Progressive changes in patients with skeletal Class III malocclusion treated by 2-jaw surgery with minimal and conventional presurgical orthodontics: A comparative study.

PubMed

Zhou, Yang; Li, Zili; Wang, Xiaoxia; Zou, Bingshuang; Zhou, Yanheng

2016-02-01

In this study, we aimed to compare treatment efficacy and postsurgical stability between minimal presurgical orthodontics and conventional presurgical orthodontics for patients with skeletal Class III malocclusion. Forty patients received minimal presurgical orthodontics (n = 20) or conventional presurgical orthodontics (n = 20). Lateral cephalograms were obtained before treatment, before orthognathic surgery, and at 1 week, 3 months, 6 months, and 12 months after surgery. Changes of overjet and mandibular incisal angle before surgery were greater in the conventional presurgical orthodontics group than in the minimal presurgical orthodontics group. Postsurgical horizontal changes in Points A and B, overjet, and mandibular incisal angle showed significant differences among the time points. Most of the horizontal and vertical relapses in the maxilla and the mandible occurred within the first 6 months in both groups. Minimal presurgical orthodontics and conventional presurgical orthodontics showed similar extents and directions of skeletal changes in patients with Class III malocclusion. However, orthodontists and surgeons should preoperatively consider the postsurgical counterclockwise rotation of the mandible when using minimal presurgical orthodontics. Close and frequent observations are recommended in the early postsurgical stages. Copyright © 2016 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

Daytime outpatient versus inpatient video-EEG monitoring for presurgical evaluation in temporal lobe epilepsy.

PubMed

Guerreiro, Carlos A M; Montenegro, Maria Augusta; Kobayashi, Eliane; Noronha, Ana Lúcia A; Guerreiro, Marilisa M; Cendes, Fernando

2002-06-01

Video-EEG monitoring documentation of seizure localization is one of the most important aspects of a presurgical investigation in refractory temporal lobe epilepsy (TLE) patients. The objective of this study was to evaluate the efficacy of inpatient versus daytime outpatient telemetry. The authors evaluated prospectively 73 patients with medically intractable TLE. Ninety-one telemetry sessions were performed: 35 as inpatients and 56 as outpatients. Outpatient monitoring was performed in the EEG laboratory. They used 18-channel digital EEG. Medications were not changed in the outpatient group. For analysis of the data, time was counted in periods (12 hours = 1 period). Statistical analyses were performed using Student's t-test and the chi2 test. There were no differences between the two groups (outpatient versus inpatient) with respect to age and mean seizure frequency before monitoring, mean time to record the first seizure (1.1 versus 1.4 periods), mean number of seizures per period (0.6 for both groups), lateralization by interictal spiking (46% versus 57%), and lateralization by ictal EEG (59% versus 77%). Daytime outpatient video-EEG monitoring for presurgical evaluation is efficient and comparable with inpatient monitoring. Therefore, the improved cost benefit of outpatient monitoring may increase the access to surgery for individuals with intractable TLE.

[Presurgical orthodontics for facial asymmetry].

PubMed

Labarrère, H

2003-03-01

As with the treatment of all facial deformities, orthodontic pre-surgical preparation for facial asymmetry should aim at correcting severe occlusal discrepancies not solely on the basis of a narrow occlusal analysis but also in a way that will not disturb the proposed surgical protocol. In addition, facial asymmetries require specific adjustments, difficult to derive and to apply because of their inherent atypical morphological orientation of both alveolar and basal bony support. Three treated cases illustrate different solutions to problems posed by pathological torque: this torque must be considered with respect to proposed surgical changes, within the framework of their limitations and their possible contra-indications.

Presurgical cleft lip and palate orthopedics: an overview

PubMed Central

Alzain, Ibtesam; Batwa, Waeil; Cash, Alex; Murshid, Zuhair A

2017-01-01

Patients with cleft lip and/or palate go through a lifelong journey of multidisciplinary care, starting from before birth and extending until adulthood. Presurgical orthopedic (PSO) treatment is one of the earliest stages of this care plan. In this paper we provide a review of the PSO treatment. This review should help general and specialist dentists to better understand the cleft patient care path and to be able to answer patient queries more efficiently. The objectives of this paper were to review the basic principles of PSO treatment, the various types of techniques used in this therapy, and the protocol followed, and to critically evaluate the advantages and disadvantages of some of these techniques. In conclusion, we believe that PSO treatment, specifically nasoalveolar molding, does help to approximate the segments of the cleft maxilla and does reduce the intersegment space in readiness for the surgical closure of cleft sites. However, what we remain unable to prove equivocally at this point is whether the reduction in the dimensions of the cleft presurgically and the manipulation of the nasal complex benefit our patients in the long term. PMID:28615974

[Magnetoencephalography in the presurgical evaluation of patients with drug-resistant epilepsy].

PubMed

Koptelova, A M; Arkhipova, N A; Golovteev, A L; Chadaev, V A; Grinenko, O A; Kozlova, A B; Novikova, S I; Stepanenko, A Iu; Melikian, A G; Stroganova, T A

2013-01-01

Magnetoencephalography (MEG) in combination with structural MRI (magnetic source imaging, MSI) plays an increasingly important role as one of the tools for presurgical evaluation of medically intractable focal epilepsy. The aim of the study was to compare the MSI and commonly used video EEG monitoring method (vEEG) in their sensitivity to interictal epileptic discharges (IED) in 22 patients with drug resistant epilepsy. Furthermore, the detection and localization results obtained by both methods were verified using the data of electrocorticography (ECoG) and postsurgical outcome in 13 patients who underwent invasive EEG monitoring and surgery. The results showed that MSI was superior to vEEC in terms of sensitivity to IED with difference in sensitivity of 22%. The data also suggested that MSI superiority to vEEG in detecting epileptic discharges might, at least partly, arise from better MEG responsiveness to epileptic events coming from the medial, opercular and basal aspects of cortical lobes. MSI localization estimates were in the same cortical lobe and at the same lobar aspects as the epileptic foci detected by ECoG in all patients. Thus, magnetic source imaging can provide critical localization information that is not available when other noninvasive methods, such as vEEG and MRI, are used.

Hypnosis decreases presurgical distress in excisional breast biopsy patients.

PubMed

Schnur, Julie B; Bovbjerg, Dana H; David, Daniel; Tatrow, Kristin; Goldfarb, Alisan B; Silverstein, Jeffrey H; Weltz, Christina R; Montgomery, Guy H

2008-02-01

Excisional breast biopsy is associated with presurgical psychological distress. Such distress is emotionally taxing, and may have negative implications for postsurgical side effects and satisfaction with anesthesia. We investigated the ability of a brief hypnosis session to reduce presurgical psychological distress in excisional breast biopsy patients. Ninety patients presenting for excisional breast biopsy were randomly assigned to receive either a 15-minute presurgery hypnosis session (n = 49, mean age: 46.4 (95% CI: 42.3-50.4)) or a 15-minute presurgery attention control session (n = 41, mean age: 45.0 (95% CI: 40.8-49.2)). The hypnosis session involved suggestions for increased relaxation and decreased distress. The attention control session involved nondirective empathic listening. Presurgery distress was measured using visual analog scales (VAS) and the short version of the Profile of Mood States (SV-POMS). Data were analyzed using analysis of variance and chi2 procedures. Groups did not differ in terms of the following: demographics (age, education, ethnicity, marital status, all P's > 0.28); medical variables (presurgery diagnosis, previous excisional biopsy, previous breast cancer, all P's > 0.11); or preintervention distress (SV-POMS P > 0.74) assessed on the day of surgery. Postintervention, and before surgery, patients in the hypnosis group had significantly lower mean values for presurgery VAS emotional upset (16.5 vs 38.2, P < 0.0001, d = .85), VAS depressed mood (6.6 vs 19.9, P < 0.02, d = .67), and SV-POMS anxiety (10.0 vs 5.0, P < 0.0001, d = 0.85); and significantly higher levels for VAS relaxation (75.7 vs 54.2, P < 0.001, d = -0.76) than attention controls. The study results indicate that a brief presurgery hypnosis intervention can be an effective means of controlling presurgical distress in women awaiting diagnostic breast cancer surgery.

An access to care study for the pre-surgical nasoalveolar molding and other treatments for cleft lip and palate.

PubMed

Blume, Carlen P; Henson, Timothy B

2011-07-01

This study is designed to ascertain whether a regional bias exists, as well as provide a reference to those seeking the various modalities used in pre-surgical intervention for cleft lip and palate either for their own patients or educational purposes. A survey was constructed using Survey Monkey and distributed via e-mail to American Academy of Pediatric Dentistry members. Approximately 3689 surveys were delivered consisting of 12 questions asking whether they provide pre-surgical intervention to cleft lip and palate patients, and what type of interventions they use. A total of 572 members responded. Of the respondents, 480 reported they treat children affected by cleft lip and/or cleft palate. Of these, only 102 reported that they provide pre-surgical treatment. Pre-surgical nasoalveolar molding (PNAM) represented 29.2 percent of the interventions used and was most heavily concentrated in Texas. Other modalities used included the Latham appliance, lip adhesion/tacking, the passive appliance, and a category 'other' was included. Those checking 'other' most often described alveolar grafting prior to later surgical procedures than were of interest in this study. The University of Texas Health Science Center San Antonio had the largest number of respondents using the PNAM. A very small proportion of pediatric dentists are providing pre-surgical intervention of any kind to patients with cleft lip and palate. However, those that are providing the service are spread around the country enough to consider PNAM as the standard of care for pre-surgical infant cleft treatment.

Pre-Surgical Integration of fMRI and DTI of the Sensorimotor System in Transcortical Resection of a High-Grade Insular Astrocytoma

PubMed Central

Ekstrand, Chelsea L.; Mickleborough, Marla J. S.; Fourney, Daryl R.; Gould, Layla A.; Lorentz, Eric J.; Ellchuk, Tasha; Borowsky, Ron W.

2016-01-01

Herein we report on a patient with a WHO Grade III astrocytoma in the right insular region in close proximity to the internal capsule who underwent a right frontotemporal craniotomy. Total gross resection of insular gliomas remains surgically challenging based on the possibility of damage to the corticospinal tracts. However, maximizing the extent of resection has been shown to decrease future adverse outcomes. Thus, the goal of such surgeries should focus on maximizing extent of resection while minimizing possible adverse outcomes. In this case, pre-surgical planning included integration of functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), to localize motor and sensory pathways. Novel fMRI tasks were individually developed for the patient to maximize both somatosensory and motor activation simultaneously in areas in close proximity to the tumor. Information obtained was used to optimize resection trajectory and extent, facilitating gross total resection of the astrocytoma. Across all three motor-sensory tasks administered, fMRI revealed an area of interest just superior and lateral to the astrocytoma. Further, DTI analyses showed displacement of the corona radiata around the superior dorsal surface of the astrocytoma, extending in the direction of the activation found using fMRI. Taking into account these results, a transcortical superior temporal gyrus surgical approach was chosen in order to avoid the area of interest identified by fMRI and DTI. Total gross resection was achieved and minor post-surgical motor and sensory deficits were temporary. This case highlights the utility of comprehensive pre-surgical planning, including fMRI and DTI, to maximize surgical outcomes on a case-by-case basis. PMID:27013996

Localizing seizure-onset zones in presurgical evaluation of drug-resistant epilepsy by electroencephalography/fMRI: effectiveness of alternative thresholding strategies.

PubMed

Hauf, M; Jann, K; Schindler, K; Scheidegger, O; Meyer, K; Rummel, C; Mariani, L; Koenig, T; Wiest, R

2012-10-01

Simultaneous EEG/fMRI is an effective noninvasive tool for identifying and localizing the SOZ in patients with focal epilepsy. In this study, we evaluated different thresholding strategies in EEG/fMRI for the assessment of hemodynamic responses to IEDs in the SOZ of drug-resistant epilepsy. Sixteen patients with focal epilepsy were examined by using simultaneous 92-channel EEG and BOLD fMRI. The temporal fluctuation of epileptiform signals on the EEG was extracted by independent component analysis to predict the hemodynamic responses to the IEDs. We applied 3 different threshold criteria to detect hemodynamic responses within the SOZ: 1) PA, 2) a fixed threshold at P < .05 corrected for multiple comparison (FWE), and 3) FAV (4000 ± 200 activated voxels within the brain). PA identified the SOZ in 9 of 16 patients; FWE resulted in concordant BOLD signal correlates in 11 of 16, and FAV in 13 of 16 patients. Hemodynamic responses were detected within the resected areas in 5 (PA), 6 (FWE), and 8 (FAV) of 10 patients who remained seizure-free after surgery. EEG/fMRI is a noninvasive tool for the presurgical work-up of patients with epilepsy, which can be performed during seizure-free periods and is complementary to the ictal electroclinical assessment. Our findings suggest that the effectiveness of EEG/fMRI in delineating the SOZ may be further improved by the additional use of alternative analysis strategies such as FAV.

Psychogenic nonepileptic seizures in patients with surgically treated temporal lobe epilepsy: Presurgical and de novo postsurgical occurrence.

PubMed

González Otárula, Karina A; Tan, Yee-Leng; Dubeau, François; Correa, José A; Chang, Edward; Hall, Jeffery A; Knowlton, Robert C; Kobayashi, Eliane

2017-10-01

Whether occurring before or after an epilepsy surgery, psychogenic nonepileptic seizures (PNES) impact treatment options and quality of life of patients with epilepsy. We investigated the frequency of pre- and postsurgical PNES, and the postsurgical Engel and psychiatric outcomes in patients with drug-resistant temporal lobe epilepsy (TLE). We reviewed 278 patients with mean age at surgery of 37.1±12.4years. Postsurgical follow-up information was available in 220 patients, with average follow-up of 4years. Nine patients (9/278 or 3.2%) had presurgical documented PNES. Eight patients (8/220 or 3.6%) developed de novo PNES after surgery. Pre- and postsurgery psychiatric comorbidities were similar to the patients without PNES. After surgery, in the group with presurgical PNES, five patients were seizure-free, and three presented persistent PNES. In the group with de novo postsurgery PNES, 62.5% had Engel II-IV, and 37.5% had Engel I. All presented PNES at last follow-up. Presurgical video-EEG monitoring is crucial in the diagnosis of coexisting PNES. Patients presenting presurgical PNES and drug-resistant TLE should not be denied surgery based on this comorbidity, as they can have good postsurgical epilepsy and psychiatric outcomes. Psychogenic nonepileptic seizures may appear after TLE surgery in a low but noteworthy proportion of patients regardless of the Engel outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

Presurgical levels of circulating cell-derived microparticles discriminate between patients with and without transfusion in coronary artery bypass graft surgery.

PubMed

Jy, Wenche; Gómez-Marín, Orlando; Salerno, Tomas A; Panos, Anthony L; Williams, Donald; Horstman, Lawrence L; Ahn, Yeon S

2015-01-01

Improved understanding of presurgical risk factors for transfusions will lead to reduction in their number and related complications. The goal of this study is to identify these factors in coronary artery bypass graft (CABG) surgery. Presented herein are results of analyses of data from an ongoing study of transfusion in CABG surgery. Of 122 patients, 81 received transfusion (Tx) and 41 did not (NoTx). In addition to routine tests, presurgical levels of microparticles from platelets (PMPs), red cells (RMPs), and other lineages were assayed. The Tx and NoTx groups were similar with respect to most presurgical variables but differed in distribution of gender, blood type, diabetes prevalence, activated partial thromboplastin time (aPTT), hemoglobin (HGB), and microparticle levels. Stepwise multiple logistic regression was used to evaluate presurgical variables and to develop a model to assess risk factors for transfusion. CD41(+) PMP and CD235(+) RMP levels were found to be the main risk factors for transfusion. The Model's discriminating ability was assessed using receiver operating characteristic curve analysis, which showed that the area under the model curve (± standard error) was 0.86 ± 0.04 (95% confidence interval, 0.77-0.94). According to the model, patients with higher presurgical levels of circulating CD41(+) PMP, CD235a(+) RMP, and HGB, as well as a shorter aPTT, are less likely to receive transfusion(s). Presurgical levels of CD41(+) PMPs and CD235a(+) RMPs are the main risk factors for transfusion in CABG, followed by HGB and aPTT. Copyright © 2015 The American Association for Thoracic Surgery. Published by Elsevier Inc. All rights reserved.

Presurgical language localization with visual naming associated ECoG high- gamma modulation in pediatric drug-resistant epilepsy.

PubMed

Arya, Ravindra; Wilson, J Adam; Fujiwara, Hisako; Rozhkov, Leonid; Leach, James L; Byars, Anna W; Greiner, Hansel M; Vannest, Jennifer; Buroker, Jason; Milsap, Griffin; Ervin, Brian; Minai, Ali; Horn, Paul S; Holland, Katherine D; Mangano, Francesco T; Crone, Nathan E; Rose, Douglas F

2017-04-01

This prospective study compared presurgical language localization with visual naming-associated high-γ modulation (HGM) and conventional electrical cortical stimulation (ECS) in children with intracranial electrodes. Patients with drug-resistant epilepsy who were undergoing intracranial monitoring were included if able to name pictures. Electrocorticography (ECoG) signals were recorded during picture naming (overt and covert) and quiet baseline. For each electrode the likelihood of high-γ (70-116 Hz) power modulation during naming task relative to the baseline was estimated. Electrodes with significant HGM were plotted on a three-dimensional (3D) cortical surface model. Sensitivity, specificity, and accuracy were calculated compared to clinical ECS. Seventeen patients with mean age of 11.3 years (range 4-19) were included. In patients with left hemisphere electrodes (n = 10), HGM during overt naming showed high specificity (0.81, 95% confidence interval [CI] 0.78-0.85), and accuracy (0.71, 95% CI 0.66-0.75, p < 0.001), but modest sensitivity (0.47) when ECS interference with naming (aphasia or paraphasic errors) and/or oral motor function was regarded as the gold standard. Similar results were reproduced by comparing covert naming-associated HGM with ECS naming sites. With right hemisphere electrodes (n = 7), no ECS-naming deficits were seen without interference with oral-motor function. HGM mapping showed a high specificity (0.81, 95% CI 0.78-0.84), and accuracy (0.76, 95% CI 0.71-0.81, p = 0.006), but modest sensitivity (0.44) compared to ECS interference with oral-motor function. Naming-associated ECoG HGM was consistently observed over Broca's area (left posterior inferior-frontal gyrus), bilateral oral/facial motor cortex, and sometimes over the temporal pole. This study supports the use of ECoG HGM mapping in children in whom adverse events preclude ECS, or as a screening method to prioritize electrodes for ECS testing. Wiley Periodicals, Inc. �

Seizure clusters and adverse events during pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper.

PubMed

Di Gennaro, Giancarlo; Picardi, Angelo; Sparano, Antonio; Mascia, Addolorata; Meldolesi, Giulio N; Grammaldo, Liliana G; Esposito, Vincenzo; Quarato, Pier P

2012-03-01

To evaluate the efficiency and safety of pre-surgical video-EEG monitoring with a slow anti-epileptic drug (AED) taper and a rescue benzodiazepine protocol. Fifty-four consecutive patients with refractory focal epilepsy who underwent pre-surgical video-electroencephalography (EEG) monitoring during the year 2010 were included in the study. Time to first seizure, duration of monitoring, incidence of 4-h and 24-h seizure clustering, secondarily generalised tonic-clonic seizures (sGTCS), status epilepticus, falls and cardiac asystole were evaluated. A total of 190 seizures were recorded. Six (11%) patients had 4-h clusters and 21 (39%) patients had 24-h clusters. While 15 sGTCS were recorded in 14 patients (26%), status epilepticus did not occur and no seizure was complicated with cardiac asystole. Epileptic falls with no significant injuries occurred in three patients. The mean time to first seizure was 3.3days and the time to conclude video-EEG monitoring averaged 6days. Seizure clustering was common during pre-surgical video-EEG monitoring, although serious adverse events were rare with a slow AED tapering and a rescue benzodiazepine protocol. Slow AED taper pre-surgical video-EEG monitoring is fairly safe when performed in a highly specialised and supervised hospital setting. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

A novel technique for presurgical nasoalveolar molding using computer-aided reverse engineering and rapid prototyping.

PubMed

Yu, Quan; Gong, Xin; Wang, Guo-Min; Yu, Zhe-Yuan; Qian, Yu-Fen; Shen, Gang

2011-01-01

To establish a new method of presurgical nasoalveolar molding (NAM) using computer-aided reverse engineering and rapid prototyping technique in infants with unilateral cleft lip and palate (UCLP). Five infants (2 males and 3 females with mean age of 1.2 w) with complete UCLP were recruited. All patients were subjected to NAM before the cleft lip repair. The upper denture casts were recorded using a three-dimensional laser scanner within 2 weeks after birth in UCLP infants. A digital model was constructed and analyzed to simulate the NAM procedure with reverse engineering software. The digital geometrical data were exported to print the solid model with rapid prototyping system. The whole set of appliances was fabricated based on these solid models. Laser scanning and digital model construction simplified the NAM procedure and estimated the treatment objective. The appliances were fabricated based on the rapid prototyping technique, and for each patient, the complete set of appliances could be obtained at one time. By the end of presurgical NAM treatment, the cleft was narrowed, and the malformation of nasoalveolar segments was aligned normally. We have developed a novel technique of presurgical NAM based on a computer-aided design. The accurate digital denture model of UCLP infants could be obtained with laser scanning. The treatment design and appliance fabrication could be simplified with a computer-aided reverse engineering and rapid prototyping technique.

The use of presurgical psychological screening to predict the outcome of spine surgery.

PubMed

Block, A R; Ohnmeiss, D D; Guyer, R D; Rashbaum, R F; Hochschuler, S H

2001-01-01

Several previous studies have shown that psychosocial factors can influence the outcome of elective spine surgery. The purpose of the current study was to determine how well a presurgical screening instrument could predict surgical outcome. The study was conducted by staff of a psychologist's office. They performed preoperative screening for spine surgery candidates and collected the follow-up data. Presurgical screening and follow-up data collection was performed on 204 patients who underwent laminectomy/discectomy (n=118) or fusion (n=86) of the lumbar spine. The outcome measures used in the study were visual analog pain scales, the Oswestry Disability Questionnaire, and medication use. A semi-structured interview and psychometric testing were used to identify specific, quantifiable psychological, and "medical" risk factors for poor surgical outcome. A presurgical psychological screening (PPS) scorecard was completed for each patient, assessing whether the patient had a high or low level of risk on these psychological and medical dimensions. Based on the scorecard, an overall surgical prognosis of "good," "fair," or "poor" was generated. Results showed spine surgery led to significant overall improvements in pain, functional ability, and medication use. Medical and psychological risk levels were significantly related to outcome, with the poorest results obtained by patients having both high psychological and medical risk. Further, the accuracy of PPS surgical prognosis in predicting overall outcome was 82%. Only 9 of 53 patients predicted to have poor outcome achieved fair or good results from spine surgery. These findings suggest that PPS should become a more routine part of the evaluation of chronic pain patients in whom spine surgery is being considered.

Presurgical Planning for Supratentorial Lesions with Free Slicer Software and Sina App.

PubMed

Chen, Ji-Gang; Han, Kai-Wei; Zhang, Dan-Feng; Li, Zhen-Xing; Li, Yi-Ming; Hou, Li-Jun

2017-10-01

Neuronavigation systems are used widely in the localization of intracranial lesions with satisfactory accuracy. However, they are expensive and difficult to learn. Therefore, a simple and practical augmented reality (AR) system using mobile devices might be an alternative technique. We introduce a mobile AR system for the localization of supratentorial lesions. Its practicability and accuracy were examined by clinical application in patients and comparison with a standard neuronavigation system. A 3-dimensional (3D) model including lesions was created with 3D Slicer. A 2-dimensional image of this 3D model was obtained and overlapped on the patient's head with the Sina app. Registration was conducted with the assistance of anatomical landmarks and fiducial markers. The center of lesion projected on scalp was identified with our mobile AR system and standard neuronavigation system, respectively. The difference in distance between the centers identified by these 2 systems was measured. Our mobile AR system was simple and accurate in the localization of supratentorial lesions with a mean distance difference of 4.4 ± 1.1 mm. Registration added on an average of 141.7 ± 39 seconds to operation time. There was no statistically significant difference for the required time among 3 registrations (P = 0.646). The mobile AR system presents an alternative technology for image-guided neurosurgery and proves to be practical and reliable. The technique contributes to optimal presurgical planning for supratentorial lesions, especially in the absence of a neuronavigation system. Copyright © 2017 Elsevier Inc. All rights reserved.

Using presurgical psychological testing to predict 1-year appointment adherence and weight loss in bariatric surgery patients: predictive validity and methodological considerations.

PubMed

Marek, Ryan J; Tarescavage, Anthony M; Ben-Porath, Yossef S; Ashton, Kathleen; Merrell Rish, Julie; Heinberg, Leslie J

2015-01-01

Previous studies suggest that presurgical psychopathology accounts for some of the variance in suboptimal weight loss outcomes among Roux-en-Y gastric bypass (RYGB) patients, but research has been equivocal. The present study seeks to extend the past literature by examining associations between presurgical scale scores on the broadband Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and suboptimal weight loss and poor adherence to follow-up 1 year postoperatively after accounting for several methodologic considerations. Cleveland Clinic Bariatric and Metabolic Institute, Cleveland, Ohio, USA. The sample consisted of 498 RYGB patients, who produced a valid presurgical MMPI-2-RF protocol at program intake. The sample was primarily female (72.9%), Caucasian (64.9%), and middle-aged (mean = 46.4 years old; standard deviation [SD] = 11.6). The mean presurgical body mass index (BMI) was 47.4 kg/m(2) (SD = 8.2) and mean percent weight loss (%WL) at 1 year postoperatively was 31.18 %WL (SD = 8.44). As expected, scales from the Behavioral/Externalizing Dysfunction (BXD) domain of the MMPI-2-RF were associated with worse weight loss outcomes and poor adherence to follow-up, particularly after accounting for range restriction due to underreporting. Individuals producing elevated scores on these scales were at greater risk for achieving suboptimal weight loss (<50% excess weight loss) and not following up with their appointment compared with those who scored below cut-offs. Patients who are more likely to engage in undercontrolled behavior (e.g., poor impulse control), as indicated by presurgical MMPI-2-RF findings, are at greater risk for suboptimal weight loss and poor adherence to follow-up following RYGB. Objective psychological assessments should also be conducted postoperatively to ensure that intervention is administered in a timely manner. Future research in the area of presurgical psychological screening should consider the impact of

Corneal Injury from Presurgical Chlorhexidine Skin Preparation.

PubMed

Bever, Gregory J; Brodie, Frank L; Hwang, David G

2016-12-01

Chlorhexidine skin preparation has been shown to provide highly effective antimicrobial presurgical skin cleansing. However, there is a significant risk of ocular toxicity when it is used in periocular areas. We describe 2 cases of significant corneal damage resulting from 4% chlorhexidine gluconate preoperative skin cleanser, despite the use of protective occlusive dressing over the eyes. Because of the potential for severe corneal toxicity resulting from use of chlorhexidine, alternative agents such as 10% povidone-iodine should be considered for skin preparation near periocular areas whenever possible. If chlorhexidine gluconate must be employed near periocular areas, great care must be exercised to avoid contact with the eyes, and additional protective measures (e.g., absorbent eye pads along with tightly occlusive dressings) must be used whenever possible. Copyright © 2016 Elsevier Inc. All rights reserved.

Presurgical motor, somatosensory and language fMRI: Technical feasibility and limitations in 491 patients over 13 years.

PubMed

Tyndall, Anthony J; Reinhardt, Julia; Tronnier, Volker; Mariani, Luigi; Stippich, Christoph

2017-01-01

To analyse the long-term feasibility and limitations of presurgical fMRI in a cohort of tumour and epilepsy patients with different MR-scanners at 1.5 and 3.0 T. Four hundred and ninety-one consecutive patients undergoing presurgical fMRI between 2000 and 2012 on five different MR-scanners using established paradigms and semi-automated data processing were included. Success rates of task performance and BOLD-activation were determined for motor and somatosensory somatotopic mapping and language localisation. Procedural success, failures and imaging artifacts were analysed. MR-field strengths were compared. Two thousand three hundred fifteen of 2348 (98.6 %) attempted paradigms (1033 motor, 1220 speech, 95 somatosensory) were successfully performed. 100 paradigms (4.3 %) were repetition runs. 23 speech, 6 motor and 2 sensory paradigms failed for non-compliance and technical issues. Most language paradigm failures were noted in overt sentence generation. Average significant BOLD-activation was higher for motor than language paradigms (95.8 vs. 81.6 %). Most language paradigms showed significantly higher activation rates at 3 T compared to 1.5 T, whereas no significant difference was found for motor paradigms. fMRI proved very robust for the presurgical localisation of the different motor and somatosensory body representations, as well as Broca's and Wernicke's language areas across different MR-scanners at 1.5 and 3.0 T over 13 years. • Standardised presurgical motor and language fMRI is robust across various MRI platforms. • Motor fMRI is less dependent on field strength than language fMRI. • fMRI task failures are relatively low and are reduced by paradigm repetition.

Inclusion of attentional networks in the pre-surgical neuroimaging assessment of a large deep hemispheric cavernous malformation: an FMRI case report.

PubMed

Mickleborough, Marla J S; Kelly, Michael E; Gould, Layla; Ekstrand, Chelsea; Lorentz, Eric; Ellchuk, Tasha; Babyn, Paul; Borowsky, Ron

2015-01-01

Functional magnetic resonance imaging (fMRI) is a noninvasive and reliable tool for mapping eloquent cortex in patients prior to brain surgery. Ensuring intact perceptual and cognitive processing is a key goal for neurosurgeons, and recent research has indicated the value of including attentional network processing in pre-surgical fMRI in order to help preserve such abilities, including reading, after surgery. We report a 42-year-old patient with a large cavernous malformation, near the left basal ganglia. The lesion measured 3.8 × 1.7 × 1.8 cm. In consultation with the patient and the multidisciplinary cerebrovascular team, the decision was made to offer the patient surgical resection. The surgical resection involved planned access via the left superior parietal lobule using stereotactic location. The patient declined an awake craniotomy; therefore, direct electrocortical stimulation (ECS) could not be used for intraoperative language localization in this case. Pre-surgical planning included fMRI localization of language, motor, sensory, and attentional processing. The key finding was that both reading and attention-processing tasks revealed consistent activation of the left superior parietal lobule, part of the attentional control network, and the site of the planned surgical access. Given this information, surgical access was adjusted to avoid interference with the attentional control network. The lesion was removed via the left inferior parietal lobule. The patient had no new neurologic deficits postoperatively but did develop mild neuropathic pain in the left hand. This case report supports recent research that indicates the value of including fMRI maps of attentional tasks along with traditional language-processing tasks in preoperative planning in patients undergoing neurosurgery procedures. © 2015 S. Karger AG, Basel.

Health Technology Assessment report on the presurgical evaluation and surgical treatment of drug-resistant epilepsy.

PubMed

Marras, Carlo Efisio; Canevini, Maria Paola; Colicchio, Gabriella; Guerrini, Renzo; Rubboli, Guido; Scerrati, Massimo; Spreafico, Roberto; Tassi, Laura; LoRusso, Giorgio; Tinuper, Paolo

2013-10-01

Epilepsy is a neurologic disorder with major social impact. Surgery is a valuable option in patients who are not responding to antiepileptic drugs. The literature reports demonstrate that a proportion ranging from 40 to 100% of patients with epilepsy achieve seizure remission after surgery. A presurgical evaluation (clinical and instrumental) must be performed in all patients with drug-resistant epilepsy to assess their suitability for surgical intervention. Health Technology Assessment (HTA) represents a modern approach to the analysis of technologies used for health care. HTA could be considered a bridge between science that produces evidence and the decisions that can be taken on the basis of that evidence at different levels of the health care system. The aim of this study is the HTA of epilepsy surgery including clinical, ethical, social, and economic features. The present study includes an analysis of the diagnostic and surgical workup performed at the Italian centers for the diagnosis and treatment of drug-resistant epilepsy (DRE). The study includes the following issues: (1) social, ethical impact, and costs of the disease; (2) clinical results, efficacy, and safety of surgery; (3) ethics and quality of life after surgery; and (4) economic impact and productivity regained after surgery. The cost of managing a patient with DRE included in the presurgical study was estimated by the bottom-up microcosting technique that starts from a detailed collection of data on consumption of resources and full costing. The phases analyzed were (1) noninvasive diagnostic workup; (2) neurosurgical intervention; and (3) follow-up. The literature reports indicate epilepsy surgery as an effective treatment both on clinical results and on ethical, social, and quality of life aspects. The workup including the noninvasive presurgical study followed by surgery has a total cost of €20,827. Management of short-term follow-up increases the overhead to €22,291 at the first year

Environmental Flux and Locally Focused College Writing

ERIC Educational Resources Information Center

Shepley, Nathan

2014-01-01

This article reviews insights from place-based education and ecological models of writing to show how these theories can work together to shape locally focused composition pedagogies. From place-based education, the researcher takes an emphasis on physical specificity, and from ecological models of writing, the researcher takes an emphasis on…

Presurgical EEG-fMRI in a complex clinical case with seizure recurrence after epilepsy surgery

PubMed Central

Zhang, Jing; Liu, Qingzhu; Mei, Shanshan; Zhang, Xiaoming; Wang, Xiaofei; Liu, Weifang; Chen, Hui; Xia, Hong; Zhou, Zhen; Li, Yunlin

2013-01-01

Epilepsy surgery has improved over the last decade, but non-seizure-free outcome remains at 10%–40% in temporal lobe epilepsy (TLE) and 40%–60% in extratemporal lobe epilepsy (ETLE). This paper reports a complex multifocal case. With a normal magnetic resonance imaging (MRI) result and nonlocalizing electroencephalography (EEG) findings (bilateral TLE and ETLE, with more interictal epileptiform discharges [IEDs] in the right frontal and temporal regions), a presurgical EEG-functional MRI (fMRI) was performed before the intraoperative intracranial EEG (icEEG) monitoring (icEEG with right hemispheric coverage). Our previous EEG-fMRI analysis results (IEDs in the left hemisphere alone) were contradictory to the EEG and icEEG findings (IEDs in the right frontal and temporal regions). Thus, the EEG-fMRI data were reanalyzed with newly identified IED onsets and different fMRI model options. The reanalyzed EEG-fMRI findings were largely concordant with those of EEG and icEEG, and the failure of our previous EEG-fMRI analysis may lie in the inaccurate identification of IEDs and wrong usage of model options. The right frontal and temporal regions were resected in surgery, and dual pathology (hippocampus sclerosis and focal cortical dysplasia in the extrahippocampal region) was found. The patient became seizure-free for 3 months, but his seizures restarted after antiepileptic drugs (AEDs) were stopped. The seizures were not well controlled after resuming AEDs. Postsurgical EEGs indicated that ictal spikes in the right frontal and temporal regions reduced, while those in the left hemisphere became prominent. This case suggested that (1) EEG-fMRI is valuable in presurgical evaluation, but requires caution; and (2) the intact seizure focus in the remaining brain may cause the non-seizure-free outcome. PMID:23926432

Pre-surgical nasoalveolar moulding in patient with unilateral cleft of lip, alveolus and palate: case report.

PubMed

Patel, Dolly; Goyal, Ramesh

2012-01-01

A 2 month-old infant with unilateral cleft lip, alveolus and palate was presented with wide alveolar defect, soft-tissue deformity and a markedly sunken nasal wing at the cleft side. The patient was treated with a moulding plate and additionally with a nasal stent. The device consisted of an acrylic plate with an attached nasal stent that lifted the nasal dome. Under this pre-surgical treatment, the cleft edges moved closer by 9 mm and 6 mm at the alveolar ridge and palate, respectively. The nasal wing was lifted considerably. Pre-surgical nasoalveolar moulding helped to reduce the cleft gap, improve the arch form, approximate lip segments and distinctly improve the morphology of the nose by correcting flattened nasal wings. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Presurgical nasoalveolar molding: A boon to facilitate the surgical repair in infants with cleft lip and palate

PubMed Central

Attiguppe, Prabhakar Ramasetty; Karuna, Y. M.; Yavagal, Chandrashekar; Naik, Saraswathi V.; Deepak, B. M.; Maganti, Rekhamani; Krishna, Chaithanya G.

2016-01-01

Cleft lip and palate (CLP) is the most common congenital craniofacial anomaly. Rehabilitation of CLP generally requires a team approach. Alveolar and nasal reconstruction for these patients is a challenge for the reconstructive surgeon. Various procedures have been attempted to reduce the cleft gap, so as to obtain esthetic results postsurgically. The presurgical nasoalveolar molding (PNAM) technique, developed by Grayson, is a new approach to presurgical infant orthopedics. PNAM reduces the severity of the initial cleft alveolar and nasal deformity. Thus, it enables the surgeon and the patient to enjoy the benefits associated with repair of a cleft deformity that is minimal in severity. This article presents a brief insight into PNAM with a case series of three different cases (one unilateral and two bilateral) which underwent PNAM treatment and gave an excellent surgical prognosis. PMID:27994432

Presurgical Nasoalveolar Molding for Correction of Cleft Lip Nasal Deformity: Experience From Northern India

PubMed Central

Mishra, Brijesh; Singh, Arun K.; Zaidi, Javed; Singh, G. K.; Agrawal, Rajiv; Kumar, Vijay

2010-01-01

Context: The cleft lip type nasal deformity presents one of the most complex surgical challenges. The long-term postoperative results are still not satisfactory despite an emphasis on primary nasal correction. This is attributed to tissue memory and healing. Nasoalveolar molding is used effectively to reshape the nasal cartilage and to mold the maxillary arch before cleft lip repair. Aims: This study was undertaken to evaluate the role of presurgical nasoalveolar molding in correction of cleft lip nasal deformity for patients with unilateral and bilateral clefts of the lip. Settings and Design: Twenty-three cases of clefts of lip and palate with nasal deformity were subjected to present study from May 2004 to May 2006. These cases were initially treated on outpatient basis, and they were admitted at the time of operation. All of these patients were children of less than 1 year of age, belonging to north Indian population. Material and Methods: Study consisted of patients of cleft lip and palate who were given presurgical nasoalveolar splints at early age. Lip repair was done after at least 2 months of molding. These patients along with control group (without presurgical nasoalveolar molding) were followed up for 1 year. Measurements were taken at different intervals in study over dental cast and on patients. Data obtained from comparison of 2 groups were analyzed using “MSTAT” analysis software (developed by Dr Russel Freed, Professor & Director, Crop & Soil Sciences Department, Michigan State University, East Lansing, Michigan). Results: In our study, we found that nostril height was more in patients of experimental group (P = .18), while nostril width and alar perimeter were not changed significantly. Children with nasoalveolar molding had significant lengthening of columella (P = .02). Patients of unilateral cleft lip had more reduction in alveolar gap (P = .08) than bilateral group (P = .15). Conclusions: Nasoalveolar molding can be a useful adjunct for

Combined EEG/MEG Can Outperform Single Modality EEG or MEG Source Reconstruction in Presurgical Epilepsy Diagnosis

PubMed Central

Aydin, Ümit; Vorwerk, Johannes; Dümpelmann, Matthias; Küpper, Philipp; Kugel, Harald; Heers, Marcel; Wellmer, Jörg; Kellinghaus, Christoph; Haueisen, Jens; Rampp, Stefan; Stefan, Hermann; Wolters, Carsten H.

2015-01-01

We investigated two important means for improving source reconstruction in presurgical epilepsy diagnosis. The first investigation is about the optimal choice of the number of epileptic spikes in averaging to (1) sufficiently reduce the noise bias for an accurate determination of the center of gravity of the epileptic activity and (2) still get an estimation of the extent of the irritative zone. The second study focuses on the differences in single modality EEG (80-electrodes) or MEG (275-gradiometers) and especially on the benefits of combined EEG/MEG (EMEG) source analysis. Both investigations were validated with simultaneous stereo-EEG (sEEG) (167-contacts) and low-density EEG (ldEEG) (21-electrodes). To account for the different sensitivity profiles of EEG and MEG, we constructed a six-compartment finite element head model with anisotropic white matter conductivity, and calibrated the skull conductivity via somatosensory evoked responses. Our results show that, unlike single modality EEG or MEG, combined EMEG uses the complementary information of both modalities and thereby allows accurate source reconstructions also at early instants in time (epileptic spike onset), i.e., time points with low SNR, which are not yet subject to propagation and thus supposed to be closer to the origin of the epileptic activity. EMEG is furthermore able to reveal the propagation pathway at later time points in agreement with sEEG, while EEG or MEG alone reconstructed only parts of it. Subaveraging provides important and accurate information about both the center of gravity and the extent of the epileptogenic tissue that neither single nor grand-averaged spike localizations can supply. PMID:25761059

Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity

PubMed Central

Kinouchi, Nao; Horiuchi, Shinya; Yasue, Akihiro; Kuroda, Yuko; Kawai, Nobuhiko; Watanabe, Keiichiro; Izawa, Takashi; Hashimoto, Ichiro; Hassan, Ali H.; Tanaka, Eiji

2018-01-01

Objectives: To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age. PMID:29436566

Effectiveness of presurgical nasoalveolar molding therapy on unilateral cleft lip nasal deformity.

PubMed

Kinouchi, Nao; Horiuchi, Shinya; Yasue, Akihiro; Kuroda, Yuko; Kawai, Nobuhiko; Watanabe, Keiichiro; Izawa, Takashi; Hashimoto, Ichiro; Hassan, Ali H; Tanaka, Eiji

2018-02-01

To evaluate the effectiveness of pre-surgical nasoalveolar molding (PNAM) in patients with unilateral cleft lip nasal deformities. Methods: This was a retrospective study involving 29 patients with unilateral cleft lip and palate defects, of whom 13 were treated with palatal devices with nasal stents (PNAM group) and 16 were treated with palatal devices without nasal stents or surgical tapes (control group). Submental oblique photographs and orthodontic models were longitudinally obtained at the initial visit (T1) and immediately before (T2) and  after cheiloplasty (T3). Asymmetry of the external nose, degree of columellar shifting, nasal tip/ala nose ratio, nasal base angle, interalveolar gap, and the sagittal difference in the alveolar gap were measured. The study was conducted in the Orthodontic Clinic at Tokushima University Hospital, Tokushima, Japan between 1997 and 2012. Results: At T1, there were no significant intergroup differences in the first 4 asymmetry parameters. At T2, the PNAM group showed a significant improvement in all values compared to the control group. At T3, the PNAM group showed significant improvement in nasal asymmetry and columellar shifting. Model analysis showed significantly greater changes in the inter-alveolar gap and the sagittal difference of the alveolar cleft gap from T1 to T2 in the PNAM group. Conclusion: The use of PNAM is indispensable for pre-surgical orthodontic treatment at the early postnatal age.

An Examination of the Effects of Pre-Surgical Education on Patient Expectations in Total Knee Arthroplasties

ERIC Educational Resources Information Center

Montez-Ray, Natasha Dawn

2011-01-01

As patients prepare for total-knee arthroplasty surgery, they have numerous expectations related to their long-term recovery and function. This research discerned whether the use of a pre-surgical patient education class with an additional long-term expectation module addressing recovery during the first 12 months after surgery was more effective…

[Presurgical alveolar molding using computer aided design in infants with unilateral complete cleft lip and palate].

PubMed

Zgong, Xin; Yu, Quan; Yu, Zhe-yuan; Wang, Guo-min; Qian, Yu-fen

2012-04-01

To establish a new method of presurgical alveolar molding using computer aided design(CAD) in infants with complete unilateral cleft lip and palate (UCLP). Ten infants with complete UCLP were recruited. A maxillary impression was taken at the first examination after birth. The study model was scanned by a non-contact three-dimensional laser scanner and a digital model was constructed and analyzed to simulate the alveolar molding procedure with reverse engineering software (RapidForm 2006). The digital geometrical data were exported to produce a scale model using rapid prototyping technology. The whole set of appliances was fabricated based on these solid models. The digital model could be viewed and measured from any direction by the software. By the end of the NAM treatment before surgical lip repair, the cleft was narrowed and the malformation of alveolar segments was aligned normally, significantly improving nasal symmetry and nostril shape. Presurgical NAM using CAD could simplify the treatment procedure and estimate the treatment objective, which enabled precise control of the force and direction of the alveolar segments movement.

Clinical utility of BOLD fMRI in preoperative work-up of epilepsy

PubMed Central

Ganesan, Karthik; Ursekar, Meher

2014-01-01

Surgical techniques have emerged as a viable therapeutic option in patients with drug refractory epilepsy. Pre-surgical evaluation of epilepsy requires a comprehensive, multiparametric, and multimodal approach for precise localization of the epileptogenic focus. Various non-invasive techniques are available at the disposal of the treating physician to detect the epileptogenic focus, which include electroencephalography (EEG), video-EEG, magnetic resonance imaging (MRI), functional MRI including blood oxygen level dependent (BOLD) techniques, single photon emission tomography (SPECT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Currently, non-invasive high-resolution MR imaging techniques play pivotal roles in the preoperative detection of the seizure focus, and represent the foundation for successful epilepsy surgery. BOLD functional magnetic resonance imaging (fMRI) maps allow for precise localization of the eloquent cortex in relation to the seizure focus. This review article focuses on the clinical utility of BOLD (fMRI) in the pre-surgical work-up of epilepsy patients. PMID:24851002

Family companions' involvement during pre-surgical consent visits for major cancer surgery and its relationship to visit communication and satisfaction.

PubMed

Isenberg, Sarina R; Aslakson, Rebecca A; Dionne-Odom, James N; Clegg Smith, Katherine; Singh, Sarabdeep; Larson, Susan; Bridges, John F P; Smith, Thomas J; Wolff, Jennifer L; Roter, Debra L

2018-06-01

To examine the association between family companion presence during pre-surgical visits to discuss major cancer surgery and patient-provider communication and satisfaction. Secondary analysis of 61 pre-surgical visit recordings with eight surgical oncologists at an academic tertiary care hospital using the Roter Interaction Analysis System (RIAS). Surgeons, patients, and companions completed post-visit satisfaction questionnaires. Poisson and logistic regression models assessed differences in communication and satisfaction when companions were present vs. absent. There were 46 visits (75%) in which companions were present, and 15 (25%) in which companions were absent. Companion communication was largely emotional and facilitative, as measured by RIAS. Companion presence was associated with more surgeon talk (IRR 1.29, p = 0.006), and medical information-giving (IRR 1.41, p = 0.001). Companion presence was associated with less disclosure of lifestyle/psychosocial topics by patients (IRR 0.55, p = 0.037). In adjusted analyses, companions' presence was associated with lower levels of patient-centeredness (IRR 0.77, p 0.004). There were no differences in patient or surgeon satisfaction based on companion presence. Companions' presence during pre-surgical visits was associated with patient-surgeon communication but was not associated with patient or surgeon satisfaction. Future work is needed to develop interventions to enhance patient-companion-provider interactions in this setting. Copyright © 2018 Elsevier B.V. All rights reserved.

The Contribution of Functional Near-Infrared Spectroscopy (fNIRS) to the Presurgical Assessment of Language Function in Children

ERIC Educational Resources Information Center

Gallagher, Anne; Beland, Renee; Lassonde, Maryse

2012-01-01

Before performing neurosurgery, an exhaustive presurgical assessment is required, usually including an investigation of language cerebral lateralization. Among the available procedures, the intracarotid amobarbital test (IAT) was formerly the most widely used. However, this procedure has many limitations: it is invasive and potentially traumatic,…

Near-Field Source Localization by Using Focusing Technique

NASA Astrophysics Data System (ADS)

He, Hongyang; Wang, Yide; Saillard, Joseph

2008-12-01

We discuss two fast algorithms to localize multiple sources in near field. The symmetry-based method proposed by Zhi and Chia (2007) is first improved by implementing a search-free procedure for the reduction of computation cost. We present then a focusing-based method which does not require symmetric array configuration. By using focusing technique, the near-field signal model is transformed into a model possessing the same structure as in the far-field situation, which allows the bearing estimation with the well-studied far-field methods. With the estimated bearing, the range estimation of each source is consequently obtained by using 1D MUSIC method without parameter pairing. The performance of the improved symmetry-based method and the proposed focusing-based method is compared by Monte Carlo simulations and with Crammer-Rao bound as well. Unlike other near-field algorithms, these two approaches require neither high-computation cost nor high-order statistics.

