrae in Spinal SBRT with 6D Couch

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wang, X; Zhao, Z; Yang, J

Purpose: To assess the initial setup accuracy in treating more than 3 vertebral body levels in spinal SBRT using a 6D couch. Methods: We retrospectively analyzed last 20 spinal SBRT patients (4 cervical, 9 thoracic, 7 lumbar/sacrum) treated in our clinic. These patients in customized immobilization device were treated in 1 or 3 fractions. Initial setup used ExacTrac and Brainlab 6D couch to align target within 1 mm and 1 degree, following by a cone beam CT (CBCT) for verification. Our current standard practice allows treating a maximum of three continuous vertebrae. Here we assess the possibility to achieve submore » millimeter setup accuracy for more than three vertebrae by examining the residual error in every slice of CBCT. The CBCT had a range of 17.5 cm, which covered 5 to 9 continuous vertebrae depending on the patient and target location. In the study, CBCT from the 1st fraction treatment was rigidly registered with the planning CT in Pinnacle. The residual setup error of a vertebra was determined by expanding the vertebra contour on the planning CT to be large enough to enclose the corresponding vertebra on CBCT. The margin of the expansion was considered as setup error. Results: Out of the 20 patients analyzed, initial setup accuracy can be achieved within 1 mm for a span of 5 or more vertebrae starting from T2 vertebra to inferior vertebra levels. 2 cervical and 2 upper thoracic patients showed the cervical spine was difficult to achieve sub millimeter accuracy for multi levels without a customized immobilization headrest. Conclusion: If the curvature of spinal columns can be reproduced in customized immobilization device during treatment as simulation, multiple continuous vertebrae can be setup within 1 mm with the use of a 6D couch.« less

SU-C-19A-06: A Robust and Affordable Table Indexing Approach for Total Lymphoid Irradiation Treatment

DOE Office of Scientific and Technical Information (OSTI.GOV)

Yu, S; Fahimian, B; Kenyon, M

2014-06-15

Purpose: Total lymphoid irradiation (TLI) is conventionally delivered through the dosimetric matching of mantle, spleen, and pelvis fields, necessitating multiple isocenters delivered through a combination of couch shifts and sliding of patients relative to the couch rendering the technique susceptible to shifting errors. To address this challenge, a novel technique for the couch indexing of TLI treatments is developed and evaluated through a multi-patient pilot trial. Methods: An immobilization device was designed consisting of a movable indexed slide board with an Exact Lok-Bar drilled into it. A Timo headrests were used fixate the head of the patient relative to themore » slide board. For the Varian Exact Couch™, the immobilization board was connected to the H3 notch to avoid the metal infrastructure of the couch for the delivery of the mantle and spleen fields. For tall patients the required shift for the pelvis isocenter reaches the shifting limit and the board was slid from H3 to H4 (a fixed distance of 14 cm). A total 22 patients were stratified in two groups of 11, one consisting of the conventional setup, and one group with the proposed immobilization technique. Results: The standard deviations (SD) of the couch positions in lateral, longitudinal, and vertical directions for 10 fractions for each patient in both groups were calculated. In the non-indexed group, the positioning SD ranged from 0.9 to 4.7 cm. Using our device, the positioning SD was reduced to a range of 0.2 to 0.9 cm, with the longitudinal direction showing the largest improvement. Conclusion: Matched field TLI remains error prone to geometrical misses. The feasibility of full indexing TLI treatments was validated and shown to result in a significant reduction of positioning errors.« less

Aircraft disinsection: exposure assessment and evaluation of a new pre-embarkation method.

PubMed

Berger-Preiss, Edith; Koch, Wolfgang; Gerling, Susanne; Kock, Heiko; Klasen, Jutta; Hoffmann, Godehard; Appel, Klaus E