Spinal cord stimulation: Subjective pain intensity and presurgical correlates in chronic pain patients.

PubMed

Sumner, Lekeisha A; Lofland, Kenneth

2014-09-01

This study determined the changes in pain intensity prior to and after permanent placement of spinal cord stimulation (SCS), as measured by the Visual Analog Scale (VAS) and, examined associations of presurgical characteristics to both pre- and post-SCS VAS scores. Demographic, disease, and psychological data were extracted from the medical charts of chronic pain patients (N = 58) being treated at a Hospital in IL, USA. Most patients were diagnosed with complex regional pain syndrome (51.9%) and low back pain (33.3%). The majority were White (72.5%), male (60%), married (72%), and temporary disabled or receiving worker's compensation (40%). Study objectives were tested with correlational and univariate analysis. A significant reduction between pre (M = 6.87; SD = 1.38) and Post-(M = 4.11; SD = 1.54) SCS pain intensity scores was observed (p < .000). Pre-SCS pain intensity scores were associated with medical diagnosis (p < .01), marital status (p < .05), and catastrophizing (p < .05). Post-SCS pain intensity scores were associated with body mass index (p < .05), medical diagnosis (p < .05), employment status (p < .05), bodily concern (p < .05), marital status (p < .05), and race (p < .05). Results strengthen support for the short-term effectiveness of SCS and demonstrate the differential associations of presurgical factors on pain intensity. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

High-Intensity Focused Ultrasound (HIFU) in Localized Prostate Cancer Treatment.

PubMed

Alkhorayef, Mohammed; Mahmoud, Mustafa Z; Alzimami, Khalid S; Sulieman, Abdelmoneim; Fagiri, Maram A

2015-01-01

High-intensity focused ultrasound (HIFU) applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue through ablation. This study intended to review HIFU to explain the fundamentals of HIFU, evaluate the evidence concerning the role of HIFU in the treatment of prostate cancer (PC), review the technologies used to perform HIFU and the published clinical literature regarding the procedure as a primary treatment for PC. Studies addressing HIFU in localized PC were identified in a search of internet scientific databases. The analysis of outcomes was limited to journal articles written in English and published between 2000 and 2013. HIFU is a non-invasive approach that uses a precisely delivered ultrasound energy to achieve tumor cell necrosis without radiation or surgical excision. In current urological oncology, HIFU is used clinically in the treatment of PC. Clinical research on HIFU therapy for localized PC began in the 1990s, and the majority of PC patients were treated with the Ablatherm device. HIFU treatment for localized PC can be considered as an alternative minimally invasive therapeutic modality for patients who are not candidates for radical prostatectomy. Patients with lower pre-HIFU PSA level and favourable pathologic Gleason score seem to present better oncologic outcomes. Future advances in technology and safety will undoubtedly expand the HIFU role in this indication as more of patient series are published, with a longer follow-up period.

High-Intensity Focused Ultrasound (HIFU) in Localized Prostate Cancer Treatment

PubMed Central

Alkhorayef, Mohammed; Mahmoud, Mustafa Z.; Alzimami, Khalid S.; Sulieman, Abdelmoneim; Fagiri, Maram A.

2015-01-01

Summary Background High-intensity focused ultrasound (HIFU) applies high-intensity focused ultrasound energy to locally heat and destroy diseased or damaged tissue through ablation. This study intended to review HIFU to explain the fundamentals of HIFU, evaluate the evidence concerning the role of HIFU in the treatment of prostate cancer (PC), review the technologies used to perform HIFU and the published clinical literature regarding the procedure as a primary treatment for PC. Material/Methods Studies addressing HIFU in localized PC were identified in a search of internet scientific databases. The analysis of outcomes was limited to journal articles written in English and published between 2000 and 2013. Results HIFU is a non-invasive approach that uses a precisely delivered ultrasound energy to achieve tumor cell necrosis without radiation or surgical excision. In current urological oncology, HIFU is used clinically in the treatment of PC. Clinical research on HIFU therapy for localized PC began in the 1990s, and the majority of PC patients were treated with the Ablatherm device. Conclusions HIFU treatment for localized PC can be considered as an alternative minimally invasive therapeutic modality for patients who are not candidates for radical prostatectomy. Patients with lower pre-HIFU PSA level and favourable pathologic Gleason score seem to present better oncologic outcomes. Future advances in technology and safety will undoubtedly expand the HIFU role in this indication as more of patient series are published, with a longer follow-up period. PMID:25806099

Resting-state blood oxygen level-dependent functional magnetic resonance imaging for presurgical planning.

PubMed

Kamran, Mudassar; Hacker, Carl D; Allen, Monica G; Mitchell, Timothy J; Leuthardt, Eric C; Snyder, Abraham Z; Shimony, Joshua S

2014-11-01

Resting-state functional MR imaging (rsfMR imaging) measures spontaneous fluctuations in the blood oxygen level-dependent (BOLD) signal and can be used to elucidate the brain's functional organization. It is used to simultaneously assess multiple distributed resting-state networks. Unlike task-based functional MR imaging, rsfMR imaging does not require task performance. This article presents a brief introduction of rsfMR imaging processing methods followed by a detailed discussion on the use of rsfMR imaging in presurgical planning. Example cases are provided to highlight the strengths and limitations of the technique. Copyright © 2014 Elsevier Inc. All rights reserved.

Overcoming challenges in designing and implementing a phase II randomized controlled trial using a presurgical model to test a dietary intervention in prostate cancer

PubMed Central

George, Stephen L; Switzer, Boyd R; Snyder, Denise C; Madden, John F; Polascik, Thomas J; Ruffin, Mack T; Vollmer, Robin T

2008-01-01

Background The time between the diagnosis of cancer and a planned definitive surgical procedure offers a strong and direct approach for assessing the impact of interventions (including lifestyle interventions) on the biology of the target tissue and the tumor. Despite the many strengths of presurgical models, there are practical issues and challenges that arise when using this approach. Purpose/Methods We recently completed an NIH-funded phase II trial that utilized a presurgical model in testing the comparative effects of flaxseed supplementation and/or dietary fat restriction on the biology and biomarkers associated with prostatic carcinoma. Herein, we report the rationale for our original design, discuss modifications in strategy, and relay experiences in implementing this trial related to the following topics: (1) subject accrual; (2) subject retention; (3) intervention delivery; and (4) retrieval and completion rates regarding the collection of paraffin-embedded and fresh frozen prostate tissue, blood, urine, ejaculate, anthropometric measures and survey data. Results This trial achieved its accrual target, i.e., a racially-representative (70% white, 30% minority) sample of 161 participants, low rates of attrition (7%); and collection rates that exceeded 90% for almost all biospecimens and survey data. While the experience gained from pilot studies was invaluable in designing this trial, the complexity introduced by the collection of several biospecimens, inclusion of a team of pathologists (to provide validated readings), and shifts in practice patterns related to prostatectomy, made it necessary to revise our protocol; lessons from our experiences are offered within this article. Conclusions While our experience specifically relates to the implementation of a presurgical model-based trial in prostate cancer aimed at testing flaxseed-supplemented and fat-restricted diets, many of the lessons learned have broad application to trials that utilize a presurgical

Figuring of plano-elliptical neutron focusing mirror by local wet etching.

PubMed

Yamamura, Kazuya; Nagano, Mikinori; Takai, Hiroyuki; Zettsu, Nobuyuki; Yamazaki, Dai; Maruyama, Ryuji; Soyama, Kazuhiko; Shimada, Shoichi

2009-04-13

Local wet etching technique was proposed to fabricate high-performance aspherical mirrors. In this process, only the limited area facing to the small nozzle is removed by etching on objective surface. The desired objective shape is deterministically fabricated by performing the numerically controlled scanning of the nozzle head. Using the technique, a plano-elliptical mirror to focus the neutron beam was successfully fabricated with the figure accuracy of less than 0.5 microm and the focusing gain of 6. The strong and thin focused neutron beam is expected to be a useful tool for the analyses of various material properties.

Leading up to saying "yes": A qualitative study on the experience of patients with refractory epilepsy regarding presurgical investigation for resective surgery.

PubMed

Shih, Patti; Nikpour, Armin; Bleasel, Andrew; Herkes, Geoffrey; Mitchell, Rebecca; Seah, Rebecca; Mumford, Virginia; Braithwaite, Jeffrey; Vagholkar, Sanjyot; Rapport, Frances

2018-06-01

Adult patients with refractory epilepsy who are potential candidates for resective surgery undergo a period of presurgical investigation in tertiary epilepsy centers (TECs), where they engage extensively with healthcare professionals and receive a range of treatment-related information. This qualitative study aimed to examine the experiences of adult patients with refractory epilepsy leading up to and during presurgical investigation and how their perceptions of resective surgery are shaped. In-depth interviews with 12 patients and six epilepsy specialist clinicians and 12 observations of routine patient-clinician consultations took place at two TECs in Sydney, Australia. Data were thematically analyzed via group work. Patients reflected on prior experiences of poor seizure control and inadequate antiepileptic drug management and a lack of clarity about their condition before referral to tertiary care. Poor continuity of care and disrupted care transitions affected patients from regional locations. Tertiary referral increased engagement with personalized information about refractory epilepsy, which intensified during presurgical assessments with additional hospital visits and consultations. Experiential information, such as testimonials of other patients, influenced perceptions of surgery and fostered more trust and confidence towards healthcare professionals. Qualitative inquiry detailed multifaceted effects of information on patients' overall treatment trajectory and experience of healthcare. Earlier patient identification for surgical assessments should be accompanied by access to good quality information at primary and community care levels and strengthened referral processes. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

An Intelligibility Assessment of Toddlers with Cleft Lip and Palate Who Received and Did Not Receive Presurgical Infant Orthopedic Treatment.

ERIC Educational Resources Information Center

Konst, Emmy M.; Weersink-Braks, Hanny; Rietveld, Toni; Peters, Herman

2000-01-01

The influence of presurgical infant orthopedic treatment (PIO) on speech intelligibility was evaluated with 10 toddlers who used PIO during the first year of life and 10 who did not. Treated children were rated as exhibiting greater intelligibility, however, transcription data indicated there were not group differences in actual intelligibility.…

Enhanced Approximate Nearest Neighbor via Local Area Focused Search.

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

Gonzales, Antonio; Blazier, Nicholas Paul

Approximate Nearest Neighbor (ANN) algorithms are increasingly important in machine learning, data mining, and image processing applications. There is a large family of space- partitioning ANN algorithms, such as randomized KD-Trees, that work well in practice but are limited by an exponential increase in similarity comparisons required to optimize recall. Additionally, they only support a small set of similarity metrics. We present Local Area Fo- cused Search (LAFS), a method that enhances the way queries are performed using an existing ANN index. Instead of a single query, LAFS performs a number of smaller (fewer similarity comparisons) queries and focuses onmore » a local neighborhood which is refined as candidates are identified. We show that our technique improves performance on several well known datasets and is easily extended to general similarity metrics using kernel projection techniques.« less

Study on localization of epileptic focus based on causality analysis

NASA Astrophysics Data System (ADS)

Shan, Shaojie; Li, Hanjun; Tang, Xiaoying

2018-05-01

In this paper, we considered that the ECoG signal contain abundant pathological information, which can be used for the localization of epileptic focus before epileptic seizures in 1-2 mins. In order to validate this hypothesis, cutting the ECoG into three stages: before seizure, seizure and after seizure, then through using Granger causality algorithm, PSI causality algorithm, Transfer Entropy causality algorithm at different stages of epilepsy ECoG, we were able to do the causality analysis of ECoG data. The results have shown that there is significant difference with the causality value of the epileptic focus area in before seizure, seizure and after seizure. An increase is in the causality value of each channel during epileptic seizure. After epileptic seizure, the causality between the channels showed a downward trend, but the difference was not obvious. The difference of the causality provides a reliable technical method to assist the clinical diagnosis of epileptic focus.

Localized solutions of Lugiato-Lefever equations with focused pump.

PubMed

Cardoso, Wesley B; Salasnich, Luca; Malomed, Boris A

2017-12-04

Lugiato-Lefever (LL) equations in one and two dimensions (1D and 2D) accurately describe the dynamics of optical fields in pumped lossy cavities with the intrinsic Kerr nonlinearity. The external pump is usually assumed to be uniform, but it can be made tightly focused too-in particular, for building small pixels. We obtain solutions of the LL equations, with both the focusing and defocusing intrinsic nonlinearity, for 1D and 2D confined modes supported by the localized pump. In the 1D setting, we first develop a simple perturbation theory, based in the sech ansatz, in the case of weak pump and loss. Then, a family of exact analytical solutions for spatially confined modes is produced for the pump focused in the form of a delta-function, with a nonlinear loss (two-photon absorption) added to the LL model. Numerical findings demonstrate that these exact solutions are stable, both dynamically and structurally (the latter means that stable numerical solutions close to the exact ones are found when a specific condition, necessary for the existence of the analytical solution, does not hold). In 2D, vast families of stable confined modes are produced by means of a variational approximation and full numerical simulations.

American Society of Functional Neuroradiology-Recommended fMRI Paradigm Algorithms for Presurgical Language Assessment.

PubMed

Black, D F; Vachha, B; Mian, A; Faro, S H; Maheshwari, M; Sair, H I; Petrella, J R; Pillai, J J; Welker, K

2017-10-01

Functional MR imaging is increasingly being used for presurgical language assessment in the treatment of patients with brain tumors, epilepsy, vascular malformations, and other conditions. The inherent complexity of fMRI, which includes numerous processing steps and selective analyses, is compounded by institution-unique approaches to patient training, paradigm choice, and an eclectic array of postprocessing options from various vendors. Consequently, institutions perform fMRI in such markedly different manners that data sharing, comparison, and generalization of results are difficult. The American Society of Functional Neuroradiology proposes widespread adoption of common fMRI language paradigms as the first step in countering this lost opportunity to advance our knowledge and improve patient care. A taskforce of American Society of Functional Neuroradiology members from multiple institutions used a broad literature review, member polls, and expert opinion to converge on 2 sets of standard language paradigms that strike a balance between ease of application and clinical usefulness. The taskforce generated an adult language paradigm algorithm for presurgical language assessment including the following tasks: Sentence Completion, Silent Word Generation, Rhyming, Object Naming, and/or Passive Story Listening. The pediatric algorithm includes the following tasks: Sentence Completion, Rhyming, Antonym Generation, or Passive Story Listening. Convergence of fMRI language paradigms across institutions offers the first step in providing a "Rosetta Stone" that provides a common reference point with which to compare and contrast the usefulness and reliability of fMRI data. From this common language task battery, future refinements and improvements are anticipated, particularly as objective measures of reliability become available. Some commonality of practice is a necessary first step to develop a foundation on which to improve the clinical utility of this field. © 2017 by

Predicting pain relief: Use of pre-surgical trigeminal nerve diffusion metrics in trigeminal neuralgia.

PubMed

Hung, Peter S-P; Chen, David Q; Davis, Karen D; Zhong, Jidan; Hodaie, Mojgan

2017-01-01

Trigeminal neuralgia (TN) is a chronic neuropathic facial pain disorder that commonly responds to surgery. A proportion of patients, however, do not benefit and suffer ongoing pain. There are currently no imaging tools that permit the prediction of treatment response. To address this paucity, we used diffusion tensor imaging (DTI) to determine whether pre-surgical trigeminal nerve microstructural diffusivities can prognosticate response to TN treatment. In 31 TN patients and 16 healthy controls, multi-tensor tractography was used to extract DTI-derived metrics-axial (AD), radial (RD), mean diffusivity (MD), and fractional anisotropy (FA)-from the cisternal segment, root entry zone and pontine segment of trigeminal nerves for false discovery rate-corrected Student's t -tests. Ipsilateral diffusivities were bootstrap resampled to visualize group-level diffusivity thresholds of long-term response. To obtain an individual-level statistical classifier of surgical response, we conducted discriminant function analysis (DFA) with the type of surgery chosen alongside ipsilateral measurements and ipsilateral/contralateral ratios of AD and RD from all regions of interest as prediction variables. Abnormal diffusivity in the trigeminal pontine fibers, demonstrated by increased AD, highlighted non-responders (n = 14) compared to controls. Bootstrap resampling revealed three ipsilateral diffusivity thresholds of response-pontine AD, MD, cisternal FA-separating 85% of non-responders from responders. DFA produced an 83.9% (71.0% using leave-one-out-cross-validation) accurate prognosticator of response that successfully identified 12/14 non-responders. Our study demonstrates that pre-surgical DTI metrics can serve as a highly predictive, individualized tool to prognosticate surgical response. We further highlight abnormal pontine segment diffusivities as key features of treatment non-response and confirm the axiom that central pain does not commonly benefit from peripheral

Three-dimensional intracranial EEG monitoring in presurgical assessment of MRI-negative frontal lobe epilepsy

PubMed Central

Yang, Peng-Fan; Shang, Ming-Chao; Lin, Qiao; Xiao, Hui; Mei, Zhen; Jia, Yan-Zeng; Liu, Wei; Zhong, Zhong-Hui

2016-01-01

Abstract Magnetic resonance imaging (MRI)-negative epilepsy is associated with poor clinical outcomes prognosis. The present study was aimed to assess whether intracranial 3D interictal and ictal electroencephalography (EEG) findings, a combination of EEG at a different depth, in addition to clinical, scalp EEG, and positron emission tomography–computed tomography (PETCT) data help to predict outcome in a series of patients with MRI-negative frontal lobe epilepsy (FLE) after surgery. Patients with MRI-negative FLE who were presurgically evaluated by 3D-intracranial EEG (3D-iEEG) recording were included. Outcome predictors were compared in patients with seizure freedom (group 1) and those with recurrent seizures (group 2) at least 24 months after surgery. Forty-seven patients (15 female) were included in this study. MRI was found normal in 38 patients, whereas a focal or regional hypometabolism was observed in 33 cases. Twenty-three patients (48.9%) were seizure-free (Engel class I), and 24 patients (51.1%) continued to have seizures (12 were class II, 7 were class III, and 5 were class IV). Detailed analysis of intracranial EEG revealed widespread (>2 cm) (17.4%:75%; P = 0.01) in contrast to focal seizure onset as well as shorter latency to onset of seizure spread (5.9 ± 7.1 s; 1.4 ± 2.9 s; P = 0.016) and to ictal involvement of brain structures beyond the frontal lobe (21.8 ± 20.3 s; 4.9 ± 5.1 s; P = 0.025) in patients without seizure freedom. The results suggest that presurgical evaluation using 3D-iEEG monitoring lead to a better surgical outcome as seizure free in MRI-negative FLE patients. PMID:27977572

Frontal lobe seizures: from clinical semiology to localization.

PubMed

Bonini, Francesca; McGonigal, Aileen; Trébuchon, Agnès; Gavaret, Martine; Bartolomei, Fabrice; Giusiano, Bernard; Chauvel, Patrick

2014-02-01

Frontal lobe seizures are difficult to characterize according to semiologic and electrical features. We wished to establish whether different semiologic subgroups can be identified and whether these relate to anatomic organization. We assessed all seizures from 54 patients with frontal lobe epilepsy that were explored with stereoelectroencephalography (SEEG) during presurgical evaluation. Semiologic features and concomitant intracerebral EEG changes were documented and quantified. These variables were examined using Principal Component Analysis and Cluster Analysis, and semiologic features correlated with anatomic localization. Four main groups of patients were identified according to semiologic features, and correlated with specific patterns of anatomic seizure localization. Group 1 was characterized clinically by elementary motor signs and involved precentral and premotor regions. Group 2 was characterized by a combination of elementary motor signs and nonintegrated gestural motor behavior, and involved both premotor and prefrontal regions. Group 3 was characterized by integrated gestural motor behavior with distal stereotypies and involved anterior lateral and medial prefrontal regions. Group 4 was characterized by seizures with fearful behavior and involved the paralimbic system (ventromedial prefrontal cortex ± anterior temporal structures). The groups were organized along a rostrocaudal axis, representing bands within a spectrum rather than rigid categories. The more anterior the seizure organization, the more likely was the occurrence of integrated behavior during seizures. Distal stereotypies were associated with the most anterior prefrontal localizations, whereas proximal stereotypies occurred in more posterior prefrontal regions. Meaningful categorization of frontal seizures in terms of semiology is possible and correlates with anatomic organization along a rostrocaudal axis, in keeping with current hypotheses of frontal lobe hierarchical organization

Focus on Local Reaction.

ERIC Educational Resources Information Center

Howe, Rod

1999-01-01

Discusses how the student newspaper "The Lance" (at Westside High School in Omaha, Nebraska) covered the shootings at Columbine High School. Notes that the staff localized the event and brought the student body into the story. (RS)

Localization of focused-ultrasound beams in a tissue phantom, using remote thermocouple arrays.

PubMed

Hariharan, Prasanna; Dibaji, Seyed Ahmad Reza; Banerjee, Rupak K; Nagaraja, Srinidhi; Myers, Matthew R

2014-12-01

In focused-ultrasound procedures such as vessel cauterization or clot lysis, targeting accuracy is critical. To investigate the targeting accuracy of the focused-ultrasound systems, tissue phantoms embedded with thermocouples can be employed. This paper describes a method that utilizes an array of thermocouples to localize the focused ultrasound beam. All of the thermocouples are located away from the beam, so that thermocouple artifacts and sensor interference are minimized. Beam propagation and temperature rise in the phantom are simulated numerically, and an optimization routine calculates the beam location that produces the best agreement between the numerical temperature values and those measured with thermocouples. The accuracy of the method was examined as a function of the array characteristics, including the number of thermocouples in the array and their orientation. For exposures with a 3.3-MHz source, the remote-thermocouple technique was able to predict the focal position to within 0.06 mm. Once the focal location is determined using the localization method, temperatures at desired locations (including the focus) can be estimated from remote thermocouple measurements by curve fitting an analytical solution to the heat equation. Temperature increases in the focal plane were predicted to within 5% agreement with measured values using this method.

Adaptive Localization of Focus Point Regions via Random Patch Probabilistic Density from Whole-Slide, Ki-67-Stained Brain Tumor Tissue

PubMed Central

Alomari, Yazan M.; MdZin, Reena Rahayu

2015-01-01

Analysis of whole-slide tissue for digital pathology images has been clinically approved to provide a second opinion to pathologists. Localization of focus points from Ki-67-stained histopathology whole-slide tissue microscopic images is considered the first step in the process of proliferation rate estimation. Pathologists use eye pooling or eagle-view techniques to localize the highly stained cell-concentrated regions from the whole slide under microscope, which is called focus-point regions. This procedure leads to a high variety of interpersonal observations and time consuming, tedious work and causes inaccurate findings. The localization of focus-point regions can be addressed as a clustering problem. This paper aims to automate the localization of focus-point regions from whole-slide images using the random patch probabilistic density method. Unlike other clustering methods, random patch probabilistic density method can adaptively localize focus-point regions without predetermining the number of clusters. The proposed method was compared with the k-means and fuzzy c-means clustering methods. Our proposed method achieves a good performance, when the results were evaluated by three expert pathologists. The proposed method achieves an average false-positive rate of 0.84% for the focus-point region localization error. Moreover, regarding RPPD used to localize tissue from whole-slide images, 228 whole-slide images have been tested; 97.3% localization accuracy was achieved. PMID:25793010

[Pre-surgical period and non-work-related sickness absence due to inguinal hernia].

PubMed

Ruiz-Moraga, Montserrat; Catalina-Romero, Carlos; Martínez-Muñoz, Paloma; Cobo-Santiago, María Dolores; González-López, Maite; Cabrera-Sierra, Martha; Porrero-Carro, José Luis; Calvo-Bonacho, Eva

2014-04-01

To analyze non-work-related sickness absence (NWR-SA) due to inguinal hernia and the factors related to its duration, paying particular attention to the pre-surgical period of NWR-SA. Prospective cohort study was conducted on 1,003 workers with an episode of NWR-SA due to an inguinal hernia, belonging to the insured population of a mutual insurance company. We assessed the duration of the NWR-SA episodes and the main demographic, occupational and clinical variables potentially related to it. Cox regression analyses were conducted to establish the predictors of NWR-SA duration. The mean duration of NWR-SA due to inguinal hernia was 68.6 days. After multivariate analysis (Cox regression), having a pre-surgical period of NWR-SA (HR = 0.35; 95%CI: 0.28-0.43), manual occupations (HR=0.68; 95%CI: 0.49-0.95), construction sector (HR=0.71; 95%CI: 0.58-0.88), direct payment methods by a Mutual Insurance Company during sick leave in self-employed workers (HR=0.58; 95%CI, 0.41-0.82), or employees (HR=0.51; 95%CI: 0.36-0.72), comorbidity (HR=0.45; 95%CI:0.34-0.59), and surgery performed under an entity other than the Public Health System or a mutual insurance company (HR=0,76; 95%CI: 0.59-0.97) were associated with longer NWR-SA. The Mutual Insurance Company always performed the surgery when a pre-surgery period of NWR-SA existed (mean duration=47 ±39.6 days); that was associated with shorter periods of post-surgical NWR-SA (P=.001). The NWR-SA due to inguinal hernia is a multifactorial phenomenon in which the pre-surgery period plays an important role. The collaboration between organizations involved in the management of NWR-SA seems to be an effective strategy for reducing its duration. Copyright © 2012 AEC. Published by Elsevier Espana. All rights reserved.

High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI).

PubMed

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-08-07

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R(2) = 0.821 at p < 0.002 in the 2D HMI system. We demonstrated the

High Intensity Focused Ultrasound (HIFU) Focal Spot Localization Using Harmonic Motion Imaging (HMI)

PubMed Central

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-01-01

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of High-Intensity Focused Ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic Motion Imaging for Focused Ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the −3 dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p<0.002 in the 2D HMI system. We demonstrated the

High intensity focused ultrasound (HIFU) focal spot localization using harmonic motion imaging (HMI)

NASA Astrophysics Data System (ADS)

Han, Yang; Hou, Gary Yi; Wang, Shutao; Konofagou, Elisa

2015-08-01

Several ultrasound-based imaging modalities have been proposed for image guidance and monitoring of high-intensity focused ultrasound (HIFU) treatment. However, accurate localization and characterization of the effective region of treatment (focal spot) remain important obstacles in the clinical implementation of HIFU ablation. Harmonic motion imaging for focused ultrasound (HMIFU) is a HIFU monitoring technique that utilizes radiation-force-induced localized oscillatory displacement. HMIFU has been shown to correctly identify the formation and extent of HIFU thermal ablation lesions. However a significant problem remains in identifying the location of the HIFU focus, which is necessary for treatment planning. In this study, the induced displacement was employed to localize the HIFU focal spot inside the tissue prior to treatment. Feasibility was shown with two separate systems. The 1D HMIFU system consisted of a HIFU transducer emitting an amplitude-modulated HIFU beam for mechanical excitation and a confocal single-element, pulse-echo transducer for simultaneous RF acquisition. The 2D HIFU system consists of a HIFU phased array, and a co-axial imaging phased array for simultaneous imaging. Initial feasibility was first performed on tissue-mimicking gelatin phantoms and the focal zone was defined as the region corresponding to the  -3dB full width at half maximum of the HMI displacement. Using the same parameters, in vitro experiments were performed in canine liver specimens to compare the defined focal zone with the lesion. In vitro measurements showed good agreement between the HMI predicted focal zone and the induced HIFU lesion location. HMIFU was experimentally shown to be capable of predicting and tracking the focal region in both phantoms and in vitro tissues. The accuracy of focal spot localization was evaluated by comparing with the lesion location in post-ablative tissues, with a R2 = 0.821 at p  <  0.002 in the 2D HMI system. We demonstrated

Presurgical language fMRI: Clinical practices and patient outcomes in epilepsy surgical planning.

PubMed

Benjamin, Christopher F A; Li, Alexa X; Blumenfeld, Hal; Constable, R Todd; Alkawadri, Rafeed; Bickel, Stephan; Helmstaedter, Christoph; Meletti, Stefano; Bronen, Richard; Warfield, Simon K; Peters, Jurriaan M; Reutens, David; Połczyńska, Monika; Spencer, Dennis D; Hirsch, Lawrence J

2018-03-12

The goal of this study was to document current clinical practice and report patient outcomes in presurgical language functional MRI (fMRI) for epilepsy surgery. Epilepsy surgical programs worldwide were surveyed as to the utility, implementation, and efficacy of language fMRI in the clinic; 82 programs responded. Respondents were predominantly US (61%) academic programs (85%), and evaluated adults (44%), adults and children (40%), or children only (16%). Nearly all (96%) reported using language fMRI. Surprisingly, fMRI is used to guide surgical margins (44% of programs) as well as lateralize language (100%). Sites using fMRI for localization most often use a distance margin around activation of 10mm. While considered useful, 56% of programs reported at least one instance of disagreement with other measures. Direct brain stimulation typically confirmed fMRI findings (74%) when guiding margins, but instances of unpredicted decline were reported by 17% of programs and 54% reported unexpected preservation of function. Programs reporting unexpected decline did not clearly differ from those which did not. Clinicians using fMRI to guide surgical margins do not typically map known language-critical areas beyond Broca's and Wernicke's. This initial data shows many clinical teams are confident using fMRI not only for language lateralization but also to guide surgical margins. Reported cases of unexpected language preservation when fMRI activation is resected, and cases of language decline when it is not, emphasize a critical need for further validation. Comprehensive studies comparing commonly-used fMRI paradigms to predict stimulation mapping and post-surgical language decline remain of high importance. © 2018 The Authors Human Brain Mapping Published by Wiley Periodicals, Inc.

A New Classification System for Unilateral Cleft Lip and Palate Infants to assist Presurgical Infant Orthopedics.

PubMed

Daigavane, P S; Hazarey, P V; Niranjane, P; Vasudevan, S D; Thombare, B R; Daigavane, S

2015-01-01

The proposed advantages of pre-surgical naso-alveolar moulding (PNAM) are easy primary lip repair which heals under minimum tension reducing the scar formation and improving the aesthetic results in addition to reshaping of alar cartilage and improvement of nasal symmetry.However, the anatomy and alveolar morphology varies for each cleft child; the procedure for PNAM differs accordingly. In an attempt to categorize unilateral cleft lip and palate cases as per anatomical variations, a new classification system has been proposed. This classification aims to give an insight in unilateral cleft morphology based on which modification in PNAM procedure could be done.

Partnering Students, Scientists, and the Local Community in a Regionally-focused Field Campaign

NASA Astrophysics Data System (ADS)

McLaughlin, J. W.; Lemone, M. A.; Seavey, M. M.; Washburne, J. C.

2006-05-01

The GLOBE Program (www.globe.gov) involves students and scientists in a worldwide environmental data collection effort. The GLOBE ONE field campaign (www.globe.gov/globeone) represents a model for a focused implementation of GLOBE via a geographically-specific project. The campaign, which occurred in Black Hawk County, Iowa from February 2004 to February 2006, was developed by GLOBE Principal Investigators (PIs), the GLOBE Program Office, and GLOBE Iowa. The central scientific objective was to compare quantitatively the environmental effects of various soil tillage techniques. In addition, student research projects were supported that spanned a variety of Earth science topics. The campaign established a partnership between students and scientists to collect a structured, multidisciplinary data set and also increase GLOBE visibility. The fact that GLOBE ONE occurred in a focused geographic area made it necessary to form a network for local support. This started with choosing an active GLOBE partner, namely the Iowa Academy of Science, who had the ability to oversee the local implementation of such a project. Once this partner was chosen, additional local groups needed to be recruited to support the project. The local network included K-12 schools, the County Conservation Board, the University of Northern Iowa, Hawkeye Community College, and community volunteers. This network collected data via automated instrumentation, first-hand observations, and through special events organized with a focus on a specific measurement. The first major step in supporting student research was a teacher training workshop held in March of 2006 that helped to provide tools for, and increase comfort levels with, promoting scientific inquiry in the classroom. Student-scientists interactions were promoted via scientist visits, video conferences, letters, and email exchanges. The culminating event was a Student Research Symposium held in February 2006 which gave students and scientists a

Current and Emerging Potential of Magnetoencephalography in the Detection and Localization of High-Frequency Oscillations in Epilepsy

PubMed Central

Tamilia, Eleonora; Madsen, Joseph R.; Grant, Patricia Ellen; Pearl, Phillip L.; Papadelis, Christos

2017-01-01

Up to one-third of patients with epilepsy are medically intractable and need resective surgery. To be successful, epilepsy surgery requires a comprehensive preoperative evaluation to define the epileptogenic zone (EZ), the brain area that should be resected to achieve seizure freedom. Due to lack of tools and methods that measure the EZ directly, this area is defined indirectly based on concordant data from a multitude of presurgical non-invasive tests and intracranial recordings. However, the results of these tests are often insufficiently concordant or inconclusive. Thus, the presurgical evaluation of surgical candidates is frequently challenging or unsuccessful. To improve the efficacy of the surgical treatment, there is an overriding need for reliable biomarkers that can delineate the EZ. High-frequency oscillations (HFOs) have emerged over the last decade as new potential biomarkers for the delineation of the EZ. Multiple studies have shown that HFOs are spatially associated with the EZ. Despite the encouraging findings, there are still significant challenges for the translation of HFOs as epileptogenic biomarkers to the clinical practice. One of the major barriers is the difficulty to detect and localize them with non-invasive techniques, such as magnetoencephalography (MEG) or scalp electroencephalography (EEG). Although most literature has studied HFOs using invasive recordings, recent studies have reported the detection and localization of HFOs using MEG or scalp EEG. MEG seems to be particularly advantageous compared to scalp EEG due to its inherent advantages of being less affected by skull conductivity and less susceptible to contamination from muscular activity. The detection and localization of HFOs with MEG would largely expand the clinical utility of these new promising biomarkers to an earlier stage in the diagnostic process and to a wider range of patients with epilepsy. Here, we conduct a thorough critical review of the recent MEG literature that

Focusing Leaky Waves: A Class of Electromagnetic Localized Waves with Complex Spectra

NASA Astrophysics Data System (ADS)

Fuscaldo, Walter; Comite, Davide; Boesso, Alessandro; Baccarelli, Paolo; Burghignoli, Paolo; Galli, Alessandro

2018-05-01

Localized waves, i.e., the wide class of limited-diffraction, limited-dispersion solutions to the wave equation are generally characterized by real wave numbers. We consider the role played by localized waves with generally complex "leaky" wave numbers. First, the impact of the imaginary part of the wave number (i.e., the leakage constant) on the diffractive (spatial broadening) features of monochromatic localized solutions (i.e., beams) is rigorously evaluated. Then general conditions are derived to show that only a restricted class of spectra (either real or complex) allows for generating a causal localized wave. It turns out that backward leaky waves fall into this category. On this ground, several criteria for the systematic design of wideband radiators, namely, periodic radial waveguides based on backward leaky waves, are established in the framework of leaky-wave theory. An effective design method is proposed to minimize the frequency dispersion of the proposed class of devices and the impact of the "leakage" on the dispersive (temporal broadening) features of polychromatic localized solutions (i.e., pulses) is accounted for. Numerical results corroborate the concept, clearly highlighting the advantages and limitations of the leaky-wave approach for the generation of localized pulses at millimeter-wave frequencies, where energy focusing is in high demand in modern applications.

[The effect of pre-surgical orthodontics on secondary alveolar bone grafting in the patients with complete cleft lip and palate].

PubMed

Jia, Yi-lin; Fu, Min-kui; Ma, Lian

2004-05-01

To examine the effect of pre-surgical orthodontics on the outcome of the secondary alveolar bone grafting in the patients with complete cleft lip and palate. Sixteen complete cleft lip and palate patients (9 males and 7 females) with collapsed upper arch or severe mal-positioned upper incisors were selected. The cleft was not easily grafted because of the poor access. The total cleft sites were 22 (10 patients with UCLP and 6 patients with BCLP). The age range of the patients was from 8 to 22 years. Pre-surgical orthodontic treatment was mainly to expand the collapsed upper arch and correct the mal-positioned upper incisors. After the secondary alveolar bone grafting, the patients were followed up and anterior occlusal radiograph/intraoral panograph were taken regularly. The observation period was from 6 months to 4 years. Bergland criteria were used to evaluate the interdental septal height. Upper arch expansion and the correction of the mal-positioned upper incisors done by the orthodontic treatment made the bone grafting procedure easier. The clinically successful rate reached 86%. The severe upper arch collapse and mal-positioned upper incisors in the patients with complete cleft lip and palate should be corrected orthodontically before the secondary alveolar bone grafting.

Assessment of presurgical clefts and predicted surgical outcome in patients treated with and without nasoalveolar molding.

PubMed

Rubin, Marcie S; Clouston, Sean; Ahmed, Mohammad M; M Lowe, Kristen; Shetye, Pradip R; Broder, Hillary L; Warren, Stephen M; Grayson, Barry H

2015-01-01

Obtaining an esthetic and functional primary surgical repair in patients with complete cleft lip and palate (CLP) can be challenging because of tissue deficiencies and alveolar ridge displacement. This study aimed to describe surgeons' assessments of presurgical deformity and predicted surgical outcomes in patients with complete unilateral and bilateral CLP (UCLP and BCLP, respectively) treated with and without nasoalveolar molding (NAM). Cleft surgeon members of the American Cleft Palate-Craniofacial Association completed online surveys to evaluate 20 presurgical photograph sets (frontal and basal views) of patients with UCLP (n = 10) and BCLP (n = 10) for severity of cleft deformity, quality of predicted surgical outcome, and likelihood of early surgical revision. Five patients in each group (UCLP and BCLP) received NAM, and 5 patients did not receive NAM. Surgeons were masked to patient group. Twenty-four percent (176/731) of surgeons with valid e-mail addresses responded to the survey. For patients with UCLP, surgeons reported that, for NAM-prepared patients, 53.3% had minimum severity clefts, 58.9% were anticipated to be among their best surgical outcomes, and 82.9% were unlikely to need revision surgery. For patients with BCLP, these percentages were 29.8%, 38.6%, and 59.9%, respectively. Comparing NAM-prepared with non-NAM-prepared patients showed statistically significant differences (P < 0.001), favoring NAM-prepared patients. This study suggests that cleft surgeons assess NAM-prepared patients as more likely to have less severe clefts, to be among the best of their surgical outcomes, and to be less likely to need revision surgery when compared with patients not prepared with NAM.

Surgeons’ Assessment of Presurgical Clefts and Predicted Surgical Outcome in Patients Treated with and without Nasoalveolar Molding

PubMed Central

Rubin, Marcie S.; Clouston, Sean; Ahmed, Mohammad M.; Lowe, Kristen; Shetye, Pradip R.; Broder, Hillary L.; Warren, Stephen M.; Grayson, Barry H.

2014-01-01

Obtaining an aesthetic and functional primary surgical repair in patients with complete cleft lip and palate (CLP) can be challenging due to tissue deficiencies and alveolar ridge displacement. This study aimed to describe surgeons’ assessments of presurgical deformity and predicted surgical outcomes in patients with complete unilateral and bilateral CLP (UCLP and BCLP, respectively) treated with and without nasoalveolar molding (NAM). Cleft surgeon members of the American Cleft Palate-Craniofacial Association completed online surveys to evaluate 20 presurgical photograph sets (frontal and basal views) of patients with UCLP (n=10) and BCLP (n=10) for severity of cleft deformity, quality of predicted surgical outcome, and likelihood of early surgical revision. Five patients in each group (UCLP and BCLP) received NAM and five did not receive NAM. Surgeons were masked to patient group. Twenty-four percent (176/731) of surgeons with valid email addresses responded to the survey. For patients with UCLP, surgeons reported that for NAM-prepared patients 53.3% had minimum severity clefts, 58.9% were anticipated to be among their best surgical outcomes, and 82.9% were unlikely to need revision surgery. For patients with BCLP, these percentages were 29.8%, 38.6%, and 59.9%, respectively. Comparing NAM to non-NAM prepared patients showed statistically significant differences (p < 0.001), favoring NAM-prepared patients. This study suggests that cleft surgeons assess NAM-prepared patients as more likely to have less severe clefts, to be among the best of their surgical outcomes, and to be less likely to need revision surgery when compared to patients not prepared with NAM. PMID:25534051

Orbit-induced localized spin angular momentum in strong focusing of optical vectorial vortex beams

NASA Astrophysics Data System (ADS)

Li, Manman; Cai, Yanan; Yan, Shaohui; Liang, Yansheng; Zhang, Peng; Yao, Baoli

2018-05-01

Light beams may carry optical spin or orbital angular momentum, or both. The spin and orbital parts manifest themselves by the ellipticity of the state of polarization and the vortex structure of phase of light beams, separately. Optical spin and orbit interaction, arising from the interaction between the polarization and the spatial structure of light beams, has attracted enormous interest recently. The optical spin-to-orbital angular momentum conversion under strong focusing is well known, while the converse process, orbital-to-spin conversion, has not been reported so far. In this paper, we predict in theory that the orbital angular momentum can induce a localized spin angular momentum in strong focusing of a spin-free azimuthal polarization vortex beam. This localized longitudinal spin of the focused field can drive the trapped particle to spin around its own axis. This investigation provides a new degree of freedom for spinning particles by using a vortex phase, which may have considerable potentials in optical spin and orbit interaction, light-beam shaping, or optical manipulation.

Presurgical weight loss affects tumour traits and circulating biomarkers in men with prostate cancer

PubMed Central

Demark-Wahnefried, Wendy; Rais-Bahrami, Soroush; Desmond, Renee A; Gordetsky, Jennifer B; Hunter, Gary R; Yang, Eddy S; Azrad, Maria; Frugé, Andrew D; Tsuruta, Yuko; Norian, Lyse A; Segal, Roanne; Grizzle, William E

2017-01-01

Background: Obesity is associated with aggressive prostate cancer. To explore whether weight loss favourably affects tumour biology and other outcomes, we undertook a presurgical trial among overweight and obese men with prostate cancer. Methods: This single-blinded, two-arm randomised controlled trial explored outcomes of a presurgical weight loss intervention (WLI) that promoted ∼1 kg per week loss via caloric restriction and increased physical activity (PA). Forty overweight/obese men with clinically confirmed prostate cancer were randomised to the WLI presurgery or to a control arm; changes in weight, body composition, quality-of-life, circulating biomarkers, gene expression, and immunohistochemical markers in tumour and benign prostatic tissue were evaluated. Results: The study period averaged 50 days. Mean (s.d.) change scores for the WLI vs control arms were as follows: weight: −4.7 (3.1) kg vs −2.2 (4.4) kg (P=0.0508); caloric intake: −500 (636) vs −159 (600) kcal per day (P=0.0034); PA: +0.9 (3.1) vs +1.7 (4.6) MET-hours per day (NS); vitality: +5.3 (7.l4) vs −1.8 (8.1) (P=0.0491); testosterone: +55.1 (86.0) vs −48.3 (203.7) ng dl−1 (P=0.0418); sex hormone-binding globulin: +14.0 (14.6) vs +1.8 (7.6) nmol l−1 (P=0.0023); and leptin: −2.16 (2.6) vs −0.03 (3.75) (P=0.0355). Follow-up Ki67 was significantly higher in WLI vs control arms; median (interquartile range): 5.0 (2.5,10.0) vs 0.0 (0.0,2.5) (P=0.0061) and several genes were upregulated, for example, CTSL, GSK3B, MED12, and LAMC2. Conclusions: Intentional weight loss shows mixed effects on circulating biomarkers, tumour gene expression, and proliferative markers. More study is needed before recommending weight loss, in particular rapid weight loss, among men with prostate cancer. PMID:28881355

Current use of imaging and electromagnetic source localization procedures in epilepsy surgery centers across Europe.

PubMed

Mouthaan, Brian E; Rados, Matea; Barsi, Péter; Boon, Paul; Carmichael, David W; Carrette, Evelien; Craiu, Dana; Cross, J Helen; Diehl, Beate; Dimova, Petia; Fabo, Daniel; Francione, Stefano; Gaskin, Vladislav; Gil-Nagel, Antonio; Grigoreva, Elena; Guekht, Alla; Hirsch, Edouard; Hecimovic, Hrvoje; Helmstaedter, Christoph; Jung, Julien; Kalviainen, Reetta; Kelemen, Anna; Kimiskidis, Vasilios; Kobulashvili, Teia; Krsek, Pavel; Kuchukhidze, Giorgi; Larsson, Pål G; Leitinger, Markus; Lossius, Morten I; Luzin, Roman; Malmgren, Kristina; Mameniskiene, Ruta; Marusic, Petr; Metin, Baris; Özkara, Cigdem; Pecina, Hrvoje; Quesada, Carlos M; Rugg-Gunn, Fergus; Rydenhag, Bertil; Ryvlin, Philippe; Scholly, Julia; Seeck, Margitta; Staack, Anke M; Steinhoff, Bernhard J; Stepanov, Valentin; Tarta-Arsene, Oana; Trinka, Eugen; Uzan, Mustafa; Vogt, Viola L; Vos, Sjoerd B; Vulliémoz, Serge; Huiskamp, Geertjan; Leijten, Frans S S; Van Eijsden, Pieter; Braun, Kees P J

2016-05-01

In 2014 the European Union-funded E-PILEPSY project was launched to improve awareness of, and accessibility to, epilepsy surgery across Europe. We aimed to investigate the current use of neuroimaging, electromagnetic source localization, and imaging postprocessing procedures in participating centers. A survey on the clinical use of imaging, electromagnetic source localization, and postprocessing methods in epilepsy surgery candidates was distributed among the 25 centers of the consortium. A descriptive analysis was performed, and results were compared to existing guidelines and recommendations. Response rate was 96%. Standard epilepsy magnetic resonance imaging (MRI) protocols are acquired at 3 Tesla by 15 centers and at 1.5 Tesla by 9 centers. Three centers perform 3T MRI only if indicated. Twenty-six different MRI sequences were reported. Six centers follow all guideline-recommended MRI sequences with the proposed slice orientation and slice thickness or voxel size. Additional sequences are used by 22 centers. MRI postprocessing methods are used in 16 centers. Interictal positron emission tomography (PET) is available in 22 centers; all using 18F-fluorodeoxyglucose (FDG). Seventeen centers perform PET postprocessing. Single-photon emission computed tomography (SPECT) is used by 19 centers, of which 15 perform postprocessing. Four centers perform neither PET nor SPECT in children. Seven centers apply magnetoencephalography (MEG) source localization, and nine apply electroencephalography (EEG) source localization. Fourteen combinations of inverse methods and volume conduction models are used. We report a large variation in the presurgical diagnostic workup among epilepsy surgery centers across Europe. This diversity underscores the need for high-quality systematic reviews, evidence-based recommendations, and harmonization of available diagnostic presurgical methods. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

Are pre-treatment psychological characteristics influenced by pre-surgical orthodontics?

PubMed

Cunningham, S J; Gilthorpe, M S; Hunt, N P

2001-12-01

A number of investigations have looked at psychological changes occurring in association with orthognathic treatment. However, most of these studies have used a pre-surgery questionnaire as the baseline measurement. There is little data relating to the true baseline, i.e. that prior to any active treatment. Until this aspect is investigated, it is not possible to assume that pre-surgery is an acceptable baseline. This questionnaire based study aimed to assess changes in six psychological outcome measures between T1 (prior to any active treatment) and T2 (following pre-surgical orthodontics/prior to surgery). The outcome variables were: state anxiety, trait anxiety, depression, self-esteem, body image, and facial body image. Sixty-two patients (39 females and 23 males) completed both questionnaires. The results showed that intervention, in the form of orthodontic treatment, had a minimal effect on the chosen psychometric outcome variables. There was a significant reduction in satisfaction with body image amongst patients who initially reported mild to moderate dental/facial problems, whilst a moderate increase in satisfaction occurred in those patients reporting severe conditions initially. Also of note were significant increases in state anxiety amongst older patients whilst trait anxiety showed greater increases in females than males.

Localized conductive patterning via focused electron beam reduction of graphene oxide

NASA Astrophysics Data System (ADS)

Kim, Songkil; Kulkarni, Dhaval D.; Henry, Mathias; Zackowski, Paul; Jang, Seung Soon; Tsukruk, Vladimir V.; Fedorov, Andrei G.

2015-03-01

We report on a method for "direct-write" conductive patterning via reduction of graphene oxide (GO) sheets using focused electron beam induced deposition (FEBID) of carbon. FEBID treatment of the intrinsically dielectric graphene oxide between two metal terminals opens up the conduction channel, thus enabling a unique capability for nanoscale conductive domain patterning in GO. An increase in FEBID electron dose results in a significant increase of the domain electrical conductivity with improving linearity of drain-source current vs. voltage dependence, indicative of a change of graphene oxide electronic properties from insulating to semiconducting. Density functional theory calculations suggest a possible mechanism underlying this experimentally observed phenomenon, as localized reduction of graphene oxide layers via interactions with highly reactive intermediates of electron-beam-assisted dissociation of surface-adsorbed hydrocarbon molecules. These findings establish an unusual route for using FEBID as nanoscale lithography and patterning technique for engineering carbon-based nanomaterials and devices with locally tailored electronic properties.

Site-selective local fluorination of graphene induced by focused ion beam irradiation.

PubMed

Li, Hu; Daukiya, Lakshya; Haldar, Soumyajyoti; Lindblad, Andreas; Sanyal, Biplab; Eriksson, Olle; Aubel, Dominique; Hajjar-Garreau, Samar; Simon, Laurent; Leifer, Klaus

2016-01-29

The functionalization of graphene remains an important challenge for numerous applications expected by this fascinating material. To keep advantageous properties of graphene after modification or functionalization of its structure, local approaches are a promising road. A novel technique is reported here that allows precise site-selective fluorination of graphene. The basic idea of this approach consists in the local radicalization of graphene by focused ion beam (FIB) irradiation and simultaneous introduction of XeF2 gas. A systematic series of experiments were carried out to outline the relation between inserted defect creation and the fluorination process. Based on a subsequent X-ray photoelectron spectroscopy (XPS) analysis, a 6-fold increase of the fluorine concentration on graphene under simultaneous irradiation was observed when compared to fluorination under normal conditions. The fluorine atoms are predominately localized at the defects as indicated from scanning tunneling microscopy (STM). The experimental findings are confirmed by density functional theory which predicts a strong increase of the binding energy of fluorine atoms when bound to the defect sites. The developed technique allows for local fluorination of graphene without using resists and has potential to be a general enabler of site-selective functionalization of graphene using a wide range of gases.

Site-selective local fluorination of graphene induced by focused ion beam irradiation

PubMed Central

Li, Hu; Daukiya, Lakshya; Haldar, Soumyajyoti; Lindblad, Andreas; Sanyal, Biplab; Eriksson, Olle; Aubel, Dominique; Hajjar-Garreau, Samar; Simon, Laurent; Leifer, Klaus

2016-01-01

The functionalization of graphene remains an important challenge for numerous applications expected by this fascinating material. To keep advantageous properties of graphene after modification or functionalization of its structure, local approaches are a promising road. A novel technique is reported here that allows precise site-selective fluorination of graphene. The basic idea of this approach consists in the local radicalization of graphene by focused ion beam (FIB) irradiation and simultaneous introduction of XeF2 gas. A systematic series of experiments were carried out to outline the relation between inserted defect creation and the fluorination process. Based on a subsequent X-ray photoelectron spectroscopy (XPS) analysis, a 6-fold increase of the fluorine concentration on graphene under simultaneous irradiation was observed when compared to fluorination under normal conditions. The fluorine atoms are predominately localized at the defects as indicated from scanning tunneling microscopy (STM). The experimental findings are confirmed by density functional theory which predicts a strong increase of the binding energy of fluorine atoms when bound to the defect sites. The developed technique allows for local fluorination of graphene without using resists and has potential to be a general enabler of site-selective functionalization of graphene using a wide range of gases. PMID:26822900

Site-selective local fluorination of graphene induced by focused ion beam irradiation

NASA Astrophysics Data System (ADS)

Li, Hu; Daukiya, Lakshya; Haldar, Soumyajyoti; Lindblad, Andreas; Sanyal, Biplab; Eriksson, Olle; Aubel, Dominique; Hajjar-Garreau, Samar; Simon, Laurent; Leifer, Klaus

2016-01-01

The functionalization of graphene remains an important challenge for numerous applications expected by this fascinating material. To keep advantageous properties of graphene after modification or functionalization of its structure, local approaches are a promising road. A novel technique is reported here that allows precise site-selective fluorination of graphene. The basic idea of this approach consists in the local radicalization of graphene by focused ion beam (FIB) irradiation and simultaneous introduction of XeF2 gas. A systematic series of experiments were carried out to outline the relation between inserted defect creation and the fluorination process. Based on a subsequent X-ray photoelectron spectroscopy (XPS) analysis, a 6-fold increase of the fluorine concentration on graphene under simultaneous irradiation was observed when compared to fluorination under normal conditions. The fluorine atoms are predominately localized at the defects as indicated from scanning tunneling microscopy (STM). The experimental findings are confirmed by density functional theory which predicts a strong increase of the binding energy of fluorine atoms when bound to the defect sites. The developed technique allows for local fluorination of graphene without using resists and has potential to be a general enabler of site-selective functionalization of graphene using a wide range of gases.

Verbal memory and verbal fluency tasks used for language localization and lateralization during magnetoencephalography.

PubMed

Pirmoradi, Mona; Jemel, Boutheina; Gallagher, Anne; Tremblay, Julie; D'Hondt, Fabien; Nguyen, Dang Khoa; Béland, Renée; Lassonde, Maryse

2016-01-01

The aim of this study was to develop a presurgical magnetoencephalography (MEG) protocol to localize and lateralize expressive and receptive language function as well as verbal memory in patients with epilepsy. Two simple language tasks and a different analytical procedure were developed. Ten healthy participants and 13 epileptic patients completed two language tasks during MEG recording: a verbal memory task and a verbal fluency task. As a first step, principal component analyses (PCA) were performed on source data from the group of healthy participants to identify spatiotemporal factors that were relevant to these paradigms. Averaged source data were used to localize areas activated during each task and a laterality index (LI) was computed on an individual basis for both groups, healthy participants and patients, using sensor data. PCA revealed activation in the left temporal lobe (300 ms) during the verbal memory task, and from the frontal lobe (210 ms) to the temporal lobe (500 ms) during the verbal fluency task in healthy participants. Averaged source data showed activity in the left hemisphere (250-750 ms), in Wernicke's area, for all participants. Left hemisphere dominance was demonstrated better using the verbal memory task than the verbal fluency task (F1,19=4.41, p=0.049). Cohen's kappa statistic revealed 93% agreement (k=0.67, p=0.002) between LIs obtained from MEG sensor data and fMRI, the IAT, electrical cortical stimulation or handedness with the verbal memory task for all participants. At 74%, agreement results for the verbal fluency task did not reach statistical significance. Analysis procedures yielded interesting findings with both tasks and localized language-related activation. However, based on source localization and laterality indices, the verbal memory task yielded better results in the context of the presurgical evaluation of epileptic patients. The verbal fluency task did not add any further information to the verbal memory task as

Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

PubMed

Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

2017-12-01

Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ 2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality ( p = 0.09): at the academic site, patients who used the decision were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict ( p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites ( p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

Effect of patient decision aid was influenced by presurgical evaluation among patients with osteoarthritis of the knee.

PubMed

Boland, Laura; Taljaard, Monica; Dervin, Geoffrey; Trenaman, Logan; Tugwell, Peter; Pomey, Marie-Pascale; Stacey, Dawn

2018-02-01

Decision aids help patients make total joint arthroplasty decisions, but presurgical evaluation might influence the effects of a decision aid. We compared the effects of a decision aid among patients considering total knee arthroplasty at 2 surgical screening clinics with different evaluation processes. We performed a subgroup analysis of a randomized controlled trial. Patients were recruited from 2 surgical screening clinics: an academic clinic providing 20-minute physician consultations and a community clinic providing 45-minute physiotherapist/nurse consultations with education. We compared the effects of decision quality, decisional conflict and surgery rate using Cochran-Mantel-Haenszel χ 2 tests and the Breslow-Day test. We evaluated 242 patients: 123 from the academic clinic (61 who used the decision aid and 62 controls) and 119 from the community clinic (59 who used the decision aid and 60 controls). Results suggested a between-site difference in the effect of the decision aid on the patients' decision quality ( p = 0.09): at the academic site, patients who used the decision aid were more likely to make better-quality decisions than controls (54% v. 35%, p = 0.044), but not at the community site (47% v. 51%, p = 0.71). Fewer patients who used decision aids at the academic site than at the community site experienced decisional conflict ( p = 0.007) (33% v. 52%, p = 0.05 at the academic site and 40% v. 24%, p = 0.08 at the community site). The effect of the decision aid on surgery rates did not differ between sites ( p = 0.65). The decision aid had a greater effect at the academic site than at the community site, which provided longer consultations with more verbal education. Hence, decision aids might be of greater value when more extensive total knee arthroplasty presurgical assessment and counselling are either impractical or unavailable.

Think Globally, Act Locally (Focus on Teaching).

ERIC Educational Resources Information Center

Vesper, Joan F.

1994-01-01

Describes a project, carried out jointly between a business communication class and a local chamber of commerce, that brings students into partnership with international merchants in the local community. (SR)

Continuous EEG-fMRI in Pre-Surgical Evaluation of a Patient with Symptomatic Seizures: Bold Activation Linked to Interictal Epileptic Discharges Caused by Cavernoma.

PubMed

Avesani, M; Formaggio, E; Milanese, F; Baraldo, A; Gasparini, A; Cerini, R; Bongiovanni, L G; Pozzi Mucelli, R; Fiaschi, A; Manganotti, P

2008-04-07

We used continuous electroencephalography-functional magnetic resonance imaging (EEG-fMRI) to identify the linkage between the "epileptogenic" and the "irritative" area in a patient with symptomatic epilepsy (cavernoma, previously diagnosed and surgically treated), i.e. a patient with a well known "epileptogenic area", and to increase the possibility of a non invasive pre-surgical evaluation of drug-resistant epilepsies. A compatible MRI system was used (EEG with 29 scalp electrodes and two electrodes for ECG and EMG) and signals were recorded with a 1.5 Tesla MRI scanner. After the recording session and MRI artifact removal, EEG data were analyzed offline and used as paradigms in fMRI study. Activation (EEG sequences with interictal slow-spiked-wave activity) and rest (sequences of normal EEG) conditions were compared to identify the potential resulting focal increase in BOLD signal and to consider if this is spatially linked to the interictal focus used as a paradigm and to the lesion. We noted an increase in the BOLD signal in the left neocortical temporal region, laterally and posteriorly to the poro-encephalic cavity (residual of cavernoma previously removed), that is around the "epileptogenic area". In our study "epileptogenic" and "irritative" areas were connected with each other. Combined EEG-fMRI may become routine in clinical practice for a better identification of an irritative and lesional focus in patients with symptomatic drug-resistant epilepsy.

More attentional focusing through binaural beats: evidence from the global-local task.

PubMed

Colzato, Lorenza S; Barone, Hayley; Sellaro, Roberta; Hommel, Bernhard

2017-01-01

A recent study showed that binaural beats have an impact on the efficiency of allocating attention over time. We were interested to see whether this impact affects attentional focusing or, even further, the top-down control over irrelevant information. Healthy adults listened to gamma-frequency (40 Hz) binaural beats, which are assumed to increase attentional concentration, or a constant tone of 340 Hz (control condition) for 3 min before and during a global-local task. While the size of the congruency effect (indicating the failure to suppress task-irrelevant information) was unaffected by the binaural beats, the global-precedence effect (reflecting attentional focusing) was considerably smaller after gamma-frequency binaural beats than after the control condition. Our findings suggest that high-frequency binaural beats bias the individual attentional processing style towards a reduced spotlight of attention.

Muscle and eye movement artifact removal prior to EEG source localization.

PubMed

Hallez, Hans; Vergult, Anneleen; Phlypo, Ronald; Van Hese, Peter; De Clercq, Wim; D'Asseler, Yves; Van de Walle, Rik; Vanrumste, Bart; Van Paesschen, Wim; Van Huffel, Sabine; Lemahieu, Ignace

2006-01-01

Muscle and eye movement artifacts are very prominent in the ictal EEG of patients suffering from epilepsy, thus making the dipole localization of ictal activity very unreliable. Recently, two techniques (BSS-CCA and pSVD) were developed to remove those artifacts. The purpose of this study is to assess whether the removal of muscle and eye movement artifacts improves the EEG dipole source localization. We used a total of 8 EEG fragments, each from another patient, first unfiltered, then filtered by the BSS-CCA and pSVD. In both the filtered and unfiltered EEG fragments we estimated multiple dipoles using RAP-MUSIC. The resulting dipoles were subjected to a K-means clustering algorithm, to extract the most prominent cluster. We found that the removal of muscle and eye artifact results to tighter and more clear dipole clusters. Furthermore, we found that localization of the filtered EEG corresponded with the localization derived from the ictal SPECT in 7 of the 8 patients. Therefore, we can conclude that the BSS-CCA and pSVD improve localization of ictal activity, thus making the localization more reliable for the presurgical evaluation of the patient.

Focused Impedance Method (FIM) and Pigeon Hole Imaging (PHI) for localized measurements - a review

NASA Astrophysics Data System (ADS)

Siddique-e Rabbani, K.

2010-04-01

This paper summarises up to date development in Focused Impedance Method (FIM) initiated by us. It basically involves taking the sum of two orthogonal tetra-polar impedance measurements around a common central region, giving a localized enhanced sensitivity. Although the basic idea requires 8 electrodes, versions with 6- and 4-electrodes were subsequently conceived and developed. The focusing effect has been verified in 2D and 3D phantoms and through numerical analysis. Dynamic stomach emptying, and ventilation of localized lung regions have been studied successfully suggesting further applications in monitoring of gastric acid secretion, artificial respiration, bladder emptying, etc. Multi-frequency FIM may help identify some diseases and disorders including certain cancers. FIM, being much simpler and having less number of electrodes, appears to have the potential to replace EIT for applications involving large and shallow organs. An enhancement of 6-electrode FIM led to Pigeon Hole Imaging (PHI) in a square matrix through backprojection in two orthogonal directions, good for localising of one or two well separated objects.

Ectonucleotidases in the digestive system: focus on NTPDase3 localization.

PubMed

Lavoie, Elise G; Gulbransen, Brian D; Martín-Satué, Mireia; Aliagas, Elisabet; Sharkey, Keith A; Sévigny, Jean

2011-04-01

Extracellular nucleotides and adenosine are biologically active molecules that bind members of the P2 and P1 receptor families, respectively. In the digestive system, these receptors modulate various functions, including salivary, gastric, and intestinal epithelial secretion and enteric neurotransmission. The availability of P1 and P2 ligands is modulated by ectonucleotidases, enzymes that hydrolyze extracellular nucleotides into nucleosides. Nucleoside triphosphate diphosphohydrolases (NTPDases) and ecto-5'-nucleotidase are the dominant ectonucleotidases at physiological pH. While there is some information about the localization of ecto-5'-nucleotidase and NTPDase1 and -2, the distribution of NTPDase3 in the digestive system is unknown. We examined the localization of these ectonucleotidases, with a focus on NTPDase3, in the gastrointestinal tract and salivary glands. NTPDase1, -2, and -3 are responsible for ecto-ATPase activity in these tissues. Semiquantitative RT-PCR, immunohistochemistry, and in situ enzyme activity revealed the presence of NTPDase3 in some epithelial cells in serous acini of salivary glands and mucous acini and duct cells of sublingual salivary glands, in cells from the stratified esophageal and forestomach epithelia, and in some enteroendocrine cells of the gastric antrum. Interestingly, NTPDase2 and ecto-5'-nucleotidase are coexpressed with NTPDase3 in salivary gland cells and stratified epithelia. In the colon, neurons express NTPDase3 and glial cells express NTPDase2. Ca(2+) imaging experiments demonstrate that NTPDases regulate P2 receptor ligand availability in the enteric nervous system. In summary, the specific localization of NTPDase3 in the digestive system suggests functional roles of the enzyme, in association with NTPDase2 and ecto-5'-nucleotidase, in epithelial functions such as secretion and in enteric neurotransmission.

Global, local and focused geographic clustering for case-control data with residential histories

PubMed Central

Jacquez, Geoffrey M; Kaufmann, Andy; Meliker, Jaymie; Goovaerts, Pierre; AvRuskin, Gillian; Nriagu, Jerome

2005-01-01

Background This paper introduces a new approach for evaluating clustering in case-control data that accounts for residential histories. Although many statistics have been proposed for assessing local, focused and global clustering in health outcomes, few, if any, exist for evaluating clusters when individuals are mobile. Methods Local, global and focused tests for residential histories are developed based on sets of matrices of nearest neighbor relationships that reflect the changing topology of cases and controls. Exposure traces are defined that account for the latency between exposure and disease manifestation, and that use exposure windows whose duration may vary. Several of the methods so derived are applied to evaluate clustering of residential histories in a case-control study of bladder cancer in south eastern Michigan. These data are still being collected and the analysis is conducted for demonstration purposes only. Results Statistically significant clustering of residential histories of cases was found but is likely due to delayed reporting of cases by one of the hospitals participating in the study. Conclusion Data with residential histories are preferable when causative exposures and disease latencies occur on a long enough time span that human mobility matters. To analyze such data, methods are needed that take residential histories into account. PMID:15784151

Localized Harmonic Motion Imaging for Focused Ultrasound Surgery Targeting

PubMed Central

Curiel, Laura; Hynynen, Kullervo

2011-01-01

Recently, an in vivo real-time ultrasound-based monitoring technique that uses localized harmonic motion (LHM) to detect changes in tissues during focused ultrasound surgery (FUS) has been proposed to control the exposure. This technique can potentially be used as well for targeting imaging. In the present study we evaluated the potential of using LHM to detect changes in stiffness and the feasibility of using it for imaging purposes in phantoms and in vivo tumor detection. A single-element FUS transducer (80 mm focal length, 100 mm diameter, 1.485 MHz) was used for inducing a localized harmonic motion and a separate ultrasound diagnostic transducer excited by a pulser/receiver (5 kHz PRF, 5 MHz) was used to track motion. The motion was estimated using cross-correlation techniques on the acquired RF signal. Silicon phantom studies were performed in order to determine the size of inclusion that was possible to detect using this technique. Inclusions were discerned from the surroundings as a reduction on LHM amplitude and it was possible to depict inclusions as small as 4 mm. The amplitude of the induced LHM was always lower at the inclusions as compared with the one obtained at the surroundings. Ten New Zealand rabbits had VX2 tumors implanted on their thighs and LHM was induced and measured at the tumor region. Tumors (as small as 10 mm in length and 4 mm in width) were discerned from the surroundings as a reduction on LHM amplitude. PMID:21683514

Consensus-based guidelines for Video EEG monitoring in the pre-surgical evaluation of children with epilepsy in the UK.

PubMed

Pressler, Ronit M; Seri, Stefano; Kane, Nick; Martland, Tim; Goyal, Sushma; Iyer, Anand; Warren, Elliott; Notghi, Lesley; Bill, Peter; Thornton, Rachel; Appleton, Richard; Doyle, Sarah; Rushton, Sarah; Worley, Alan; Boyd, Stewart G

2017-08-01

Paediatric Epilepsy surgery in the UK has recently been centralised in order to improve expertise and quality of service available to children. Video EEG monitoring or telemetry is a highly specialised and a crucial component of the pre-surgical evaluation. Although many Epilepsy Monitoring Units work to certain standards, there is no national or international guideline for paediatric video telemetry. Due to lack of evidence we used a modified Delphi process utilizing the clinical and academic expertise of the clinical neurophysiology sub-specialty group of Children's Epilepsy Surgical Service (CESS) centres in England and Wales. This process consisted of the following stages I: Identification of the consensus working group, II: Identification of key areas for guidelines, III: Consensus practice points and IV: Final review. Statements that gained consensus (median score of either 4 or 5 using a five-point Likerttype scale) were included in the guideline. Two rounds of feedback and amendments were undertaken. The consensus guidelines includes the following topics: referral pathways, neurophysiological equipment standards, standards of recording techniques, with specific emphasis on safety of video EEG monitoring both with and without drug withdrawal, a protocol for testing patient's behaviours, data storage and guidelines for writing factual reports and conclusions. All statements developed received a median score of 5 and were adopted by the group. Using a modified Delphi process we were able to develop universally-accepted video EEG guidelines for the UK CESS. Although these recommendations have been specifically developed for the pre-surgical evaluation of children with epilepsy, it is assumed that most components are transferable to any paediatric video EEG monitoring setting. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Localized delivery of low-density lipoprotein docosahexaenoic acid nanoparticles to the rat brain using focused ultrasound.

PubMed

Mulik, Rohit S; Bing, Chenchen; Ladouceur-Wodzak, Michelle; Munaweera, Imalka; Chopra, Rajiv; Corbin, Ian R

2016-03-01

Focused ultrasound exposures in the presence of microbubbles can achieve transient, non-invasive, and localized blood-brain barrier (BBB) opening, offering a method for targeted delivery of therapeutic agents into the brain. Low-density lipoprotein (LDL) nanoparticles reconstituted with docosahexaenoic acid (DHA) could have significant therapeutic value in the brain, since DHA is known to be neuroprotective. BBB opening was achieved using pulsed ultrasound exposures in a localized brain region in normal rats, after which LDL nanoparticles containing the fluorescent probe DiR (1,1'-Dioctadecyl-3,3,3',3'-Tetramethylindotricarbocyanine Iodide) or DHA were administered intravenously. Fluorescent imaging of brain tissue from rats administered LDL-DiR demonstrated strong localization of fluorescence signal in the exposed hemisphere. LDL-DHA administration produced 2 × more DHA in the exposed region of the brain, with a corresponding increase in Resolvin D1 levels, indicating DHA was incorporated into cells and metabolized. Histological evaluation did not indicate any evidence of increased tissue damage in exposed brain regions compared to normal brain. This work demonstrates that localized delivery of DHA to the brain is possible using systemically-administered LDL nanoparticles combined with pulsed focused ultrasound exposures in the brain. This technology could be used in regions of acute brain injury or as a means to target infiltrating tumor cells in the brain. Copyright © 2016 Elsevier Ltd. All rights reserved.

Localized Delivery of Low-Density Lipoprotein Docosahexaenoic Acid Nanoparticles to the Rat Brain using Focused Ultrasound

PubMed Central

Mulik, Rohit S.; Bing, Chenchen; Ladouceur-Wodzak, Michelle; Munaweera, Imalka; Chopra, Rajiv; Corbin, Ian R.

2016-01-01

Focused ultrasound exposures in the presence of microbubbles can achieve transient, non-invasive, and localized blood-brain barrier (BBB) opening, offering a method for targeted delivery of therapeutic agents into the brain. Low-density lipoprotein (LDL) nanoparticles reconstituted with docosahexaenoic acid (DHA) could have significant therapeutic value in the brain, since DHA is known to be neuroprotective. BBB opening was achieved using pulsed ultrasound exposures in a localized brain region in normal rats, after which LDL nanoparticles containing the fluorescent probe DiR (1,1′-Dioctadecyl-3,3,3′,3′-Tetramethylindotricarbocyanine Iodide) or DHA were administered intravenously. Fluorescent imaging of brain tissue from rats administered LDL-DiR demonstrated strong localization of fluorescence signal in the exposed hemisphere. LDL-DHA administration produced 2× more DHA in the exposed region of the brain, with a corresponding increase in Resolvin D1 levels, indicating DHA was incorporated into cells and metabolized. Histological evaluation did not indicate any evidence of increased tissue damage in exposed brain regions compared to normal brain. This work demonstrates that localized delivery of DHA to the brain is possible using systemically-administered LDL nanoparticles combined with pulsed focused ultrasound exposures in the brain. This technology could be used in regions of acute brain injury or as a means to target infiltrating tumor cells in the brain. PMID:26790145

Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging.

PubMed

Schilling, Kathy; Narayanan, Deepa; Kalinyak, Judith E; The, Juliette; Velasquez, Maria Victoria; Kahn, Simone; Saady, Matthew; Mahal, Ravinder; Chrystal, Larraine

2011-01-01

The objective of this study was to compare the performance characteristics of (18)F-fluorodeoxyglucose (FDG) positron emission mammography (PEM) with breast magnetic resonance imaging (MRI) as a presurgical imaging and planning option for index and ipsilateral lesions in patients with newly diagnosed, biopsy-proven breast cancer. Two hundred and eight women >25 years of age (median age = 59.7 ± 14.1 years) with biopsy-proven primary breast cancer enrolled in this prospective, single-site study. MRI, PEM, and whole-body positron emission tomography (WBPET) were conducted on each patient within 7 business days. PEM and WBPET images were acquired on the same day after intravenous administration of 370 MBq of FDG (median = 432.9 MBq). PEM and MRI images were blindly evaluated, compared with final surgical histopathology, and the sensitivity determined. Substudy analysis compared the sensitivity of PEM versus MRI in patients with different menopausal status, breast density, and use of hormone replacement therapy (HRT) as well as determination of performance characteristics for additional ipsilateral lesion detection. Two hundred and eight patients enrolled in the study of which 87% (182/208) were analyzable. Of these analyzable patients, 26.4% (48/182), 7.1% (13/182), and 64.2% (120/182) were pre-, peri-, and postmenopausal, respectively, and 48.4% (88/182) had extremely or heterogeneously dense breast tissue, while 33.5% (61/182) had a history of HRT use. Ninety-two percent (167/182) underwent core biopsy for index lesion diagnosis. Invasive cancer was found in 77.5% (141/182), while ductal carcinoma in situ (DCIS) and/or Paget's disease were found in 22.5% (41/182) of patients. Both PEM and MRI had index lesion depiction sensitivity of 92.8% and both were significantly better than WBPET (67.9%, p < 0.001, McNemar's test). For index lesions, PEM and MRI had equivalent sensitivity of various tumors, categorized by tumor stage as well as similar invasive tumor size

Hyperkahler metrics on focus-focus fibrations

NASA Astrophysics Data System (ADS)

Zhao, Jie

In this thesis, we focus on the study of hyperkahler metric in four dimensional cases, and practice GMN's construction of hyperkahler metric on focus-focus fibrations. We explicitly compute the action-angle coordinates on the local model of focus-focus fibration, and show its semi-global invariant should be harmonic to admit a compatible holomorphic 2-form. Then we study the canonical semi-flat metric on it. After the instanton correction inspired by physics, we get a family of the generalized Ooguri-Vafa metric on focus-focus fibrations, which becomes more local examples of explicit hyperkahler metric in four dimensional cases. In addition, we also make some exploration of the Ooguri-Vafa metric in the thesis. We study the potential function of the Ooguri-Vafa metric, and prove that its nodal set is a cylinder of bounded radius 1 < R < 1. As a result, we get that only on a finite neighborhood of the singular fibre the Ooguri-Vafa metric is a hyperkahler metric. Finally, we give some estimates for the diameter of the fibration under the Oogui-Vafa metric, which confirms that the Oogui-Vafa metric is not complete. The new family of metric constructed in the thesis, we think, will provide more examples to further study of Lagrangian fibrations and mirror symmetry in future.

Not single brain areas but a network is involved in language: Applications in presurgical planning.

PubMed

Alemi, Razieh; Batouli, Seyed Amir Hossein; Behzad, Ebrahim; Ebrahimpoor, Mitra; Oghabian, Mohammad Ali

2018-02-01

Language is an important human function, and is a determinant of the quality of life. In conditions such as brain lesions, disruption of the language function may occur, and lesion resection is a solution for that. Presurgical planning to determine the language-related brain areas would enhance the chances of language preservation after the operation; however, availability of a normative language template is essential. In this study, using data from 60 young individuals who were meticulously checked for mental and physical health, and using fMRI and robust imaging and data analysis methods, functional brain maps for the language production, perception and semantic were produced. The obtained templates showed that the language function should be considered as the product of the collaboration of a network of brain regions, instead of considering only few brain areas to be involved in that. This study has important clinical applications, and extends our knowledge on the neuroanatomy of the language function. Copyright © 2018 Elsevier B.V. All rights reserved.

Positron emission mammography in breast cancer presurgical planning: comparisons with magnetic resonance imaging

PubMed Central

Narayanan, Deepa; Kalinyak, Judith E.; The, Juliette; Velasquez, Maria Victoria; Kahn, Simone; Saady, Matthew; Mahal, Ravinder; Chrystal, Larraine

2010-01-01

Purpose The objective of this study was to compare the performance characteristics of 18F-fluorodeoxyglucose (FDG) positron emission mammography (PEM) with breast magnetic resonance imaging (MRI) as a presurgical imaging and planning option for index and ipsilateral lesions in patients with newly diagnosed, biopsy-proven breast cancer. Methods Two hundred and eight women >25 years of age (median age = 59.7 ± 14.1 years) with biopsy-proven primary breast cancer enrolled in this prospective, single-site study. MRI, PEM, and whole-body positron emission tomography (WBPET) were conducted on each patient within 7 business days. PEM and WBPET images were acquired on the same day after intravenous administration of 370 MBq of FDG (median = 432.9 MBq). PEM and MRI images were blindly evaluated, compared with final surgical histopathology, and the sensitivity determined. Substudy analysis compared the sensitivity of PEM versus MRI in patients with different menopausal status, breast density, and use of hormone replacement therapy (HRT) as well as determination of performance characteristics for additional ipsilateral lesion detection. Results Two hundred and eight patients enrolled in the study of which 87% (182/208) were analyzable. Of these analyzable patients, 26.4% (48/182), 7.1% (13/182), and 64.2% (120/182) were pre-, peri-, and postmenopausal, respectively, and 48.4% (88/182) had extremely or heterogeneously dense breast tissue, while 33.5% (61/182) had a history of HRT use. Ninety-two percent (167/182) underwent core biopsy for index lesion diagnosis. Invasive cancer was found in 77.5% (141/182), while ductal carcinoma in situ (DCIS) and/or Paget’s disease were found in 22.5% (41/182) of patients. Both PEM and MRI had index lesion depiction sensitivity of 92.8% and both were significantly better than WBPET (67.9%, p < 0.001, McNemar’s test). For index lesions, PEM and MRI had equivalent sensitivity of various tumors, categorized by tumor

Association between outcome and changes in plasma lactate concentration during presurgical treatment in dogs with gastric dilatation-volvulus: 64 cases (2002-2008).

PubMed

Zacher, Laurie A; Berg, John; Shaw, Scott P; Kudej, Raymond K

2010-04-15

To determine whether changes in presurgical plasma lactate concentration (before and after initial fluid resuscitation and gastric decompression) were associated with short-term outcome for dogs with gastric dilatation-volvulus (GDV). Retrospective case series. 64 dogs. Medical records were reviewed, and signalment, history, resuscitative treatments, serial presurgical lactate concentrations, surgical findings, and short-term outcome were obtained for dogs with confirmed GDV. 36 of 40 (90%) dogs with an initial lactate concentration 9.0 mmol/L). Within HIL dogs, there was no difference in mean +/- SD initial lactate concentration between survivors and nonsurvivors (10.6 +/- 2.3 mmol/L vs 11.2 +/- 2.3 mmol/L, respectively); however, there were significant differences in post-treatment lactate concentration, absolute change in lactate concentration, and percentage change in lactate concentration following resuscitative treatment. By use of optimal cutoff values within HIL dogs, survival rates for dogs with final lactate concentration > 6.4 mmol/L (23%), absolute change in lactate concentration 4 mmol/L (86%), or percentage change in lactate concentration > 42.5% (100%). Calculating changes in plasma lactate concentration following initial treatment in dogs with GDV may assist in determining prognosis and identifying patients that require more aggressive treatment.

Evaluation of the factors influencing brain language laterality in presurgical planning.

PubMed

Batouli, Seyed Amir Hossein; Hasani, Nafiseh; Gheisari, Sara; Behzad, Ebrahim; Oghabian, Mohammad Ali

2016-10-01

Brain lesions cause functional deficits, and one treatment for this condition is lesion resection. In most cases, presurgical planning (PSP) and the information from laterality indices are necessary for maximum preservation of the critical functions after surgery. Language laterality index (LI) is reliably estimated using functional magnetic resonance imaging (fMRI); however, this measure is under the influence of some external factors. In this study, we investigated the influence of a number of factors on language LI, using data from 120 patients (mean age=35.65 (±13.4) years) who underwent fMRI for PSP. Using two proposed language tasks from our previous works, brain left hemisphere was showed to be dominant for the language function, although a higher LI was obtained using the "Word Generation" task, compared to the "Reverse Word Reading". In addition, decline of LIs with age, and lower LI when the lesion invaded brain language area were observed. Meanwhile, gender, lesion side (affected hemisphere), LI calculation strategy, and fMRI analysis Z-values did not statistically show any influences on the LIs. Although fMRI is widely used to estimate language LI, it is shown here that in order to present a reliable language LI and to correctly select the dominant hemisphere of the brain, the influence of external factors should be carefully considered. Copyright © 2016 Associazione Italiana di Fisica Medica. Published by Elsevier Ltd. All rights reserved.

Relations between perceptual and conceptual scope: how global versus local processing fits a focus on similarity versus dissimilarity.

PubMed

Förster, Jens

2009-02-01

Nine studies showed a bidirectional link (a) between a global processing style and generation of similarities and (b) between a local processing style and generation of dissimilarities. In Experiments 1-4, participants were primed with global versus local perception styles and then asked to work on an allegedly unrelated generation task. Across materials, participants generated more similarities than dissimilarities after global priming, whereas for participants with local priming, the opposite was true. Experiments 5-6 demonstrated a bidirectional link whereby participants who were first instructed to search for similarities attended more to the gestalt of a stimulus than to its details, whereas the reverse was true for those who were initially instructed to search for dissimilarities. Because important psychological variables are correlated with processing styles, in Experiments 7-9, temporal distance, a promotion focus, and high power were predicted and shown to enhance the search for similarities, whereas temporal proximity, a prevention focus, and low power enhanced the search for dissimilarities. (PsycINFO Database Record (c) 2009 APA, all rights reserved).

Presurgical Nasal Molding With a Nasal Spring in Patients With Mild-to-Moderate Nasal Deformity With Incomplete Unilateral Cleft Lip With or Without Cleft Palate.

PubMed

Peanchitlertkajorn, Supakit

2018-01-01

Traditional nasoalveolar molding (NAM) requires steep learning curve for clinicians and significant compliance from parents. Nasal springs have been developed by the author to simplify presurgical nasal molding. This article presents the design, construction, and application of the spring. The treatment goal is to improve nasal deformity prior to primary repair in infants born with incomplete unilateral cleft lip with or without cleft palate. The design, fabrication, and utility of the nasal spring are described. The spring has a simpler design and construction compared to a traditional NAM appliance. Two patients with incomplete unilateral cleft lip with and without cleft palate are presented. The spring is constructed and delivered. The active arm of the spring can be 3-dimensionally (3-D) adjusted to mold the alar cartilage of the affected nostril. The spring does not require an oral plate for adherence as a traditional NAM appliance does, hence an oral impression is not needed. The spring is easy for clinicians to adjust. It also requires less compliance by parents. Main Outcome Measures/Results: The presurgical molding achieved by the use of a nasal spring improved surgical nasolabial aesthetic outcomes. The nasal springs are effective in reducing the initial cleft nasal deformity. This facilitates primary surgical cleft lip and nose correction and improves surgical outcomes in patients with incomplete unilateral cleft lip with or without cleft palate.

Trastuzumab Benefits Women with Locally Advanced or Inflammatory

Cancer.gov

Women treated with trastuzumab (Herceptin) and chemotherapy before surgery and trastuzumab again after surgery had a reduced risk of the disease recurring or progressing compared with women who received pre-surgical chemotherapy but no trastuzumab, accord

Effects of dose reduction on multi-detector computed tomographic images in evaluating the maxilla and mandible for pre-surgical implant planning: a cadaveric study.

PubMed

Koizumi, Hiroshi; Sur, Jaideep; Seki, Kenji; Nakajima, Koh; Sano, Tsukasa; Okano, Tomohiro

2010-08-01

To assess effects of dose reduction on image quality in evaluating maxilla and mandible for pre-surgical implant planning using cadavers. Six cadavers were used for the study using multi-detector computed tomography (CT) operated at 120 kV and the variable tube current of 80, 40, 20 and 10 mA. A slice thickness of 0.625 mm and pitch 1 were used. Multi-planar images perpendicular and parallel to dentitions were created. The images were evaluated by five oral radiologists in terms of visibility of the anatomical landmarks including alveolar crest, mandibular canal, floors of the maxillary sinus and nasal cavity, contours/cortical layer of jaw bones and the details of trabecular bone. Observers were asked to determine the quality of the images in comparison with 80 mA images based on the criteria: excellent, good, fair or non-diagnostic. The average scores of all observers were calculated for each specimen in all exposure conditions. The 40 mA images could visualize such landmarks and were evaluated to be same or almost equivalent in quality to the 80 mA images. Even the 20 mA images could be accepted just for diagnostic purpose for implant with substantial deterioration of the image quality. The 10 mA images may not be accepted because of the obscured contour caused by image noise. Significant dose reduction by lowering mA can be utilized for pre-surgical implant planning in multi-detector CT.

Pharmacodynamic and pharmacokinetic neoadjuvant study of hedgehog pathway inhibitor Sonidegib (LDE-225) in men with high-risk localized prostate cancer undergoing prostatectomy.

PubMed

Ross, Ashley E; Hughes, Robert M; Glavaris, Stephanie; Ghabili, Kamyar; He, Ping; Anders, Nicole M; Harb, Rana; Tosoian, Jeffrey J; Marchionni, Luigi; Schaeffer, Edward M; Partin, Alan W; Allaf, Mohamad E; Bivalacqua, Trinity J; Chapman, Carolyn; O'Neal, Tanya; DeMarzo, Angelo M; Hurley, Paula J; Rudek, Michelle A; Antonarakis, Emmanuel S

2017-11-28

To determine the pharmacodynamic effects of Sonidegib (LDE-225) in prostate tumor tissue from men with high-risk localized prostate cancer, by comparing pre-surgical core-biopsy specimens to tumor tissue harvested post-treatment at prostatectomy. We conducted a prospective randomized (Sonidegib vs. observation) open-label translational clinical trial in men with high-risk localized prostate cancer undergoing radical prostatectomy. The primary endpoint was the proportion of patients in each arm who achieved at least a two-fold reduction in GLI1 mRNA expression in post-treatment versus pre-treatment tumor tissue. Secondary endpoints included the effect of pre-surgical treatment with Sonidegib on disease progression following radical prostatectomy, and safety. Fourteen men were equally randomized (7 per arm) to either neoadjuvant Sonidegib or observation for 4 weeks prior to prostatectomy. Six of seven men (86%) in the Sonidegib arm (and none in the control group) achieved a GLI1 suppression of at least two-fold. In the Sonidegib arm, drug was detectable in plasma and in prostatic tissue; and median intra-patient GLI1 expression decreased by 63-fold, indicating potent suppression of Hedgehog signaling. Sonidegib was well tolerated, without any Grade 3-4 adverse events observed. Disease-free survival was comparable among the two arms (HR = 1.50, 95% CI 0.26-8.69, P = 0.65). Hedgehog pathway activity (as measured by GLI1 expression) was detectable at baseline in men with localized high-risk prostate cancer. Sonidegib penetrated into prostatic tissue and induced a >60-fold suppression of the Hedgehog pathway. The oncological benefit of Hedgehog pathway inhibition in prostate cancer remains unclear.

Local entrainment of oscillatory activity induced by direct brain stimulation in humans

PubMed Central

Amengual, Julià L.; Vernet, Marine; Adam, Claude; Valero-Cabré, Antoni

2017-01-01

In a quest for direct evidence of oscillation entrainment, we analyzed intracerebral electroencephalographic recordings obtained during intracranial electrical stimulation in a cohort of three medication-resistant epilepsy patients tested pre-surgically. Spectral analyses of non-epileptogenic cerebral sites stimulated directly with high frequency electrical bursts yielded episodic local enhancements of frequency-specific rhythmic activity, phase-locked to each individual pulse. These outcomes reveal an entrainment of physiological oscillatory activity within a frequency band dictated by the rhythm of the stimulation source. Our results support future uses of rhythmic stimulation to elucidate the causal contributions of synchrony to specific aspects of human cognition and to further develop the therapeutic manipulation of dysfunctional rhythmic activity subtending the symptoms of some neuropsychiatric conditions. PMID:28256510

PreSurgMapp: a MATLAB Toolbox for Presurgical Mapping of Eloquent Functional Areas Based on Task-Related and Resting-State Functional MRI.

PubMed

Huang, Huiyuan; Ding, Zhongxiang; Mao, Dewang; Yuan, Jianhua; Zhu, Fangmei; Chen, Shuda; Xu, Yan; Lou, Lin; Feng, Xiaoyan; Qi, Le; Qiu, Wusi; Zhang, Han; Zang, Yu-Feng

2016-10-01

The main goal of brain tumor surgery is to maximize tumor resection while minimizing the risk of irreversible postoperative functional sequelae. Eloquent functional areas should be delineated preoperatively, particularly for patients with tumors near eloquent areas. Functional magnetic resonance imaging (fMRI) is a noninvasive technique that demonstrates great promise for presurgical planning. However, specialized data processing toolkits for presurgical planning remain lacking. Based on several functions in open-source software such as Statistical Parametric Mapping (SPM), Resting-State fMRI Data Analysis Toolkit (REST), Data Processing Assistant for Resting-State fMRI (DPARSF) and Multiple Independent Component Analysis (MICA), here, we introduce an open-source MATLAB toolbox named PreSurgMapp. This toolbox can reveal eloquent areas using comprehensive methods and various complementary fMRI modalities. For example, PreSurgMapp supports both model-based (general linear model, GLM, and seed correlation) and data-driven (independent component analysis, ICA) methods and processes both task-based and resting-state fMRI data. PreSurgMapp is designed for highly automatic and individualized functional mapping with a user-friendly graphical user interface (GUI) for time-saving pipeline processing. For example, sensorimotor and language-related components can be automatically identified without human input interference using an effective, accurate component identification algorithm using discriminability index. All the results generated can be further evaluated and compared by neuro-radiologists or neurosurgeons. This software has substantial value for clinical neuro-radiology and neuro-oncology, including application to patients with low- and high-grade brain tumors and those with epilepsy foci in the dominant language hemisphere who are planning to undergo a temporal lobectomy.

[Pre-surgical orthodontic treatment of skeletal class II patients with gingival smile corrected by anterior maxillary segmental osteotomy].

PubMed

Li, Xiaobing; Xiao, Liwei; Chen, Song; Chen, Yangxi

2002-11-01

To discuss the pre-surgical orthodontic treatment of skeletal class II patients with gingiva smile corrected by AMSO. We analyzed the clinical features of 20 skeletal class II patients treated by AMSO combined with Orthodontic treatment and evaluated the effects of AMSO by means of cephalometric analysis. After the AMSO treatment, ANB angle, the height of anterior maxilla, the protrusion of the upper anterior teeth, and the of A point had reduced significantly (P < 0.05). After AMSO, the appearance of patients had been improved markedly. AMSO can correct the protrusion of the maxilla and gingival smie efficiently. The anchorage of molars should be controlled carefully. The anterior part of the upper arch should be expended orthodontically to make arch relationship. Extract the upper bicuspid half a year before the surgery was recommended. When necessary, genioplasty could be performed.

A novel pre-surgical maxillary orthodontic device using β-titanium wire for wide unilateral cleft lip and palate patients: preliminary study of its efficacy and impact for the maxillary formation.

PubMed

Taniguchi, Maki; Oyama, Tomoki; Kiya, Koichiro; Sone, Yumiko; Ishii, Nobuyuki; Hosokawa, Ko

2014-02-01

For patients with a wide, complete, unilateral cleft lip and palate, pre-surgical maxillary orthodontic treatments have been used to reduce the alveolar gap before cheiloplasty. However, most of these treatments are complicated and laborious for patients and for medical professionals. Thus, we developed an original pre-surgical orthodontic device made with two separate acrylic resin plates connected with a spring-shaped β-titanium wire (β-TW). When the device was applied on the palate, each segment of the maxilla was automatically aligned for our target formation with the elastic force of β-titanium alloy. This study aimed to evaluate the efficacy of the new device and the size of the maxilla in comparison with the conventional Hotz procedures. A total of 47 patients with a wide unilateral cleft lip and palate were retrospectively evaluated; 33 patients were treated with our new device (β-TW plate group) and 14 were treated with a Hotz plate (HP group). We evaluated the alveolar gap reduction and the size of the maxilla between the two groups, obtaining intraoral maxillary impressions at birth, at 3 months and 1 year. The width of the alveolar gap in the β-TW plate group was significantly reduced compared with that in the HP group 1 month after the treatment (p < 0.001). The alveolar gap reduction continued until the age of 1 year (p = 0.02). By contrast, no significant difference in the maxillary size was observed between the two groups at any examination period. Our treatment protocol using the β-TW plate was not only easy and simple to apply but it was also cost-effective, with highly predictable outcomes. Moreover, it provided the ideal alveolar cleft reduction without detrimental collapse of the alveolar segments. Therefore, we consider our β-TW plate device to be useful for application in pre-surgical orthodontic treatments. Copyright © 2013 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights

Q-elastography in the presurgical diagnosis of thyroid nodules with indeterminate cytology.

PubMed

Cantisani, Vito; Ulisse, Salvatore; Guaitoli, Eleonora; De Vito, Corrado; Caruso, Riccardo; Mocini, Renzo; D'Andrea, Vito; Ascoli, Valeria; Antonaci, Alfredo; Catalano, Carlo; Nardi, Francesco; Redler, Adriano; Ricci, Paolo; De Antoni, Enrico; Sorrenti, Salvatore

2012-01-01

Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the "Sapienza" University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient's thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule's malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients' presurgical selection.

High-Intensity Focused Ultrasound for the Treatment of Localized and Locally Advanced Hormone-Resistant Prostate Cancer: 2,5 Year Outcome

NASA Astrophysics Data System (ADS)

Solovov, V. A.; Dvoynikov, S. Y.; Vozdvizhenskiy, M. O.

2011-09-01

Introduction & Objectives: High-Intensity Focused Ultrasound (HIFU) has been shown to be a successful treatment for localised prostate cancer (PC). Here we have explored the effectiveness of the HIFU treatment for hormone-resistant prostate cancer (HRPC). Materials & Methods: 341 patients were treated in our center between September 2007 and December 2009; all of them showed treatment failure following hormone ablation. The median time before hormone-resistance was 20 (3-48) months. In the group with localised PC: number of patients 237, Gleason score ≤7, stage T1-2N0M0, age 69 (60-89) years, mean PSA before treatment 40,0 (5,8-92,9) ng/ml, mean prostate volume—39,3 (28-92) cc; in the group with locally advanced PC: number of patients 104, Gleason score ≤9, stage T2-3N0M0, age 72 (52-83) years, PSA before treatment 30,3 (20,1-60) ng/ml, mean prostate volume—41,2 (25-198) cc. HIFU was delivered under spinal anesthesia using the Ablatherm HIFU device (EDAP, France). Pre HIFU transurethral resection of the prostate (TURP) was performed for all patients. Mean follow-up time 18 months (3-30). Results: The median PSA level 12 months after HIFU treatment was 0,04 (0-2,24) ng/ml—localised PC, and for locally advanced disease—0,05 (0-48,4) ng/ml, at 18 months after HIFU treatment this was 0,2 (0,02-2,0) ng/ml for localised PC, and for locally advanced disease 0,18 (0,04-7,45) ng/ml. Patients with localised PC has 4,5% recurrence, those with locally advanced PC 20%. Kaplan-Meir analyses of the total group indicated that the risk of recurrence after 1 year follow-up was 10%, the risk of recurrence was 19% after 2 years of follow-up. Conclusions: Our initial experience shows that ultrasound ablation is safe, minimally invasive and effective as a treatment for localised and locally advanced hormone-resistant prostate cancer.

Effective retropulsion and centralization of the severely malpositioned premaxilla in patients with bilateral cleft lip and palate: a novel modified presurgical nasoalveolar molding device with retraction screw.