2006-01-01

A new "pre-embarkation" method for aircraft disinsection was investigated using two different 2% d-phenothrin containing aerosols. Five experiments in aircrafts of the type Airbus 310 (4x) and Boeing 747-400 (1x) were performed. In the absence of passengers and crew the d-phenothrin aerosol was sprayed under the seat rows and in a second step at the height of approximately 1.60 m by moving from one end of the cabin to the other. Concentration levels of d-phenothrin were determined at different time periods after application of the aerosol spray. In a B 747-400 with the air conditioning system operating the concentrations ranged between 853 and 1753 microg/m3 during and till 5 min after the beginning of spraying at different locations in the cabin. Within 5-20min after the end of the spraying concentrations of 36-205 microg/m3 and 20-40 min thereafter only ca. 1 microg d-phenothrin/m3 were detectable (average values in relation to each period of measurement). On cabin interior surfaces the median values for mainly horizontal areas ranged from 100 to 1160 ng d-phenothrin/cm2. d-Phenothrin concentrations in the air were sufficient to kill flying insects like house flies and mosquitoes within 20 min. Horizontal surfaces were 100% effective against insects up to 24 h after spraying. Doses inhaled by sprayers determined by personal measurements were calculated to be 30-235 microg d-phenothrin per 100 g spray applied (30% in the respirable fraction for Arrow Aircraft Disinsectant; 10% for Aircraft Disinsectant Denka). If passengers will board, e.g., 20 min after the end of the disinsection operation, inhalation exposure is estimated to be practically negligible. Also possible dermal exposure from residues in seats and headrests is very low for passengers during the flight. Therefore any health effects for passengers and crew members are very unlikely.

[Whiplash injury of the neck from concepts to facts].

PubMed

Revel, M

2003-04-01

To focus on a topic of traumatology and rehabilitation becoming recently a much debated public health problem. A references search from Medline database with whiplash as keyword was carried out. Were selected articles with abstracts in french or english and focusing on accidentology, biomechanics, demonstrated lesions, epidemiology and treatments. From 1664 references found, 232 were reviewed. The usual mechanism of crash is a rear-end collision inducing in the occupants of the bumped vehicle a sudden lower cervical spine extension with upper flexion followed by a global flexion. In nearly 50% of the cases, the stress occurring in the collision is comparable to that observed in bumper cars. The velocity changes are seldom up to 15 km/h. A headrest at the level of the center of gravity of the head restrict significantly the extension of the neck. Every structure of the cervical spine could be damaged and mainly the facet joints but the lesions were only demonstrated in severes traumatisms. The discrepancies in incidence among the different countries could be related to their medicolegal system. Although subjectives, the early symptoms are rather similar among patients suggesting true anatomical or functional disorders but the chronicity seems to be mainly related to social and psychological factors. The association of: no posterior midline cervical tenderness, no intoxication, normal alertness, no focal neurological deficit and no painful distracting injuries has a good predictive value of the lack of osteo-articular lesion on X-rays. Except the grade IV of the Quebec task Force (0, no symptom; 1, pain and stiffness; 2, neck complaint and physical signs; 3, neck complaint and neurological signs; 4, fracture or dislocation) the use of a collar should be avoided and the cervical spine should be mobilized. In most whiplash injuries, the mildness should be early stated, mobilization encouraged, and procedures of compensation shortened.

The burden and determinants of neck pain in whiplash-associated disorders after traffic collisions: results of the Bone and Joint Decade 2000-2010 Task Force on Neck Pain and Its Associated Disorders.

PubMed

Holm, Lena W; Carroll, Linda J; Cassidy, J David; Hogg-Johnson, Sheilah; Côté, Pierre; Guzman, Jamie; Peloso, Paul; Nordin, Margareta; Hurwitz, Eric; van der Velde, Gabrielle; Carragee, Eugene; Haldeman, Scott

2008-02-15

Best evidence synthesis. To undertake a best evidence synthesis on the burden and determinants of whiplash-associated disorders (WAD) after traffic collisions. Previous best evidence synthesis on WAD has noted a lack of evidence regarding incidence of and risk factors for WAD. Therefore there was a warrant of a reanalyze of this body of research. A systematic search of Medline was conducted. The reviewers looked for studies on neck pain and its associated disorders published 1980-2006. Each relevant study was independently and critically reviewed by rotating pairs of reviewers. Data from studies judged to have acceptable internal validity (scientifically admissible) were abstracted into evidence tables, and provide the body of the best evidence synthesis. The authors found 32 scientifically admissible studies related to the burden and determinants of WAD. In the Western world, visits to emergency rooms due to WAD have increased over the past 30 years. The annual cumulative incidence of WAD differed substantially between countries. They found that occupant seat position and collision impact direction were associated with WAD in one study. Eliminating insurance payments for pain and suffering were associated with a lower incidence of WAD injury claims in one study. Younger ages and being a female were both associated with filing claims or seeking care for WAD, although the evidence is not consistent. Preliminary evidence suggested that headrests/car seats, aimed to limiting head extension during rear-end collisions had a preventive effect on reporting WAD, especially in females. WAD after traffic collisions affects many people. Despite many years of research, the evidence regarding risk factors for WAD is sparse but seems to include personal, societal, and environmental factors. More research including, well-defined studies with accurate denominators for calculating risk, and better consideration of confounding factors, are needed.