PubMed

Li, Wanshan; Liao, Lishu; Dai, Jingbo; Zhong, Yuxiang; Ren, Leixi; Liu, Yutao

2014-12-01

A novel, modified presurgical nasoalveolar molding (MPNAM) device with retraction screw was designed and used in patients with bilateral complete cleft lip and palate (BCCLP) to rapidly retract and centralize the protuberant and malpositioned premaxilla and correct the nasolabial and palatal deformities. The orthopedic effects and possible complications were evaluated. Nine patients with BCCLP who met the inclusion criteria were selected. After the maxillary model was obtained, the new MPNAM device with retraction screw was designed and worn until cheilorrhaphy. Changes in local deformities and complications were observed continuously, and the orthopedic effect was evaluated. All patients quickly adapted to the MPNAM appliance, and the treatment was finished after 5-8 return visits. The columella was significantly prolonged, the nasal tip was elevated, and the collapsed nasal dome was obviously improved. Simultaneously, the premaxilla was rapidly retracted and rotated, and gradually centralized; the clefts were gradually reduced and closed, and a nearly normal dental arch was formed. Although there were some complications, the orthopedic treatment was continued until cheiloplasty. The MPNAM device with retraction screw can simultaneously correct nasolabial and palatal deformities and also rapidly retract and centralize the premaxilla. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Predicting Postsurgical Satisfaction in Adolescents With Idiopathic Scoliosis: The Role of Presurgical Functioning and Expectations.

PubMed

Sieberg, Christine B; Manganella, Juliana; Manalo, Gem; Simons, Laura E; Hresko, M Timothy

2017-12-01

There is a need to better assess patient satisfaction and surgical outcomes. The purpose of the current study is to identify how preoperative expectations can impact postsurgical satisfaction among youth with adolescent idiopathic scoliosis undergoing spinal fusion surgery. The present study includes patients with adolescent idiopathic scoliosis undergoing spinal fusion surgery enrolled in a prospective, multicentered registry examining postsurgical outcomes. The Scoliosis Research Society Questionnaire-Version 30, which assesses pain, self-image, mental health, and satisfaction with management, along with the Spinal Appearance Questionnaire, which measures surgical expectations was administered to 190 patients before surgery and 1 and 2 years postoperatively. Regression analyses with bootstrapping (with n=5000 bootstrap samples) were conducted with 99% bias-corrected confidence intervals to examine the extent to which preoperative expectations for spinal appearance mediated the relationship between presurgical mental health and pain and 2-year postsurgical satisfaction. Results indicate that preoperative mental health, pain, and expectations are predictive of postsurgical satisfaction. With the shifting health care system, physicians may want to consider patient mental health, pain, and expectations before surgery to optimize satisfaction and ultimately improve clinical care and patient outcomes. Level I-prognostic study.

[Presurgical nasoalveolar molding in infants with cleft lip and palate: analysis of 29 cases].

PubMed

Hou, Yu-xia; Ren, Zhan-ping; Li, Jin-feng; Li, Xiang-lin; Ma, Si-wei; Cao, Hui-qin

2011-12-01

The objective of this study was to treat the cleft lip and alveolus, nasal deformity with presurgical nasoalveolar molding (PNAM), to elucidate the problems and treatment methods, which may be helpful for the use of PNAM in clinic. Twenty nine infants with cleft lip and palate (CLP) were treated with PNAM in our center. There were 19 unilateral and 10 bilateral CLP patients. The initial visit time was 3 to 150 days after birth. Treatment time ranged from 2.5 to 3 months. The appliance was modified at 2-week interval. According to the evaluation standards, 17 infants were treated successfully with the closure of cleft lip and alveolar processes, reposition of the deformed nasal cartilages, and increased length of columella. The lip and nasal deformities of 9 infants were corrected partly, which were helpful for surgery. There were 3 infants giving up PNAM. There were five important facts for the successful treatment, including initial visit time, impression of the intraoral cleft defect, modification of the plate and the nasal stent, and use of nasal splints. Orthodontics and plastic surgeons should have the same views for PNAM in infants, which will advance the treatment level for cleft lip and palate.

Q-Elastography in the Presurgical Diagnosis of Thyroid Nodules with Indeterminate Cytology

PubMed Central

Guaitoli, Eleonora; De Vito, Corrado; Caruso, Riccardo; Mocini, Renzo; D’Andrea, Vito; Ascoli, Valeria; Antonaci, Alfredo; Catalano, Carlo; Nardi, Francesco; Redler, Adriano; Ricci, Paolo; De Antoni, Enrico; Sorrenti, Salvatore

2012-01-01

Quantitative ultrasound (US) elastography (Q-USE), able to evaluate tissue stiffness has been indicated as a new diagnostic tool to differentiate benign from malignant thyroid lesions. Aim of this prospective study, conducted at the Department of Surgical Sciences, of the “Sapienza” University of Rome, was to evaluate the diagnostic accuracy of Q-USE, compared with US parameters, in thyroid nodules with indeterminate cytology (Thy3).The case study included 140 nodules from 140 consecutive patients. Patient’s thyroid nodules were evaluated by Q-USE, measuring the strain ratio (SR) of stiffness between nodular and surrounding normal thyroid tissue, and conventional US parameters prior fine-needle aspiration cytology. Those with Thy3 diagnosis were included in the study. Forty of the nodules analyzed harbored a malignant lesion. Q-USE demonstrated that malignant nodules have a significant higher stiffness with respect to benign one and an optimun SR cut-off value of 2.05 was individuated following ROC analysis. Univariate analysis showed that hypoechogenicity, irregular margins and SR >2.05 associated with malignancy, with an accuracy of 67.2%, 81,0% and 89.8%, respectively. Data were unaffected by nodule size or thyroiditis. These findings were confirmed in multivariate analysis demonstrating a significant association of the SR and the irregular margins with thyroid nodule’s malignancy. In conclusion, we demonstrated the diagnostic utility of Q-USE in the differential diagnosis of thyroid nodules with indeterminate cytology that, if confirmed, could be of major clinical utility in patients’ presurgical selection. PMID:23209819

Risks of presurgical embolization of feeding arteries in 137 intracranial meningeal tumors.

PubMed

Law-ye, Bruno; Clarençon, Frédéric; Sourour, Nader-Antoine; Di Maria, Federico; Jean, Betty; Bonneville, Fabrice; Biondi, Alessandra; Iosif, Christina; Navarro, Soledad; Cornu, Philippe; Chiras, Jacques

2013-04-01

Embolization of extra-axial tumors has shown its effectiveness in reducing perisurgical blood loss. However, the complication rate of this procedure is poorly reported. We aimed to evaluate the rate of procedure-related complications and their risk factors. From 1998 to 2011, 193 consecutive patients (141 females, 52 males; mean age = 52.9 years) were referred to our institution for presurgical embolization of an extra-axial tumor (meningiomas: n = 178; solitary fibrous tumors: n = 3; other: n = 12). Of 193 patients, 137 (71 %) underwent 141 embolizations (by microparticles: n = 133; by glue: n = 8). The remaining 56 patients (29 %) were not embolized due to unstable catheterization or dangerous anastomosis. Occurrence of neurological deficit was systematically assessed during and after embolization. The risk factors of procedure-related neurological complications were evaluated. Neither intratumoral hemorrhage nor procedure-related death was reported. Two of the 137 patients (1.5 %) had ischemic events with permanent neurological deficit after microparticles embolization. One patient had cortical blindness and one had hemiparesis. Both complications involved the vertebrobasilar system. The first patient had direct intratumoral anastomosis between the middle and the posterior meningeal arteries (PMA); the second one had reflux in the vertebral artery during particles injection in the PMA. Occurrence of ischemic complication was not related to the size of the microparticles. Though embolization of meningeal tumors is considered as a safe technique, serious neurological complications may occur. Opening of dangerous anastomosis or uncontrolled reflux caused two neurological complications (1.5 %). The size of the microparticles was not associated with the occurrence of neurological event.

Tessier No. 3 and No. 4 clefts: Sequential treatment in infancy by pre-surgical orthopedic skeletal contraction, comprehensive reconstruction, and novel surgical lengthening of the ala base-canthal distance.

PubMed

Spolyar, John L; Hnatiuk, Mark; Shaheen, Kenneth W; Mertz, Jennifer K; Handler, Lawrence F; Jarial, Ravinder; Roldán, J Camilo

2015-09-01

Repair of facial clefts implies wide tissue mobilization with multi-stage surgical treatment. Authors propose pre-surgical orthopedic correction for naso-oro-ocular clefts and a novel surgical option for Tessier No. 3 cleft. Two male infants, a Tessier No. 3 cleft (age 7 months) and another Tessier No. 4 (age 3 months), were treated with a modified orthopedic Latham device with additional septo-premaxillary molding and observed to age four years. Tessier No. 3 orthopedic measurements were obtained by image corrected cephalometric analysis. Subsequent repair included tissue expansion on Tessier No. 4 and naso-frontal Rieger flap combined with myocutaneous upper lid flap on Tessier No. 3. Orthopedic movements ranged from 18.5 mm in bi-planar to 33 mm in oblique analyses. Tissue margins became aligned with platform normalization. Tissue expansion on Tessier No. 4 improved distances from ala base-lower lid and subalar base-lip. The naso-frontal flap combined with myocutaneous upper lid flap on Tessier No. 3 had similar achievement, but also sufficiently lengthened ala base-canthal distance. Repairs were facilitated by pre-surgical orthopedic correction. The naso-frontal flap combined with an upper lid myocutaneous flap seems viable as a single-stage option to lengthen ala base-canthal distance to advance repair achievement in unilateral Tessier No. 3. Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Localization of dense intracranial electrode arrays using magnetic resonance imaging

PubMed Central

Doyle, Werner K.; Halgren, Eric; Carlson, Chad; Belcher, Thomas L.; Cash, Sydney S.; Devinsky, Orrin; Thesen, Thomas

2013-01-01

Intracranial electrode arrays are routinely used in the pre-surgical evaluation of patients with medically refractory epilepsy, and recordings from these electrodes have been increasingly employed in human cognitive neurophysiology due to their high spatial and temporal resolution. For both researchers and clinicians, it is critical to localize electrode positions relative to the subject-specific neuroanatomy. In many centers, a post-implantation MRI is utilized for electrode detection because of its higher sensitivity for surgical complications and the absence of radiation. However, magnetic susceptibility artifacts surrounding each electrode prohibit unambiguous detection of individual electrodes, especially those that are embedded within dense grid arrays. Here, we present an efficient method to accurately localize intracranial electrode arrays based on pre- and post-implantation MR images that incorporates array geometry and the individual's cortical surface. Electrodes are directly visualized relative to the underlying gyral anatomy of the reconstructed cortical surface of individual patients. Validation of this approach shows high spatial accuracy of the localized electrode positions (mean of 0.96 mm±0.81 mm for 271 electrodes across 8 patients). Minimal user input, short processing time, and utilization of radiation-free imaging are strong incentives to incorporate quantitatively accurate localization of intracranial electrode arrays with MRI for research and clinical purposes. Co-registration to a standard brain atlas further allows inter-subject comparisons and relation of intracranial EEG findings to the larger body of neuroimaging literature. PMID:22759995

ACAL National Conference (Sydney, Australia, October 9-11, 1992). Conference Papers, Vol. 3, Workshops with a Local NSW Focus.

ERIC Educational Resources Information Center

Literacy & Numeracy Exchange, 1992

1992-01-01

This third of three volumes of the 1992 Australian Council for Adult Literacy (ACAL) Conference Papers is a special edition of "Literacy and Numeracy Exchange." It includes nine papers from workshops with a more local New South Wales focus. "Literacy, Language, and Numeracy in the Workplace in the Context of Industry…

A fully-automated multiscale kernel graph cuts based particle localization scheme for temporal focusing two-photon microscopy

NASA Astrophysics Data System (ADS)

Huang, Xia; Li, Chunqiang; Xiao, Chuan; Sun, Wenqing; Qian, Wei

2017-03-01

The temporal focusing two-photon microscope (TFM) is developed to perform depth resolved wide field fluorescence imaging by capturing frames sequentially. However, due to strong nonignorable noises and diffraction rings surrounding particles, further researches are extremely formidable without a precise particle localization technique. In this paper, we developed a fully-automated scheme to locate particles positions with high noise tolerance. Our scheme includes the following procedures: noise reduction using a hybrid Kalman filter method, particle segmentation based on a multiscale kernel graph cuts global and local segmentation algorithm, and a kinematic estimation based particle tracking method. Both isolated and partial-overlapped particles can be accurately identified with removal of unrelated pixels. Based on our quantitative analysis, 96.22% isolated particles and 84.19% partial-overlapped particles were successfully detected.

High-Intensity Focused Ultrasound (HIFU) for the Treatment of Localized Prostate Cancer using Sonablate-500

NASA Astrophysics Data System (ADS)

Uchida, Toyoaki; Ohkusa, Hiroshi; Yamashita, Hideyuki; Nagata, Yoshihiro

2005-03-01

We evaluated 181 patients with localized prostate cancer treated with high-intensity focused ultrasound (HIFU) for biochemical disease-free rate, safety, morbidity and predictors of biochemical outcome. A total of 181 patients underwent HIFU with the Sonablate-500 and with at least 12 months of follow-up. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The biochemical disease-free rates at 1, 3 and 5 years in all patients were 84%, 80% and 78%, respectively. The biochemical disease-free rates at 3 years for patients with pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml and more than 20.0 ng/ml were 94%, 75% and 35%, respectively (p<0.0001). According to multivariate analysis preoperative PSA (p<0.0001) was a significant independent predictor of time to biochemical recurrence. HIFU therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/ml.

A single bout of meditation biases cognitive control but not attentional focusing: Evidence from the global-local task.

PubMed

Colzato, Lorenza S; van der Wel, Pauline; Sellaro, Roberta; Hommel, Bernhard

2016-01-01

Recent studies show that a single bout of meditation can impact information processing. We were interested to see whether this impact extends to attentional focusing and the top-down control over irrelevant information. Healthy adults underwent brief single bouts of either focused attention meditation (FAM), which is assumed to increase top-down control, or open monitoring meditation (OMM), which is assumed to weaken top-down control, before performing a global-local task. While the size of the global-precedence effect (reflecting attentional focusing) was unaffected by type of meditation, the congruency effect (indicating the failure to suppress task-irrelevant information) was considerably larger after OMM than after FAM. Our findings suggest that engaging in particular kinds of meditation creates particular cognitive-control states that bias the individual processing style toward either goal-persistence or cognitive flexibility. Copyright © 2015 Elsevier Inc. All rights reserved.

Variability and bias between magnetoencephalography systems in non-invasive localization of the primary somatosensory cortex.

PubMed

Bardouille, Timothy; Power, Lindsey; Lalancette, Marc; Bishop, Ronald; Beyea, Steven; Taylor, Margot J; Dunkley, Benjamin T

2018-05-26

Magnetoencephalography (MEG) provides functional neuroimaging data for pre-surgical planning in patients with epilepsy or brain tumour. For mapping the primary somatosensory cortex (S1), MEG data are acquired while a patient undergoes median nerve stimulation (MNS) to localize components of the somatosensory evoked field (SEF). In clinical settings, only one MEG imaging session is usually possible due to limited resources. As such, it is important to have an a priori estimate of the expected variability in localization. Variability in S1 localization between mapping sessions using the same MEG system has been previously measured as 8 mm. There are different types of MEG systems available with varied hardware and software, and it is not known how using a different MEG system will impact on S1 localization. In our study, healthy participants underwent the MNS procedure with two different MEG systems (Vector View and CTF). We compared the location, amplitude and latency of SEF components between data from each system to quantify variability and bias between MEG systems. We found 8-11 mm variability in S1 localization between the two MEG systems, and no evidence for a systematic bias in location, amplitude or latency between the two systems. These findings suggest that S1 localization is not biased by the type of MEG system used, and that differences between the two systems are not a major contributor to variability in localization. Copyright © 2018. Published by Elsevier B.V.

Light focusing in the Anderson regime.

PubMed

Leonetti, Marco; Karbasi, Salman; Mafi, Arash; Conti, Claudio

2014-07-29

Anderson localization is a regime in which diffusion is inhibited and waves (also electromagnetic waves) get localized. Here we exploit adaptive optics to achieve focusing in disordered optical fibres in the Anderson regime. By wavefront shaping and optimization, we observe the generation of a propagation-invariant beam, where light is trapped transversally by disorder, and show that Anderson localizations can be also excited by extended speckled beams. We demonstrate that disordered fibres allow a more efficient focusing action with respect to standard fibres in a way independent of their length, because of the propagation-invariant features and cooperative action of transverse localizations.

Clinical recommendation for treatment planning of sinus augmentation procedures by using presurgical CAT scan images: a preliminary report.

PubMed

Kutkut, Ahmad M; Andreana, Sebastiano; Kim, Hyeong-Ll; Monaco, Edward

2011-12-01

To propose a clinical recommendation based on anatomy of maxillary sinus before sinus augmentation procedure using presurgical computerized axial tomography (CAT) scan images. CAT scan images were randomly selected from previous completed implant cases. Proposed area for the lateral window osteotomy was outlined on the panorex image of the CAT scan. Sagittal section on the CAT scan that was in the center of the outlined window was selected for sinus measurement analysis. On CAT scan, 2 lines were drawn to measure the dimensions of sinus. One line measured the horizontal width and the other line measured the vertical height. Based on the measurement data, a classification of the maxillary sinus anatomy was proposed. Narrow sinus cavity indicates favorable type anatomy in terms of bone regeneration healing and wide sinus cavity as less favorable anatomy for patient treatment planning. A narrow sinus and greater exposure to the blood supply should require shorter healing times after grafting. Conversely, wider sinus cavities and less exposure to the blood supply would require a longer healing time before implant placement.

Revised version of quality guidelines for presurgical epilepsy evaluation and surgical epilepsy therapy issued by the Austrian, German, and Swiss working group on presurgical epilepsy diagnosis and operative epilepsy treatment.

PubMed

Rosenow, Felix; Bast, Thomas; Czech, Thomas; Feucht, Martha; Hans, Volkmar H; Helmstaedter, Christoph; Huppertz, Hans-Jürgen; Noachtar, Soheyl; Oltmanns, Frank; Polster, Tilman; Seeck, Margitta; Trinka, Eugen; Wagner, Kathrin; Strzelczyk, Adam

2016-08-01

The definition of minimal standards remains pivotal as a basis for a high standard of care and as a basis for staff allocation or reimbursement. Only limited publications are available regarding the required staffing or methodologic expertise in epilepsy centers. The executive board of the working group (WG) on presurgical epilepsy diagnosis and operative epilepsy treatment published the first guidelines in 2000 for Austria, Germany, and Switzerland. In 2014, revised guidelines were published and the WG decided to publish an unaltered English translation in this report. Because epilepsy surgery is an elective procedure, quality standards are particularly high. As detailed in the first edition of these guidelines, quality control relates to seven different domains: (1) establishing centers with a sufficient number of sufficiently and specifically trained personnel, (2) minimum technical standards and equipment, (3) continuous medical education of employees, (4) surveillance by trained personnel during video electroencephalography (EEG) monitoring (VEM), (5) systematic acquisition of clinical and outcome data, (6) the minimum number of preoperative evaluations and epilepsy surgery procedures, and (7) the cooperation of epilepsy centers. These standards required the certification of the different professions involved and minimum numbers of procedures. In the subsequent decade, quite a number of colleagues were certified by the trinational WG; therefore, the executive board of the WG decided in 2013 to make these standards obligatory. This revised version is particularly relevant given that the German procedure classification explicitly refers to the guidelines of the WG with regard to noninvasive/invasive preoperative video-EEG monitoring and invasive intraoperative diagnostics in epilepsy. Wiley Periodicals, Inc. © 2016 International League Against Epilepsy.

RapidNAM: generative manufacturing approach of nasoalveolar molding devices for presurgical cleft lip and palate treatment.

PubMed

Bauer, Franz Xaver; Schönberger, Markus; Gattinger, Johannes; Eblenkamp, Markus; Wintermantel, Erich; Rau, Andrea; Güll, Florian Dieter; Wolff, Klaus-Dietrich; Loeffelbein, Denys J

2017-08-28

Nasoalveolar molding (NAM) is an accepted treatment strategy in presurgical cleft therapy. The major drawbacks of the treatment listed in the literature relate to the time of the treatment and the coordination of the required interdisciplinary team of therapists, parents, and patients. To overcome these limitations, we present the automated RapidNAM concept that facilitates the design and manufacturing process of NAM devices, and that allows the virtual modification and subsequent manufacture of the devices in advance, with a growth prediction factor adapted to the patient's natural growth. The RapidNAM concept involves (i) the prediction of three trajectories that envelope the fragmented alveolar segments with the goal to mimic a harmonic arch, (ii) the extrusion from the larger toward the smaller alveolar segment along the envelope curves toward the harmonic upper alveolar arch, and (iii) the generation of the NAM device with a ventilation hole, fixation pin, and fixation points for the nasal stents. A feasibility study for a vector-based approach was successfully conducted for unilateral and bilateral cleft lip and palate (CLP) patients. A comparison of the modified target models with the reference target models showed similar results. For further improvement, the number of landmarks used to modify the models was increased by a curve-based approach.

EEG-fMRI in the presurgical evaluation of temporal lobe epilepsy.

PubMed

Coan, Ana C; Chaudhary, Umair J; Frédéric Grouiller; Campos, Brunno M; Perani, Suejen; De Ciantis, Alessio; Vulliemoz, Serge; Diehl, Beate; Beltramini, Guilherme C; Carmichael, David W; Thornton, Rachel C; Covolan, Roberto J; Cendes, Fernando; Lemieux, Louis

2016-06-01

Drug-resistant temporal lobe epilepsy (TLE) often requires thorough investigation to define the epileptogenic zone for surgical treatment. We used simultaneous interictal scalp EEG-fMRI to evaluate its value for predicting long-term postsurgical outcome. 30 patients undergoing presurgical evaluation and proceeding to temporal lobe (TL) resection were studied. Interictal epileptiform discharges (IEDs) were identified on intra-MRI EEG and used to build a model of haemodynamic changes. In addition, topographic electroencephalographic correlation maps were calculated between the average IED during video-EEG and intra-MRI EEG, and used as a condition. This allowed the analysis of all data irrespective of the presence of IED on intra-MRI EEG. Mean follow-up after surgery was 46 months. International League Against Epilepsy (ILAE) outcomes 1 and 2 were considered good, and 3-6 poor, surgical outcome. Haemodynamic maps were classified according to the presence (Concordant) or absence (Discordant) of Blood Oxygen Level-Dependent (BOLD) change in the TL overlapping with the surgical resection. The proportion of patients with good surgical outcome was significantly higher (13/16; 81%) in the Concordant than in the Discordant group (3/14; 21%) (χ(2) test, Yates correction, p=0.003) and multivariate analysis showed that Concordant BOLD maps were independently related to good surgical outcome (p=0.007). Sensitivity and specificity of EEG-fMRI results to identify patients with good surgical outcome were 81% and 79%, respectively, and positive and negative predictive values were 81% and 79%, respectively. The presence of significant BOLD changes in the area of resection on interictal EEG-fMRI in patients with TLE retrospectively confirmed the epileptogenic zone. Surgical resection including regions of haemodynamic changes in the TL may lead to better postoperative outcome. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a

Seahorses in focus: local ecological knowledge of seahorse-watching operators in a tropical estuary.

PubMed

Ternes, Maria L F; Gerhardinger, Leopoldo C; Schiavetti, Alexandre

2016-11-08

Seahorses are endangered teleost fishes under increasing human pressures worldwide. In Brazil, marine conservationists and policy-makers are thus often skeptical about the viability of sustainable human-seahorse interactions. This study focuses on local ecological knowledge on seahorses and the implications of their non-lethal touristic use by a coastal community in northeastern Brazil. Community-based seahorse-watching activities have been carried out in Maracaípe village since 1999, but remained uninvestigated until the present study. Our goal is to provide ethnoecological understanding on this non-extractive use to support seahorse conservation and management. We interviewed 32 informants through semi-structured questionnaires to assess their socioeconomic profile, their knowledge on seahorse natural history traits, human uses, threats and abundance trends. Seahorse-watching has high socioeconomic relevance, being the primary income source for all respondents. Interviewees elicited a body of knowledge on seahorse biology largely consistent with up-to-date research literature. Most informants (65.5 %) perceived no change in seahorse abundance. Their empirical knowledge often surpassed scientific reports, i.e. through remarks on trophic ecology; reproductive aspects, such as, behavior and breeding season; spatial and temporal distribution, suggesting seahorse migration related to environmental parameters. Seahorse-watching operators were aware of seahorse biological and ecological aspects. Despite the gaps remaining on biological data about certain seahorse traits, the respondents provided reliable information on all questions, adding ethnoecological remarks not yet assessed by conventional scientific surveys. We provide novel ethnobiological insight on non-extractive modes of human-seahorse interaction, eliciting environmental policies to integrate seahorse conservation with local ecological knowledge and innovative ideas for seahorse sustainable use. Our study

Low-intensity focused ultrasound mediated localized drug delivery for liver tumors in rabbits.

PubMed

Gong, Yuping; Wang, Zhigang; Dong, Guifang; Sun, Yang; Wang, Xi; Rong, Yue; Li, Maoping; Wang, Dong; Ran, Haitao

2016-09-01

To explore the antitumor effects of low-intensity focused ultrasound (LIFU) mediated localized drug delivery of adriamycin-microbubble-PLGA nanoparticle complexes on rabbits VX2 liver tumor. ADM-NMCs were prepared by covalent linking of ADM-PLGA nanoparticles (ADM-NPs) to the shell of the microbubbles. A fixed water bag filled with microbubbles was subjected to LIFU and non-focused ultrasound respectively, and the ultrasound images of which were recorded before and after ultrasonication. A total of 54 VX2 liver tumor-burdened rabbits were divided into six groups randomly, including control, ADM-NPs combined with LIFU, microbubbles combined with LIFU, ADM-NPs and microbubbles combined with LIFU, ADM-NMCs combined with LIFU and ADM-NMCs combined with Non-FUS. The tumor volume and volume inhibition rate (VIR) of tumor progression were calculated and compared. Apoptotic cells were labeled by terminal deoxyuridine nick end. Proliferating cell nuclear antigen was detected by immunohistochemistry. The median survival time of the animals were recorded and compared. ADM-NMCs were successfully prepared with an average diameter of 1721 nm. The highest VIR and apoptotic index (AI) were found in the group of ADM-NMCs combined with LIFU while the lowest proliferating index (PI) was simultaneously observed in this group. The median survival time of the rabbits in the ADM-NMCs combined with LIFU group was the longest (71days) among all groups. ADM-NMCs combined with LIFU could inhibit the rabbits VX2 liver tumor progress by delaying the tumor proliferation and accelerating apoptosis, which presents a novel process for liver tumor targeting chemotherapy.

Effectiveness of pre-surgical infant orthopedic treatment for cleft lip and palate patients: a systematic review and meta-analysis.

PubMed

Papadopoulos, M A; Koumpridou, E N; Vakalis, M L; Papageorgiou, S N

2012-11-01

The objective of the study was to systematically summarize current evidence on the effectiveness of pre-surgical infant orthopedics (PSIO) in cleft lip and palate (CLP) patients. Electronic and manual searches were conducted, and using specific inclusion and exclusion criteria, data extraction and analysis was performed by two independent investigators. When possible, overall pooled estimates with 95% confidence intervals were obtained using the random-effects model. Twenty-four of 885 original studies met the inclusion criteria and were included in the qualitative synthesis, whereas 10 of them were included in the quantitative synthesis (meta-analysis). Except for the variable M-T-C(5) assessing maxillary arch form, which presented an increase at 48 months of follow-up, all other variables concerning craniofacial and dentoalveolar changes demonstrated no significant differences, indicating that PSIO treatment has no effect on CLP patients. The limited evidence derived from this study does not seem to support the short- or long-term effectiveness of PSIO in CLP patients. © 2012 John Wiley & Sons A/S.

Treatment outcomes of pre-surgical infant orthopedics in patients with non-syndromic cleft lip and/or palate: A systematic review and meta-analysis of randomized controlled trials

PubMed Central

2017-01-01

Background Non-syndromic clefts lip and/or palate (CL/P) defects may have manifold significant and detrimental consequences for the affected individuals and their family environment. Although the use of pre-surgical infant orthopedics (PSIO) was introduced as a means to improve management and treatment outcomes, there still remains a controversy. Objective To investigate the effectiveness of PSIO in patients with non-syndromic CL/P and evaluate the quality of the available evidence. Search methods Search without restrictions, together with hand searching, until May 2016. Selection criteria Randomized clinical trials investigating the effects of pre-surgical infant orthopedic appliances. Data collection and analysis Following study retrieval and selection, data extraction and individual study risk of bias assessment using the Cochrane Risk of Bias Tool took place. The overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development and Evaluation approach. Results Finally 20 papers (3 unique trials) were identified, involving a total of 118 patients with unilateral complete CL/P and 16 with cleft of the soft and at least two thirds of the hard palate. Eight publications were considered as being of low, four of unclear and eight of high risk of bias. In general, the investigated appliances did not present significant effects when compared to each other or to no treatment in terms of feeding and general body growth, facial esthetics, cephalometric variables, maxillary dentoalveolar variables and dental arch relationships, speech and language evaluation, caregiver-reported outcomes, economic evaluation, as well as, adverse effects and problems. Overall, the quality of the available evidence was considered low. Conclusions The aforementioned findings could provide initial guidance in the clinical setting. However, given the multitude of parameters, which may have affected the results, good practice would suggest further

Microwave focusators

NASA Astrophysics Data System (ADS)

Vinogradov, E. A.; Gridin, S. A.; Golovanov, V. I.; Danilenko, A. A.; Bulatov, E. D.

1989-01-01

A system capable of focusing monochromatic microwave radiation with a spherical or planar wavefront into a straight line segment is designed. The system consists of zone elements made with numerically controlled machine tools. The study of the image obtained revealed that the width of the formed local segment is close to the diffraction limit.

Ribociclib plus letrozole in early breast cancer: A presurgical, window-of-opportunity study.

PubMed

Curigliano, G; Gómez Pardo, P; Meric-Bernstam, F; Conte, P; Lolkema, M P; Beck, J T; Bardia, A; Martínez García, M; Penault-Llorca, F; Dhuria, S; Tang, Z; Solovieff, N; Miller, M; Di Tomaso, E; Hurvitz, S A

2016-08-01

Cyclin D-cyclin-dependent kinase (CDK) 4/6-inhibitor of CDK4/6-retinoblastoma (Rb) pathway hyperactivation is associated with hormone receptor-positive (HR+) breast cancer (BC). This study assessed the biological activity of ribociclib (LEE011; CDK4/6 inhibitor) plus letrozole compared with single-agent letrozole in the presurgical setting. Postmenopausal women (N = 14) with resectable, HR+, human epidermal growth factor receptor 2-negative (HER2-) early BC were randomized 1:1:1 to receive 2.5 mg/day letrozole alone (Arm 1), or with 400 or 600 mg/day ribociclib (Arm 2 or 3). Circulating tumor DNA and tumor biopsies were collected at baseline and, following 14 days of treatment, prior to or during surgery. The primary objective was to assess antiproliferative response per Ki67 levels in Arms 2 and 3 compared with Arm 1. Additional assessments included safety, pharmacokinetics, and genetic profiling. Mean decreases in the Ki67-positive cell fraction from baseline were: Arm 1 69% (range 38-100%; n = 2), Arm 2 96% (range 78-100%; n = 6), Arm 3 92% (range 75-100%; n = 3). Decreased phosphorylated Rb levels and CDK4, CDK6, CCND2, CCND3, and CCNE1 gene expression were observed following ribociclib treatment. Ribociclib and letrozole pharmacokinetic parameters were consistent with single-agent data. The ribociclib plus letrozole combination was well tolerated, with no Grade 3/4 adverse events over the treatment. The results suggest absence of a drug-drug interaction between ribociclib and letrozole and indicate ribociclib plus letrozole may reduce Ki67 expression in HR+, HER2- BC (NCT01919229). Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Localization of Broca's Area Using Functional MR Imaging: Quantitative Evaluation of Paradigms.

PubMed

Kim, Chi Heon; Kim, Jae-Hun; Chung, Chun Kee; Kim, June Sic; Lee, Jong-Min; Lee, Sang Kun

2009-04-01

Functional magnetic resonance imaging (fMRI) is frequently used to localize language areas in a non-invasive manner. Various paradigms for presurgical localization of language areas have been developed, but a systematic quantitative evaluation of the efficiency of those paradigms has not been performed. In the present study, the authors analyzed different language paradigms to see which paradigm is most efficient in localizing frontal language areas. Five men and five women with no neurological deficits participated (mean age, 24 years) in this study. All volunteers were right-handed. Each subject performed 4 tasks, including fixation (Fix), sentence reading (SR), pseudoword reading (PR), and word generation (WG). Fixation and pseudoword reading were used as contrasts. The functional area was defined as the area(s) with a t-value of more than 3.92 in fMRI with different tasks. To apply an anatomical constraint, we used a brain atlas mapping system, which is available in AFNI, to define the anatomical frontal language area. The numbers of voxels in overlapped area between anatomical and functional area were individually counted in the frontal expressive language area. Of the various combinations, the word generation task was most effective in delineating the frontal expressive language area when fixation was used as a contrast (p<0.05). The sensitivity of this test for localizing Broca's area was 81% and specificity was 70%. Word generation versus fixation could effectively and reliably delineate the frontal language area. A customized effective paradigm should be analyzed in order to evaluate various language functions.

Usage of fMRI for pre-surgical planning in brain tumor and vascular lesion patients: task and statistical threshold effects on language lateralization.

PubMed

Nadkarni, Tanvi N; Andreoli, Matthew J; Nair, Veena A; Yin, Peng; Young, Brittany M; Kundu, Bornali; Pankratz, Joshua; Radtke, Andrew; Holdsworth, Ryan; Kuo, John S; Field, Aaron S; Baskaya, Mustafa K; Moritz, Chad H; Meyerand, M Elizabeth; Prabhakaran, Vivek

2015-01-01

Functional magnetic resonance imaging (fMRI) is a non-invasive pre-surgical tool used to assess localization and lateralization of language function in brain tumor and vascular lesion patients in order to guide neurosurgeons as they devise a surgical approach to treat these lesions. We investigated the effect of varying the statistical thresholds as well as the type of language tasks on functional activation patterns and language lateralization. We hypothesized that language lateralization indices (LIs) would be threshold- and task-dependent. Imaging data were collected from brain tumor patients (n = 67, average age 48 years) and vascular lesion patients (n = 25, average age 43 years) who received pre-operative fMRI scanning. Both patient groups performed expressive (antonym and/or letter-word generation) and receptive (tumor patients performed text-reading; vascular lesion patients performed text-listening) language tasks. A control group (n = 25, average age 45 years) performed the letter-word generation task. Brain tumor patients showed left-lateralization during the antonym-word generation and text-reading tasks at high threshold values and bilateral activation during the letter-word generation task, irrespective of the threshold values. Vascular lesion patients showed left-lateralization during the antonym and letter-word generation, and text-listening tasks at high threshold values. Our results suggest that the type of task and the applied statistical threshold influence LI and that the threshold effects on LI may be task-specific. Thus identifying critical functional regions and computing LIs should be conducted on an individual subject basis, using a continuum of threshold values with different tasks to provide the most accurate information for surgical planning to minimize post-operative language deficits.

Environmental education with a local focus: The development of action competency in community leaders through participation in an environmental leadership program

NASA Astrophysics Data System (ADS)

Cairns, Karen Jean

2001-07-01

This dissertation is a historical and theoretical examination of environmental education to promote community leadership in local environmental issues. It begins with an overview of the history of environmental education, historical perspectives of the beginning of the field, ongoing differences in perspectives of practitioners, and its relationship to the larger field of education. Using a prevalent definition of environmental education as education with an aim of promoting actions, which are environmentally responsible and careful, I examine a variety of educational approaches and their results in achieving this objective. Reasons for using a local focus in terms of promotion of community sustainability are explored, and the literature review ends with a discussion of the value of community action through participatory democratic processes. The dissertation is divided into five chapters, covering an introduction to the purpose and significance of the study, literature review, methodology, results and analysis, and conclusion and implications of the research. Two programs, one at a city or urban level and one at a state level, and outcomes for their participants are explored and compared through data collected from interviews, field observation, and program documents. Findings demonstrated the value of a local focus for environmental education programs, plus the importance of experiential learning, or learning through some sort of personal connection and involvement. Examples of the types of experiential learning involved are tours or field trips, role-playing, and games illustrating concepts. Results emphasized the importance of educational process over content, information, or factual knowledge. The urban leadership program demonstrated the value of a local focus and experiential process in increasing motivation for action. The state program demonstrated the value of education of environmental leaders in democratic processes, especially collaboration, inclusion

Prognostic Role of Functional Neuroimaging after Multilobar Resection in Patients with Localization-Related Epilepsy.

PubMed

Cho, Eun Bin; Joo, Eun Yeon; Seo, Dae-Won; Hong, Seung-Chyul; Hong, Seung Bong

2015-01-01

To investigate the usage of functional neuroimaging as a prognostic tool for seizure recurrence and long-term outcomes in patients with multilobar resection, we recruited 90 patients who received multilobar resections between 1995 and 2013 with at least 1-year follow-up (mean 8.0 years). All patients were monitored using intracranial electroencephalography (EEG) after pre-surgical evaluation. Clinical data (demographics, electrophysiology, and neuroimaging) were reviewed retrospectively. Surgical outcomes were evaluated at 1, 2, 5 years after surgery, and at the end of the study. After 1 year, 56 patients (62.2%) became Engel class I and at the last follow-up, 47 patients (52.2%) remained seizure-free. Furthermore, non-localized 18F-fluorodeoxyglucose positron emission tomography (PET), identifying hypometabolic areas not concordant with ictal onset zones, significantly correlated with seizure recurrence after 1 year. Non-lesional magnetic resonance imaging (MRI) and left-sided resection correlated with poor outcomes. In the last follow-up, non-localized PET and left-sided resection significantly correlated with seizure recurrence. Both localized PET and ictal-interictal SPECT subtraction co-registered to MR (SISCOM) predicted good surgical outcomes in the last follow-up (69.2%, Engel I). This study suggests that PET and SISCOM may predict postoperative outcomes for patients after multilobar epilepsy and shows comparable long-term surgical outcomes after multilobar resection.

Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy

PubMed Central

Szaflarski, Jerzy P.; Gloss, David; Binder, Jeffrey R.; Gaillard, William D.; Golby, Alexandra J.; Holland, Scott K.; Ojemann, Jeffrey; Spencer, David C.; Swanson, Sara J.; French, Jacqueline A.; Theodore, William H.

2017-01-01

Objective: To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. Methods: An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded. Results and recommendations: The use of fMRI may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE; Level C), temporal epilepsy in general (Level C), or extratemporal epilepsy (Level C). For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient (Level U). fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection (Level C). The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE (Level C) but is of unclear utility in other epilepsy types (Level U). fMRI of verbal memory or language encoding should be considered for predicting verbal memory outcome (Level B). fMRI using nonverbal memory encoding may be considered for predicting visuospatial memory outcomes (Level C). Presurgical fMRI could be an adequate alternative to IAP memory testing for predicting verbal memory outcome (Level C). Clinicians should carefully advise patients of the risks and benefits of fMRI vs IAP during discussions concerning choice of specific modality in each case. PMID:28077494

Noise focusing in neuronal tissues: Symmetry breaking and localization in excitable networks with quenched disorder

NASA Astrophysics Data System (ADS)

Orlandi, Javier G.; Casademunt, Jaume

2017-05-01

We introduce a coarse-grained stochastic model for the spontaneous activity of neuronal cultures to explain the phenomenon of noise focusing, which entails localization of the noise activity in excitable networks with metric correlations. The system is modeled as a continuum excitable medium with a state-dependent spatial coupling that accounts for the dynamics of synaptic connections. The most salient feature is the emergence at the mesoscale of a vector field V (r ) , which acts as an advective carrier of the noise. This entails an explicit symmetry breaking of isotropy and homogeneity that stems from the amplification of the quenched fluctuations of the network by the activity avalanches, concomitant with the excitable dynamics. We discuss the microscopic interpretation of V (r ) and propose an explicit construction of it. The coarse-grained model shows excellent agreement with simulations at the network level. The generic nature of the observed phenomena is discussed.

Condition-specific Quality of Life Assessment at Each Stage of Class III Surgical Orthodontic Treatment -A Prospective Study.

PubMed

Tachiki, Chie; Nishii, Yasushi; Takaki, Takashi; Sueishi, Kenji

2018-01-01

Surgical orthodontic treatment has been reported to improve oral health-related quality of life (OHRQL). Such treatment comprises three stages: pre-surgical orthodontic treatment; orthognathic surgery; and post-surgical orthodontic treatment. Most studies have focused on change in OHRQL between before and after surgery. However, it is also necessary to evaluate OHRQL at the pre-surgical orthodontic treatment stage, as it may be negatively affected by dental decompensation compared with at pre-treatment. The purpose of this prospective study was to investigate the influence of surgical orthodontic treatment on QOL by assessing change in condition-specific QOL at each stage of treatment in skeletal class III cases. Twenty skeletal class III patients requiring surgical orthodontic treatment were enrolled in the study. Each patient completed the Orthognathic Quality of Life Questionnaire (OQLQ), which was developed for patients with dentofacial deformity. Its items are grouped into 4 domains: "social aspects of dentofacial deformity"; "facial esthetics"; "oral function"; and "awareness of dentofacial esthetics". The questionnaire was completed at the pre-treatment, pre-surgical orthodontic treatment, and post-surgical orthodontic treatment stages. The results revealed a significant worsening in scores between at pre-treatment and pre-surgical orthodontic treatment in the domains of facial esthetics and oral function (p<0.01), and between at pre-surgical orthodontic and post-surgical orthodontic treatment in all domains except awareness of dentofacial esthetics (p<0.05, p<0.01). A significant correlation was observed between a negative change in overjet and worsening OQLQ scores at the pre-surgical orthodontic treatment stage. Significant correlations were also observed between improvement in upper and lower lip difference, soft tissue pogonion protrusion, and ANB angle and improvement in OQLQ scores at the post-surgical orthodontic treatment stage. These results

Interrater reliability among epilepsy centers: multicenter study of epilepsy surgery.

PubMed

Haut, Sheryl R; Berg, Anne T; Shinnar, Shlomo; Cohen, Hillel W; Bazil, Carl W; Sperling, Michael R; Langfitt, John T; Pacia, Steven V; Walczak, Thaddeus S; Spencer, Susan S

2002-11-01

To measure the interrater reliability of presurgical testing and surgical decisions among epilepsy centers. Seven centers participating in an ongoing, prospective multicenter study of resective epilepsy surgery agreed to conform to a detailed protocol regarding presurgical evaluation and surgery. To assess quality assurance, each center independently reviewed 21 randomly selected surgical cases for preoperative study lateralization and localization, and surgical decisions. Interrater reliability was assessed by using intraclass correlation coefficients (ICCs), validated for use with multiple raters, and calculated in a two-way random model based on absolute agreement. Agreement for ICC values: > or = 0.75, excellent; 0.60-0.74, good; 0.40-0.59, fair; < or = 0.39, poor. One center was excluded for missing data. Agreement was excellent for extracranial EEG lateralization (0.8039), magnetic resonance imaging (MRI) lateralization (0.9521) and localization (0.9130), Wada lateralization (0.9453), and intracranial EEG localization (0.7905). Agreement was good for extracranial EEG localization (0.7384) and neuropsychological testing lateralization (0.7178) and localization (0.6891). Consensus about the decision to perform intracranial monitoring was fair (0.5397), in part reflecting one center's tendency toward intracranial monitoring. Overall agreements on whether to perform surgery (0.8311) and specific surgery recommended (0.8164) were excellent. High interrater reliability among six epilepsy centers was present for interpretation of most components of presurgical testing. Although consensus for the decision to perform intracranial monitoring was only fair, agreements for the ultimate decision about resective surgery and specific choice of resection were excellent. We believe that this study demonstrates the feasibility of implementing multicenter protocols for neurologic management, especially those involving localization, as well as protocols combining study results

Motion tracking to enable pre-surgical margin mapping in basal cell carcinoma using optical imaging modalities: initial feasibility study using optical coherence tomography

NASA Astrophysics Data System (ADS)

Duffy, M.; Richardson, T. J.; Craythorne, E.; Mallipeddi, R.; Coleman, A. J.

2014-02-01

A system has been developed to assess the feasibility of using motion tracking to enable pre-surgical margin mapping of basal cell carcinoma (BCC) in the clinic using optical coherence tomography (OCT). This system consists of a commercial OCT imaging system (the VivoSight 1500, MDL Ltd., Orpington, UK), which has been adapted to incorporate a webcam and a single-sensor electromagnetic positional tracking module (the Flock of Birds, Ascension Technology Corp, Vermont, USA). A supporting software interface has also been developed which allows positional data to be captured and projected onto a 2D dermoscopic image in real-time. Initial results using a stationary test phantom are encouraging, with maximum errors in the projected map in the order of 1-2mm. Initial clinical results were poor due to motion artefact, despite attempts to stabilise the patient. However, the authors present several suggested modifications that are expected to reduce the effects of motion artefact and improve the overall accuracy and clinical usability of the system.

High-Intensity Focused Ultrasound (HIFU) Using Sonablate-500 for the Treatment of Localized Prostate Cancer: 6-year experience

NASA Astrophysics Data System (ADS)

Uchida, Toyoaki; Shoji, Sunao; Nagata, Yoshihiro

2006-05-01

We evaluated 281 patients of localized prostate cancer treated with high-intensity focused ultrasound (HIFU) for biochemical disease-free rate, safety, morbidity and predictors of biochemical outcome. A total of 281 patients underwent HIFU with the use of Sonablate-500 and with at least 12 months of follow-up. Biochemical failure was defined according to the criteria recommended by the American Society for Therapeutic Radiology and Oncology Consensus Panel. The biochemical disease-free rates at 1, 3 and 5 years in all patients were 78%, 74% and 72%, respectively. The biochemical disease-free rates at 5 years for patients with pretreatment PSA less than 10 ng/ml, 10.01 to 20.0 ng/ml and more than 20.0 ng/ml were 88%, 70% and 17%, respectively (p<0.0001). According to multivariate analysis preoperative PSA (p<0.0001) was significant independent predictors of time to biochemical recurrence. HIFU therapy appears to be a safe and efficacious minimally invasive therapy for patients with localized prostate cancer, especially those with a pretreatment PSA level less than 20 ng/ml.

Epileptogenic zone localization using magnetoencephalography predicts seizure freedom in epilepsy surgery

PubMed Central

Englot, Dario J.; Nagarajan, Srikantan S.; Imber, Brandon S.; Raygor, Kunal P.; Honma, Susanne M.; Mizuiri, Danielle; Mantle, Mary; Knowlton, Robert C.; Kirsch, Heidi E.; Chang, Edward F.