SU-F-J-17: Patient Localization Using MRI-Guided Soft Tissue for Head-And-Neck Radiotherapy: Indication for Margin Reduction and Its Feasibility

DOE Office of Scientific and Technical Information (OSTI.GOV)

Qi, X; Yang, Y; Jack, N

Purpose: On-board MRI provides superior soft-tissue contrast, allowing patient alignment using tumor or nearby critical structures. This study aims to study H&N MRI-guided IGRT to analyze inter-fraction patient setup variations using soft-tissue targets and design appropriate CTV-to-PTV margin and clinical implication. Methods: 282 MR images for 10 H&N IMRT patients treated on a ViewRay system were retrospectively analyzed. Patients were immobilized using a thermoplastic mask on a customized headrest fitted in a radiofrequency coil and positioned to soft-tissue targets. The inter-fraction patient displacements were recorded to compute the PTV margins using the recipe: 2.5∑+0.7σ. New IMRT plans optimized on themore » revised PTVs were generated to evaluate the delivered dose distributions. An in-house dose deformation registration tool was used to assess the resulting dosimetric consequences when margin adaption is performed based on weekly MR images. The cumulative doses were compared to the reduced margin plans for targets and critical structures. Results: The inter-fraction displacements (and standard deviations), ∑ and σ were tabulated for MRI and compared to kVCBCT. The computed CTV-to-PTV margin was 3.5mm for soft-tissue based registration. There were minimal differences between the planned and delivered doses when comparing clinical and the PTV reduced margin plans: the paired t-tests yielded p=0.38 and 0.66 between the planned and delivered doses for the adapted margin plans for the maximum cord and mean parotid dose, respectively. Target V95 received comparable doses as planned for the reduced margin plans. Conclusion: The 0.35T MRI offers acceptable soft-tissue contrast and good spatial resolution for patient alignment and target visualization. Better tumor conspicuity from MRI allows soft-tissue based alignments with potentially improved accuracy, suggesting a benefit of margin reduction for H&N radiotherapy. The reduced margin plans (i.e., 2 mm) resulted in improved normal structure sparing and accurate dose delivery to achieve intended treatment goal under MR guidance.« less

Repeatability and reproducibility of corneal thickness using SOCT Copernicus HR.

PubMed

Vidal, Silvia; Viqueira, Valentín; Mas, David; Domenech, Begoña

2013-05-01

The aim of this study is to determine the reliability of corneal thickness measurements derived from SOCT Copernicus HR (Fourier domain OCT). Thirty healthy eyes of 30 subjects were evaluated. One eye of each patient was chosen randomly. Images were obtained of the central (up to 2.0 mm from the corneal apex) and paracentral (2.0 to 4.0 mm) cornea. We assessed corneal thickness (central and paracentral) and epithelium thickness. The intra-observer repeatability data were analysed using the intra-class correlation coefficient (ICC) for a range of 95 per cent within-subject standard deviation (S(W)) and the within-subject coefficient of variation (C(W)). The level of agreement by Bland-Altman analysis was also represented for the study of the reproducibility between observers and agreement between methods of measurement (automatic versus manual). The mean value of the central corneal thickness (CCT) was 542.4 ± 30.1 μm (SD). There was a high intra-observer agreement, finding the best result in the central sector with an intra-class correlation coefficient of 0.99, 95 per cent CI (0.989 to 0.997) and the worst, in the minimum corneal thickness, with an intra-class correlation coefficient of 0.672, 95 per cent CI (0.417 to 0.829). Reproducibility between observers was very high. The best result was found in the central sector thickness obtained both manually and automatically with an intra-class correlation coefficient of 0.990 in both cases and the worst result in the maximum corneal thickness with an intra-class correlation coefficient of 0.827. The agreement between measurement methods was also very high with intra-class correlation coefficient greater than 0.91. On the other hand the repeatability and reproducibility for epithelial measurements was poor. Pachymetric mapping with SOCT Copernicus HR was found to be highly repeatable and reproducible. We found that the device lacks an appropriate ergonomic design as proper focusing of the laser beam onto the cornea for anterior segment scanning required that patients were positioned slightly farther away from the machine head-rest than in the setup for retinal imaging. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

A Robust and Affordable Table Indexing Approach for Multi-isocenter Dosimetrically Matched Fields.