2015-01-01

Objective The efficacy of epilepsy surgery depends critically upon successful localization of the epileptogenic zone. Magnetoencephalography (MEG) enables non-invasive detection of interictal spike activity in epilepsy, which can then be localized in three dimensions using magnetic source imaging (MSI) techniques. However, the clinical value of MEG in the pre-surgical epilepsy evaluation is not fully understood, as studies to date are limited by either a lack of long-term seizure outcomes or small sample size. Methods We performed a retrospective cohort study of focal epilepsy patients who received MEG for interictal spike mapping followed by surgical resection at our institution. Results We studied 132 surgical patients, with mean post-operative follow-up of 3.6 years (minimum 1 year). Dipole source modelling was successful in 103 (78%) patients, while no interictal spikes were seen in others. Among patients with successful dipole modelling, MEG findings were concordant with and specific to: i) the region of resection in 66% of patients, ii) invasive electrocorticography (ECoG) findings in 67% of individuals, and iii) the MRI abnormality in 74% of cases. MEG showed discordant lateralization in ~5% of cases. After surgery, 70% of all patients achieved seizure-freedom (Engel class I outcome). Whereas 85% of patients with concordant and specific MEG findings became seizure-free, this outcome was achieved by only 37% of individuals with MEG findings that were non-specific or discordant with the region of resection (χ2 = 26.4, p < 0.001). MEG reliability was comparable in patients with or without localized scalp EEG, and overall, localizing MEG findings predicted seizure freedom with an odds ratio of 5.11 (2.23–11.8, 95% CI). Significance MEG is a valuable tool for non-invasive interictal spike mapping in epilepsy surgery, including patients with non-localized findings on long-term EEG monitoring, and localization of the epileptogenic zone using MEG is associated

Usage of fMRI for pre-surgical planning in brain tumor and vascular lesion patients: Task and statistical threshold effects on language lateralization☆☆☆

PubMed Central

Nadkarni, Tanvi N.; Andreoli, Matthew J.; Nair, Veena A.; Yin, Peng; Young, Brittany M.; Kundu, Bornali; Pankratz, Joshua; Radtke, Andrew; Holdsworth, Ryan; Kuo, John S.; Field, Aaron S.; Baskaya, Mustafa K.; Moritz, Chad H.; Meyerand, M. Elizabeth; Prabhakaran, Vivek

2014-01-01

Background and purpose Functional magnetic resonance imaging (fMRI) is a non-invasive pre-surgical tool used to assess localization and lateralization of language function in brain tumor and vascular lesion patients in order to guide neurosurgeons as they devise a surgical approach to treat these lesions. We investigated the effect of varying the statistical thresholds as well as the type of language tasks on functional activation patterns and language lateralization. We hypothesized that language lateralization indices (LIs) would be threshold- and task-dependent. Materials and methods Imaging data were collected from brain tumor patients (n = 67, average age 48 years) and vascular lesion patients (n = 25, average age 43 years) who received pre-operative fMRI scanning. Both patient groups performed expressive (antonym and/or letter-word generation) and receptive (tumor patients performed text-reading; vascular lesion patients performed text-listening) language tasks. A control group (n = 25, average age 45 years) performed the letter-word generation task. Results Brain tumor patients showed left-lateralization during the antonym-word generation and text-reading tasks at high threshold values and bilateral activation during the letter-word generation task, irrespective of the threshold values. Vascular lesion patients showed left-lateralization during the antonym and letter-word generation, and text-listening tasks at high threshold values. Conclusion Our results suggest that the type of task and the applied statistical threshold influence LI and that the threshold effects on LI may be task-specific. Thus identifying critical functional regions and computing LIs should be conducted on an individual subject basis, using a continuum of threshold values with different tasks to provide the most accurate information for surgical planning to minimize post-operative language deficits. PMID:25685705

Patient Registration Using Photogrammetric Surface Reconstruction from Smartphone Imagery

NASA Astrophysics Data System (ADS)

Hellwich, O.; Rose, A.; Bien, T.; Malolepszy, C.; Mucha, D.; Krüger, T.

2016-06-01

In navigated surgery the patient's body has to be co-registered with presurgically acquired 3D data in order to enable navigation of the surgical instrument. For this purpose the body surface of the patient can be acquired by means of photogrammetry and co-registered to corresponding surfaces in the presurgical data. In this paper this task is exemplarily solved for 3D data of human heads using the face surface to establish correspondence. We focus on investigation of achieved geometric accuracies reporting positioning errors in the range of 1 mm.

MEG source localization of spatially extended generators of epileptic activity: comparing entropic and hierarchical bayesian approaches.

PubMed

Chowdhury, Rasheda Arman; Lina, Jean Marc; Kobayashi, Eliane; Grova, Christophe

2013-01-01

Localizing the generators of epileptic activity in the brain using Electro-EncephaloGraphy (EEG) or Magneto-EncephaloGraphy (MEG) signals is of particular interest during the pre-surgical investigation of epilepsy. Epileptic discharges can be detectable from background brain activity, provided they are associated with spatially extended generators. Using realistic simulations of epileptic activity, this study evaluates the ability of distributed source localization methods to accurately estimate the location of the generators and their sensitivity to the spatial extent of such generators when using MEG data. Source localization methods based on two types of realistic models have been investigated: (i) brain activity may be modeled using cortical parcels and (ii) brain activity is assumed to be locally smooth within each parcel. A Data Driven Parcellization (DDP) method was used to segment the cortical surface into non-overlapping parcels and diffusion-based spatial priors were used to model local spatial smoothness within parcels. These models were implemented within the Maximum Entropy on the Mean (MEM) and the Hierarchical Bayesian (HB) source localization frameworks. We proposed new methods in this context and compared them with other standard ones using Monte Carlo simulations of realistic MEG data involving sources of several spatial extents and depths. Detection accuracy of each method was quantified using Receiver Operating Characteristic (ROC) analysis and localization error metrics. Our results showed that methods implemented within the MEM framework were sensitive to all spatial extents of the sources ranging from 3 cm(2) to 30 cm(2), whatever were the number and size of the parcels defining the model. To reach a similar level of accuracy within the HB framework, a model using parcels larger than the size of the sources should be considered.

MEG Source Localization of Spatially Extended Generators of Epileptic Activity: Comparing Entropic and Hierarchical Bayesian Approaches

PubMed Central

Chowdhury, Rasheda Arman; Lina, Jean Marc; Kobayashi, Eliane; Grova, Christophe

2013-01-01

Localizing the generators of epileptic activity in the brain using Electro-EncephaloGraphy (EEG) or Magneto-EncephaloGraphy (MEG) signals is of particular interest during the pre-surgical investigation of epilepsy. Epileptic discharges can be detectable from background brain activity, provided they are associated with spatially extended generators. Using realistic simulations of epileptic activity, this study evaluates the ability of distributed source localization methods to accurately estimate the location of the generators and their sensitivity to the spatial extent of such generators when using MEG data. Source localization methods based on two types of realistic models have been investigated: (i) brain activity may be modeled using cortical parcels and (ii) brain activity is assumed to be locally smooth within each parcel. A Data Driven Parcellization (DDP) method was used to segment the cortical surface into non-overlapping parcels and diffusion-based spatial priors were used to model local spatial smoothness within parcels. These models were implemented within the Maximum Entropy on the Mean (MEM) and the Hierarchical Bayesian (HB) source localization frameworks. We proposed new methods in this context and compared them with other standard ones using Monte Carlo simulations of realistic MEG data involving sources of several spatial extents and depths. Detection accuracy of each method was quantified using Receiver Operating Characteristic (ROC) analysis and localization error metrics. Our results showed that methods implemented within the MEM framework were sensitive to all spatial extents of the sources ranging from 3 cm2 to 30 cm2, whatever were the number and size of the parcels defining the model. To reach a similar level of accuracy within the HB framework, a model using parcels larger than the size of the sources should be considered. PMID:23418485

Public Engagement. IDRA Focus.

ERIC Educational Resources Information Center

IDRA Newsletter, 1996

1996-01-01

This newsletter includes six articles that examine key issues facing public schools and communities related to accountability, bilingual education, immigrant education, school finance, and school choice. In addressing these issues, articles focus on the importance of community involvement and input in local school reform efforts aimed at achieving…

Systematic Review of Cognitive Function in Euthymic Bipolar Disorder and Pre-Surgical Temporal Lobe Epilepsy.

PubMed

Bostock, Emmanuelle C S; Kirkby, Kenneth C; Garry, Michael I; Taylor, Bruce V M

2017-01-01

Bipolar disorder (BD) and temporal lobe epilepsy (TLE) overlap in domains including epidemiology, treatment response, shared neurotransmitter involvement and temporal lobe pathology. Comparison of cognitive function in both disorders may indicate temporal lobe mediated processes relevant to BD. This systematic review examines neuropsychological test profiles in euthymic bipolar disorder type I (BD-I) and pre-surgical TLE and compares experimental designs used. A search of PubMed, PsychINFO, and Scopus using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines was conducted. Inclusion criteria were comparison group or pre- to post-surgical patients; reported neuropsychological tests; participants aged 18-60 years. Fifty six studies met criteria: 27 BD-I; 29 TLE. Deficits in BD-I compared to healthy controls (HC) were in executive function, attention span and verbal memory. Deficits in TLE compared to HC were in executive function and memory. In the pre- to post-surgical comparisons, verbal memory in left temporal lobe (LTL) and, less consistently, visuospatial memory in right temporal lobe (RTL) epilepsy declined following surgery. BD-I studies used comprehensive test batteries in well-defined euthymic patients compared to matched HC groups. TLE studies used convenience samples pre- to post-surgery, comparing LTL and RTL subgroups, few included comparisons to HC (5 studies). TLE studies typically examined a narrow range of known temporal lobe-mediated neuropsychological functions, particularly verbal and visuospatial memory. Both disorders exhibit deficits in executive function and verbal memory suggestive of both frontal and temporal lobe involvement. However, deficits in TLE are measured pre- to post-surgery and not controlled at baseline pre-surgery. Further research involving a head-to-head comparison of the two disorders on a broad range of neuropsychological tests is needed to clarify the nature and extent of cognitive deficits and

3D source localization of interictal spikes in epilepsy patients with MRI lesions

NASA Astrophysics Data System (ADS)

Ding, Lei; Worrell, Gregory A.; Lagerlund, Terrence D.; He, Bin

2006-08-01

indicate that FINE provides a more satisfactory fitting of the scalp potential measurements than MUSIC in all patients. The present results suggest that FINE provides a useful brain source imaging technique, from clinical EEG recordings, for identifying and localizing epileptogenic regions in epilepsy patients with focal partial seizures. The present study may lead to the establishment of a high-resolution source localization technique from scalp-recorded EEGs for aiding presurgical planning in epilepsy patients.

High-Intensity Focused Ultrasound (HIFU) Using Sonablate® Devices for the Treatment of Benign Prostatic Hyperplasia and Localized Prostate Cancer: 18-year experience

NASA Astrophysics Data System (ADS)

Uchida, Toyoaki

2011-09-01

From 1993 to 2010, we have treated 156 patients benign prostatic hyperplasia (BPH) and 1,052 patients localized prostate cancer high-intensity focused ultrasound (HIFU). Four different HIFU devices, SonablateR-200, SonablateR-500, SonablateR-500 version 4 and Sonablate® TCM, have been used for this study. Clinical outcome of HIFU for BPH did not show any superior effects to transurethral resection of the prostate, laser surgery or transurethral vapolization of the prostate. However, HIFU appears to be a safe and minimally invasive therapy for patients with localized prostate cancer, especially low- and intermediate-risk patients. The rate of clinical outcome has significantly improved over the years due to technical improvements in the device.

Presurgical language fMRI: Mapping of six critical regions

PubMed Central

Walshaw, Patricia D.; Hale, Kayleigh; Gaillard, William D.; Baxter, Leslie C.; Berl, Madison M.; Polczynska, Monika; Noble, Stephanie; Alkawadri, Rafeed; Hirsch, Lawrence J.; Constable, R. Todd; Bookheimer, Susan Y.

2017-01-01

Abstract Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language‐critical areas are now well‐known. We evaluated whether clinicians could use a novel approach, including clinician‐driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area. We studied 22 epilepsy and tumor patients who received Wada and fMRI (age 36.4[12.5]; Wada language left/right/mixed in 18/3/1). fMRI tasks (two × three tasks) were analyzed by two clinical neuropsychologists who flexibly thresholded and combined these to identify the six regions. The resulting maps were compared to fixed threshold maps. Clinicians generated maps that overlapped significantly, and were highly consistent, when at least one task came from the same set. Cases diverged when clinicians prioritized different language regions or addressed noise differently. Language laterality closely mirrored Wada data (85% accuracy). Activation consistent with all six language regions was consistently identified. In blind review, three external, independent clinicians rated the individualized fMRI language maps as superior to fixed threshold maps; identified the majority of regions significantly more frequently; and judged language laterality to mirror Wada lateralization more often. These data provide initial validation of a novel, clinician‐based approach to localizing language cortex. They also demonstrate clinical fMRI is superior when analyzed by an experienced clinician and that when fMRI data is of low quality judgments of laterality are unreliable and should be withheld. Hum Brain Mapp 38:4239–4255, 2017. © 2017 Wiley Periodicals, Inc. PMID:28544168

Source localization of rhythmic ictal EEG activity: a study of diagnostic accuracy following STARD criteria.

PubMed

Beniczky, Sándor; Lantz, Göran; Rosenzweig, Ivana; Åkeson, Per; Pedersen, Birthe; Pinborg, Lars H; Ziebell, Morten; Jespersen, Bo; Fuglsang-Frederiksen, Anders

2013-10-01

Although precise identification of the seizure-onset zone is an essential element of presurgical evaluation, source localization of ictal electroencephalography (EEG) signals has received little attention. The aim of our study was to estimate the accuracy of source localization of rhythmic ictal EEG activity using a distributed source model. Source localization of rhythmic ictal scalp EEG activity was performed in 42 consecutive cases fulfilling inclusion criteria. The study was designed according to recommendations for studies on diagnostic accuracy (STARD). The initial ictal EEG signals were selected using a standardized method, based on frequency analysis and voltage distribution of the ictal activity. A distributed source model-local autoregressive average (LAURA)-was used for the source localization. Sensitivity, specificity, and measurement of agreement (kappa) were determined based on the reference standard-the consensus conclusion of the multidisciplinary epilepsy surgery team. Predictive values were calculated from the surgical outcome of the operated patients. To estimate the clinical value of the ictal source analysis, we compared the likelihood ratios of concordant and discordant results. Source localization was performed blinded to the clinical data, and before the surgical decision. Reference standard was available for 33 patients. The ictal source localization had a sensitivity of 70% and a specificity of 76%. The mean measurement of agreement (kappa) was 0.61, corresponding to substantial agreement (95% confidence interval (CI) 0.38-0.84). Twenty patients underwent resective surgery. The positive predictive value (PPV) for seizure freedom was 92% and the negative predictive value (NPV) was 43%. The likelihood ratio was nine times higher for the concordant results, as compared with the discordant ones. Source localization of rhythmic ictal activity using a distributed source model (LAURA) for the ictal EEG signals selected with a standardized method

Pre-surgical Psychological and Neuroendocrine Predictors of Psychiatric Morbidity Following Major Vascular Surgery: A Prospective Longitudinal Study

PubMed Central

King, Anthony P.; Abelson, James L.; Gholami, Bardia; Upchurch, Gilbert R.; Henke, Peter; Graham, Linda; Liberzon, Israel

2015-01-01

Objective Major life stressors, including major surgeries, are often followed by psychiatric symptoms and disorders. Prior retrospective work found abdominal-aortic aneurysm (AAA) repair is followed by increased psychiatric morbidity, which may adversely influence physical and functional recovery. Identifying risk factors prior to surgery, such as dysregulation in stress response systems, might be useful to improving preventative intervention. Methods Two hundred and sixteen patients receiving open AAA or aortofemoral bypass (AFB) surgeries, endovascular AAA repair (EVAR), or nonsurgical AAA treatment were recruited from two vascular surgery services. Psychiatric symptoms and salivary cortisol measures (waking, 4 pm, and 11 pm, before and after low-dose dexamethasone) were obtained at intake and 3 and 9 month followups. Results Following open surgeries, 18% of patients had new psychiatric disorders, compared to 4% of patients receiving EVAR or nonsurgical treatment (odds ratio = 6.0, 95% CI 1.6 - 22.1, p=.007). Having a history of major depression predicted onset of new disorders in surgical patients. Pre-surgical cortisol levels were associated with both baseline (r=.23, p<.05) and 9 month (r=.32, p<.01) psychiatric symptoms (cortisol B=1.0, SE=0.48, p<.05 in repeated measures mixed model). Conclusion Open AAA repair surgery is prospectively linked to development of psychiatric morbidity, and history of depression elevates risk. Cortisol measures prior to surgery are associated with current and future psychological functioning, suggesting potential neurobiological mechanisms that may contribute to vulnerability. These results can help identify surgical patients at risk, and point to potential targets for risk reduction interventions. PMID:26461854

Dynamic modulation of electronic properties of graphene by localized carbon doping using focused electron beam induced deposition

NASA Astrophysics Data System (ADS)

Kim, S.; Russell, M.; Henry, M.; Kim, S. S.; Naik, R. R.; Voevodin, A. A.; Jang, S. S.; Tsukruk, V. V.; Fedorov, A. G.

2015-09-01

We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an ``n-p-n'' junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated from a low dose of high energy (25 keV) electron beam (1 × 1018 e- per cm2). Detailed AFM imaging provides direct evidence of the new mechanism responsible for dynamic evolution of the locally varying graphene doping. The FEBID carbon atoms, which are physisorbed and weakly bound to graphene, diffuse towards the middle of graphene conduction channel due to their surface chemical potential gradient, resulting in negative shift of Dirac voltage. Increasing a primary electron dose to 1 × 1019 e- per cm2 results in a significant increase of carbon deposition, such that it covers the entire graphene conduction channel at high surface density, leading to n-doping of graphene channel. Collectively, these findings establish a unique capability of FEBID technique to dynamically modulate the doping state of graphene, thus enabling a new route to resist-free, ``direct-write'' functional patterning of graphene-based electronic devices with potential for on-demand re-configurability.We report on the first demonstration of controllable carbon doping of graphene to engineer local electronic properties of a graphene conduction channel using focused electron beam induced deposition (FEBID). Electrical measurements indicate that an ``n-p-n'' junction on graphene conduction channel is formed by partial carbon deposition near the source and drain metal contacts by low energy (<50 eV) secondary electrons due to inelastic collisions of long range backscattered primary electrons generated

Proton Therapy as Salvage Treatment for Local Relapse of Prostate Cancer Following Cryosurgery or High-Intensity Focused Ultrasound

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

Holtzman, Adam L.; Hoppe, Bradford S., E-mail: bhoppe@floridaproton.org; Letter, Haley P.

Purpose: Local recurrence of prostate cancer after cryosurgery (CS) and high-intensity focused ultrasound (HIFU) is an emerging problem for which optimal management is unknown. Proton therapy (PT) may offer advantages over other local therapeutic options. This article reviews a single institution's experience using PT for salvage of local recurrent disease after HIFU or CS. Methods and Materials: We reviewed the medical records of 21 consecutive patients treated with salvage PT following a local recurrence of prostate cancer after CS (n=12) or HIFU (n=9) between January 2007 and July 2014. Patients were treated to a median dose of 74 Gy(relative biological effectivenessmore » [RBE]; range: 74-82 Gy[RBE]) and 8 patients received androgen deprivation therapy with radiation therapy. Patients were evaluated for quality of life (QOL) by using the Expanded Prostate Index Composite questionnaire and toxicity by using Common Terminology Criteria for Adverse Events, version 3.0, weekly during treatment, every 6 months for 2 years after treatment, and then annually. Results: Median follow-up was 37 months (range: 6-95 months). The 3-year biochemical progression-free survival (bPFS) rate was 77%. The 3-year grade 3 toxicity rate was 17%; however, 2 of these patients had pre-existing grade 3 GU toxicities from their HIFU/CRYO prior to PT. At 1 year, bowel summary, urinary incontinence, and urinary obstructive QOL scores declined, but only the bowel QOL score at 12 months met the minimally important difference threshold. Conclusions: PT achieved a high rate of bPFS with acceptable toxicity and minimal changes in QOL scores compared with baseline pre-PT functions. Although most patients have done fairly well, the study size is small, follow-up is short, and early results suggest that outcomes with PT for salvage after HIFU or CS failure are inferior to outcomes with PT given in the de novo setting with respect to disease control, toxicity, and QOL.« less

Preparing for Local Labor: Curricular Stratification across Local Economies in the United States

ERIC Educational Resources Information Center

Sutton, April

2017-01-01

I investigate how the educational demands of local labor markets shape high school course offerings and student course taking. Using the Education Longitudinal Study of 2002 linked to the U.S. Census 2000, I focus on local economic variation in the share of jobs that do not demand a bachelor's degree. I find that schools in local labor markets…

Noninvasive, localized, and transient brain drug delivery using focused ultrasound and microbubbles

NASA Astrophysics Data System (ADS)

Choi, James J.

In the United States, Alzheimer's disease (AD), Parkinson's disease (PD), and brain cancer caused 72,432, 19,566 and 12,886 deaths in 2006, respectively. Whereas the number of deaths due to major disorders such as heart disease, stroke, and prostate cancer have decreased since 2006, deaths attributed to AD, PD, and brain cancer have not. Treatment options for patients with CNS disorders remain limited despite significant advances in knowledge of CNS disease pathways and development of neurologically potent agents. One of the major obstacles is that the cerebral microvasculature is lined by a specialized and highly regulated blood-brain barrier (BBB) that prevents large agents from entering the brain extracellular space. The purpose of this dissertation is to design a noninvasive, localized, and transient BBB opening system using focused ultrasound (FUS) and determine ultrasound and microbubble conditions that can effectively and safely deliver large pharmacologically-relevant-sized agents to the brain. To meet this end, an in vivo mouse brain drug delivery system using a stereotactic-based targeting method was developed. FUS was applied noninvasively through the intact skin and skull, which allowed for long-term and high-throughput studies. With this system, more than 150 mice were exposed to one of 31 distinct acoustic and microbubble conditions. The feasibility of delivering a large MRI contrast agent was first demonstrated in vivo in both wild-type and transgenic Alzheimer's disease model (APP/PS1) mice. A wide range of acoustic and microbubble conditions were then evaluated for their ability to deliver agents to a target region. Interestingly, the possible design space of parameters was found to be vast and different conditions resulted in distinct spatial distributions and doses delivered. In particular, BBB opening was shown to be dependent on the microbubble diameter, acoustic pressure, pulse repetition frequency (PRF), and pulse length (PL). Each set of

Primary aberrations in focused radially polarized vortex beams

NASA Astrophysics Data System (ADS)

Biss, David P.; Brown, T. G.

2004-02-01

We study the effect of primary aberrations on the 3-D polarization of the electric field in a focused lowest order radially polarized beam. A full vector diffraction treatment of the focused beams is used. Attention is given to the effects of primary spherical, astigmatic, and comatic aberrations on the local polarization, Strehl ratio, and aberration induced degradation of the longitudinal field at focus

Presurgery resting-state local graph-theory measures predict neurocognitive outcomes after brain surgery in temporal lobe epilepsy.

PubMed

Doucet, Gaelle E; Rider, Robert; Taylor, Nathan; Skidmore, Christopher; Sharan, Ashwini; Sperling, Michael; Tracy, Joseph I

2015-04-01

This study determined the ability of resting-state functional connectivity (rsFC) graph-theory measures to predict neurocognitive status postsurgery in patients with temporal lobe epilepsy (TLE) who underwent anterior temporal lobectomy (ATL). A presurgical resting-state functional magnetic resonance imaging (fMRI) condition was collected in 16 left and 16 right TLE patients who underwent ATL. In addition, patients received neuropsychological testing pre- and postsurgery in verbal and nonverbal episodic memory, language, working memory, and attention domains. Regarding the functional data, we investigated three graph-theory properties (local efficiency, distance, and participation), measuring segregation, integration and centrality, respectively. These measures were only computed in regions of functional relevance to the ictal pathology, or the cognitive domain. Linear regression analyses were computed to predict the change in each neurocognitive domain. Our analyses revealed that cognitive outcome was successfully predicted with at least 68% of the variance explained in each model, for both TLE groups. The only model not significantly predictive involved nonverbal episodic memory outcome in right TLE. Measures involving the healthy hippocampus were the most common among the predictors, suggesting that enhanced integration of this structure with the rest of the brain may improve cognitive outcomes. Regardless of TLE group, left inferior frontal regions were the best predictors of language outcome. Working memory outcome was predicted mostly by right-sided regions, in both groups. Overall, the results indicated our integration measure was the most predictive of neurocognitive outcome. In contrast, our segregation measure was the least predictive. This study provides evidence that presurgery rsFC measures may help determine neurocognitive outcomes following ATL. The results have implications for refining our understanding of compensatory reorganization and predicting

Focal therapy for localized unifocal and multifocal prostate cancer: A prospective development study using real time MR guided focused ultrasound

NASA Astrophysics Data System (ADS)

Napoli, A.; Caliolo, G.; Boni, F.; Anzidei, M.; Catalano, C.

2017-03-01

To assess safety and feasibility of non-invasive high intensity 3T MR guided focused ultrasound (MRgFUS) treatment of localized prostate cancer in an exploratory designed study. Men aged 45-80 years were eligible for this prospective study if they had low-risk localized prostate cancer (prostate specific antigen [PSA] ≤10 ng/mL, Gleason score ≤ 3 + 3), with no previous androgen deprivation or treatment for prostate cancer, and who could safely undergo multiparametric MRI (Discovery 750, GE; Gd-Bopta, Bracco) and have a spinal anesthetic. Patients underwent focal therapy using real time MR guided high intensity focused ultrasound (MRgFUS), delivered to all known cancer lesions, with a margin of normal tissue. Primary endpoints were adverse events (serious and otherwise) and urinary symptoms and erectile function assessed using patient questionnaires. 8 men were recruited between June 2011 and June 2012. After treatment, one man was admitted to hospital for acute urinary retention. Another patient had self-resolving, mild, intermittent dysuria (median duration 5.0 days). Urinary tract infection was not reported. Urinary debris occurred in 6 men (75%), with a median duration of 12 days. Median overall International Index of Erectile Function-15 (IIEF-15) scores were similar at baseline and at 6 to 12 months (p=0.060), as were median IIEF-15 scores for intercourse satisfaction (p=0.433), sexual desire (p=0.622), and overall satisfaction (p=0.256). There was an improvement in lower urinary tract symptoms, assessed by International Prostate Symptom Score (IPSS), between baseline and 6 to 12 months (p=0.026). All 8 men with no baseline urinary incontinence were leak-free and pad-free by 9 months. No histological evidence of cancer was identified in 7 of 8 men biopsied at 6 months (87,5%); overall, the entire population (8 patients) was free of clinically significant cancer and had no evidence of disease on multi-parametric MRI at 6 to 12 months. MR guided Focused

Pre-surgical road map for thyroid cancer and large goiters: Practical benefits of detailed radiological evaluation by surgeon.

PubMed

Panchangam, Ramakanth Bhargav; Guntupalli, Satyam; Seetharamaiah, Thotakura; Kumbhar, Uday Shamrao

2015-01-01

Pre-surgical radiological evaluation of neck is often mandatory for surgical planning in high risk thyroid cancer and large goiters. Frequently, surgeons are overdependent on radiologist's report. In this context, we analysed the practical benefits of surgeon's independent radiological evaluation in our institutional experience. This prospective study was conducted in Endocrine Surgery department of a teaching hospital in South India. Cases operated between January 2011 and June 2012 (18 months) were included. Films of cross-sectional imaging were read in detail by primary and assistant surgeons in correlation with stepwise operative planning and documented. Cases with additional radiological signs on surgeon's evaluation, which were missing in radiologist's report are discussed in detail. F: M ratio is 67:24. Mean age was 45.3 ± 9.8 years (37 - 76). Forty-seven cases of thyroid cancer and 44 cases of large goiters were analysed. Surgeon read additional signs such as obliterated fat plane between goiter and subcutaneous plane; level I lymph nodes; bilateral cervical lymphadenopathy, internal jugular vein thrombus, and pharyngeal invasion helped in pre-operatively planned modification of operative steps for optimal R0 resection and total thyroidectomy. A mean of 1.42 ± 0.83 (1 - 6), additional signs were detected on surgeon's radiological evaluation compared to radiologist's report in 41.7% of cases. These findings modified the pre-operative plan, facilitating better surgical outcome in 28.6% of cases. In high-risk thyroid cancer and large goiters, detailed radiological evaluation by surgeon facilitates optimal surgical resection and superior outcome compared to radiologist report-guided surgery.

What are the health needs, familial and social problems of Thai migrants in a local community in Australia? A focus group study.

PubMed

Vatcharavongvan, Pasitpon; Hepworth, Julie; Lim, Joanne; Marley, John

2014-02-01

This study explored the health needs, familial and social problems of Thai migrants in a local community in Brisbane, Australia. Five focus groups with Thai migrants were conducted. The qualitative data were examined using thematic content analysis that is specifically designed for focus group analysis. Four themes were identified: (1) positive experiences in Australia, (2) physical health problems, (3) mental health problems, and (4) familial and social health problems. This study revealed key health needs related to chronic disease and mental health, major barriers to health service use, such as language skills, and facilitating factors, such as the Thai Temple. We concluded that because the health needs, familial and social problems of Thai migrants were complex and culture bound, the development of health and community services for Thai migrants needs to take account of the ways in which Thai culture both negatively impacts health and offer positive solutions to problems.

21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

Code of Federal Regulations, 2014 CFR

2014-04-01

... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Focused ultrasound stimulator system for aesthetic....4590 Focused ultrasound stimulator system for aesthetic use. (a) Identification. A Focused Ultrasound Stimulator System for Aesthetic Use is a device using focused ultrasound to produce localized, mechanical...

21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

Code of Federal Regulations, 2012 CFR

2012-04-01

... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Focused ultrasound stimulator system for aesthetic....4590 Focused ultrasound stimulator system for aesthetic use. (a) Identification. A Focused Ultrasound Stimulator System for Aesthetic Use is a device using focused ultrasound to produce localized, mechanical...

21 CFR 878.4590 - Focused ultrasound stimulator system for aesthetic use.

Code of Federal Regulations, 2013 CFR

2013-04-01

... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Focused ultrasound stimulator system for aesthetic....4590 Focused ultrasound stimulator system for aesthetic use. (a) Identification. A Focused Ultrasound Stimulator System for Aesthetic Use is a device using focused ultrasound to produce localized, mechanical...

Presurgical mapping of basal cell carcinoma or squamous cell carcinoma by confocal laser endomicroscopy compared to traditional micrographic surgery: a single-centre prospective feasibility study.

PubMed

Schulz, Alexandra; Daali, Samira; Javed, Mehreen; Fuchs, Paul Christian; Brockmann, Michael; Igressa, Alhadi; Charalampaki, Patra

2016-12-01

At present, no ideal diagnostic tools exist in the market to excise cancer tissue with the required safety margins and to achieve optimal aesthetic results using tissue-conserving techniques. In this prospective study, confocal laser endomicroscopy (CLE) and the traditional gold standard of magnifying glasses (MG) were compared regarding the boundaries of in vivo basal cell carcinoma and squamous cell carcinoma. Tumour diameters defined by both methods were measured and compared with those determined by histopathological examination. Nineteen patients were included in the study. The CLE technique was found to be superior to excisional margins based on MG only. Re-excision was required in 68% of the cases following excision based on MG evaluation, but only in 27% of the cases for whom excision margins were based on CLE. Our results are promising regarding the distinction between tumour and healthy surrounding tissue, and indicate that presurgical mapping of basal cell carcinoma and squamous cell carcinoma is possible. The tool itself should be developed further with special attention to early detection of skin cancer.

Localized Ablation of Thyroid Tissue by High-Intensity Focused Ultrasound: an Alternative to Surgery?

NASA Astrophysics Data System (ADS)

Esnault, Olivier; Franc, Brigitte; Chapelon, Jean-Yves; Lacoste, Francois

2006-05-01

PURPOSE: The aim of this study was to evaluate the feasibility of using a High-intensity focused ultrasound (HIFU) device to obtain a localised destruction of the thyroid with no damage to adjacent tissues. MATERIALS AND METHODS: The ewe model was used because its thyroid gland is easily accessible with ultrasound. The animals were anaesthetised with 10 mg / kg IV injection of Penthothal. The HIFU pulses were generated by a 3-MHz spherical transducer under ultrasound guidance. Macroscopic and microscopic tissue lesions were identified after formalin fixation of the anterior part of the ewe's neck. RESULTS: After determining the optimal instrument settings to obtain localized thyroid ablation, the repeatability of the method was evaluated using a HIFU prototype designed specifically for human use: in 13 ewes (26 treated lobes), an average of 20 (range: 14-27) ultrasound pulses (pulse duration: 3 s) per lobe covering a mean volume of 0.5 cm3 (range: 0.3-0.7 cm3) were delivered. The ewes were sacrificed 2-5 weeks after treatment delivery. No damage to the nerves, trachea, esophagus or muscle was observed. Only 3 ewes suffered superficial skin burns. The desired thyroid lesions were obtained in 25/26 treated lobes, as demonstrated by fibrotic tissues, which replaced necrotic areas. CONCLUSION: These results obtained in the ewe model show that thyroid lesions of defined volume can be induced safely and suggest that the HIFU device is now ready for human trials.

Health-related quality of life after salvage high-intensity focused ultrasound (HIFU) treatment for locally radiorecurrent prostate cancer.

PubMed

Berge, Viktor; Baco, Eduard; Dahl, Alv A; Karlsen, Steinar Johan

2011-09-01

To evaluate health-related quality of life (HRQOL) after salvage high-intensity focused ultrasound (HIFU) for locally radiorecurrent prostate cancer (PCa). Since June 2006 we have treated 61 patients consecutively by salvage HIFU. All patients were offered the University of California, Los Angeles Prostate Cancer Index (UCLA-PCI) questionnaire at baseline and at follow-up. Scores ranged from 0 (worst) to 100 (best). Clinically significant changes were defined as a minimum difference of 10 points between the baseline score and the score at follow-up.   Fifty-seven patients (93%) had evaluable data at baseline, compared with 46 (75%) after treatment. The mean time lapse between HIFU treatment and questionnaire response was 17.5 months (range 6-29 months). The mean score for urinary function decreased from 79.7 ± 12.1 prior to HIFU to 67.4 ± 17.8 after HIFU (P < 0.001). The mean score for sexual function decreased from 32.1 ± 24.1 prior to HIFU to 17.2 ± 17.0 after HIFU (P < 0.001). There were no significant effects on bowel function. There was a significant reduction in the mean score for Physical HRQOL, but the mean score for Mental HRQOL was did not change significantly. Treatment of localized radiorecurrent PCa by salvage HIFU is associated with clinically significant reductions in urinary and sexual function domains after a mean follow-up of 17.5 months. © 2011 The Japanese Urological Association.

Assessment of the Utility of Ictal Magnetoencephalography in the Localization of the Epileptic Seizure Onset Zone.

PubMed

Alkawadri, Rafeed; Burgess, Richard C; Kakisaka, Yosuke; Mosher, John C; Alexopoulos, Andreas V

2018-06-11

Literature on ictal magnetoencephalography (MEG) in clinical practice and the relationship to other modalities is limited because of the brevity of routine studies. To investigate the utility and reliability of ictal MEG in the localization of the epileptogenic zone. A retrospective medical record review and prospective analysis of a novel ictal rhythm analysis method was conducted at a tertiary epilepsy center with a wide base of referrals for epilepsy surgery evaluation and included consecutive cases of patients who experienced epileptic seizures during routine MEG studies from March 2008 to February 2012. A total of 377 studies screened. Data were analyzed from November 2011 to October 2015. Presurgical workup and interictal and ictal MEG data were reviewed. The localizing value of using extended-source localization of a narrow band identified visually at onset was analyzed. Of the 44 included patients, the mean (SD) age at the time of recording was 19.3 (14.9) years, and 25 (57%) were male. The mean duration of recording was 51.2 minutes. Seizures were provoked by known triggers in 3 patients and were spontaneous otherwise. Twenty-five patients (57%) had 1 seizure, 6 (14%) had 2, and 13 (30%) had 3 or more. Magnetoencephalography single equivalent current dipole analysis was possible in 29 patients (66%), of whom 8 (28%) had no clear interictal discharges. Sublobar concordance between ictal and interictal dipoles was seen in 18 of 21 patients (86%). Three patients (7%) showed clear ictal MEG patterns without electroencephalography changes. Ictal MEG dipoles correlated with the lobe of onset in 7 of 8 patients (88%) who underwent intracranial electroencephalography evaluations. Reasons for failure to identify ictal dipoles included diffuse or poor dipolar ictal patterns, no MEG changes, and movement artifact. Resection of areas containing a minimum-norm estimate of a narrow band at onset, not single equivalent current dipole, was associated with sustained

Sex education for local tourism/hospitality employees: addressing a local health need.

PubMed

Bauer, Irmgard L

2009-11-01

Health concerns arising from sexual relationships between tourists and locals usually focus on the travelling public. The local sex partners' health, and their impact on their communities' health, seem far less acknowledged. This paper describes a local health education session which implemented recommendations based on a study in Cuzco/Peru on tourists' and locals' views, knowledge, attitudes and experiences relating to sexual relationships between them. On location, fifteen discotheque employees received a health education session at the establishment's owner's request. Concluding from the positive experience, it is argued that researchers should, where possible, respond to requests to deliver ad hoc health education sessions while on location to address an identified local health need.

Functional MRI mapping of visual function and selective attention for performance assessment and presurgical planning using conjunctive visual search.

PubMed

Parker, Jason G; Zalusky, Eric J; Kirbas, Cemil

2014-03-01

Accurate mapping of visual function and selective attention using fMRI is important in the study of human performance as well as in presurgical treatment planning of lesions in or near visual centers of the brain. Conjunctive visual search (CVS) is a useful tool for mapping visual function during fMRI because of its greater activation extent compared with high-capacity parallel search processes. The purpose of this work was to develop and evaluate a CVS that was capable of generating consistent activation in the basic and higher level visual areas of the brain by using a high number of distractors as well as an optimized contrast condition. Images from 10 healthy volunteers were analyzed and brain regions of greatest activation and deactivation were determined using a nonbiased decomposition of the results at the hemisphere, lobe, and gyrus levels. The results were quantified in terms of activation and deactivation extent and mean z-statistic. The proposed CVS was found to generate robust activation of the occipital lobe, as well as regions in the middle frontal gyrus associated with coordinating eye movements and in regions of the insula associated with task-level control and focal attention. As expected, the task demonstrated deactivation patterns commonly implicated in the default-mode network. Further deactivation was noted in the posterior region of the cerebellum, most likely associated with the formation of optimal search strategy. We believe the task will be useful in studies of visual and selective attention in the neuroscience community as well as in mapping visual function in clinical fMRI.

Salvage high-intensity focused ultrasound ablation for prostate cancer local recurrence after external-beam radiation therapy: prognostic value of prostate MRI.

PubMed

Rouvière, O; Sbihi, L; Gelet, A; Chapelon, J-Y

2013-07-01

To assess the prognostic value of magnetic resonance imaging (MRI) before salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after external-beam radiotherapy (EBRT). Forty-six patients who underwent prostate MRI before salvage HIFU for locally recurrent prostate cancer after EBRT were retrospectively studied. HIFU failure was defined as a prostate-specific antigen (PSA) value >nadir + 2 ng/ml (Phoenix criteria) or positive follow-up biopsy or initiation of any other salvage therapy. The following prognostic parameters were assessed: neoadjuvant hormone therapy, clinical stage and Gleason score of recurrence, PSA level and velocity at HIFU treatment, and six MRI-derived parameters (prostate volume, tumour volume, extracapsular extension, seminal vesicle invasion, tumour extension into the apex or anterior to the urethra). Two factors were significant independent predictors of salvage HIFU failure: the PSA level at HIFU treatment (p < 0.012; risk ratio: 1.15, 95% CI: 1.03-1.29) and the tumour extension anterior to the urethra, as assessed by MRI (p = 0.046, risk ratio: 2.51, 95% CI: 1.02-6.16). The location of cancer recurrence anterior to the urethra on MRI is an independent significant predictor of salvage HIFU failure for locally recurrent prostate cancer after EBRT. Therefore, MRI may be useful for patient selection before post-EBRT salvage HIFU ablation. Copyright © 2013 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Ventilation mapping of chest using Focused Impedance Method (FIM)

NASA Astrophysics Data System (ADS)

Kadir, M. Abdul; Ferdous, Humayra; Baig, Tanvir Noor; Siddique-e-Rabbani, K.

2010-04-01

Focused Impedance Method (FIM) provides an opportunity for localized impedance measurement down to reasonable depths within the body using surface electrodes, and has a potential application in localized lung ventilation study. This however needs assessment of normal values for healthy individuals. In this study, localized ventilation maps in terms of electrical impedance in a matrix formation around the thorax, both from the front and the back, were obtained from two normal male subjects using a modified configuration of FIM. For this the focused impedance values at full inspiration and full expiration were measured and the percentage difference with respect to the latter was used. Some of the measured values would have artefacts due to movements of the heart and the diaphragm in the relevant anatomical positions which needs to be considered with due care in any interpretation.

Foil focusing of relativistic electron beams

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

Ekdahl, Jr., Carl August

2017-10-26

When an intense relativistic electron beams (IREB) passes through a grounded metal foil, the transverse electric field due to the beam space charge is locally shorted out, and the beam is focused by the magnetic field of its current. The effect can be treated as focusing by a thin lens with first order aberration. Expressions for the focal length and aberration coefficient of the equivalent thin lens are developed in this note. These are then applied to practical examples representative of IREB research at Los Alamos National Laboratory.

Neurologic outcome after thoracolumbar partial lateral corpectomy for intervertebral disc disease in 72 dogs.

PubMed

Salger, Florian; Ziegler, Luisa; Böttcher, Irene Christine; Oechtering, Gerhard; Böttcher, Peter; Flegel, Thomas

2014-07-01

To determine neurologic outcome and factors influencing outcome after thoracolumbar partial lateral corpectomy (PLC) in dogs with intervertebral disc disease (IVDD) causing ventral spinal cord compression. Retrospective case series. Dogs with IVDD (n = 72; 87 PLC). Dogs with IVDD between T9 and L5 were included if treated by at least 1 PLC. Exclusion criteria were: previous spinal surgery, combination of PLC with another surgical procedure. Neurologic outcome was assessed by: (1) modified Frankel score (MFS) based on neurologic examinations at 4 time points (before surgery, immediately after PLC, at discharge and 4 weeks after PLC); and (2) owner questionnaire. The association of the following factors with neurologic outcome was analyzed: age, body weight, duration of current neurologic dysfunction (acute, chronic), IVDD localization, breed (chondrodystrophic, nonchondrodystrophic), number of PLCs, degree of presurgical spinal cord compression and postsurgical decompression, slot depth, presurgical MFS. Presurgical spinal cord compression was determined by CT myelography (71 dogs) or MRI (1 dog), whereas postsurgical decompression and slot depth were determined on CT myelography (69 dogs). MFS was improved in 18.7%, 31.7%, and 64.2% of dogs at the 3 postsurgical assessments, whereas it was unchanged in 62.6%, 52.8%, and 32.0% at corresponding time points. Based on owner questionnaire, 91.4% of dogs were ambulatory 6 months postsurgically with 74.5% having a normal gait. Most improvement in neurologic function developed within 6 months after surgery. Presurgical MFS was the only variable significantly associated with several neurologic outcome measurements (P < .01). PLC is an option for decompression in ventrally compressing thoracolumbar IVDD. Prognosis is associated with presurgical neurologic condition. © Copyright 2014 by The American College of Veterinary Surgeons.

Experimental observation of disorder induced self-focusing in optical fibers

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

Leonetti, Marco, E-mail: marco.leonetti@roma1.infn.it; Karbasi, Salman; Mafi, Arash

2014-10-27

We observed disorder induced focusing nonlinearity activated by a monochromatic light beam in optical fibers composed by two kinds of plastics. The two materials, arranged in disordered fashion, support modes with a degree of localization which increases with the intensity of the optical beam. The temporal response of the optical fiber demonstrates the thermal origin of this nonlinearity. Measurements of the localization length as a function of the input power with broadband and monochromatic inputs show the effectiveness of focusing action with respect to the case of homogeneous fibers.

Temporal lobe origin is common in patients who have undergone epilepsy surgery for hypermotor seizures.

PubMed

Arain, Amir M; Azar, Nabil J; Lagrange, Andre H; McLean, Michael; Singh, Pradumna; Sonmezturk, Hasan; Konrad, Peter; Neimat, Joseph; Abou-Khalil, Bassel

2016-11-01

Hypermotor seizures are most often reported from the frontal lobe but may also have temporal, parietal, or insular origin. We noted a higher proportion of patients with temporal lobe epilepsy in our surgical cohort who had hypermotor seizures. We evaluated the anatomic localization and surgical outcome in patient with refractory hypermotor seizures who had epilepsy surgery in our center. We identified twenty three patients with refractory hypermotor seizures from our epilepsy surgery database. We analyzed demographics, presurgical evaluation including semiology, MRI, PET scan, interictal/ictal scalp video-EEG, intracranial recording, and surgical outcomes. We evaluated preoperative variables as predictors of outcome. Most patients (65%) had normal brain MRI. Intracranial EEG was required in 20 patients (86.9%). Based on the presurgical evaluation, the resection was anterior temporal in fourteen patients, orbitofrontal in four patients, cingulate in four patients, and temporoparietal in one patient. The median duration of follow-up after surgery was 76.4months. Fourteen patients (60%) had been seizure free at the last follow up while 3 patients had rare disabling seizures. Hypermotor seizures often originated from the temporal lobe in this series of patients who had epilepsy surgery. This large proportion of temporal lobe epilepsy may be the result of a selection bias, due to easier localization and expected better outcome in temporal lobe epilepsy. With extensive presurgical evaluation, including intracranial EEG when needed, seizure freedom can be expected in the majority of patients. Copyright © 2016. Published by Elsevier Inc.

Three-dimensional printed prototypes refine the anatomy of post-modified Norwood-1 complex aortic arch obstruction and allow presurgical simulation of the repair.

PubMed

Kiraly, Laszlo; Tofeig, Magdi; Jha, Neerod Kumar; Talo, Haitham

2016-02-01

Three-dimensional (3D) printed prototypes of malformed hearts have been used for education, communication, presurgical planning and simulation. We present a case of a 5-month old infant with complex obstruction at the neoaortic to transverse arch and descending aortic junction following the neonatal modified Norwood-1 procedure for hypoplastic left heart syndrome. Digital 3D models were created from a routine 64-slice CT dataset; then life-size solid and magnified hollow models were printed with a 3D printer. The solid model provided further insights into details of the anatomy, whereas the surgical approach and steps of the operation were simulated on the hollow model. Intraoperative assessment confirmed the anatomical accuracy of the 3D models. The operation was performed in accordance with preoperative simulation: sliding autologous flaps achieved relief of the obstruction without additional patching. Knowledge gained from the models fundamentally contributed to successful outcome and improved patient safety. This case study presents an effective use of 3D models in exploring complex spatial relationship at the aortic arch and in simulation-based planning of the operative procedure. © The Author 2015. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

High intensity focused ultrasound (HIFU).

PubMed

Barkin, Jack

2011-04-01

Curative treatments for localized prostate cancer, from least invasive to most invasive, include brachytherapy, cryosurgery, three-dimensional conformal radiation therapy, external beam radiation therapy, and radical prostatectomy. A patient with localized, low risk or intermediate risk prostate cancer who is diagnosed at an early age and receives one of these treatments has only an approximately 50% chance of maintaining an undetectable prostate-specific antigen (PSA) level, good spontaneous erections, and total continence by 5 years after treatment. This article discusses transrectal high intensity focused ultrasound (HIFU) treatment of localized prostate cancer using the Sonablate 500 (Focus Surgery, Indianapolis, IN, USA) device, which the author has adopted in favor of the Ablatherm (EDAP, TMS S. A., Lyons, France) device, the other HIFU device approved for use in Canada. Characteristics of the ideal prostate cancer include stage T1-T2b, less than 40 cc in size, and with an anterior-posterior dimension of up to 35 mm high. The anterior zone of the prostate is treated before the posterior zone. The procedure involves 2 to 3 second bursts of ultrasound energy, followed by 3 second cooling cycles. In each treatment lesion, the physician achieves a temperature of 100 C at the focal point. The device allows for real-time visualization of tissue response following the delivery of ultrasound energy. HIFU is a minimally invasive, outpatient treatment for localized prostate cancer that provides similar short term and medium term cure rates and considerably less morbidity and side effects than other treatments. Although the effectiveness of HIFU has not yet been demonstrated in large, long term studies, this treatment option should be discussed with patients who have just been diagnosed with low risk or intermediate risk prostate cancer and desire aggressive, noninvasive, curative therapy, with potentially a lower incidence of side effects compared to conventional

Patient-specific three-dimensional printing for pre-surgical planning in hepatocellular carcinoma treatment.