PubMed

Yu, Amy; Fahimian, Benjamin; Million, Lynn; Hsu, Annie

2017-05-23

Purpose  Radiotherapy treatment planning of extended volume typically necessitates the utilization of multiple field isocenters and abutting dosimetrically matched fields in order to enable coverage beyond the field size limits. A common example includes total lymphoid irradiation (TLI) treatments, which are conventionally planned using dosimetric matching of the mantle, para-aortic/spleen, and pelvic fields. Due to the large irradiated volume and system limitations, such as field size and couch extension, a combination of couch shifts and sliding of patients are necessary to be correctly executed for accurate delivery of the plan. However, shifting of patients presents a substantial safety issue and has been shown to be prone to errors ranging from minor deviations to geometrical misses warranting a medical event. To address this complex setup and mitigate the safety issues relating to delivery, a practical technique for couch indexing of TLI treatments has been developed and evaluated through a retrospective analysis of couch position. Methods The indexing technique is based on the modification of the commonly available slide board to enable indexing of the patient position. Modifications include notching to enable coupling with indexing bars, and the addition of a headrest used to fixate the head of the patient relative to the slide board. For the clinical setup, a Varian Exact Couch TM (Varian Medical Systems, Inc, Palo Alto, CA) was utilized. Two groups of patients were treated: 20 patients with table indexing and 10 patients without. The standard deviations (SDs) of the couch positions in longitudinal, lateral, and vertical directions through the entire treatment cycle for each patient were calculated and differences in both groups were analyzed with Student's t-test. Results The longitudinal direction showed the largest improvement. In the non-indexed group, the positioning SD ranged from 2.0 to 7.9 cm. With the indexing device, the positioning SD was reduced to a range of 0.4 to 1.3 cm (p < 0.05 with 95% confidence level). The lateral positioning was slightly improved (p < 0.05 with 95% confidence level), while no improvement was observed in the vertical direction. Conclusions The conventional matched field TLI treatment is error-prone to geometrical setup error. The feasibility of full indexing TLI treatments was validated and shown to result in a significant reduction of positioning and shifting errors.

Automated recognition of rear seat occupants' head position using Kinect™ 3D point cloud.

PubMed

Loeb, Helen; Kim, Jinyong; Arbogast, Kristy; Kuo, Jonny; Koppel, Sjaan; Cross, Suzanne; Charlton, Judith

2017-12-01

Child occupant safety in motor-vehicle crashes is evaluated using Anthropomorphic Test Devices (ATD) seated in optimal positions. However, child occupants often assume suboptimal positions during real-world driving trips. Head impact to the seat back has been identified as one important injury causation scenario for seat belt restrained, head-injured children (Bohman et al., 2011). There is therefore a need to understand the interaction of children with the Child Restraint System to optimize protection. Naturalistic driving studies (NDS) will improve understanding of out-of-position (OOP) trends. To quantify OOP positions, an NDS was conducted. Families used a study vehicle for two weeks during their everyday driving trips. The positions of rear-seated child occupants, representing 22 families, were evaluated. The study vehicle - instrumented with data acquisition systems, including Microsoft Kinect™ V1 - recorded rear seat occupants in 1120 driving 26 trips. Three novel analytical methods were used to analyze data. To assess skeletal tracking accuracy, analysts recorded occurrences where Kinect™ exhibited invalid head recognition among a randomly-selected subset (81 trips). Errors included incorrect target detection (e.g., vehicle headrest) or environmental interference (e.g., sunlight). When head data was present, Kinect™ was correct 41% of the time; two other algorithms - filtering for extreme motion, and background subtraction/head-based depth detection are described in this paper and preliminary results are presented. Accuracy estimates were not possible because of their experimental nature and the difficulty to use a ground truth for this large database. This NDS tested methods to quantify the frequency and magnitude of head positions for rear-seated child occupants utilizing Kinect™ motion-tracking. This study's results informed recent ATD sled tests that replicated observed positions (most common and most extreme), and assessed the validity of child occupant protection on these typical CRS uses. Optimal protection in vehicles requires an understanding of how child occupants use the rear seat space. This study explored the feasibility of using Kinect™ to log positions of rear seated child occupants. Initial analysis used the Kinect™ system's skeleton recognition and two novel analytical algorithms to log head location. This research will lead to further analysis leveraging Kinect™ raw data - and other NDS data - to quantify the frequency/magnitude of OOP situations, ATD sled tests that replicate observed positions, and advances in the design and testing of child occupant protection technology. Copyright © 2017 National Safety Council and Elsevier Ltd. All rights reserved.