PubMed

Perica, Elizabeth; Sun, Zhonghua

2017-12-01

Recently, three-dimensional (3D) printing has shown great interest in medicine, and 3D printed models may be rendered as part of the pre-surgical planning process in order to better understand the complexities of an individual's anatomy. The aim of this study is to investigate the feasibility of utilising 3D printed liver models as clinical tools in pre-operative planning for resectable hepatocellular carcinoma (HCC) lesions. High-resolution contrast-enhanced computed tomography (CT) images were acquired and utilized to generate a patient-specific 3D printed liver model. Hepatic structures were segmented and edited to produce a printable model delineating intrahepatic anatomy and a resectable HCC lesion. Quantitative assessment of 3D model accuracy compared measurements of critical anatomical landmarks acquired from the original CT images, standard tessellation language (STL) files, and the 3D printed liver model. Comparative analysis of surveys completed by two radiologists investigated the clinical value of 3D printed liver models in radiology. The application of utilizing 3D printed liver models as tools in surgical planning for resectable HCC lesions was evaluated through kappa analysis of questionnaires completed by two abdominal surgeons. A scaled down multi-material 3D liver model delineating patient-specific hepatic anatomy and pathology was produced, requiring a total production time of 25.25 hours and costing a total of AUD $1,250. A discrepancy was found in the total mean of measurements at each stage of production, with a total mean of 18.28±9.31 mm for measurements acquired from the original CT data, 15.63±8.06 mm for the STL files, and 14.47±7.71 mm for the 3D printed liver model. The 3D liver model did not enhance the radiologists' perception of patient-specific anatomy or pathology. Kappa analysis of the surgeon's responses to survey questions yielded a percentage agreement of 80%, and a κ value of 0.38 (P=0.24) indicating fair agreement. Study

Pre-surgical CT-assessment of neurogenic myositis ossificans of the hip and risk factors of recurrence: a series of 101 consecutive patients.

PubMed

Law-Ye, Bruno; Hangard, Chloé; Felter, Adrien; Safa, Dominique; Denormandie, Philippe; Genet, François; Carlier, Robert-Yves

2016-10-18

Neurogenic Myositis Ossificans (NMO) is a rare disabling pathology characterized by peri-articular heterotopic ossifications following severe peripheral or central nervous system injuries. It results in ankylosis and vessels or nerves compressions. Our study aimed to describe the pre-operative findings of patients with NMO of the hip using biphasic computerized tomography (CT). Between 2006 and 2012, we retrospectively analyzed 101 consecutive patients with hip NMO. We analyzed all CTs and surgical reports following a standardized grid depicting the osteoma and its relations with joint capsule, vessels and nerves and bone mineralization. We studied surgical complications and recurrence during follow-up. Chi2-test and Fischer's test were performed to compare qualitative values with respectively normal and non-normal distribution. Quantitative values were analyzed with a one factor analysis of variance (ANOVA) test. Agreement between pre-surgical CT and surgical observations was evaluated with Cohen's kappa test. Correlation between pre-operative CT and surgical findings was excellent regarding relationships with vessels (0,82) and was good concerning relationships with sciatic nerves (0.62) and with joint capsule (0.68). Close contact or disruption of joint capsule (p = 0.005), joint space narrowing (p = 0.007) and bone demineralization (p < 0.001) were correlated with NMO recurrence. Biphasic enhanced-CT allows pre-operative assessment of NMO with good correlation to surgical observations and helps prevent surgical complications.

Policies, Local Control, and Other Antiquities.

ERIC Educational Resources Information Center

Davies, Daniel R.; And Others

1988-01-01

This bulletin focuses on the views of four authors. The first, Daniel R. Davies, describes the rise and fall of local control and local school board policies and predicts how the vacuum will be filled. Specifically, he analyzes the concomitant waning of local control and school board policymaking power and forecasts stages in the transition from…

Methods of Knowledge Exchange and Learning Focused on Local Authorities' Experiences of Flood Science Communication

ERIC Educational Resources Information Center

Stokes, Alison; Roberts, Carolyn; Crowley, Kate; McEwen, Lindsey

2015-01-01

Devastating floods in 2007 across western England resulted in legislative changes which have placed increased responsibility on local government for managing and mitigating local flood risk. For these changes to be effective, professional stakeholders need to understand fundamental concepts in flood science of which they may have no prior…

Long-term effect of presurgical nasoalveolar molding on growth of maxillary arch in unilateral cleft lip and palate: randomized controlled trial.

PubMed

Shetty, V; Agrawal, R K; Sailer, H F

2017-08-01

The objective of this study was to investigate the long-term effect of presurgical nasoalveolar molding (PNAM) on growth of the maxillary arch through early childhood until 6 years of age in complete unilateral cleft lip and palate (UCLP) patients presenting for PNAM at different ages. Complete UCLP patients who were treated at our centre were divided into two groups. The study group underwent PNAM and was further subdivided into three subgroups (PNAM initiated within 1 month, between 1 and 6 months, and between 6 and 12 months of age in subgroup I, II, and III, respectively). The control group did not undergo PNAM and was further subdivided into three subgroups. Patients were evaluated at T1 (first visit), T2 (before cheiloplasty), and T3 (at 6 years). Between T1and T2, the intersegment distance (ISD) reduced significantly in the study group but increased in the control group, whereas the intercanine width (ICW) in both the study and control groups did not show significant change. Between T2 and T3, ISD and ICW were reduced significantly in the control group due to arch collapse, whereas in the study group, ISD reduced slightly with ICW remaining almost similar to noncleft norms. We conclude that reduced ISD following PNAM improves arch symmetry and stability, and thus may prevent arch collapse in the long term. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Functional MRI mapping of visual function and selective attention for performance assessment and presurgical planning using conjunctive visual search

PubMed Central

Parker, Jason G; Zalusky, Eric J; Kirbas, Cemil

2014-01-01

Background Accurate mapping of visual function and selective attention using fMRI is important in the study of human performance as well as in presurgical treatment planning of lesions in or near visual centers of the brain. Conjunctive visual search (CVS) is a useful tool for mapping visual function during fMRI because of its greater activation extent compared with high-capacity parallel search processes. Aims The purpose of this work was to develop and evaluate a CVS that was capable of generating consistent activation in the basic and higher level visual areas of the brain by using a high number of distractors as well as an optimized contrast condition. Materials and methods Images from 10 healthy volunteers were analyzed and brain regions of greatest activation and deactivation were determined using a nonbiased decomposition of the results at the hemisphere, lobe, and gyrus levels. The results were quantified in terms of activation and deactivation extent and mean z-statistic. Results The proposed CVS was found to generate robust activation of the occipital lobe, as well as regions in the middle frontal gyrus associated with coordinating eye movements and in regions of the insula associated with task-level control and focal attention. As expected, the task demonstrated deactivation patterns commonly implicated in the default-mode network. Further deactivation was noted in the posterior region of the cerebellum, most likely associated with the formation of optimal search strategy. Conclusion We believe the task will be useful in studies of visual and selective attention in the neuroscience community as well as in mapping visual function in clinical fMRI. PMID:24683515

Therapeutic gymnastics in comprehensive treatment of patients with generalized myasthenia

NASA Technical Reports Server (NTRS)

Kapelovich, R. L.

1980-01-01

The technique of therapeutic gymnastics was used for patients with mayasthenia gravis to control the consequences of hypodynamia induced by the myasthenic process. It is concluded that during myasthenia, the severity of the disease is due to the affection of the cross striated musculature. The most life threatening are the disorders in respiration and swallowing, that can be intensified by forced stay in bed and immobility. It is also concluded that the use of therapeutic gymnastics in patients which myasthenia promotes efficient presurgical preparation, and in the post surgical period; prevention of pulmonary complications and normalization of respiration. Therapeutic gymnastics with regard to the severity and localization of the myasthenic disorders must be a component part of the presurgical preparation and postsurgical management of patients with generalized myasthenia.

Local modifications of magnetism and structure in FePt (001) epitaxial thin films by focused ion beam: Two-dimensional perpendicular patterns

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

Albertini, F.; Nasi, L.; Casoli, F.

Focused ion beam was utilized to locally modify magnetism and structure of L1{sub 0} FePt perpendicular thin films. As a first step, we have performed a magnetic, morphological, and structural study of completely irradiated FePt films with different Ga{sup +} doses (1x10{sup 13} -4x10{sup 16} ions/cm{sup 2}) and ion beam energy of 30 keV. For doses of 1x10{sup 14} ions/cm{sup 2} and above a complete transition from the ordered L1{sub 0} to the disordered A1 phase was found to occur, resulting in a drop of magnetic anisotropy and in the consequent moment reorientation from out-of-plane to in-plane. The lowest effectivemore » dose in disordering the structure (1x10{sup 14} ions/cm{sup 2}) was found not to affect the film morphology. Taking advantage of these results, continuous two-dimensional (2D) patterns of perpendicular magnetic structures (250 nm dots, 1 {mu}m dots, 1 {mu}m-large stripes) were produced by focused ion beam without affecting the morphology. The 2D patterns were revealed by means of magnetic force microscopy, that evidenced peculiar domain structures in the case of 1 {mu}m dots.« less

Locally Appropriate Energy Strategies for the Developing World: A focus on Clean Energy Opportunities in Borneo

NASA Astrophysics Data System (ADS)

Shirley, Rebekah Grace

This dissertation focuses on an integration of energy modeling tools to explore energy transition pathways for emerging economies. The spate of growth in the global South has led to a global energy transition, evidenced in part by a surge in the development of large scale energy infrastructure projects for the provision of reliable electricity service. The rational of energy security and exigency often usher these large scale projects through to implementation with minimal analysis of costs: social and environmental impact, ecological risk, or opportunity costs of alternative energy transition pathways foregone. Furthermore, development of energy infrastructure is inherently characterized by the involvement of a number of state and non-state actors, with varying interests, objectives and access to authority. Being woven through and into social institutions necessarily impacts the design, control and functionality of infrastructure. In this dissertation I therefore conceptualize energy infrastructure as lying at the intersection, or nexus, of people, the environment and energy security. I argue that energy infrastructure plans and policy should, and can, be informed by each of these fields of influence in order to appropriately satisfy local development needs. This case study explores the socio-techno-environmental context of contemporary mega-dam development in northern Borneo. I describe the key actors of an ongoing mega-dam debate and the constellation of their interaction. This highlights the role that information may play in public discourse and lends insight into how inertia in the established system may stymie technological evolution. I then use a combination of power system simulation, ecological modeling and spatial analysis to analyze the potential for, and costs and tradeoffs of, future energy scenarios. In this way I demonstrate reproducible methods that can support energy infrastructure decision making by directly addressing data limitation barriers. I

Promoting Creativity in Local Tourist Businesses

ERIC Educational Resources Information Center

Perivoliotis-Chryssovergis, Margaret-Catherine

2007-01-01

This paper discusses an e-learning pilot study focusing on local tourist producers and businesses involved in the production of artefacts, mainly textiles. The project included research into the possibilities of incorporating the strengths of local cultural heritage as a vital starting point for design creativity, innovation, production and…

Etomidate accurately localizes the epileptic area in patients with temporal lobe epilepsy.

PubMed

Pastor, Jesús; Wix, Rybel; Meilán, María Luisa; Martínez-Chacón, José Luís; de Dios, Eva; Domínguez-Gadea, Luis; Herrera-Peco, Iván; Sola, Rafael G

2010-04-01

A variety of drugs have been used to activate and identify the epileptogenic area in patients during presurgical evaluation. We have evaluated the safety and usefulness of etomidate in identifying the epileptic zone by measuring bioelectrical brain activity and cerebral blood flow (CBF). We studied 13 men and 9 women under presurgical evaluation for temporal lobe epilepsy. We applied etomidate (0.1 mg/kg) while patients were monitored by video-electroencephalography (VEEG) with foramen ovale electrodes. In a subset of 15 patients, we also measured CBF with single photon emission computed tomography (SPECT). (1) Etomidate induced seizures in 2 of 22 patients. (2) The main side-effects observed were myoclonus (14 of 20) and moderate pain (3 of 20). (3) No changes in capillary oxygen saturation, respiration, or heart rate were observed. (4) Irritative activity specifically increased in the temporal mesial and lateral areas. No spikes were observed in other areas, aside from those observed under baseline conditions. (5) Irritative activity induced by etomidate correctly lateralized the ictal onset zone in 19 of 20 patients. In addition, the two etomidate-induced seizures appeared in the same regions as spontaneous ones. (6) The kinetics of pharmacologically induced activity was higher in the region of the ictal-onset zone. (7) Etomidate increased the CBF in the basal ganglia and especially in the posterior hippocampus of the temporal mesial region contralateral to the ictal-onset zone. Etomidate activation is a safe, specific, and quick test that can be used to identify the epileptic region in patients evaluated as candidates for temporal lobe epilepsy surgery.

Localism: The Changing Picture for Adult Learning

ERIC Educational Resources Information Center

Lamb, Penny

2012-01-01

The rapidly changing picture on localism and the government's focus on local economic growth have significant implications for adult learning and skills providers in England. Government now sees a sense of place as key to economic growth and recognises the need for a renewed debate on how business and state interact with localities. There is a…

Characterization of long-range functional connectivity in epileptic networks by neuronal spike-triggered local field potentials

NASA Astrophysics Data System (ADS)

Lopour, Beth A.; Staba, Richard J.; Stern, John M.; Fried, Itzhak; Ringach, Dario L.

2016-04-01

Objective. Quantifying the relationship between microelectrode-recorded multi-unit activity (MUA) and local field potentials (LFPs) in distinct brain regions can provide detailed information on the extent of functional connectivity in spatially widespread networks. These methods are common in studies of cognition using non-human animal models, but are rare in humans. Here we applied a neuronal spike-triggered impulse response to electrophysiological recordings from the human epileptic brain for the first time, and we evaluate functional connectivity in relation to brain areas supporting the generation of seizures. Approach. Broadband interictal electrophysiological data were recorded from microwires adapted to clinical depth electrodes that were implanted bilaterally using stereotactic techniques in six presurgical patients with medically refractory epilepsy. MUA and LFPs were isolated in each microwire, and we calculated the impulse response between the MUA on one microwire and the LFPs on a second microwire for all possible MUA/LFP pairs. Results were compared to clinical seizure localization, including sites of seizure onset and interictal epileptiform discharges. Main results. We detected significant interictal long-range functional connections in each subject, in some cases across hemispheres. Results were consistent between two independent datasets, and the timing and location of significant impulse responses reflected anatomical connectivity. However, within individual subjects, the spatial distribution of impulse responses was unique. In two subjects with clear seizure localization and successful surgery, the epileptogenic zone was associated with significant impulse responses. Significance. The results suggest that the spike-triggered impulse response can provide valuable information about the neuronal networks that contribute to seizures using only interictal data. This technique will enable testing of specific hypotheses regarding functional connectivity

Characterization of long-range functional connectivity in epileptic networks by neuronal spike-triggered local field potentials

PubMed Central

Lopour, Beth A; Staba, Richard J; Stern, John M; Fried, Itzhak; Ringach, Dario L

2017-01-01

Objective Quantifying the relationship between microelectrode-recorded multi-unit activity (MUA) and local field potentials (LFPs) in distinct brain regions can provide detailed information on the extent of functional connectivity in spatially widespread networks. These methods are common in studies of cognition using non-human animal models, but are rare in humans. Here we applied a neuronal spike-triggered impulse response to electrophysiological recordings from the human epileptic brain for the first time, and we evaluate functional connectivity in relation to brain areas supporting the generation of seizures. Approach Broadband interictal electrophysiological data were recorded from microwires adapted to clinical depth electrodes that were implanted bilaterally using stereotactic techniques in six presurgical patients with medically refractory epilepsy. MUA and LFPs were isolated in each microwire, and we calculated the impulse response between the MUA on one microwire and the LFPs on a second microwire for all possible MUA/LFP pairs. Results were compared to clinical seizure localization, including sites of seizure onset and interictal epileptiform discharges. Main results We detected significant interictal long-range functional connections in each subject, in some cases across hemispheres. Results were consistent between two independent datasets, and the timing and location of significant impulse responses reflected anatomical connectivity. However, within individual subjects, the spatial distribution of impulse responses was unique. In two subjects with clear seizure localization and successful surgery, the epileptogenic zone was associated with significant impulse responses. Significance The results suggest that the spike-triggered impulse response can provide valuable information about the neuronal networks that contribute to seizures using only interictal data. This technique will enable testing of specific hypotheses regarding functional connectivity in

MR-guided adaptive focusing of ultrasound

PubMed Central

Larrat, Benoît; Pernot, Mathieu; Montaldo, Gabriel; Fink, Mathias; Tanter, Mickaël

2010-01-01

Adaptive focusing of ultrasonic waves under the guidance of a Magnetic Resonance (MR) system is demonstrated for medical applications. This technique is based on the maximization of the ultrasonic wave intensity at one targeted point in space. The wave intensity is indirectly estimated from the local tissue displacement induced at the chosen focus by the acoustic radiation force of ultrasonic beams. Coded ultrasonic waves are transmitted by an ultrasonic array and an MRI scanner is used to measure the resulting local displacements through a motion sensitive MR sequence. After the transmission of a set of spatially encoded ultrasonic waves, a non iterative inversion process is employed to accurately estimate the spatial-temporal aberration induced by the propagation medium and to maximize the acoustical intensity at the target. Both programmable and physical aberrating layers introducing strong distortions (up to 2π radians) were recovered within acceptable errors (<0.8 rad). This non invasive technique is shown to accurately correct phase aberrations in a phantom gel with negligible heat deposition and limited acquisition time. These refocusing performances demonstrate a major potential in the field of MR-Guided Ultrasound Therapy in particular for transcranial brain HIFU. PMID:20704061

Researching, Writing, and Publishing Local History.

ERIC Educational Resources Information Center

Felt, Thomas E.

The book provides practical guidelines for the layman who is interested in researching, writing, and publishing local history. Two standards considered to be essential to the writing of local history are ethics and competence. The three aspects of competence which are discussed focus on researching, writing, and publishing. Chapter I identifies…

Active Presurgical Infant Orthopedics for Unilateral Cleft Lip and Palate: Intercenter Outcome Comparison of Latham, Modified McNeil, and Nasoalveolar Molding.

PubMed

Kornbluth, Michelle; Campbell, Richard E; Daskalogiannakis, John; Ross, Elizabeth J; Glick, Patricia H; Russell, Kathleen A; Doucet, Jean-Charles; Hathaway, Ronald R; Long, Ross E; Sitzman, Thomas J

2018-05-01

To compare dental arch relationship, craniofacial form, and nasolabial aesthetic outcomes among cleft centers using distinct methods of presurgical infant orthopedics (PSIO). Retrospective cohort study. Four cleft centers in North America. One hundred ninety-one children with repaired complete unilateral cleft lip and palate (CUCLP). Dental arch relationship was assessed using the GOSLON Yardstick. Craniofacial form was assessed by 12 cephalometric measurements. Nasolabial aesthetics were assessed using the Asher-McDade system. Assessments were performed between 6 and 12 years of age. The center that used no PSIO achieved the most favorable dental arch relationship and maxillomandibular relationship, with a median GOSLON score of 2.3 ( P < .01) and an ANB angle of 5.1° ( P < .05). The proportion of children assigned a GOSLON score of 4 or 5, predictive of the need for orthognathic surgery in adolescence, was 16% at the center that used no PSIO and no secondary surgery, compared to 76% at the centers that used the Latham appliance and early secondary lip and nose surgery ( P < .01). The center that used no PSIO and no secondary surgery achieved significantly less favorable nasolabial aesthetic outcomes than the centers using Latham appliance or nasoalveolar molding (NAM) ( P < .01). Effects of active PSIO are multifaceted and intertwined with use of revision surgery. In our study, centers using either the Latham appliance combined with early revision surgery or the NAM appliance without revision surgery achieved better nasolabial aesthetic outcomes but worse maxillary growth, compared to a center using no PSIO and secondary surgery.

Effects of pre-surgical nasoalveolar moulding on maxillary arch and nasal form in unilateral cleft lip and palate before lip surgery.

PubMed

Fuchigami, T; Kimura, N; Kibe, T; Tezuka, M; Amir, M S; Suga, H; Takemoto, Y; Hashiguchi, M; Maeda-Iino, A; Nakamura, N

2017-11-01

To investigate the effects of pre-surgical nasoalveolar moulding (PNAM) on the maxillary arch and nasal form in patients with unilateral cleft lip and palate (UCLP). This is a retrospective case series study. The subjects were infants with complete UCLP who were treated with PNAM (n = 18) at Kagoshima University Medical and Dental Hospital (Japan) between 2006 and 2013. Maxillary dental casts and facial photographs were taken at the time of the first visit and immediately prior to lip surgery to evaluate the maxillary arch and nasal form changes. The dental casts were scanned with a laser scanner, and changes in the 3-Dimensional coordinates of anatomical landmarks and alveolar cleft width were analysed. Moreover, we investigated the correlation between the changes in the maxillary alveolar arch and nasal form. Regarding the maxillary alveolar arch form, the anterior points of the major segment had moved significantly to the cleft side just prior to the time of lip repair, and the alveolar cleft width was significantly decreased. For nasal form, the inclination and displacement of the columella were significantly improved. The improvement of columella inclination was moderately correlated with the posterior movement of the anterior points of the major segment. These findings indicate that PNAM for infants with UCLP enhanced symmetry in the maxillary alveolar arch and nasolabial form. In addition, the posterior movement of the anterior points of the maxillary alveolar arch was correlated with the improvement of columella deformation. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Teaching Local History.

ERIC Educational Resources Information Center

Singer, Alan, Ed.

2003-01-01

This Social Science Docket theme issue focuses on teaching local history and included theme and non-themed articles, lesson plans, learning activities, and book, movie, and museum reviews designed for K-12 social studies teachers. Articles and materials in this issue are: "Editing Is Not Censorship" (Alan Singer); "Teachers Respond…

Activation of signaling pathways following localized delivery of systemically administered neurotrophic factors across the blood-brain barrier using focused ultrasound and microbubbles

NASA Astrophysics Data System (ADS)

Baseri, Babak; Choi, James J.; Deffieux, Thomas; Samiotaki, Gesthimani; Tung, Yao-Sheng; Olumolade, Oluyemi; Small, Scott A.; Morrison, Barclay, III; Konofagou, Elisa E.

2012-04-01

The brain-derived neurotrophic factor (BDNF) has been shown to have broad neuroprotective effects in addition to its therapeutic role in neurodegenerative disease. In this study, the efficacy of delivering exogenous BDNF to the left hippocampus is demonstrated in wild-type mice (n = 7) through the noninvasively disrupted blood-brain barrier (BBB) using focused ultrasound (FUS). The BDNF bioactivity was found to be preserved following delivery as assessed quantitatively by immunohistochemical detection of the pTrkB receptor and activated pAkt, pMAPK, and pCREB in the hippocampal neurons. It was therefore shown for the first time that systemically administered neurotrophic factors can cross the noninvasively disrupted BBB and trigger neuronal downstream signaling effects in a highly localized region in the brain. This is the first time that the administered molecule is tracked through the BBB and localized in the neuron triggering molecular effects. Additional preliminary findings are shown in wild-type mice with two additional neurotrophic factors such as the glia-derived neurotrophic factor (n = 12) and neurturin (n = 2). This further demonstrates the impact of FUS for the early treatment of CNS diseases at the cellular and molecular level and strengthens its premise for FUS-assisted drug delivery and efficacy.

The value of magnetoencephalography for seizure-onset zone localization in magnetic resonance imaging-negative partial epilepsy

PubMed Central

Bouet, Romain; Delpuech, Claude; Ryvlin, Philippe; Isnard, Jean; Guenot, Marc; Bertrand, Olivier; Hammers, Alexander; Mauguière, François

2013-01-01

-free. As a whole, patients having focal magnetoencephalography results with volumetric imaging of epileptic spikes are good surgical candidates and the implantation strategy should incorporate volumetric imaging of epileptic spikes results. On the contrary, patients with non-focal magnetoencephalography results are less likely to have a localized seizure-onset zone and stereo electroencephalography is not advised unless clear localizing information is provided by other presurgical investigation methods. PMID:24014520

The value of magnetoencephalography for seizure-onset zone localization in magnetic resonance imaging-negative partial epilepsy.

PubMed

Jung, Julien; Bouet, Romain; Delpuech, Claude; Ryvlin, Philippe; Isnard, Jean; Guenot, Marc; Bertrand, Olivier; Hammers, Alexander; Mauguière, François

2013-10-01

-free. As a whole, patients having focal magnetoencephalography results with volumetric imaging of epileptic spikes are good surgical candidates and the implantation strategy should incorporate volumetric imaging of epileptic spikes results. On the contrary, patients with non-focal magnetoencephalography results are less likely to have a localized seizure-onset zone and stereo electroencephalography is not advised unless clear localizing information is provided by other presurgical investigation methods.

Multichannel interictal spike activity detection using time-frequency entropy measure.

PubMed

Thanaraj, Palani; Parvathavarthini, B

2017-06-01

Localization of interictal spikes is an important clinical step in the pre-surgical assessment of pharmacoresistant epileptic patients. The manual selection of interictal spike periods is cumbersome and involves a considerable amount of analysis workload for the physician. The primary focus of this paper is to automate the detection of interictal spikes for clinical applications in epilepsy localization. The epilepsy localization procedure involves detection of spikes in a multichannel EEG epoch. Therefore, a multichannel Time-Frequency (T-F) entropy measure is proposed to extract features related to the interictal spike activity. Least squares support vector machine is used to train the proposed feature to classify the EEG epochs as either normal or interictal spike period. The proposed T-F entropy measure, when validated with epilepsy dataset of 15 patients, shows an interictal spike classification accuracy of 91.20%, sensitivity of 100% and specificity of 84.23%. Moreover, the area under the curve of Receiver Operating Characteristics plot of 0.9339 shows the superior classification performance of the proposed T-F entropy measure. The results of this paper show a good spike detection accuracy without any prior information about the spike morphology.

Maxillary growth after the use of protraction head gear in conjunction with presurgical orthopedics and gingivoperiosteoplasty for complete bilateral cleft lip and alveolus patients.

PubMed

Kobayashi, Shinji; Hirakawa, Takashi; Fukawa, Toshihiko; Maegawa, Jiro

2013-09-01

Maxillary development is often inadequate in bilateral cleft patients. The use of presurgical orthopedics (PSO) and gingivoperiosteoplasty (GPP) may promote bone formation at the alveolar cleft, but can also have detrimental effects on maxillary development. Our objective was to investigate the effect of PSO and GPP on maxillary development in bilateral cleft lip and alveolus (BCLA) patients. We had 3 complete BCLA patients who had received PSO. All patients underwent cheiloplasty and GPP simultaneously. At 4 years, maxillary protraction head gear was used as part of the protocol. They were evaluated by cephalometric analysis at 4 and 8 years of age, and by CT imaging at 5 years of age. At 4 years of age, patients with all BCLA had anterior crossbite of deciduous central incisors. As a result of maxillary protraction, jaw development at 8 years was good. Among all patients, only one showed bone formation at the alveolar cleft sufficient to avoid alveolar bone grafting (ABG). All patients presented anterior crossbite in the premaxillary region, but had good maxillary growth at 8 years old as a result of maxillary protraction. The combination of PSO and GPP can potentially eliminate the need for ABG and does not significantly retard maxillary development. PSO with GPP and protraction head gear may be an option, but long-term growth is not known.

Detail and gestalt focus in individuals with optimal outcomes from autism spectrum disorders.

PubMed

Fitch, Allison; Fein, Deborah A; Eigsti, Inge-Marie

2015-06-01

Individuals with high-functioning autism (HFA) have a cognitive style that privileges local over global or gestalt details. While not a core symptom of autism, individuals with HFA seem to reliably show this bias. Our lab has been studying a sample of children who have overcome their early ASD diagnoses, showing "optimal outcomes" (OO). This study characterizes performance by OO, HFA, and typically developing (TD) adolescents as they describe paintings under cognitive load. Analyses of detail focus in painting descriptions indicated that the HFA group displayed significantly more local focus than both OO and TD groups, while the OO and TD groups did not differ. We discuss implications for the centrality of detail focus to the autism diagnosis.

Release of Cell-free MicroRNA Tumor Biomarkers into the Blood Circulation with Pulsed Focused Ultrasound: A Noninvasive, Anatomically Localized, Molecular Liquid Biopsy

PubMed Central

Chevillet, John R.; Khokhlova, Tatiana D.; Giraldez, Maria D.; Schade, George R.; Starr, Frank; Wang, Yak-Nam; Gallichotte, Emily N.; Wang, Kai; Hwang, Joo Ha

2017-01-01

Purpose To compare the abilities of three pulsed focused ultrasound regimes (that cause tissue liquefaction, permeabilization, or mild heating) to release tumor-derived microRNA into the circulation in vivo and to evaluate release dynamics. Materials and Methods All rat experiments were approved by the University of Washington Institutional Animal Care and Use Committee. Reverse-transcription quantitative polymerase chain reaction array profiling was used to identify candidate microRNA biomarkers in a rat solid tumor cell line. Rats subcutaneously grafted with these cells were randomly assigned among three pulsed focused ultrasound treatment groups: (a) local tissue liquefaction via boiling histotripsy, (b) tissue permeabilization via inertial cavitation, and (c) mild (<10°C) heating of tissue, as well as a sham-treated control group. Blood specimens were drawn immediately prior to treatment and serially over 24 hours afterward. Plasma microRNA was quantified with reverse-transcription quantitative polymerase chain reaction, and statistical significance was determined with one-way analysis of variance (Kruskal-Wallis and Friedman tests), followed by the Dunn multiple-comparisons test. Results After tissue liquefaction and cavitation treatments (but not mild heating), plasma quantities of candidate biomarkers increased significantly (P value range, <.0001 to .04) relative to sham-treated controls. A threefold to 32-fold increase occurred within 15 minutes after initiation of pulsed focused ultrasound tumor treatment, and these increases persisted for 3 hours. Histologic examination confirmed complete liquefaction of the targeted tumor area with boiling histotripsy, in addition to areas of petechial hemorrhage and tissue disruption by means of cavitation-based treatment. Conclusion Mechanical tumor tissue disruption with pulsed focused ultrasound–induced bubble activity significantly increases the plasma abundance of tumor-derived microRNA rapidly after treatment

Breast Cancer Diagnosis Using Ultrasound and Diffusive Light

DTIC Science & Technology

2004-08-01

been widely used in clinical studies. The fundamental problem remains the intense light scattering in tissue, which makes the lesion localization...Our 3 unique approach may have significant clinical applications on 1) breast cancer diagnosis; and 2) assessing treatment response and estimating...the response of cancers to presurgical chemotherapy are not completely understood [20]. Although recent trials reported clinical response rates >70

Fifteen-Year Follow-Up Results of Presurgical Orthopedics Followed by Primary Correction for Unilateral Cleft Lip Nose in Program SEHATI in Indonesia.

PubMed

Sulaiman, Farida Kamil; Haryanto, Inge Gustiningsih; Hak, Syafrudin; Nakamura, Norifumi; Sasaguri, Masaaki; Ohishi, Masamichi

2013-03-01

Objective : To assess long-term effects of nasal correction in infancy on nasal form and growth in patients with unilateral cleft lip, alveolus, and palate (UCLP). Design : Retrospective longitudinal study. Patients : Seventeen patients with complete UCLP treated in Program SEHATI in Harapan Kita Children and Maternity Hospital, Indonesia, and followed for approximately 15 years were enrolled. Interventions : Subjects received presurgical orthopedics using a Hotz's plate and simultaneous primary lip and nose repair in which the lower lateral cartilage was repositioned through a reverse-U incision. Main Outcome Measures : Preoperative and postoperative nasal forms, including the nostril height and width ratio, the ratio of the height of the top of the alar groove, and the ratio of nostril surface areas were analyzed using color photos taken serially. One-way analysis of variance was used for statistical analyses. Results : The nostril height and width ratio and the height of the alar groove were significantly improved postoperatively and maintained for 15 years. The mean ratio of nostril surface areas was 1.01 ± 0.12 fifteen years postoperatively, and there was no significant difference from the ratio 1 year postoperatively. The major persistent deformities were septal deviation and a small skin web on the nostril rim. Conclusions : Our primary cleft lip nose correction has provided an acceptable nose form and absence of disturbance of the nasal growth in patients with UCLP. However, the repositioning of the nasal cartilage at infancy might not eliminate the need for secondary correction after puberty.

Dual-color multiple-particle tracking at 50-nm localization and over 100-µm range in 3D with temporal focusing two-photon microscopy

PubMed Central

Ding, Yu; Li, Chunqiang

2016-01-01

Nanoscale particle tracking in three dimensions is crucial to directly observe dynamics of molecules and nanoparticles in living cells. Here we present a three-dimensional particle tracking method based on temporally focused two-photon excitation. Multiple particles are imaged at 30 frames/s in volume up to 180 × 180 × 100 µm3. The spatial localization precision can reach 50 nm. We demonstrate its capability of tracking fast swimming microbes at speed of ~200 µm/s. Two-photon dual-color tracking is achieved by simultaneously exciting two kinds of fluorescent beads at 800 nm to demonstrate its potential in molecular interaction studies. Our method provides a simple wide-field fluorescence imaging approach for deep multiple-particle tracking. PMID:27867724

Shifting the Focus of Validity for Test Use

ERIC Educational Resources Information Center

Moss, Pamela A.

2016-01-01

The conventional focus of validity in educational measurement has been on intended interpretations and uses of test scores. Empirical studies of test use by teachers, administrators and policy-makers show that actual interpretations and uses of test scores in context are invariably shaped by local users' questions, which frequently require…

Identifying the role of initial wave parameters on tsunami focusing

NASA Astrophysics Data System (ADS)

Aydın, Baran

2018-04-01

Unexpected local tsunami amplification, which is referred to as tsunami focusing, is attributed to two different mechanisms: bathymetric features of the ocean bottom such as underwater ridges and dipolar shape of the initial wave itself. In this study, we characterize the latter; that is, we explore how amplitude and location of the focusing point vary with certain geometric parameters of the initial wave such as its steepness and crest length. Our results reveal two important features of tsunami focusing: for mild waves maximum wave amplitude increases significantly with transverse length of wave crest, while location of the focusing point is almost invariant. For steep waves, on the other hand, increasing crest length dislocates focusing point significantly, while it causes a rather small increase in wave maximum.

MR Anatomy of Deep Brain Nuclei with Special Reference to Specific Diseases and Deep Brain Stimulation Localization

PubMed Central

Telford, Ryan; Vattoth, Surjith

2014-01-01

Summary Diseases affecting the basal ganglia and deep brain structures vary widely in etiology and include metabolic, infectious, ischemic, and neurodegenerative conditions. Some neurologic diseases, such as Wernicke encephalopathy or pseudohypoparathyroidism, require specific treatments, which if unrecognized could lead to further complications. Other pathologies, such as hypertrophic olivary degeneration, if not properly diagnosed may be mistaken for a primary medullary neoplasm and create unnecessary concern. The deep brain structures are complex and can be difficult to distinguish on routine imaging. It is imperative that radiologists first understand the intrinsic anatomic relationships between the different basal ganglia nuclei and deep brain structures with magnetic resonance (MR) imaging. It is important to understand the "normal" MR signal characteristics, locations, and appearances of these structures. This is essential to recognizing diseases affecting the basal ganglia and deep brain structures, especially since most of these diseases result in symmetrical, and therefore less noticeable, abnormalities. It is also crucial that neurosurgeons correctly identify the deep brain nuclei presurgically for positioning deep brain stimulator leads, the most important being the subthalamic nucleus for Parkinson syndromes and the thalamic ventral intermediate nucleus for essential tremor. Radiologists will be able to better assist clinicians in diagnosis and treatment once they are able to accurately localize specific deep brain structures. PMID:24571832

The Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF): incremental validity in predicting early postoperative outcomes in spine surgery candidates.

PubMed

Marek, Ryan J; Block, Andrew R; Ben-Porath, Yossef S

2015-03-01

A substantial proportion of individuals who undergo surgical procedures to relieve spine pain continue to report significant pain and dysfunction after recovery. Psychopathology and patient expectations have been linked to poor results, leading to an increasing reliance on presurgical psychological screening (PPS) as part of the surgical diagnostic process. The original Minnesota Multiphasic Personality Inventory (MMPI; Hathaway & McKinley, 1943) and the MMPI-2 (Butcher, Graham, Ben-Porath, Tellegen, & Dahlstrom, 2001) were among the measures most commonly used in PPS evaluations and research. This study focuses on the newest version of the test, the MMPI-2-Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008/2011; Tellegen & Ben-Porath, 2008/2011) as a predictor of outcomes for spine surgery candidates. Using a sample of 172 men and 210 women who underwent a PPS, we examined the ability of MMPI-2-RF scale scores to predict early surgical outcomes independent of other presurgical risk factors identified by other means, as well as patients' presurgical expectations. MMPI-2-RF results accounted for up to 11% of additional variance in measures of early postoperative functioning. MMPI-2-RF scales that assess for emotional/internalizing problems, specifically Demoralization, measures of somatoform dysfunction, and interpersonal problems contributed most to the prediction of diminished outcome. 2015 APA, all rights reserved

Functional magnetic resonance imaging.

PubMed

Buchbinder, Bradley R

2016-01-01

Functional magnetic resonance imaging (fMRI) maps the spatiotemporal distribution of neural activity in the brain under varying cognitive conditions. Since its inception in 1991, blood oxygen level-dependent (BOLD) fMRI has rapidly become a vital methodology in basic and applied neuroscience research. In the clinical realm, it has become an established tool for presurgical functional brain mapping. This chapter has three principal aims. First, we review key physiologic, biophysical, and methodologic principles that underlie BOLD fMRI, regardless of its particular area of application. These principles inform a nuanced interpretation of the BOLD fMRI signal, along with its neurophysiologic significance and pitfalls. Second, we illustrate the clinical application of task-based fMRI to presurgical motor, language, and memory mapping in patients with lesions near eloquent brain areas. Integration of BOLD fMRI and diffusion tensor white-matter tractography provides a road map for presurgical planning and intraoperative navigation that helps to maximize the extent of lesion resection while minimizing the risk of postoperative neurologic deficits. Finally, we highlight several basic principles of resting-state fMRI and its emerging translational clinical applications. Resting-state fMRI represents an important paradigm shift, focusing attention on functional connectivity within intrinsic cognitive networks. © 2016 Elsevier B.V. All rights reserved.

Interictal High Frequency Oscillations Detected with Simultaneous Magnetoencephalography and Electroencephalography as Biomarker of Pediatric Epilepsy

PubMed Central

Papadelis, Christos; Tamilia, Eleonora; Stufflebeam, Steven; Grant, Patricia E.; Madsen, Joseph R.; Pearl, Phillip L.; Tanaka, Naoaki

2016-01-01

Crucial to the success of epilepsy surgery is the availability of a robust biomarker that identifies the Epileptogenic Zone (EZ). High Frequency Oscillations (HFOs) have emerged as potential presurgical biomarkers for the identification of the EZ in addition to Interictal Epileptiform Discharges (IEDs) and ictal activity. Although they are promising to localize the EZ, they are not yet suited for the diagnosis or monitoring of epilepsy in clinical practice. Primary barriers remain: the lack of a formal and global definition for HFOs; the consequent heterogeneity of methodological approaches used for their study; and the practical difficulties to detect and localize them noninvasively from scalp recordings. Here, we present a methodology for the recording, detection, and localization of interictal HFOs from pediatric patients with refractory epilepsy. We report representative data of HFOs detected noninvasively from interictal scalp EEG and MEG from two children undergoing surgery. The underlying generators of HFOs were localized by solving the inverse problem and their localization was compared to the Seizure Onset Zone (SOZ) as this was defined by the epileptologists. For both patients, Interictal Epileptogenic Discharges (IEDs) and HFOs were localized with source imaging at concordant locations. For one patient, intracranial EEG (iEEG) data were also available. For this patient, we found that the HFOs localization was concordant between noninvasive and invasive methods. The comparison of iEEG with the results from scalp recordings served to validate these findings. To our best knowledge, this is the first study that presents the source localization of scalp HFOs from simultaneous EEG and MEG recordings comparing the results with invasive recordings. These findings suggest that HFOs can be reliably detected and localized noninvasively with scalp EEG and MEG. We conclude that the noninvasive localization of interictal HFOs could significantly improve the

Detail and gestalt focus in individuals with optimal outcomes from Autism Spectrum Disorders

PubMed Central

Fitch, Allison; Fein, Deborah A.; Eigsti, Inge-Marie

2015-01-01

Individuals with high-functioning autism (HFA) have a cognitive style that privileges local over global or gestalt details. While not a core symptom of autism, individuals with HFA seem to reliably show this bias. Our lab has been studying a sample of children who have overcome their early ASD diagnoses, showing “optimal outcomes” (OO). This study characterizes performance by OO, HFA, and typically developing (TD) adolescents as they describe paintings under cognitive load. Analyses of detail focus in painting descriptions indicated that the HFA group displayed significantly more local focus than both OO and TD groups, while the OO and TD groups did not differ. We discuss implications for the centrality of detail focus to the autism diagnosis. PMID:25563455

Direct Exploration of the Role of the Ventral Anterior Temporal Lobe in Semantic Memory: Cortical Stimulation and Local Field Potential Evidence From Subdural Grid Electrodes

PubMed Central

Shimotake, Akihiro; Matsumoto, Riki; Ueno, Taiji; Kunieda, Takeharu; Saito, Satoru; Hoffman, Paul; Kikuchi, Takayuki; Fukuyama, Hidenao; Miyamoto, Susumu; Takahashi, Ryosuke; Ikeda, Akio; Lambon Ralph, Matthew A.

2015-01-01

Semantic memory is a crucial higher cortical function that codes the meaning of objects and words, and when impaired after neurological damage, patients are left with significant disability. Investigations of semantic dementia have implicated the anterior temporal lobe (ATL) region, in general, as crucial for multimodal semantic memory. The potentially crucial role of the ventral ATL subregion has been emphasized by recent functional neuroimaging studies, but the necessity of this precise area has not been selectively tested. The implantation of subdural electrode grids over this subregion, for the presurgical assessment of patients with partial epilepsy or brain tumor, offers the dual yet rare opportunities to record cortical local field potentials while participants complete semantic tasks and to stimulate the functionally identified regions in the same participants to evaluate the necessity of these areas in semantic processing. Across 6 patients, and utilizing a variety of semantic assessments, we evaluated and confirmed that the anterior fusiform/inferior temporal gyrus is crucial in multimodal, receptive, and expressive, semantic processing. PMID:25491206

Direct Exploration of the Role of the Ventral Anterior Temporal Lobe in Semantic Memory: Cortical Stimulation and Local Field Potential Evidence From Subdural Grid Electrodes.

PubMed

Shimotake, Akihiro; Matsumoto, Riki; Ueno, Taiji; Kunieda, Takeharu; Saito, Satoru; Hoffman, Paul; Kikuchi, Takayuki; Fukuyama, Hidenao; Miyamoto, Susumu; Takahashi, Ryosuke; Ikeda, Akio; Lambon Ralph, Matthew A

2015-10-01

Semantic memory is a crucial higher cortical function that codes the meaning of objects and words, and when impaired after neurological damage, patients are left with significant disability. Investigations of semantic dementia have implicated the anterior temporal lobe (ATL) region, in general, as crucial for multimodal semantic memory. The potentially crucial role of the ventral ATL subregion has been emphasized by recent functional neuroimaging studies, but the necessity of this precise area has not been selectively tested. The implantation of subdural electrode grids over this subregion, for the presurgical assessment of patients with partial epilepsy or brain tumor, offers the dual yet rare opportunities to record cortical local field potentials while participants complete semantic tasks and to stimulate the functionally identified regions in the same participants to evaluate the necessity of these areas in semantic processing. Across 6 patients, and utilizing a variety of semantic assessments, we evaluated and confirmed that the anterior fusiform/inferior temporal gyrus is crucial in multimodal, receptive, and expressive, semantic processing. © The Author 2014. Published by Oxford University Press.

Closure of a local public hospital in Korea: focusing on the organizational life cycle

PubMed Central

Yeo, Young Hyun; Lee, Keon-Hyung; Kim, Hye Jeong

2016-01-01

Just as living organisms have a creation-maintenance-extinction life cycle, organizations also have a life cycle. Private organizations will not survive if they fail to acquire necessary resources through market competition. Public organizations, however, continue to survive because the government has provided financial support in order to enhance public interest. Only a few public organizations in Korea have closed. With the introduction of new public management since the economic crisis in 1997, however, public organizations have had to compete with private organizations. Public hospitals are not free to open or close their business. They are also controlled by the government in terms of their prices, management, budgets, and operations. As they pursue public interest by fulfilling the government’s order such as providing free or lower-priced care to the vulnerable population, they tend to provide a lower quality of care and suffer a financial burden. Employing a case study analysis, this study attempts to understand the external environment that local public hospitals face. The fundamental problem of local public hospitals in Korea is the value conflict between public interest and profitability. Local public hospitals are required to pursue public interest by assignment of a public mission including building a medical safety net for low-income patients and managing nonprofitable medical facilities and emergent health care situations. At the same time, they are required to pursue profitability by achieving high-quality care through competition and the operation of an independent, self-supporting system according to private business logic. Under such paradoxical situations, a political decision may cause an unexpected result. PMID:29355194

Closure of a local public hospital in Korea: focusing on the organizational life cycle.

PubMed

Yeo, Young Hyun; Lee, Keon-Hyung; Kim, Hye Jeong

2016-01-01

Just as living organisms have a creation-maintenance-extinction life cycle, organizations also have a life cycle. Private organizations will not survive if they fail to acquire necessary resources through market competition. Public organizations, however, continue to survive because the government has provided financial support in order to enhance public interest. Only a few public organizations in Korea have closed. With the introduction of new public management since the economic crisis in 1997, however, public organizations have had to compete with private organizations. Public hospitals are not free to open or close their business. They are also controlled by the government in terms of their prices, management, budgets, and operations. As they pursue public interest by fulfilling the government's order such as providing free or lower-priced care to the vulnerable population, they tend to provide a lower quality of care and suffer a financial burden. Employing a case study analysis, this study attempts to understand the external environment that local public hospitals face. The fundamental problem of local public hospitals in Korea is the value conflict between public interest and profitability. Local public hospitals are required to pursue public interest by assignment of a public mission including building a medical safety net for low-income patients and managing nonprofitable medical facilities and emergent health care situations. At the same time, they are required to pursue profitability by achieving high-quality care through competition and the operation of an independent, self-supporting system according to private business logic. Under such paradoxical situations, a political decision may cause an unexpected result.

Clinical responses to focused ultrasound applied to women with vulval intraepithelial neoplasia.

PubMed

Jia, Ying; Wu, Jin; Xu, Man; Tang, Liangdan; Li, Chengzhi; Luo, Ming; Lou, Meng

2014-11-01

Focused ultrasound waves penetrate superficial tissues and are aimed toward the target tissues at specific depths to exert their biological effects. Focused ultrasound has been applied for a number of clinical indications, including vulval dystrophies and low-grade vulval disease. This study aimed to assess the efficacy and safety of focused ultrasound treatment of high-grade vulval intraepithelial neoplasia (VIN). Eighteen women with high-grade VIN were recruited and treated with focused ultrasound. During each posttreatment follow-up, the safety of, side effects of, and clinical responses to focused ultrasound were evaluated by a standardized protocol, including symptoms, clinical appearance, and histologic findings. All patients completed the designed follow-ups. In most cases, superficial mild to moderate swelling and blisters were seen in the focused ultrasound-treated skin but not in adjacent normal skin. Of the 18 patients, 16 showed complete histologic regression and resolution of symptoms 6 months after treatment. Of the other 2 patients, 1 showed complete regression after a second focused ultrasound treatment. The other patient did not respond to the focused ultrasound treatment and underwent a partial vulvectomy 6 months after treatment. None of the patients developed invasive carcinoma of the vulva during the follow-up period. One patient had local pruritus that was not alleviated by anti-inflammatory medication and local care. The complete responses observed in women with high-grade VIN treated by focused ultrasound, together with the preservation of adjacent normal tissue, suggest that focused ultrasound may be considered for treatment of high-grade VIN. © 2014 by the American Institute of Ultrasound in Medicine.

Social representations of climate change in Swedish lay focus groups: local or distant, gradual or catastrophic?

PubMed

Wibeck, Victoria

2014-02-01

This paper explores social representations of climate change, investigating how climate change is discussed by Swedish laypeople interacting in focus group interviews. The analysis focuses on prototypical examples and metaphors, which were key devices for objectifying climate change representations. The paper analyzes how the interaction of focus group participants with other speakers, ideas, arguments, and broader social representations shaped their representations of climate change. Climate change was understood as a global but distant issue with severe consequences. There was a dynamic tension between representations of climate change as a gradual vs. unpredictable process. Implications for climate change communication are discussed.