Factors associated with rear seating of children in motor vehicles: a study in two low-income, predominantly Hispanic communities.

PubMed

Greenberg-Seth, Jennifer; Hemenway, David; Gallagher, Susan S; Lissy, Karen S; Ross, Julie B

2004-07-01

This study examined child seating patterns in two predominantly low-income, Hispanic communities in Massachusetts. The purpose was to determine the factors associated with child rear seating in the community as a whole and for a subset of Hispanic motorists. Five hundred and five vehicles carrying child passengers and no adult other than the driver were observed in parking lots of fast food restaurants and grocery stores. Four hundred and thirty-two vehicle drivers agreed to be interviewed. A child was defined as a passenger younger than age 12 as determined by appearance and height (head below the vehicle headrest when seated). Variables under study included driver gender, age, ethnicity, and educational attainment; driver shoulder belt use; driver perception of passenger-side airbag presence; and the number and ages of children in the car. Overall, 51% of vehicles were observed with all children seated in the rear. In a bivariate analysis, child rear seating was strongly associated with female drivers ( P = 0.01), younger drivers ( P = 0.02) driver shoulder belt use ( P < 0.00), perceived presence of a passenger-side airbag ( P < 0.00), all children in the vehicle

Performance Evaluation of Multichannel Adaptive Algorithms for Local Active Noise Control

NASA Astrophysics Data System (ADS)

DE DIEGO, M.; GONZALEZ, A.

2001-07-01

This paper deals with the development of a multichannel active noise control (ANC) system inside an enclosed space. The purpose is to design a real practical system which works well in local ANC applications. Moreover, the algorithm implemented in the adaptive controller should be robust, of low computational complexity and it should manage to generate a uniform useful-size zone of quite in order to allow the head motion of a person seated on a seat inside a car. Experiments were carried out under semi-anechoic and listening room conditions to verify the successful implementation of the multichannel system. The developed prototype consists of an array of up to four microphones used as error sensors mounted on the headrest of a seat place inside the enclosure. One loudspeaker was used as single primary source and two secondary sources were placed facing the seat. The aim of this multichannel system is to reduce the sound pressure levels in an area around the error sensors, following a local control strategy. When using this technique, the cancellation points are not only the error sensor positions but an area around them, which is measured by using a monitoring microphone. Different multichannel adaptive algorithms for ANC have been analyzed and their performance verified. Multiple error algorithms are used in order to cancel out different types of primary noise (engine noise and random noise) with several configurations (up to four channels system). As an alternative to the multiple error LMS algorithm (multichannel version of the filtered-X LMS algorithm, MELMS), the least maximum mean squares (LMMS) and the scanning error-LMS algorithm have been developed in this work in order to reduce computational complexity and achieve a more uniform residual field. The ANC algorithms were programmed on a digital signal processing board equipped with a TMS320C40 floating point DSP processor. Measurements concerning real-time experiments on local noise reduction in two environments and at frequencies below 230 Hz are presented. Better noise levels attenuation is obtained in the semianechoic chamber due to the simplicity of the acoustic field. The size of the zone of quiet makes the system useful at relatively low frequencies and it is large enough to cover a listener's head movements. The spatial extent of the zones of quiet is generally observed to increase as the error sensors are moved away from the secondary source, they are put closer together or its number increases. In summary, different algorithms' performance and the viability of the multichannel system for local active noise control in real listening conditions are evaluated and some guidelines for designing such systems are then proposed.