Twelve years' experience with high-intensity focused ultrasound (HIFU) using sonablate™ devices for the treatment of localized prostate cancer

NASA Astrophysics Data System (ADS)

Uchida, Toyoaki; Nakano, Muyura; Shoji, Sunao; Nagata, Yoshihiro; Usui, Yukio; Terachi, Toshiro

2012-10-01

To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Patients with clinical Stage T1c-T3N0M0, biopsy proven, localized prostate cancer, with a serum prostate specific antigen (PSA) level of <30 ng/ml, any Gleason score were included. All patients underwent HIFU using the Sonablate™ (S) device and were required to have a minimal follow-up of 2 years after the last HIFU session to be included in this analysis. Four different generation HIFU devices, S200, S500, S500 version 4 and S500 TCM, have been used for this study. Biochemical failure was defined according to the Phoenix definition (PSA nadir+2ng/ml). Seven hundred and fifty-three men with prostate cancer were included. The patients were divided into two groups: in the Former group, 421 patients were treated with S200 and 500 from 1990 to 2005; in the Latter group, 332 patients were treated with S500 ver. 4 and TCM from 2005 to 2009. The mean age, PSA, Gleason score, operation time, and follow-up period in the Former and Latter groups were 68 and 67 years, 11.3 and 9.7 ng/ml, 6.2 and 6.6, 167 and 101 min, and 49 and 38 months, respectively. The biochemical disease-free rate (BDFR) in the groups at 5 years was, respectively, 67% and 53%, and was 50% at 10 years in the Former group (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Former group at 5 and 10 years were 68% and 65%, 52% and 48%, and 43% and 40%, respectively (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the Latter group at 5 years were 83%, 76%, and 42% (p<0.0001). The negative prostate biopsy rate in the Former and Latter groups was 81% and 93%, respectively. Postoperative erectile dysfunction was noted in 45%, 38%, and 24% of patients at 6 months, 12 months, and 2 years after HIFU. The results after long-term follow-up have indicated that HIFU is an efficient and safe treatment for patients with

Salvage high-intensity focused ultrasound (HIFU) for locally recurrent prostate cancer after failed radiation therapy: Multi-institutional analysis of 418 patients.

PubMed

Crouzet, Sebastien; Blana, Andreas; Murat, Francois J; Pasticier, Gilles; Brown, Stephen C W; Conti, Giario N; Ganzer, Roman; Chapet, Olivier; Gelet, Albert; Chaussy, Christian G; Robertson, Cary N; Thuroff, Stefan; Ward, John F

2017-06-01

To report the oncological outcome of salvage high-intensity focused ultrasound (S-HIFU) for locally recurrent prostate cancer after external beam radiotherapy (EBRT) from a multicentre database. This retrospective study comprises patients from nine centres with local recurrent disease after EBRT treated with S-HIFU from 1995 to 2009. The biochemical failure-free survival (bFFS) rate was based on the 'Phoenix' definition (PSA nadir + 2 ng/mL). Secondary endpoints included progression to metastasis and cancer-specific death. Kaplan-Meier analysis was performed examining overall (OS), cancer-specific (CSS) and metastasis-free survival (MFS). Adverse events and quality of life status are reported. In all, 418 patients with a mean (SD) follow-up of 3.5 (2.5) years were included. The mean (SD) age was 68.6 (5.8) years and the PSA level before S-HIFU was 6.8 (7.8) ng/mL. The median PSA nadir after S-HIFU was 0.19 ng/mL. The OS, CSS and MFS rates at 7 years were 72%, 82% and 81%, respectively. At 5 years the bFFS rate was 58%, 51% and 36% for pre-EBRT low-, intermediate- and high-risk patients, respectively. The 5-year bFFS rate was 67%, 42% and 22% for pre-S-HIFU PSA level ≤4, 4-10 and ≥10 ng/mL, respectively. Complication rates decreased after the introduction of specific post-RT parameters: incontinence (grade II or III) from 32% to 19% (P = 0.002); bladder outlet obstruction or stenosis from 30% to 15% (P = 0.003); recto-urethral fistula decreased from 9% to 0.6% (P < 0.001). Study limitations include being a retrospective analysis from a registry with no control group. S-HIFU for locally recurrent prostate cancer after failed EBRT is associated with 7-year CSS and MFS rates of >80% at a price of significant morbidity. S-HIFU should be initiated early following EBRT failure. © 2017 The Authors BJU International © 2017 BJU International Published by John Wiley & Sons Ltd.

Keeping It Local: Incorporating a Local Case Study in the Business Curriculum

ERIC Educational Resources Information Center

Johnson, Larry Alan; Helms, Marilyn M.

2008-01-01

Purpose: The purpose of this article is to evaluate the inclusion of team case analyses and presentations in undergraduate finance courses that usually focus on analyzing provided financial statement data. Design/methodology/approach: In this paper the authors argue the early use of a local company case can illustrate key course concepts while…

State and Local Government Publications.

ERIC Educational Resources Information Center

Nakata, Yuri; Kopec, Karen

1980-01-01

Reviews trends in library programs for state and local government publications and documents the increased interest in microforms and databases. Discussion focuses on publication distribution and control, and efforts to support interstate networking. There are 28 references. (RAA)

Flat-Lens Focusing of Electron Beams in Graphene

PubMed Central

Tang, Yang; Cao, Xiyuan; Guo, Ran; Zhang, Yanyan; Che, Zhiyuan; Yannick, Fouodji T.; Zhang, Weiping; Du, Junjie

2016-01-01

Coupling electron beams carrying information into electronic units is fundamental in microelectronics. This requires precision manipulation of electron beams through a coupler with a good focusing ability. In graphene, the focusing of wide electron beams has been successfully demonstrated by a circular p-n junction. However, it is not favorable for information coupling since the focal length is so small that the focal spot locates inside the circular gated region, rather than in the background region. Here, we demonstrate that an array of gate-defined quantum dots, which has gradually changing lattice spacing in the direction transverse to propagation, can focus electrons outside itself, providing a possibility to make a coupler in graphene. The focusing effect can be understood as due to the gradient change of effective refractive indices, which are defined by the local energy band in a periodic potential. The strong focusing can be achieved by suitably choosing the lattice gradient and the layer number in the incident direction, offering an effective solution to precision manipulation of electron beams with wide electron energy range and high angular tolerance. PMID:27628099

Fast focus estimation using frequency analysis in digital holography.

PubMed

Oh, Seungtaik; Hwang, Chi-Young; Jeong, Il Kwon; Lee, Sung-Keun; Park, Jae-Hyeung

2014-11-17

A novel fast frequency-based method to estimate the focus distance of digital hologram for a single object is proposed. The focus distance is computed by analyzing the distribution of intersections of smoothed-rays. The smoothed-rays are determined by the directions of energy flow which are computed from local spatial frequency spectrum based on the windowed Fourier transform. So our method uses only the intrinsic frequency information of the optical field on the hologram and therefore does not require any sequential numerical reconstructions and focus detection techniques of conventional photography, both of which are the essential parts in previous methods. To show the effectiveness of our method, numerical results and analysis are presented as well.

A dual-mode hemispherical sparse array for 3D passive acoustic mapping and skull localization within a clinical MRI guided focused ultrasound device

NASA Astrophysics Data System (ADS)

Crake, Calum; Brinker, Spencer T.; Coviello, Christian M.; Livingstone, Margaret S.; McDannold, Nathan J.

2018-03-01

Previous work has demonstrated that passive acoustic imaging may be used alongside MRI for monitoring of focused ultrasound therapy. However, past implementations have generally made use of either linear arrays originally designed for diagnostic imaging or custom narrowband arrays specific to in-house therapeutic transducer designs, neither of which is fully compatible with clinical MR-guided focused ultrasound (MRgFUS) devices. Here we have designed an array which is suitable for use within an FDA-approved MR-guided transcranial focused ultrasound device, within the bore of a 3 Tesla clinical MRI scanner. The array is constructed from 5  ×  0.4 mm piezoceramic disc elements arranged in pseudorandom fashion on a low-profile laser-cut acrylic frame designed to fit between the therapeutic elements of a 230 kHz InSightec ExAblate 4000 transducer. By exploiting thickness and radial resonance modes of the piezo discs the array is capable of both B-mode imaging at 5 MHz for skull localization, as well as passive reception at the second harmonic of the therapy array for detection of cavitation and 3D passive acoustic imaging. In active mode, the array was able to perform B-mode imaging of a human skull, showing the outer skull surface with good qualitative agreement with MR imaging. Extension to 3D showed the array was able to locate the skull within  ±2 mm/2° of reference points derived from MRI, which could potentially allow registration of a patient to the therapy system without the expense of real-time MRI. In passive mode, the array was able to resolve a point source in 3D within a  ±10 mm region about each axis from the focus, detect cavitation (SNR ~ 12 dB) at burst lengths from 10 cycles to continuous wave, and produce 3D acoustic maps in a flow phantom. Finally, the array was used to detect and map cavitation associated with microbubble activity in the brain in nonhuman primates.

Local shear stress and its correlation with local volume fraction in concentrated non-Brownian suspensions: Lattice Boltzmann simulation

NASA Astrophysics Data System (ADS)

Lee, Young Ki; Ahn, Kyung Hyun; Lee, Seung Jong

2014-12-01

The local shear stress of non-Brownian suspensions was investigated using the lattice Boltzmann method coupled with the smoothed profile method. Previous studies have only focused on the bulk rheology of complex fluids because the local rheology of complex fluids was not accessible due to technical limitations. In this study, the local shear stress of two-dimensional solid particle suspensions in Couette flow was investigated with the method of planes to correlate non-Newtonian fluid behavior with the structural evolution of concentrated particle suspensions. Shear thickening was successfully captured for highly concentrated suspensions at high particle Reynolds number, and both the local rheology and local structure of the suspensions were analyzed. It was also found that the linear correlation between the local particle stress and local particle volume fraction was dramatically reduced during shear thickening. These results clearly show how the change in local structure of suspensions influences the local and bulk rheology of the suspensions.

Youth Violence: Developing Local and State Solutions. Hearings before the Subcommittee on Youth Violence of the Committee on the Judiciary. United States Senate, One Hundred Fourth Congress, Second Session on Focusing on Youth Violence and Developing Local and State Solutions (Memphis and Nashville, TN, February 15 and 16, 1996).

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on the Judiciary.

This hearing focused on youth violence and the importance of developing local and state solutions. Senator Fred Thompson made an introductory statement. This was followed by four panels on each of 2 days of testimony. Day one's first panel included involved students and business people from Memphis, TN. The second panel included two Tennessee…

Cranioplasty using presurgically fabricated presterilised polymethyl methacrylate plate by a simple, cost-effective technique on patients with and without original bone flap: study on 29 patients.

PubMed

Sharavanan, G M; Jayabalan, Suresh; Rajasukumaran, K; Veerasekar, Ganesh; Sathya, G

2015-06-01

The purpose of the study was to assess the clinical effectiveness of presurgically fabricated pre-sterilized polymethyl methacrylate (PMMA) plate as a cranioplasty material. The study group consisted of 29 patients with skull defect following decompressive craniectomy. Some patients had their original bone flap preserved and some were without it. In either group pre-sterilized prefabricated PMMA plate was used. On each visit, patients were clinically assessed; CT scans were taken in immediate follow up period but if needed more films were taken in subsequent follow ups. Post-op complications that include infection, post-op hematoma, chronic pain, aesthetic, biocompatibility, post-op dimensional changes of prosthesis were evaluated. Mean follow up was 7 1/2 months. Five patients developed swelling and pain in the subsequent follow ups. One patient was treated conservatively with antibiotics. Tapping was performed in couple of patients. Surgical evacuation of hematoma was performed in one patient. Of the five infected plates, one demanded removal from the patient. One complained of chronic pain. Post-op follow up assessed clinically and by CT scan confirmed good aesthetic result, biocompatibility and dimensional stability of prosthesis. The result of this study support the view that the use of prefabricated pre-sterilized PMMA plate as cranioplasty material is a simple, reliable, convenient way that brings acceptable function and aesthetics to patients who underwent decompressive craniectomy, in an inexpensive way.

American Schools and the Future of Local Control.

ERIC Educational Resources Information Center

Doyle, Denis P.; Finn, Chester E., Jr.

1984-01-01

Analyzes the concept of local control against a background of rising state control. Focuses on school funding, equity, the excellence movement, and diversity and proposes a statewide educational voucher system. Concludes that the traditional conception of local control must be updated, but that school-level control is essential to improving…

Knitting Local History Together: Collaborating To Construct Curriculum.

ERIC Educational Resources Information Center

Black, Mary S.; Blake, Marie E.

2001-01-01

Discusses a collaboration among an educator, a historical archaeologist, and a historian in order to create a local history curriculum that focuses on the life of African Americans on a Texas farm. Discusses how the curriculum was actually developed focusing on the role of the three team members. (CMK)

Parents' Views on Preschool Care and Education in Local Community

ERIC Educational Resources Information Center

Devjak, Tatjana; Bercnik, Sanja

2009-01-01

In this text, the authors are analyzing preschool care and education in local community. They are focusing on the problem of information transfer between the kindergarten, parents and local community, as well as the model of relationship participation. Cooperation between parents, kindergarten and local community is an important element in the…

EpiTools, A software suite for presurgical brain mapping in epilepsy: Intracerebral EEG.

PubMed

Medina Villalon, S; Paz, R; Roehri, N; Lagarde, S; Pizzo, F; Colombet, B; Bartolomei, F; Carron, R; Bénar, C-G

2018-06-01

In pharmacoresistant epilepsy, exploration with depth electrodes can be needed to precisely define the epileptogenic zone. Accurate location of these electrodes is thus essential for the interpretation of Stereotaxic EEG (SEEG) signals. As SEEG analysis increasingly relies on signal processing, it is crucial to make a link between these results and patient's anatomy. Our aims were thus to develop a suite of software tools, called "EpiTools", able to i) precisely and automatically localize the position of each SEEG contact and ii) display the results of signal analysis in each patient's anatomy. The first tool, GARDEL (GUI for Automatic Registration and Depth Electrode Localization), is able to automatically localize SEEG contacts and to label each contact according to a pre-specified nomenclature (for instance that of FreeSurfer or MarsAtlas). The second tool, 3Dviewer, enables to visualize in the 3D anatomy of the patient the origin of signal processing results such as rate of biomarkers, connectivity graphs or Epileptogenicity Index. GARDEL was validated in 30 patients by clinicians and proved to be highly reliable to determine within the patient's individual anatomy the actual location of contacts. GARDEL is a fully automatic electrode localization tool needing limited user interaction (only for electrode naming or contact correction). The 3Dviewer is able to read signal processing results and to display them in link with patient's anatomy. EpiTools can help speeding up the interpretation of SEEG data and improving its precision. Copyright © 2018 Elsevier B.V. All rights reserved.

Localized Down-regulation of P-glycoprotein by Focused Ultrasound and Microbubbles induced Blood-Brain Barrier Disruption in Rat Brain

NASA Astrophysics Data System (ADS)

Cho, Hongseok; Lee, Hwa-Youn; Han, Mun; Choi, Jong-Ryul; Ahn, Sanghyun; Lee, Taekwan; Chang, Yongmin; Park, Juyoung

2016-08-01

Multi-drug resistant efflux transporters found in Blood-Brain Barrier (BBB) acts as a functional barrier, by pumping out most of the drugs into the blood. Previous studies showed focused ultrasound (FUS) induced microbubble oscillation can disrupt the BBB by loosening the tight junctions in the brain endothelial cells; however, no study was performed to investigate its impact on the functional barrier of the BBB. In this study, the BBB in rat brains were disrupted using the MRI guided FUS and microbubbles. The immunofluorescence study evaluated the expression of the P-glycoprotein (P-gp), the most dominant multi-drug resistant protein found in the BBB. Intensity of the P-gp expression at the BBB disruption (BBBD) regions was significantly reduced (63.2 ± 18.4%) compared to the control area. The magnitude of the BBBD and the level of the P-gp down-regulation were significantly correlated. Both the immunofluorescence and histologic analysis at the BBBD regions revealed no apparent damage in the brain endothelial cells. The results demonstrate that the FUS and microbubbles can induce a localized down-regulation of P-gp expression in rat brain. The study suggests a clinically translation of this method to treat neural diseases through targeted delivery of the wide ranges of brain disorder related drugs.

News focus: Report on state and local air toxics regulatory strategies published by STAPPA/ALAPCO (State and Territorial Air Pollution Program Administrators/Association of Local Air Pollution Control Officials)

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

Not Available

1989-12-01

The report is entitled Toxic Air Pollutants: State and Local Regulatory Strategies - 1989. The 364-page report is the result of a survey of state and local air pollution control agencies, which solicited information on their programs to control air toxics. According to the survey, every state currently has a program to address emissions of air toxics. Additionally, 27 of the 40 local agencies that responded to the survey have, or are developing, air toxics programs. The strategies employed by state and local agencies vary widely, including control technology requirements, risk assessment, acceptable ambient guidelines, or a combination of thesemore » approaches. This is a report summarizing the air toxics control programs currently implemented (or under development) by state and local air pollution control agencies throughout the US. The report is based upon a survey of all 50 states and 220 local air pollution control agencies conducted by the State and Territorial Air Pollution Program Administrators (STAPPA) and the Association of Local Air Pollution Control Officials (ALAPCO). This survey updates one published five years earlier.« less

Gamma knife treatment for refractory epilepsy in seizure focus localized by positron emission tomography/CT★

PubMed Central

Bai, Xia; Wang, Xuemei; Wang, Hongwei; Zhao, Shigang; Han, Xiaodong; Hao, Linjun; Wang, Xiangcheng

2012-01-01

A total of 80 patients with refractory epilepsy were recruited from the Inner Mongolia Medical College Affiliated Hospital. The foci of 60% of the patients could be positioned using a combined positron emission tomography/CT imaging modality. Hyper- and hypometabolism foci were examined as part of this study. Patients who had abnormal metabolism in positron emission tomography/CT imaging were divided into intermittent-phase group and the seizure-phase group. The intermittent-phase group was further divided into a single-focus group and a multiple-foci group according to the number of seizure foci detected by imaging. Following gamma knife treatment, seizure frequency was significantly lower in the intermittent-phase group and the seizure-phase group. Wieser’s classification reached Grade I or II in nearly 40% of patients. Seizure frequency was significantly lower following treatment, but Wieser’s classification score was significantly higher in the seizure-phase group compared with the intermittent-phase group. Seizure frequency was significantly lower following treatment in the single-focus group, but Wieser’s classification score was significantly higher in the single-focus group as compared with the multiple-foci group. PMID:25317147

Local Anesthetic-Induced Neurotoxicity

PubMed Central

Verlinde, Mark; Hollmann, Markus W.; Stevens, Markus F.; Hermanns, Henning; Werdehausen, Robert; Lirk, Philipp

2016-01-01

This review summarizes current knowledge concerning incidence, risk factors, and mechanisms of perioperative nerve injury, with focus on local anesthetic-induced neurotoxicity. Perioperative nerve injury is a complex phenomenon and can be caused by a number of clinical factors. Anesthetic risk factors for perioperative nerve injury include regional block technique, patient risk factors, and local anesthetic-induced neurotoxicity. Surgery can lead to nerve damage by use of tourniquets or by direct mechanical stress on nerves, such as traction, transection, compression, contusion, ischemia, and stretching. Current literature suggests that the majority of perioperative nerve injuries are unrelated to regional anesthesia. Besides the blockade of sodium channels which is responsible for the anesthetic effect, systemic local anesthetics can have a positive influence on the inflammatory response and the hemostatic system in the perioperative period. However, next to these beneficial effects, local anesthetics exhibit time and dose-dependent toxicity to a variety of tissues, including nerves. There is equivocal experimental evidence that the toxicity varies among local anesthetics. Even though the precise order of events during local anesthetic-induced neurotoxicity is not clear, possible cellular mechanisms have been identified. These include the intrinsic caspase-pathway, PI3K-pathway, and MAPK-pathways. Further research will need to determine whether these pathways are non-specifically activated by local anesthetics, or whether there is a single common precipitating factor. PMID:26959012

Local Anesthetic-Induced Neurotoxicity.

PubMed

Verlinde, Mark; Hollmann, Markus W; Stevens, Markus F; Hermanns, Henning; Werdehausen, Robert; Lirk, Philipp

2016-03-04

This review summarizes current knowledge concerning incidence, risk factors, and mechanisms of perioperative nerve injury, with focus on local anesthetic-induced neurotoxicity. Perioperative nerve injury is a complex phenomenon and can be caused by a number of clinical factors. Anesthetic risk factors for perioperative nerve injury include regional block technique, patient risk factors, and local anesthetic-induced neurotoxicity. Surgery can lead to nerve damage by use of tourniquets or by direct mechanical stress on nerves, such as traction, transection, compression, contusion, ischemia, and stretching. Current literature suggests that the majority of perioperative nerve injuries are unrelated to regional anesthesia. Besides the blockade of sodium channels which is responsible for the anesthetic effect, systemic local anesthetics can have a positive influence on the inflammatory response and the hemostatic system in the perioperative period. However, next to these beneficial effects, local anesthetics exhibit time and dose-dependent toxicity to a variety of tissues, including nerves. There is equivocal experimental evidence that the toxicity varies among local anesthetics. Even though the precise order of events during local anesthetic-induced neurotoxicity is not clear, possible cellular mechanisms have been identified. These include the intrinsic caspase-pathway, PI3K-pathway, and MAPK-pathways. Further research will need to determine whether these pathways are non-specifically activated by local anesthetics, or whether there is a single common precipitating factor.

Operator Localization of Virtual Objects

NASA Technical Reports Server (NTRS)

Ellis, Stephen R.; Menges, Brian M.; Null, Cynthia H. (Technical Monitor)

1998-01-01

Errors in the localization of nearby virtual objects presented via see-through, helmet mounted displays are examined as a function of viewing conditions and scene content. Monocular, biocular or stereoscopic presentation of the virtual objects, accommodation (required focus), subjects'age, and the position of physical surfaces are examined. Nearby physical surfaces are found to introduce localization errors that differ depending upon the other experimental factors. The apparent physical size and transparency of the virtual objects and physical surfaces respectively are also influenced by their relative position when superimposed. Design implications are discussed.

Localizing value of electrical source imaging: Frontal lobe, malformations of cortical development and negative MRI related epilepsies are the best candidates.

PubMed

Abdallah, Chifaou; Maillard, Louis G; Rikir, Estelle; Jonas, Jacques; Thiriaux, Anne; Gavaret, Martine; Bartolomei, Fabrice; Colnat-Coulbois, Sophie; Vignal, Jean-Pierre; Koessler, Laurent

2017-01-01

We aimed to prospectively assess the anatomical concordance of electric source localizations of interictal discharges with the epileptogenic zone (EZ) estimated by stereo-electroencephalography (SEEG) according to different subgroups: the type of epilepsy, the presence of a structural MRI lesion, the aetiology and the depth of the EZ. In a prospective multicentric observational study, we enrolled 85 consecutive patients undergoing pre-surgical SEEG investigation for focal drug-resistant epilepsy. Electric source imaging (ESI) was performed before SEEG. Source localizations were obtained from dipolar and distributed source methods. Anatomical concordance between ESI and EZ was defined according to 36 predefined sublobar regions. ESI was interpreted blinded to- and subsequently compared with SEEG estimated EZ. 74 patients were finally analyzed. 38 patients had temporal and 36 extra-temporal lobe epilepsy. MRI was positive in 52. 41 patients had malformation of cortical development (MCD), 33 had another or an unknown aetiology. EZ was medial in 27, lateral in 13, and medio-lateral in 34. In the overall cohort, ESI completely or partly localized the EZ in 85%: full concordance in 13 cases and partial concordance in 50 cases. The rate of ESI full concordance with EZ was significantly higher in (i) frontal lobe epilepsy (46%; p  = 0.05), (ii) cases of negative MRI (36%; p  = 0.01) and (iii) MCD (27%; p  = 0.03). The rate of ESI full concordance with EZ was not statistically different according to the depth of the EZ. We prospectively demonstrated that ESI more accurately estimated the EZ in subgroups of patients who are often the most difficult cases in epilepsy surgery: frontal lobe epilepsy, negative MRI and the presence of MCD.

Preparing for Local Labor: Curricular Stratification across Local Economies in the United States

PubMed Central

Sutton, April

2017-01-01

I investigate how the educational demands of local labor markets shape high school course offerings and student course taking. Using the Education Longitudinal Study of 2002 linked to the U.S. Census 2000, I focus on local economic variation in the share of jobs that do not demand a bachelor’s degree. I find that schools in local labor markets with higher concentrations of subbaccalaureate jobs devote a larger share of their course offerings to career and technical education (CTE) courses and a smaller share to advanced college-preparatory courses compared to schools in labor markets with lower concentrations of subbaccalaureate jobs, even net of school resources. Students in labor markets with higher concentrations of subbaccalaureate jobs take greater numbers of CTE courses, and higher-achieving students in these labor markets are less likely to take advanced math and Advanced Placement/International Baccalaureate courses. These course-taking disparities are largely due to school course offerings. This study shows how local economic inequalities shape high school curricular stratification, and suggests that school curricula linked to the educational demands of local jobs delimits the college preparation opportunities of high-achieving students. PMID:29531407

Preparing for Local Labor: Curricular Stratification across Local Economies in the United States.

PubMed

Sutton, April

2017-04-01

I investigate how the educational demands of local labor markets shape high school course offerings and student course taking. Using the Education Longitudinal Study of 2002 linked to the U.S. Census 2000, I focus on local economic variation in the share of jobs that do not demand a bachelor's degree. I find that schools in local labor markets with higher concentrations of subbaccalaureate jobs devote a larger share of their course offerings to career and technical education (CTE) courses and a smaller share to advanced college-preparatory courses compared to schools in labor markets with lower concentrations of subbaccalaureate jobs, even net of school resources. Students in labor markets with higher concentrations of subbaccalaureate jobs take greater numbers of CTE courses, and higher-achieving students in these labor markets are less likely to take advanced math and Advanced Placement/International Baccalaureate courses. These course-taking disparities are largely due to school course offerings. This study shows how local economic inequalities shape high school curricular stratification, and suggests that school curricula linked to the educational demands of local jobs delimits the college preparation opportunities of high-achieving students.

Local and Global Auditory Processing: Behavioral and ERP Evidence

PubMed Central

Sanders, Lisa D.; Poeppel, David

2007-01-01

Differential processing of local and global visual features is well established. Global precedence effects, differences in event-related potentials (ERPs) elicited when attention is focused on local versus global levels, and hemispheric specialization for local and global features all indicate that relative scale of detail is an important distinction in visual processing. Observing analogous differential processing of local and global auditory information would suggest that scale of detail is a general organizational principle of the brain. However, to date the research on auditory local and global processing has primarily focused on music perception or on the perceptual analysis of relatively higher and lower frequencies. The study described here suggests that temporal aspects of auditory stimuli better capture the local-global distinction. By combining short (40 ms) frequency modulated tones in series to create global auditory patterns (500 ms), we independently varied whether pitch increased or decreased over short time spans (local) and longer time spans (global). Accuracy and reaction time measures revealed better performance for global judgments and asymmetric interference that were modulated by amount of pitch change. ERPs recorded while participants listened to identical sounds and indicated the direction of pitch change at the local or global levels provided evidence for differential processing similar to that found in ERP studies employing hierarchical visual stimuli. ERP measures failed to provide evidence for lateralization of local and global auditory perception, but differences in distributions suggest preferential processing in more ventral and dorsal areas respectively. PMID:17113115

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work.

PubMed

Parker, Gary; Ali, Samira; Ringell, Kassia; McKay, Mary

2014-03-01

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined.

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work

PubMed Central

Ali, Samira; Ringell, Kassia; McKay, Mary

2014-01-01

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined. PMID:25346884

Predicting one and three month postoperative Somatic Concerns, Psychological Distress, and Maladaptive Eating Behaviors in bariatric surgery candidates with the Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF).

PubMed

Marek, Ryan J; Ben-Porath, Yossef S; Merrell, Julie; Ashton, Kathleen; Heinberg, Leslie J

2014-04-01

Presurgical psychological screening of bariatric surgery candidates includes some form of standardized psychological assessment. However, associations between presurgical psychological screening and postoperative outcome have not been extensively studied. Here, we explore associations between presurgical Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) scores and early postoperative Somatic Concerns, Psychological Distress, and Maladaptive Eating Behaviors. The sample consisted of male (n = 238) and female (n = 621) patients who were administered the MMPI-2-RF at their presurgical psychological evaluation and received bariatric surgery. Patients were evaluated at their 1- and 3-month postoperative appointments. Confirmatory factor analysis indicated that three latent constructs-somatic concerns, psychological distress, and maladaptive eating behaviors-were represented by responses to a postoperative assessment and that these constructs could be measured consistently over time. Presurgical scores on MMPI-2-RF scales measuring internalizing dysfunction were associated with more psychological distress at postoperative follow-ups, scores on scales measuring somatization were associated with more postoperative somatic concerns, and scores on scales assessing emotional/internalizing, behavioral/externalizing, cognitive complaints, and thought dysfunction prior to surgery were associated with maladaptive eating behaviors after surgery. In conjunction with a presurgical psychological interview, the MMPI-2-RF provides information that can assist in anticipating postoperative outcomes and inform efforts to prevent them.

Assessing Locally Focused Stability Operations

DTIC Science & Technology

2014-01-01

Detailed Theory -of-Change Chart RAND RR387-4.2 LFSO actions Immediate goals LFSO main goal Higher -level goals Sustainable stability in region Reduced...projects in the vil- lage, and laying the groundwork for starting a village council. At the higher level, the Theory of Change now documents the assumption... Theory of Change RAND RR387-4.5 LFSO actions Immediate goals Chain of consequences LFSO main goal Higher -level goals HN commandos targeting INS 13

Rural hospital focus: accommodation.

PubMed

Couper, I D

2003-01-01

Rural and Remote Health is committed to the task of providing a freely accessible, international, peer-reviewed evidence base for rural and remote health practice. Inherent in this aim is a recognition of the universal nature of rural health issues that transcends both regional interests and local culture. While RRH is already publishing peer-reviewed material, the Editorial Board believes many articles of potential worth are largely inaccessible due to their primary publication in small-circulation, paper-based journals whose readership is geographically limited. In order to augment our already comprehensive, international evidence base, the RRH Editorial Board has decided to republish, with permission, selected articles from such journals. This will also give worthwhile small-circulation articles the wide audience only a web-based journal can offer. The RRH editorial team encourages journal users to nominate similar, suitable articles from their own world region. This article 'Rural hospital focus: accommodation', is third in our series. It first appeared in South African Family Practice 2000; 22 (7), and is reproduced here in its original form, with kind permission of both publisher and author, prominent South African rural doctor, Professor Ian Couper. 'Rural hospital focus' was the title of the SAFP column which presented this article.

When can a green entrepreneur manage the local environment?

PubMed

Brandt, Urs Steiner; Svendsen, Gert Tinggaard

2016-12-01

How do we deal with environmental management issues at the local level? Traditionally, the approach proposed from an environmental management perspective has involved various kinds of "top-down" regulatory measures, such as defining a standard that must be satisfied or a tax on pollution. Conversely, there has been less focus on the analysis of local, bottom-up approaches, as for example the effectiveness of various ways of organizing a local environmental transition process. Our focus is on analyzing of under what conditions it is possible for a "green entrepreneur" (GE) to manage a transition from brown to green energy? Theoretically, we consider four entrepreneurial skills, at least two of which must be present for the GE to succeed. In the case of the Danish island of Samsø and its rapid introduction of renewable energy, three of these skills are found to be present: profits, communication, and trustworthiness. The GE, however, failed to activate the fourth skill concerning the ability to persuade local non-green actors regarding the value of the green component. Thus, a main result is that it is crucial to convince non-green locals about the profitability of local environmental management rather than its potentially green components. Copyright © 2016 Elsevier Ltd. All rights reserved.

Performance-Based Compensation: Focus on Special Education Teachers. inForum

ERIC Educational Resources Information Center

Burdette, Paula

2011-01-01

The purpose of this document is to describe states' work in the area of performance-based compensation with a focus on special educators, including how teacher evaluation informs compensation decisions, support given to local education agencies (LEAs), variables used to make compensation decisions and how performance-based compensation is funded.…

Asymptotic localization in the Bose-Hubbard model

NASA Astrophysics Data System (ADS)

Bols, Alex; De Roeck, Wojciech

2018-02-01

We consider the Bose-Hubbard model. Our focus is on many-body localization, which was described by many authors in such models, even in the absence of disorder. Since our work is rigorous, and since we believe that the localization in this type of models is not strictly valid in the infinite-time limit, we necessarily restrict our study to "asymptotic localization" also known as "quasi-localization:" We prove that transport and thermalization are small beyond perturbation theory in the limit of large particle density. Our theorem takes the form of a many-body Nekhoroshev estimate. An interesting and new aspect of this model is the following: The localization cannot be inferred from a lack of hybridization between zero-hopping eigenstates. Naively speaking, all these eigenstates appear resonant and one has to move to a dressed basis to see the absence of resonances that are responsible for (quasi-)localization.

The promise of subtraction ictal SPECT co-registered to MRI for improved seizure localization in pediatric epilepsies: Affecting factors and relationship to the surgical outcome

PubMed Central

Stamoulis, Catherine; Verma, Nishant; Kaulas, Himanshu; Halford, Jonathan J.; Duffy, Frank H.; Pearl, Phillip L.; Treves, S. Ted

2016-01-01

Objective Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery. Methods Scalp EEG and ictal SPECT studies from 95 patients (48 males and 47 females, median age = 11 years, (25th, 75th) quartiles = (6.0, 14.75) years) with pharmacoresistant focal epilepsy and no prior epilepsy surgery were reviewed. The ictal SPECT result was examined as a function of the radiotracer injection delay, seizure duration, epilepsy etiology, cerebral lobe of seizure onset identified by EEG and MRI findings. Thirty two patients who later underwent epilepsy surgery had postoperative seizure freedom data at <1, 6 and 12 months. Results Sixty patients (63.2%) had positive SPECT localizations - 51 with a hyperperfused region that was concordant with the cerebral lobe of seizure origin identified by EEG and 9 with discordant localizations. Of these, 35 patients (58.3%) had temporal and 25 (41.7%) had extratemporal seizures. The ictal SPECT result was significantly correlated with the injection delay (p<0.01) and cerebral lobe of seizure onset (specifically frontal versus temporal; p = 0.02) but not MRI findings (p = 0.33), epilepsy etiology (p ≥ 0.27) or seizure duration (p = 0.20). Concordance of SPECT, scalp EEG and resected area was significantly correlated with seizure freedom at 6 months after surgery (p=0.04). Significance Ictal SPECT holds promise as a powerful source imaging tool for presurgical planning in pediatric epilepsies. To optimize the SPECT result the radiotracer injection delay should be minimized to

The promise of subtraction ictal SPECT co-registered to MRI for improved seizure localization in pediatric epilepsies: Affecting factors and relationship to the surgical outcome.

PubMed

Stamoulis, Catherine; Verma, Nishant; Kaulas, Himanshu; Halford, Jonathan J; Duffy, Frank H; Pearl, Phillip L; Treves, S Ted

2017-01-01

Ictal SPECT is promising for accurate non-invasive localization of the epileptogenic brain tissue in focal epilepsies. However, high quality ictal scans require meticulous attention to the seizure onset. In a relatively large cohort of pediatric patients, this study investigated the impact of the timing of radiotracer injection, MRI findings and seizure characteristics on ictal SPECT localizations, and the relationship between concordance of ictal SPECT, scalp EEG and resected area with seizure freedom following epilepsy surgery. Scalp EEG and ictal SPECT studies from 95 patients (48 males and 47 females, median age=11years, (25th, 75th) quartiles=(6.0, 14.75) years) with pharmacoresistant focal epilepsy and no prior epilepsy surgery were reviewed. The ictal SPECT result was examined as a function of the radiotracer injection delay, seizure duration, epilepsy etiology, cerebral lobe of seizure onset identified by EEG and MRI findings. Thirty two patients who later underwent epilepsy surgery had postoperative seizure freedom data at <1, 6 and 12 months. Sixty patients (63.2%) had positive SPECT localizations - 51 with a hyperperfused region that was concordant with the cerebral lobe of seizure origin identified by EEG and 9 with discordant localizations. Of these, 35 patients (58.3%) had temporal and 25 (41.7%) had extratemporal seizures. The ictal SPECT result was significantly correlated with the injection delay (p<0.01) and cerebral lobe of seizure onset (specifically frontal versus temporal; p=0.02) but not MRI findings (p=0.33), epilepsy etiology (p≥0.27) or seizure duration (p=0.20). Concordance of SPECT, scalp EEG and resected area was significantly correlated with seizure freedom at 6 months after surgery (p=0.04). Ictal SPECT holds promise as a powerful source imaging tool for presurgical planning in pediatric epilepsies. To optimize the SPECT result the radiotracer injection delay should be minimized to≤25s, although the origin of seizure onset

Local election: does bureaucracy become one of main political power?

NASA Astrophysics Data System (ADS)

Amin, Muryanto; Musthafa Sembiring, Walid

2018-03-01

This writing aims to analyze the emergence of bureaucracy as one of political power in local level after the local election is held in Indonesia. Due to information authorization, media network, and stable structure, the bureaucracy soon transforms into political power which can compete with the other political power at the local level. In Medan local election in 2010 and 2015 has evidently proven the power of bureaucracy network in winning the bureaucrat-background candidates. As methods of the research, the researcher held a Focus-Group Discussion (FGD) and had an in-depth interview with ten bureaucracy elites in Medan and local political elites. The observation and Focus-Group Discussion (FGD) are analyzed using qualitative analysis technique typology. The result states that the bureaucracy network in Medan has been used in a massive way as the political power of winning. The structure of bureaucracy – from the top to the low – is involved in the winning. The most governmental programs were applied to attract the mass’ sympathy toward the candidates. The bureaucratic proximity to media network is also used to do a campaign in a massive way. The conclusion of the research is that bureaucracy emerges as a new, massive, effective local political power in the local election.

Mandatory weight loss during the wait for bariatric surgery.

PubMed

Glenn, Nicole M; Raine, Kim D; Spence, John C

2015-01-01

Mandatory presurgical, behavior-induced weight loss, although not standard, is a relatively common practice among bariatric surgical clinics. We explore the patient's experience of this practice using phenomenology. We gathered experiential accounts from 7 individuals waiting to have the procedure at a large publically funded clinic in western Canada. In writing this article, we focused on four phenomenological themes: "just nod your head and carry on"-silencing through the ideal; waiting and weighing-promoting weight consciousness to the weight conscious; paying for surgical approval through weight loss; and presurgical weight loss and questioning the need for weight loss surgery altogether. We contrast the experiential findings with the clinical literature to question the impact and possible (unintended or unexpected) effects the practice might have, particularly on patients' lives. We situate this article within a larger discussion about the possible contribution of experiential knowledge to clinical guidelines, practices, and pedagogies. © The Author(s) 2014.

Magnetic resonance imaging validation of pituitary gland compression and distortion by typical sellar pathology.

PubMed

Cho, Charles H; Barkhoudarian, Garni; Hsu, Liangge; Bi, Wenya Linda; Zamani, Amir A; Laws, Edward R

2013-12-01

Identification of the normal pituitary gland is an important component of presurgical planning, defining many aspects of the surgical approach and facilitating normal gland preservation. Magnetic resonance imaging is a proven imaging modality for optimal soft-tissue contrast discrimination in the brain. This study is designed to validate the accuracy of localization of the normal pituitary gland with MRI in a cohort of surgical patients with pituitary mass lesions, and to evaluate for correlation between presurgical pituitary hormone values and pituitary gland characteristics on neuroimaging. Fifty-eight consecutive patients with pituitary mass lesions were included in the study. Anterior pituitary hormone levels were measured preoperatively in all patients. Video recordings from the endoscopic or microscopic surgical procedures were available for evaluation in 47 cases. Intraoperative identification of the normal gland was possible in 43 of 58 cases. Retrospective MR images were reviewed in a blinded fashion for the 43 cases, emphasizing the position of the normal gland and the extent of compression and displacement by the lesion. There was excellent agreement between imaging and surgery in 84% of the cases for normal gland localization, and in 70% for compression or noncompression of the normal gland. There was no consistent correlation between preoperative pituitary dysfunction and pituitary gland localization on imaging, gland identification during surgery, or pituitary gland compression. Magnetic resonance imaging proved to be accurate in identifying the normal gland in patients with pituitary mass lesions, and was useful for preoperative surgical planning.

Site-Specific Preparation of Intact Solid–Liquid Interfaces by Label-Free In Situ Localization and Cryo-Focused Ion Beam Lift-Out

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

Zachman, Michael J.; Asenath-Smith, Emily; Estroff, Lara A.

Abstract Scanning transmission electron microscopy (STEM) allows atomic scale characterization of solid–solid interfaces, but has seen limited applications to solid–liquid interfaces due to the volatility of liquids in the microscope vacuum. Although cryo-electron microscopy is routinely used to characterize hydrated samples stabilized by rapid freezing, sample thinning is required to access the internal interfaces of thicker specimens. Here, we adapt cryo-focused ion beam (FIB) “lift-out,” a technique recently developed for biological specimens, to prepare intact internal solid–liquid interfaces for high-resolution structural and chemical analysis by cryo-STEM. To guide the milling process we introduce a label-freein situmethod of localizing subsurface structuresmore » in suitable materials by energy dispersive X-ray spectroscopy (EDX). Monte Carlo simulations are performed to evaluate the depth-probing capability of the technique, and show good qualitative agreement with experiment. We also detail procedures to produce homogeneously thin lamellae, which enable nanoscale structural, elemental, and chemical analysis of intact solid–liquid interfaces by analytical cryo-STEM. This work demonstrates the potential of cryo-FIB lift-out and cryo-STEM for understanding physical and chemical processes at solid–liquid interfaces.« less

Evaluation Design, 1978-1979. Local/State Bilingual Education Evaluation.

ERIC Educational Resources Information Center

Weibly, Gary; And Others

The evaluation design of the 1978-79 local/state bilingual education program of Austin Independent School District is presented. The primary focus of the evaluation is the assessment of the objectives in language development and concept development submitted to the Texas Education Agency. A secondary focus is the collection of information related…

Repair of localized defects in multilayer-coated reticle blanks for extreme ultraviolet lithography

DOEpatents

Stearns, Daniel G [Los Altos, CA; Sweeney, Donald W [San Ramon, CA; Mirkarimi, Paul B [Sunol, CA

2004-11-23

A method is provided for repairing defects in a multilayer coating layered onto a reticle blank used in an extreme ultraviolet lithography (EUVL) system. Using high lateral spatial resolution, energy is deposited in the multilayer coating in the vicinity of the defect. This can be accomplished using a focused electron beam, focused ion beam or a focused electromagnetic radiation. The absorbed energy will cause a structural modification of the film, producing a localized change in the film thickness. The change in film thickness can be controlled with sub-nanometer accuracy by adjusting the energy dose. The lateral spatial resolution of the thickness modification is controlled by the localization of the energy deposition. The film thickness is adjusted locally to correct the perturbation of the reflected field. For example, when the structural modification is a localized film contraction, the repair of a defect consists of flattening a mound or spreading out the sides of a depression.

Transcranial Propagation with an Ultrasonic Mono-element Focused Transducer

NASA Astrophysics Data System (ADS)

Iglesias, P. C.; Jiménez, N.; Konofagou, E.; Camarena, F.; Redondo, J.

Focused Ultrasound is the only truly transient, local and non-invasive technique able to induce safe Blood-Brain Barrier Opening (BBBO), technique used in Parkinson or Alzheimer diseases research. However, the presence of the skull in the path usually affects the focus characteristics (gain, beam width, shape and maxima location). In this work, transcranial acoustic wave propagation generated by a mono-element focused transducer has been modeled using 2D and 3D FDTD methods. Skull structure of the non-human primate under test can be compared in terms of density and sound speed with polymethylmethacrylate (PMMA) films. Then, focus aberration and the phenomena that cause it are characterized, providing a better control of the beam focus using the BBBO technique. Results throw that focal axial displacements are constant with the angle of incidence for PMMA flat films. In normal incidence, a shift of 6 mm is given for axial displacement in the 2D transcranial propagation. Moreover, if the skull geometry under the action of the ultrasonic beam can be compared with the curvature radius of the transducer, displacements should be constant with angle independency, like those seeing in the homogenous flat films with the same thickness.

Gravitationally Focused Dark Matter around Compact Stars

NASA Astrophysics Data System (ADS)

Bromley, Benjamin C.

2011-12-01

If dark matter self-annihilates then it may produce an observable signal when its density is high. The details depend on the intrinsic properties of dark matter and how it clusters in space. For example, the density profile of some dark matter candidates may rise steeply enough toward the Galactic Center that self-annihilation may produce detectable γ-ray emission. Here, we discuss the possibility that an annihilation signal arises near a compact object (e.g., neutron star or black hole) even when the density of dark matter in the neighborhood of the object is uniform. Gravitational focusing produces a local enhancement of density with a profile that falls off approximately as the inverse square-root of distance from the compact star. While geometric dilution may overwhelm the annihilation signal from this local enhancement, magnetic fields tied to the compact object can increase the signal's contrast relative to the background.

A Novel Approach to Regeneration of Bone: Using Focused Ultrasound for the Spatiotemporal Patterning of Angiogenic and Osteogenic Factors

DTIC Science & Technology

2012-04-01

approach uses high intensity focused ultrasound ( HIFU ) and heat shock/ligand-dependent gene switches. Focused ultrasound generates localized...vasculature and bone. The approach uses high intensity focused ultrasound ( HIFU ) and heat shock/ligand-dependent gene switches. Focused ultrasound ...regeneration. Biomedical applications of high intensity focused ultrasound ( HIFU ) have revolved primarily around the mechanical and thermal ablation of

[Treatment of localized prostate cancer].

PubMed

Vallancien, Guy; Cathelineau, Xavier; Rozet, François; Barret, Eric

2008-05-01

Treatments for localized prostate cancer include radical prostatectomy, brachytherapy, conformal external beam irradiation, and focused ultrasound. This paper describes the oncologic and functional results of each approach. The treatment choice depends on the patient's general status and on the results of biopsy and imaging studies. Watchful waiting and hormone therapy are other options for elderly patients.

St. Cloud State University's Impact on the Local Economy.

ERIC Educational Resources Information Center

Lange, Mark D.

The economic impact of St. Cloud State University, Minnesota, on the local economy was studied. Using models developed by the American Council on Education, estimates were made of the dollar outlays by the local economic sectors that are associated with or influenced by the university. The focus is the measurable impacts, in dollar terms, of the…

Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

PubMed

Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

2011-10-01

Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

Impedance measurement of non-locally reactive samples and the influence of the assumption of local reaction.

PubMed

Brandão, Eric; Mareze, Paulo; Lenzi, Arcanjo; da Silva, Andrey R

2013-05-01

In this paper, the measurement of the absorption coefficient of non-locally reactive sample layers of thickness d1 backed by a rigid wall is investigated. The investigation is carried out with the aid of real and theoretical experiments, which assume a monopole sound source radiating sound above an infinite non-locally reactive layer. A literature search revealed that the number of papers devoted to this matter is rather limited in comparison to those which address the measurement of locally reactive samples. Furthermore, the majority of papers published describe the use of two or more microphones whereas this paper focuses on the measurement with the pressure-particle velocity sensor (PU technique). For these reasons, the assumption that the sample is locally reactive is initially explored, so that the associated measurement errors can be quantified. Measurements in the impedance tube and in a semi-anechoic room are presented to validate the theoretical experiment. For samples with a high non-local reaction behavior, for which the measurement errors tend to be high, two different algorithms are proposed in order to minimize the associated errors.

Preliminary demonstration using localized skin temperature elevation as observed with thermal imaging as an indicator of fat-specific absorption during focused-field radiofrequency therapy.

PubMed

Key, Douglas J

2014-07-01

This study incorporates concurrent thermal camera imaging as a means of both safely extending the length of each treatment session within skin surface temperature tolerances and to demonstrate not only the homogeneous nature of skin surface temperature heating but the distribution of that heating pattern as a reflection of localization of subcutaneous fat distribution. Five subjects were selected because of a desire to reduce abdomen and flank fullness. Full treatment field thermal camera imaging was captured at 15 minute intervals, specifically at 15, 30, and 45 minutes into active treatment with the purpose of monitoring skin temperature and avoiding any patterns of skin temperature excess. Peak areas of heating corresponded anatomically to the patients' areas of greatest fat excess ie, visible "pinchable" fat. Preliminary observation of high-resolution thermal camera imaging used concurrently with focused field RF therapy show peak skin heating patterns overlying the areas of greatest fat excess.

MRI-Guided Focused Ultrasound as a New Method of Drug Delivery

PubMed Central

Thanou, M.; Gedroyc, W.

2013-01-01

Ultrasound-mediated drug delivery under the guidance of an imaging modality can improve drug disposition and achieve site-specific drug delivery. The term focal drug delivery has been introduced to describe the focal targeting of drugs in tissues with the help of imaging and focused ultrasound. Focal drug delivery aims to improve the therapeutic profile of drugs by improving their specificity and their permeation in defined areas. Focused-ultrasound- (FUS-) mediated drug delivery has been applied with various molecules to improve their local distribution in tissues. FUS is applied with the aid of microbubbles to enhance the permeability of bioactive molecules across BBB and improve drug distribution in the brain. Recently, FUS has been utilised in combination with MRI-labelled liposomes that respond to temperature increase. This strategy aims to “activate” nanoparticles to release their cargo locally when triggered by hyperthermia induced by FUS. MRI-guided FUS drug delivery provides the opportunity to improve drug bioavailability locally and therefore improve the therapeutic profiles of drugs. This drug delivery strategy can be directly translated to clinic as MRg FUS is a promising clinically therapeutic approach. However, more basic research is required to understand the physiological mechanism of FUS-enhanced drug delivery. PMID:23738076

Vortex formation through inertial wave focusing

NASA Astrophysics Data System (ADS)

Duran-Matute, Matias; Flor, Jan-Bert; Godeferd, Fabien

2011-11-01

We present a novel experimental and numerical study on the formation of columnar vortical structures by inertial waves in a rotating fluid. Two inertial-wave cones are generated by a vertically oscillating torus in a fluid in solid body rotation At the tip of the cones, there is a singular point towards which the energy of the waves gets focused. The particularity of this configuration, as compared to those of previous experiments (e.g. oscillating sphere or disc), is that the singular point's position within the fluid leads to complex non-linear wave interaction, which may lead to the formation of a localized vortex that expands in the vertical in the form of a Taylor column. Using detailed PIV measurements we consider the flow evolution from the localized wave overturning motion to the Taylor column formation as well as the inertial wave dynamics during this process, The results are discussed in the context of turbulence in rotating fluids. We acknowledge financial support from projects ANR ANISO and CIBLE.

Local Institutional Development and Organizational Change for Advancing Sustainable Urban Water Futures

NASA Astrophysics Data System (ADS)

Brown, Rebekah R.

2008-02-01

This paper presents the local institutional and organizational development insights from a five-year ongoing interdisciplinary research project focused on advancing the implementation of sustainable urban water management. While it is broadly acknowledged that the inertia associated with administrative systems is possibly the most significant obstacle to advancing sustainable urban water management, contemporary research still largely prioritizes investigations at the technological level. This research is explicitly concerned with critically informing the design of methodologies for mobilizing and overcoming the administrative inertia of traditional urban water management practice. The results of fourteen in-depth case studies of local government organizations across Metropolitan Sydney primarily reveal that (i) the political institutionalization of environmental concern and (ii) the commitment to local leadership and organizational learning are key corporate attributes for enabling sustainable management. A typology of five organizational development phases has been proposed as both a heuristic and capacity benchmarking tool for urban water strategists, policy makers, and decision makers that are focused on improving the level of local implementation of sustainable urban water management activity. While this investigation has focused on local government, these findings do provide guideposts for assessing the development needs of future capacity building programs across a range of different institutional contexts.

Local institutional development and organizational change for advancing sustainable urban water futures.

PubMed

Brown, Rebekah R

2008-02-01

This paper presents the local institutional and organizational development insights from a five-year ongoing interdisciplinary research project focused on advancing the implementation of sustainable urban water management. While it is broadly acknowledged that the inertia associated with administrative systems is possibly the most significant obstacle to advancing sustainable urban water management, contemporary research still largely prioritizes investigations at the technological level. This research is explicitly concerned with critically informing the design of methodologies for mobilizing and overcoming the administrative inertia of traditional urban water management practice. The results of fourteen in-depth case studies of local government organizations across Metropolitan Sydney primarily reveal that (i) the political institutionalization of environmental concern and (ii) the commitment to local leadership and organizational learning are key corporate attributes for enabling sustainable management. A typology of five organizational development phases has been proposed as both a heuristic and capacity benchmarking tool for urban water strategists, policy makers, and decision makers that are focused on improving the level of local implementation of sustainable urban water management activity. While this investigation has focused on local government, these findings do provide guideposts for assessing the development needs of future capacity building programs across a range of different institutional contexts.

Local capacity for groundwater protection in Ontario.

PubMed

De Loë, Rob C; Di Giantomasso, Sandra E; Kreutzwiser, Reid D

2002-02-01

Preventing groundwater contamination is vastly cheaper than remediation. Recognizing this, attention in water and land management agencies in North America increasingly turn to groundwater protection. Local agencies, such as municipalities and watershed management districts, are vital to successful groundwater protection, but they face daunting challenges. In the United States, senior governments have recognized these challenges and provide considerable support for local agencies. In Ontario, Canada, local agencies are, to a much greater extent, on their own. The aims in this paper are to analyze factors that shape local capacity for groundwater protection, focusing on Ontario, and to recommend avenues for capacity building. Interrelationships among five dimensions of capacity (technical, financial, institutional, social, and political) are explored through an analysis of three smaller Ontario communities: City of Guelph (population 93,400), Town of Orangeville (population 22,188), and Town of Erin (population 11,000). Size clearly influences capacity for groundwater protection. However, other considerations unrelated to size appear to be as important. These other factors include the ability to form horizontal and vertical linkages with external agencies, political leadership and commitment, and citizen involvement. Thus, smaller communities in Ontario (and other jurisdictions with limited senior government support) would do well to focus on these areas at the same time as they develop their technical, financial, and institutional capacity.

Focusing-schlieren visualization in a dual-mode scramjet

NASA Astrophysics Data System (ADS)

Kouchi, Toshinori; Goyne, Christopher P.; Rockwell, Robert D.; McDaniel, James C.

2015-12-01

Schlieren imaging is particularly suited to measuring density gradients in compressible flowfields and can be used to capture shock waves and expansion fans, as well as the turbulent structures of mixing and wake flows. Conventional schlieren imaging, however, has difficulty clearly capturing such structures in long-duration supersonic combustion test facilities. This is because the severe flow temperatures locally change the refractive index of the window glass that is being used to provide optical access. On the other hand, focusing-schlieren imaging presents the potential of reduced sensitivity to thermal distortion of the windows and to clearly capture the flow structures even during a combustion test. This reduced sensitivity is due the technique's ability to achieve a narrow depth of focus. As part of this study, a focusing-schlieren system was developed with a depth of focus near ±5 mm and was applied to a direct-connect, continuous-flow type, supersonic combustion test facility with a stagnation temperature near 1200 K. The present system was used to successfully visualize the flowfield inside a dual-mode scramjet. The imaging system captured combustion-induced volumetric expansion of the fuel jet and an anchored bifurcated shock wave at the trailing edge of the ramp fuel injector. This is the first time successful focusing-schlieren measurements have been reported for a dual-mode scramjet.

The role of local wisdom in developing friendly city

NASA Astrophysics Data System (ADS)

Sibarani, Robert

2018-03-01

This present paper discusses the local wisdom which can be applied to build the character of people living in a friendly city. It aims at (1) finding the main local wisdom which can be used to construct the integrity of human beings dwelling in it and (2) describing the concept of developing the friendly city based on local wisdom. Anthropolinguistics is applied to study this topic by focusing on the performance, indexicality, and participation. The analytic parameters are interconnection, evaluability, and sustainability.

Multi-focus image fusion based on window empirical mode decomposition

NASA Astrophysics Data System (ADS)

Qin, Xinqiang; Zheng, Jiaoyue; Hu, Gang; Wang, Jiao

2017-09-01

In order to improve multi-focus image fusion quality, a novel fusion algorithm based on window empirical mode decomposition (WEMD) is proposed. This WEMD is an improved form of bidimensional empirical mode decomposition (BEMD), due to its decomposition process using the adding window principle, effectively resolving the signal concealment problem. We used WEMD for multi-focus image fusion, and formulated different fusion rules for bidimensional intrinsic mode function (BIMF) components and the residue component. For fusion of the BIMF components, the concept of the Sum-modified-Laplacian was used and a scheme based on the visual feature contrast adopted; when choosing the residue coefficients, a pixel value based on the local visibility was selected. We carried out four groups of multi-focus image fusion experiments and compared objective evaluation criteria with other three fusion methods. The experimental results show that the proposed fusion approach is effective and performs better at fusing multi-focus images than some traditional methods.

Noninvasive transcranial focused ultrasonic-magnetic stimulation for modulating brain oscillatory activity

NASA Astrophysics Data System (ADS)

Yuan, Yi; Chen, Yudong; Li, Xiaoli

2016-02-01

A novel technique, transcranial focused ultrasonic-magnetic stimulation (tFUMS), has been developed for noninvasive brain modulation in vivo. tFUMS has a higher spatial resolution (<2 mm) and a higher penetration depth than other noninvasive neuromodulation methods. The in vivo animal experimental results show that tFUMS can not only increase the power of local field potentials and the firing rate of the neurons, but also enhance the effect of transcranial focused ultrasound stimulation on the neuromodulation. The results demonstrate that tFUMS can modulate brain oscillatory activities by stimulating brain tissues.

Locally Motivated GLOBE Investigations - A Key to Success

NASA Astrophysics Data System (ADS)

Washburne, J. C.; Geery, W.

2003-12-01

The GLOBE program was set up to help students make a core set of environmental observations at or near their schools, report their data through the internet to share with other students and scientists, analyze their data both locally and globally, and use this knowledge to form a better understanding of their environment. While the GLOBE program has been successful promoting more meaningful data collection, many of the tools and much of the infrastructure available to schools to synthesize their observations are underused. Schools that integrate GLOBE protocols with locally motivated investigations are more likely to implement the higher-order analysis and synthesis components of the program. Indicators of a successful observational program are things like measurement persistence, high data quality, and regular data. Participation in community forums and student-based research projects are evidence of a successful integrated program. A locally motivated issue allows a school to mold their GLOBE investigations around a multi-faceted question that they have first-hand knowledge of, that is both relevant and engaging to their students, and that can be supported by local expertise. In contrast, many GLOBE investigations are designed around abstract, non-site specific, narrowly focused and externally analyzed questions that limit local involvement and motivation. The main focus of this presentation is a few case histories of successful local investigations that incorporated GLOBE soil and air temperature data-logger measurements. The main example is drawn from Mr. Geery's fifth grade class investigation of why temperature differences exist between a local river bottom area and the school, which is located several kilometers away and 100 meters higher.

Achievement of needle-like focus by engineering radial-variant vector fields.

PubMed

Gu, Bing; Wu, Jia-Lu; Pan, Yang; Cui, Yiping

2013-12-16

We present and demonstrate a novel method for engineering the radial-variant polarization on the incident field to achieve a needle of transversally polarized field without any pupil filters. We generate a new kind of localized linearly-polarized vector fields with distributions of states of polarization (SoPs) describing by the radius to the power p and explore its tight focusing, nonparaxial focusing, and paraxial focusing properties. By tuning the power p, we obtain the needle-like focal field with hybrid SoPs and give the formula for describing the length of the needle. Experimentally, we systematically investigate both the intensity distributions and the polarization evolution of the optical needle by paraxial focusing the generated vector field. Such an optical needle, which enhances the light-matter interaction, has intriguing applications in optical microma-chining and nonlinear optics.

The local implementation of a chronic disease management model for childhood overweight and obesity.

PubMed

Brink-Melis, Willy J; Derksen, Elze R E; Westerman, Marjan J; Renders, Carry M; Seidell, Jacob C; Visscher, Tommy L S

2012-01-01

The aim of this study is to determine opportunities and barriers regarding the management of overweight and obese children in daily practice, and to show the value of using focus groups when developing an action plan for childhood overweight management in a local context. Seven focus groups and four semi-structured interviews were conducted with 29 professionals from nine different care disciplines and 7 parents of overweight and obese children aged 4-19 years. After thorough analysis of the focus groups, issues concerning finding the most appropriate care and realising a long-term weight management in daily practice have become clear. Some examples of these issues are: lack of awareness, reluctance to discuss and refer, mutual cooperation, contradictory advice and expectations of treatment and lack of effective support strategies. Focus groups deliver important information on local issues that are important for the development and implementation of a childhood overweight management action plan. And, besides delivering necessary information, focus groups lead to an increased awareness and willingness to improve childhood overweight management in a local context. Copyright © 2012 S. Karger GmbH, Freiburg.

Localization/Globalization and the Midwife State: Strategic Dilemmas for State Feminism in Education?

ERIC Educational Resources Information Center

Blackmore, Jill

1999-01-01

Explores implications of the globalization/localization process for state feminism, focusing on Australia. Localization is one response to globalization, exemplified by devolution to self-managing schools. However, global/local relations have gendered effects that resonate cross-nationally. Problems will emerge as the state withdraws from its…

State Size and Government Level Matter Most: A Structural Equation Model of Local Health Department Policy Behaviors.

PubMed

Meyerson, Beth E; Sayegh, M Aaron

2016-01-01

To explore relationships between local health department policy behaviors, levels of government activity, policy focus areas, and selected health department characteristics. Cross-sectional analysis of secondary data from the 2013 National Association of County & City Health Officials (NACCHO) Profile Survey. Local health departments throughout the United States. A total of 2000 local health departments responding to the 2013 Profile Survey of Local Health Departments. Survey data were gathered by the NACCHO. Secondary analysis of reported policy behaviors for the 2013 NACCHO Profile Survey. A structural equation model tested effects on and between state population size, rurality, census region and policy focus, and the latent variables of policy behavior formed from a confirmatory factor analysis. Policy behaviors, levels of government activity (local, state, and federal), policy focus areas, and selected local health department characteristics. The majority (85.1%) of health departments reported at least one of the possible policy behaviors. State population size increased the probability of local policy behavior, and local behavior increased the probability of state policy behavior. State size increased the likelihood of federal policy behavior and the focus on tobacco, emergency preparedness, and obesity/chronic disease. However, the more rural a state was, the more likely policy behavior was at the state and federal levels and not at local levels. Specific policy behaviors mattered less than the level of government activity. Size of state and rurality of health departments influence the government level of policy behavior.

Leading the Local: Teachers Union Presidents Chart Their Own Course

ERIC Educational Resources Information Center

Johnson, Susan Moore; Donaldson, Morgaen L.; Munger, Mindy Sick; Papay, John P.; Qazilbash, Emily K.

2009-01-01

Teachers unions are among the most powerful, yet least studied, actors in public education today. Although public attention focuses on the influence of national unions, the policies that most affect teachers and schooling are bargained by local unions and school boards. Interviews with 30 recently elected local union presidents reveal that these…

Rapid communication: Global-local processing affects recognition of distractor emotional faces.

PubMed

Srinivasan, Narayanan; Gupta, Rashmi

2011-03-01

Recent studies have shown links between happy faces and global, distributed attention as well as sad faces to local, focused attention. Emotions have been shown to affect global-local processing. Given that studies on emotion-cognition interactions have not explored the effect of perceptual processing at different spatial scales on processing stimuli with emotional content, the present study investigated the link between perceptual focus and emotional processing. The study investigated the effects of global-local processing on the recognition of distractor faces with emotional expressions. Participants performed a digit discrimination task with digits at either the global level or the local level presented against a distractor face (happy or sad) as background. The results showed that global processing associated with broad scope of attention facilitates recognition of happy faces, and local processing associated with narrow scope of attention facilitates recognition of sad faces. The novel results of the study provide conclusive evidence for emotion-cognition interactions by demonstrating the effect of perceptual processing on emotional faces. The results along with earlier complementary results on the effect of emotion on global-local processing support a reciprocal relationship between emotional processing and global-local processing. Distractor processing with emotional information also has implications for theories of selective attention.

Comparison of intra-aortic computed tomography angiography to conventional angiography in the presurgical visualization of the Adamkiewicz artery: first results in patients with thoracoabdominal aortic aneurysms.

PubMed

Clarençon, Frédéric; Di Maria, Federico; Cormier, Evelyne; Gaudric, Julien; Sourour, Nader; Gabrieli, Joseph; Iosif, Christina; Jenny, Catherine; Koskas, Fabien; Chiras, Jacques

2013-11-01

The aim of this study was to compare the sensitivity of intra-aortic computed tomography angiography (IA-CTA) to that of regular spinal digital subtraction angiography for the presurgical location of the Adamkiewicz artery (AKA). Thirty patients (21 males, 9 females; mean age 64 years) had an IA-CTA for the location of the AKA before surgery of aneurysm (n = 24) or dissection (n = 6) of the thoracoabdominal aorta. After femoral artery puncture, a pigtail catheter was positioned at the origin of the descending aorta. CT acquisition was performed with an intra-aortic iodinated contrast media injection (15 mL/s, 120 mL). The visualization of the AKA and the location of the feeder(s) to the AKA were independently evaluated by two observers. Interrater agreement was calculated using a kappa test. Spinal angiogram by selective catheterization was systematically performed to confirm the results of the IA-CTA. The AKA was visualized by the IA-CTA in 27/30 cases (90 %); in 26/31 (84 %) cases, the continuity with the aorta was satisfactorily seen. Interrater agreement was good for the visualization of the AKA and its feeder(s): 0.625 and 0.87, respectively. In 75 % of the cases for which the AKA was visualized, the selective catheterization confirmed the results of the IA-CTA. In the remaining 25 % of the cases, the selective catheterization could not be performed due to marked vessels' tortuosity or ostium stenosis. IA-CTA is a feasible technique in a daily practice that presents a good sensitivity for the location of the AKA.

Financial instability from local market measures

NASA Astrophysics Data System (ADS)

Bardoscia, Marco; Livan, Giacomo; Marsili, Matteo

2012-08-01

We study the emergence of instabilities in a stylized model of a financial market, when different market actors calculate prices according to different (local) market measures. We derive typical properties for ensembles of large random markets using techniques borrowed from statistical mechanics of disordered systems. We show that, depending on the number of financial instruments available and on the heterogeneity of local measures, the market moves from an arbitrage-free phase to an unstable one, where the complexity of the market—as measured by the diversity of financial instruments—increases, and arbitrage opportunities arise. A sharp transition separates the two phases. Focusing on two different classes of local measures inspired by real market strategies, we are able to analytically compute the critical lines, corroborating our findings with numerical simulations.

Model Offices: Flexible Options, Local Innovations.

ERIC Educational Resources Information Center

Perspective: Essays and Reviews of Issues in Employment Security and Employment and Training Programs, 1990

1990-01-01

This volume of an annual journal contains 17 articles that focus on model local offices of the employment security (ES) and training systems. The articles are arranged in three parts. Part I, on developing new initiatives, contains the following five articles: "A Public Employment Service for the 1990s" (Elizabeth Dole); "The…

Time reversal focusing of elastic waves in plates for an educational demonstration.

PubMed

Heaton, Christopher; Anderson, Brian E; Young, Sarah M

2017-02-01

The purpose of this research is to develop a visual demonstration of time reversal focusing of vibrations in a thin plate. Various plate materials are tested to provide optimal conditions for time reversal focusing. Specifically, the reverberation time in each plate and the vibration coupling efficiency from a shaker to the plate are quantified to illustrate why a given plate provides the best spatially confined focus as well as the highest focal amplitude possible. A single vibration speaker and a scanning laser Doppler vibrometer (SLDV) are used to provide the time reversal focusing. Table salt is sprinkled onto the plate surface to allow visualization of the high amplitude, spatially localized time reversal focus; the salt is thrown upward only at the focal position. Spatial mapping of the vibration focusing on the plate using the SLDV is correlated to the visual salt jumping demonstration. The time reversal focusing is also used to knock over an object when the object is placed at the focal position; some discussion of optimal objects to use for this demonstration are given.

Focus control enhancement and on-product focus response analysis methodology

NASA Astrophysics Data System (ADS)

Kim, Young Ki; Chen, Yen-Jen; Hao, Xueli; Samudrala, Pavan; Gomez, Juan-Manuel; Mahoney, Mark O.; Kamalizadeh, Ferhad; Hanson, Justin K.; Lee, Shawn; Tian, Ye

2016-03-01

With decreasing CDOF (Critical Depth Of Focus) for 20/14nm technology and beyond, focus errors are becoming increasingly critical for on-product performance. Current on product focus control techniques in high volume manufacturing are limited; It is difficult to define measurable focus error and optimize focus response on product with existing methods due to lack of credible focus measurement methodologies. Next to developments in imaging and focus control capability of scanners and general tool stability maintenance, on-product focus control improvements are also required to meet on-product imaging specifications. In this paper, we discuss focus monitoring, wafer (edge) fingerprint correction and on-product focus budget analysis through diffraction based focus (DBF) measurement methodology. Several examples will be presented showing better focus response and control on product wafers. Also, a method will be discussed for a focus interlock automation system on product for a high volume manufacturing (HVM) environment.

Integration of Functional Magnetic Resonance Imaging and Magnetoencephalography Functional Maps Into a CyberKnife Planning System: Feasibility Study for Motor Activity Localization and Dose Planning.

PubMed

De Martin, Elena; Duran, Dunja; Ghielmetti, Francesco; Visani, Elisa; Aquino, Domenico; Marchetti, Marcello; Sebastiano, Davide Rossi; Cusumano, Davide; Bruzzone, Maria Grazia; Panzica, Ferruccio; Fariselli, Laura

2017-12-01

Magnetoencephalography (MEG) and functional magnetic resonance imaging (fMRI) provide noninvasive localization of eloquent brain areas for presurgical planning. The aim of this study is the integration of MEG and fMRI maps into a CyberKnife (CK) system to optimize dose planning. Four patients with brain metastases in the motor area underwent functional imaging study of the hand motor cortex before radiosurgery. MEG data were acquired during a visually cued hand motor task. Motor activations were identified also using an fMRI block-designed paradigm. MEG and fMRI maps were then integrated into a CK system and contoured as organs at risk for treatment planning optimization. The integration of fMRI data into the CK system was achieved for all patients by means of a standardized protocol. We also implemented an ad hoc pipeline to convert the MEG signal into a DICOM standard, to make sure that it was readable by our CK treatment planning system. Inclusion of the activation areas into the optimization plan allowed the creation of treatment plans that reduced the irradiation of the motor cortex yet not affecting the brain peripheral dose. The availability of advanced neuroimaging techniques is playing an increasingly important role in radiosurgical planning strategy. We successfully imported MEG and fMRI activations into a CK system. This additional information can improve dose sparing of eloquent areas, allowing a more comprehensive investigation of the related dose-volume constraints that in theory could translate into a gain in tumor local control, and a reduction of neurological complications. Copyright © 2017 Elsevier Inc. All rights reserved.

Locality-preserving logical operators in topological stabilizer codes

NASA Astrophysics Data System (ADS)

Webster, Paul; Bartlett, Stephen D.

2018-01-01

Locality-preserving logical operators in topological codes are naturally fault tolerant, since they preserve the correctability of local errors. Using a correspondence between such operators and gapped domain walls, we describe a procedure for finding all locality-preserving logical operators admitted by a large and important class of topological stabilizer codes. In particular, we focus on those equivalent to a stack of a finite number of surface codes of any spatial dimension, where our procedure fully specifies the group of locality-preserving logical operators. We also present examples of how our procedure applies to codes with different boundary conditions, including color codes and toric codes, as well as more general codes such as Abelian quantum double models and codes with fermionic excitations in more than two dimensions.

Improved telescope focus using only two focus images

NASA Astrophysics Data System (ADS)

Barrick, Gregory; Vermeulen, Tom; Thomas, James

2008-07-01

In an effort to reduce the amount of time spent focusing the telescope and to improve the quality of the focus, a new procedure has been investigated and implemented at the Canada-France-Hawaii Telescope (CFHT). The new procedure is based on a paper by Tokovinin and Heathcote and requires only two out-of-focus images to determine the best focus for the telescope. Using only two images provides a great time savings over the five or more images required for a standard through-focus sequence. In addition, it has been found that this method is significantly less sensitive to seeing variations than the traditional through-focus procedure, so the quality of the resulting focus is better. Finally, the new procedure relies on a second moment calculation and so is computationally easier and more robust than methods using a FWHM calculation. The new method has been implemented for WIRCam for the past 18 months, for MegaPrime for the past year, and has recently been implemented for ESPaDOnS.

Matriculation Evaluation: Monographs on Designs from the Local Research Options Project.

ERIC Educational Resources Information Center

1992

In November 1989, nine research designs developed to assist local colleges in the evaluation of their matriculation activities were disseminated to the California community colleges. These designs, created as part of the Local Research Options Project, focused on measuring the effects of the colleges' matriculation activities on student…

Humanitarianism and local service institutions in Angola.

PubMed

Christoplos, I

1998-03-01

The role of local service institutions is not a major focus of current discourse on humanitarianism and complex emergencies. These institutions, in the few places where they are mentioned, are usually presented as either the seed of civil society and future democracy, or as pawns and components of the predatory economic, political and military élites. Few would deny that examples can be found which conform to both of these stereotypes. This simplistic representation of local institutions ignores the perspectives of the actors themselves--the nurses, extension agents, school teachers and others who actually staff most NGO-supported projects. The debate has focused on what 'we' should do; the moral dilemmas of aid agencies and their expatriate staff, inevitably leading to the question of whether or not humanitarian workers should stay or leave situations in which aid may be causing more harm than good. Without denying the fundamental importance of these issues, it is important to consider also how the discourse has unfortunately moved away from those humanitarian workers who have no such choice, since they live there. Current concerns about keeping humanitarian aid from feeding local political and military struggles may inadvertently and paradoxically serve to constrain room for maneuver in the field, particularly among those individuals with the greatest tacit understanding of the predatory environment. There is a need to understand how actors in local service institutions make sense of their own situations, including the factors which frame their moral dilemmas and their day-to-day choices. By analysing the organisational processes within local service institutions, this study is intended to provoke consideration of how these individuals and their institutions may be effectively supported in complex emergencies through a focus on how they themselves deal with danger and complexity. It is suggested that there is a value in considering the lessons learnt in recent

On the theory of self-focusing of powerful wave beams in nonhomogeneous media

NASA Technical Reports Server (NTRS)

Yerokhin, N. S.; Fadeyev, A. P.

1983-01-01

The stationary self-focusing of the Gauss wave beam is considered in a nonhomogeneous medium in the case of local nonlinearity. Equations of the aberrationless approximation for the beam width, the field on the beam axis and the refraction factor are integrated on a computer. Self-focusing in dependence of the nonlinearity level and initial divergence, the dissipation, the length of nonhomogeneity of the dielectric permittivity nondisturbed by a beam, and the diffraction parameter are investigated.

Sound localization in the alligator.

PubMed

Bierman, Hilary S; Carr, Catherine E

2015-11-01

In early tetrapods, it is assumed that the tympana were acoustically coupled through the pharynx and therefore inherently directional, acting as pressure difference receivers. The later closure of the middle ear cavity in turtles, archosaurs, and mammals is a derived condition, and would have changed the ear by decoupling the tympana. Isolation of the middle ears would then have led to selection for structural and neural strategies to compute sound source localization in both archosaurs and mammalian ancestors. In the archosaurs (birds and crocodilians) the presence of air spaces in the skull provided connections between the ears that have been exploited to improve directional hearing, while neural circuits mediating sound localization are well developed. In this review, we will focus primarily on directional hearing in crocodilians, where vocalization and sound localization are thought to be ecologically important, and indicate important issues still awaiting resolution. Copyright © 2015 Elsevier B.V. All rights reserved.

Quantum transport modeling of magnetic focusing in graphene p-n junctions

NASA Astrophysics Data System (ADS)

Lagasse, Samuel; Lee, Ji Ung

We demonstrate a new model for studying transverse magnetic focusing experiments in graphene p-n junctions, using quantum transport methods. By including a combination of dephasing edge contacts and Landauer-Büttiker multi-terminal analysis, we observe an exceptional degree of agreement with recent experimental data from Chen et al, without fitting parameters. Our model captures both the resonance and off-resonance non-local resistances from experiment. Our calculated quantum transmission functions indicate the origin of the sign of the measured resistance. Spatially resolved flow maps of local particle current density are used to explain our results and rapidly convey the mechanisms of device operation. Mode-by-mode analysis of transport shows the complex interplay between semi-classical skipping orbits and quantum effects. Quantum interference, p-n filtering, and edge scattering are clearly seen. Additionally, we are able to explain subtle features from experiment, such as the p-p- to p-p+ transition and the second p-n focusing resonance. The authors acknolwedge financial support provided by the U.S. Naval Research Laboratory (Grant Number: N00173-14-1-G017).

Tight focusing of higher orders Laguerre-Gaussian modes

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

Savelyev, Dmitry A., E-mail: dmitrey.savelyev@yandex.ru; Khonina, Svetlana N.; Samara State Aerospace University, 34 Moskovskoye Shosse, Samara 443086

2016-04-13

The spatial redistribution of the contribution of different electric field components provides a decrease in the size of the central focal spot for higher orders Laguerre-Gaussian modes. It was shown that when sharply focusing laser beams with vortex or special binary phase plate, a sub-wavelength light localization of separate vector field components is possible for any polarization type. This fact should be considered for the interaction of laser radiation with materials selectively sensitive to lateral and longitudinal components of the electromagnetic field.

Magnetic resonance guided high-intensity focused ultrasound ablation of musculoskeletal tumors

PubMed Central

Avedian, Raffi S.; Gold, Garry; Ghanouni, Pejman; Pauly, Kim Butts

2015-01-01

This article reviews the fundamental principles and clinical experimental uses of magnetic resonance guided high-intensity focused ultrasound (MRgHIFU) ablation of musculoskeletal tumors. MRgHIFU is a noninvasive treatment modality that takes advantage of the ability of magnetic resonance to measure tissue temperature and uses this technology to guide high-intensity focused ultrasound waves to a specific focus within the human body that results in heat generation and complete thermal necrosis of the targeted tissue. Adjacent normal tissues are spared because of the accurate delivery of thermal energy, as well as, local blood perfusion that provides a cooling effect. MRgHIFU is approved by the Food and Drug Administration for the treatment of uterine fibroids and is used on an experimental basis to treat breast, prostate, liver, bone, and brain tumors. PMID:26120376

Perceptual interaction of local motion signals

PubMed Central

Nitzany, Eyal I.; Loe, Maren E.; Palmer, Stephanie E.; Victor, Jonathan D.

2016-01-01

Motion signals are a rich source of information used in many everyday tasks, such as segregation of objects from background and navigation. Motion analysis by biological systems is generally considered to consist of two stages: extraction of local motion signals followed by spatial integration. Studies using synthetic stimuli show that there are many kinds and subtypes of local motion signals. When presented in isolation, these stimuli elicit behavioral and neurophysiological responses in a wide range of species, from insects to mammals. However, these mathematically-distinct varieties of local motion signals typically co-exist in natural scenes. This study focuses on interactions between two kinds of local motion signals: Fourier and glider. Fourier signals are typically associated with translation, while glider signals occur when an object approaches or recedes. Here, using a novel class of synthetic stimuli, we ask how distinct kinds of local motion signals interact and whether context influences sensitivity to Fourier motion. We report that local motion signals of different types interact at the perceptual level, and that this interaction can include subthreshold summation and, in some subjects, subtle context-dependent changes in sensitivity. We discuss the implications of these observations, and the factors that may underlie them. PMID:27902829

Perceptual interaction of local motion signals.

PubMed

Nitzany, Eyal I; Loe, Maren E; Palmer, Stephanie E; Victor, Jonathan D

2016-11-01

Motion signals are a rich source of information used in many everyday tasks, such as segregation of objects from background and navigation. Motion analysis by biological systems is generally considered to consist of two stages: extraction of local motion signals followed by spatial integration. Studies using synthetic stimuli show that there are many kinds and subtypes of local motion signals. When presented in isolation, these stimuli elicit behavioral and neurophysiological responses in a wide range of species, from insects to mammals. However, these mathematically-distinct varieties of local motion signals typically co-exist in natural scenes. This study focuses on interactions between two kinds of local motion signals: Fourier and glider. Fourier signals are typically associated with translation, while glider signals occur when an object approaches or recedes. Here, using a novel class of synthetic stimuli, we ask how distinct kinds of local motion signals interact and whether context influences sensitivity to Fourier motion. We report that local motion signals of different types interact at the perceptual level, and that this interaction can include subthreshold summation and, in some subjects, subtle context-dependent changes in sensitivity. We discuss the implications of these observations, and the factors that may underlie them.

Global Education and Local School Change.

ERIC Educational Resources Information Center

Otero, George

1983-01-01

Change strategies that focus on improving local schools' abilities to manage change are described, and examples of how the strategies can be applied to help the schools prepare students for life in a global society are furnished. Specific strategies are based on the work of Las Palomas de Taos, an agency promoting change in the Southwest. (PP)

Studying localized corrosion using liquid cell transmission electron microscopy

DOE PAGES

Chee, See Wee; Pratt, Sarah H.; Hattar, Khalid; ...

2014-11-07

Using liquid cell transmission electron microscopy (LCTEM), localized corrosion of Cu and Al thin films immersed in aqueous NaCl solutions was studied. We demonstrate that potentiostatic control can be used to initiate pitting and that local compositional changes, due to focused ion beam implantation of Au + ions, can modify the corrosion susceptibility of Al films. Likewise, a discussion on strategies to control the onset of pitting is also presented.

Theory of spin and lattice wave dynamics excited by focused laser pulses

NASA Astrophysics Data System (ADS)

Shen, Ka; Bauer, Gerrit E. W.

2018-06-01

We develop a theory of spin wave dynamics excited by ultrafast focused laser pulses in a magnetic film. We take into account both the volume and surface spin wave modes in the presence of applied, dipolar and magnetic anisotropy fields and include the dependence on laser spot exposure size and magnetic damping. We show that the sound waves generated by local heating by an ultrafast focused laser pulse can excite a wide spectrum of spin waves (on top of a dominant magnon–phonon contribution). Good agreement with recent experiments supports the validity of the model.

GGOS Focus Area 3: Understanding and Forecasting Sea-Level Rise and Variability

NASA Astrophysics Data System (ADS)

Schöne, Tilo; Shum, Ck; Tamisiea, Mark; Woodworth, Philip

2017-04-01

Sea level and its change have been measured for more than a century. Especially for coastal nations, deltaic regions, and coastal-oriented industries, observations of tides, tidal extremes, storm surges, and sea level rise at the interannual or longer scales have substantial impacts on coastal vulnerability towards resilience and sustainability of world's coastal regions. To date, the observed global sea level rise is largely associated with climate related changes. To find the patterns and fingerprints of those changes, and to e.g., separate the land motion from sea level signals, different monitoring techniques have been developed. Some of them are local, e.g., tide gauges, while others are global, e.g., satellite altimetry. It is well known that sea level change and land vertical motion varies regionally, and both signals need to be measured in order to quantify relative sea level at the local scale. The Global Geodetic Observing System (GGOS) and its services contribute in many ways to the monitoring of the sea level. These includes tide gauge observations, estimation of gravity changes, satellite altimetry, InSAR/Lidar, GNSS-control of tide gauges, providing ground truth sites for satellite altimetry, and importantly the maintenance of the International Reference Frame. Focus Area 3 (Understanding and Forecasting Sea-Level Rise and Variability) of GGOS establishes a platform and a forum for researchers and authorities dealing with estimating global and local sea level changes in a 10- to 30-year time span, and its project to the next century or beyond. It presents an excellent opportunity to emphasize the global, through to regional and local, importance of GGOS to a wide range of sea-level related science and practical applications. Focus Area 3 works trough demonstration projects to highlight the value of geodetic techniques to sea level science and applications. Contributions under a call for participation (http://www.ggos.org/Applications/theme3_SL

Mechanisms for focusing mitotic spindle poles by minus end-directed motor proteins.

PubMed

Goshima, Gohta; Nédélec, François; Vale, Ronald D

2005-10-24

During the formation of the metaphase spindle in animal somatic cells, kinetochore microtubule bundles (K fibers) are often disconnected from centrosomes, because they are released from centrosomes or directly generated from chromosomes. To create the tightly focused, diamond-shaped appearance of the bipolar spindle, K fibers need to be interconnected with centrosomal microtubules (C-MTs) by minus end-directed motor proteins. Here, we have characterized the roles of two minus end-directed motors, dynein and Ncd, in such processes in Drosophila S2 cells using RNA interference and high resolution microscopy. Even though these two motors have overlapping functions, we show that Ncd is primarily responsible for focusing K fibers, whereas dynein has a dominant function in transporting K fibers to the centrosomes. We also report a novel localization of Ncd to the growing tips of C-MTs, which we show is mediated by the plus end-tracking protein, EB1. Computer modeling of the K fiber focusing process suggests that the plus end localization of Ncd could facilitate the capture and transport of K fibers along C-MTs. From these results and simulations, we propose a model on how two minus end-directed motors cooperate to ensure spindle pole coalescence during mitosis.

A NEW METHOD FOR THE GENERATION AND USE OF FOCUSED ULTRASOUND IN EXPERIMENTAL BIOLOGY

PubMed Central

Lynn, John G.; Zwemer, Raymund L.; Chick, Arthur J.; Miller, August E.

1942-01-01

1. An efficient generator of focused ultrasound has been designed, built, and successfully operated. 2. The generator has been used to produce focal heating in the centers of paraffin blocks, and in a similar manner, focal areas of destruction were obtained deep in fresh liver tissue with minimal effects at the surface and no effects on the intervening tissue. 3. In animals, focused ultrasound of high intensity produced local cerebral changes as inferred from behavior disabilities and as demonstrated at autopsy. This local brain effect was achieved through intervening scalp, skull, and meninges. The resulting behavior disabilities disappeared in from 2 to 16 hours. 4. To date, it has not been possible to produce such brain changes without incidental injury to the skin and subcutaneous tissue lying at the base of the cone of radiation. 5. Improvements in generation and application of the focused supersonic beam are suggested whereby it should be possible to increase still further the focal effects in the brain, with a corresponding decrease or elimination of complicating surface injury. PMID:19873337

Gravity localization in sine-Gordon braneworlds

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

Cruz, W.T., E-mail: wilamicruz@gmail.com; Maluf, R.V., E-mail: r.v.maluf@fisica.ufc.br; Sousa, L.J.S., E-mail: luisjose@fisica.ufc.br

2016-01-15

In this work we study two types of five-dimensional braneworld models given by sine-Gordon potentials. In both scenarios, the thick brane is generated by a real scalar field coupled to gravity. We focus our investigation on the localization of graviton field and the behaviour of the massive spectrum. In particular, we analyse the localization of massive modes by means of a relative probability method in a Quantum Mechanics context. Initially, considering a scalar field sine-Gordon potential, we find a localized state to the graviton at zero mode. However, when we consider a double sine-Gordon potential, the brane structure is changedmore » allowing the existence of massive resonant states. The new results show how the existence of an internal structure can aid in the emergence of massive resonant modes on the brane.« less

MR-guided adaptive focusing of therapeutic ultrasound beams in the human head

PubMed Central

Marsac, Laurent; Chauvet, Dorian; Larrat, Benoît; Pernot, Mathieu; Robert, B.; Fink, Mathias; Boch, Anne-Laure; Aubry, Jean-François; Tanter, Mickaël

2012-01-01

Purpose This study aims to demonstrate, using human cadavers the feasibility of energy-based adaptive focusing of ultrasonic waves using Magnetic Resonance Acoustic Radiation Force Imaging (MR-ARFI) in the framework of non-invasive transcranial High Intensity Focused Ultrasound (HIFU) therapy. Methods Energy-based adaptive focusing techniques were recently proposed in order to achieve aberration correction. We evaluate this method on a clinical brain HIFU system composed of 512 ultrasonic elements positioned inside a full body 1.5 T clinical Magnetic Resonance (MR) imaging system. Cadaver heads were mounted onto a clinical Leksell stereotactic frame. The ultrasonic wave intensity at the chosen location was indirectly estimated by the MR system measuring the local tissue displacement induced by the acoustic radiation force of the ultrasound (US) beams. For aberration correction, a set of spatially encoded ultrasonic waves was transmitted from the ultrasonic array and the resulting local displacements were estimated with the MR-ARFI sequence for each emitted beam. A non-iterative inversion process was then performed in order to estimate the spatial phase aberrations induced by the cadaver skull. The procedure was first evaluated and optimized in a calf brain using a numerical aberrator mimicking human skull aberrations. The full method was then demonstrated using a fresh human cadaver head. Results The corrected beam resulting from the direct inversion process was found to focus at the targeted location with an acoustic intensity 2.2 times higher than the conventional non corrected beam. In addition, this corrected beam was found to give an acoustic intensity 1.5 times higher than the focusing pattern obtained with an aberration correction using transcranial acoustic simulation based on X-ray computed tomography (CT) scans. Conclusion The proposed technique achieved near optimal focusing in an intact human head for the first time. These findings confirm the strong

Family Resource Coalition Report. Focus: Families of Children with Special Needs.

ERIC Educational Resources Information Center

Family Resource Coalition Report, 1988

1988-01-01

This special issue of a periodical focuses on building support and resources for families of children with special needs. It contains 13 articles in addition to descriptions of 10 programs serving special needs families at the local level, a list of 15 resource organizations and 10 publications/audiovisual aids, and a message from the coalition's…

Investigating the Self-Perceived Science Teaching Needs of Local Elementary Educators

NASA Astrophysics Data System (ADS)

Carver, Cynthia G.

Elementary teachers in one school system have expressed low self-efficacy teaching science and desire more support teaching science. However, little research has been conducted on how best to meet these teachers' needs. The theories of perceived self-efficacy, social cognition, and behaviorism make up the conceptual framework of this study. The focus of this qualitative project study was on the needs of local elementary educators. These teachers were asked what they felt they needed most to be more effective science educators. The methodology of phenomenology was used in this study in which local elementary teachers were questioned in focus groups regarding their own science teaching efficacy and perceived needs. Using inductive analysis, data were coded for links to discussion questions as well as any additional patterns that emerged. Findings indicated that local elementary teachers desire improved communication among administrators and teachers as well as better science content support and training. Focus group participants agreed that teacher self-efficacy affects the time spent, effort toward, and quality of elementary science education. Using the results of the study, a science mentor program was developed to support the needs of elementary teachers and increase teacher self-efficacy, thus improving local elementary science education. Implications for positive social change include the development and support of elementary science programs in other school systems with the goal of improving science education for elementary students.

Acoustic droplet vaporization is initiated by superharmonic focusing.

PubMed

Shpak, Oleksandr; Verweij, Martin; Vos, Hendrik J; de Jong, Nico; Lohse, Detlef; Versluis, Michel

2014-02-04

Acoustically sensitive emulsion droplets composed of a liquid perfluorocarbon have the potential to be a highly efficient system for local drug delivery, embolotherapy, or for tumor imaging. The physical mechanisms underlying the acoustic activation of these phase-change emulsions into a bubbly dispersion, termed acoustic droplet vaporization, have not been well understood. The droplets have a very high activation threshold; its frequency dependence does not comply with homogeneous nucleation theory and localized nucleation spots have been observed. Here we show that acoustic droplet vaporization is initiated by a combination of two phenomena: highly nonlinear distortion of the acoustic wave before it hits the droplet and focusing of the distorted wave by the droplet itself. At high excitation pressures, nonlinear distortion causes significant superharmonics with wavelengths of the order of the droplet size. These superharmonics strongly contribute to the focusing effect; therefore, the proposed mechanism also explains the observed pressure thresholding effect. Our interpretation is validated with experimental data captured with an ultrahigh-speed camera on the positions of the nucleation spots, where we find excellent agreement with the theoretical prediction. Moreover, the presented mechanism explains the hitherto counterintuitive dependence of the nucleation threshold on the ultrasound frequency. The physical insight allows for the optimization of acoustic droplet vaporization for therapeutic applications, in particular with respect to the acoustic pressures required for activation, thereby minimizing the negative bioeffects associated with the use of high-intensity ultrasound.

Acoustic droplet vaporization is initiated by superharmonic focusing

PubMed Central

Shpak, Oleksandr; Verweij, Martin; Vos, Hendrik J.; de Jong, Nico; Lohse, Detlef; Versluis, Michel

2014-01-01

Acoustically sensitive emulsion droplets composed of a liquid perfluorocarbon have the potential to be a highly efficient system for local drug delivery, embolotherapy, or for tumor imaging. The physical mechanisms underlying the acoustic activation of these phase-change emulsions into a bubbly dispersion, termed acoustic droplet vaporization, have not been well understood. The droplets have a very high activation threshold; its frequency dependence does not comply with homogeneous nucleation theory and localized nucleation spots have been observed. Here we show that acoustic droplet vaporization is initiated by a combination of two phenomena: highly nonlinear distortion of the acoustic wave before it hits the droplet and focusing of the distorted wave by the droplet itself. At high excitation pressures, nonlinear distortion causes significant superharmonics with wavelengths of the order of the droplet size. These superharmonics strongly contribute to the focusing effect; therefore, the proposed mechanism also explains the observed pressure thresholding effect. Our interpretation is validated with experimental data captured with an ultrahigh-speed camera on the positions of the nucleation spots, where we find excellent agreement with the theoretical prediction. Moreover, the presented mechanism explains the hitherto counterintuitive dependence of the nucleation threshold on the ultrasound frequency. The physical insight allows for the optimization of acoustic droplet vaporization for therapeutic applications, in particular with respect to the acoustic pressures required for activation, thereby minimizing the negative bioeffects associated with the use of high-intensity ultrasound. PMID:24449879

The Interplay between Topic Shift and Focus in the Dynamic Construction of Discourse Representations.

PubMed

Yang, Xiaohong; Zhang, Xiuping; Wang, Cheng; Chang, Ruohan; Li, Weijun

2017-01-01

Previous studies have suggested that focusing an element can enhance the activation of the focused element and bring about a number of processing benefits. However, whether and how this local prominence of information interacts with global discourse organization remains unclear. In the present study, we addressed this issue in two experiments. Readers were presented with four-sentence discourses. The first sentence of each discourse contained a critical word that was either focused or unfocused in relation to a wh-question preceding the discourse. The second sentence either maintained or shifted the topic of the first sentence. Participants were told to read for comprehension and for a probe recognition task in which the memory of the critical words was tested. In Experiment 1, when the probe words were tested immediately after the point of topic shift, we found shorter response times for the focused critical words than the unfocused ones regardless of topic manipulation. However, in Experiment 2, when the probe words were tested two sentences away from the point of topic shift, we found the facilitation effect of focus only in the topic-maintained discourses, but not in the topic-shifted discourses. This suggests that the facilitation effect of focus was not immediately suppressed at the point of topic shifting, but when additional information was added to the new topic. Our findings provide evidence for the dynamic interplay between global topic structure and local salience of information and have important implications on how activation of information fluctuates in mental representation.

The Interplay between Topic Shift and Focus in the Dynamic Construction of Discourse Representations

PubMed Central

Yang, Xiaohong; Zhang, Xiuping; Wang, Cheng; Chang, Ruohan; Li, Weijun

2017-01-01

Previous studies have suggested that focusing an element can enhance the activation of the focused element and bring about a number of processing benefits. However, whether and how this local prominence of information interacts with global discourse organization remains unclear. In the present study, we addressed this issue in two experiments. Readers were presented with four-sentence discourses. The first sentence of each discourse contained a critical word that was either focused or unfocused in relation to a wh-question preceding the discourse. The second sentence either maintained or shifted the topic of the first sentence. Participants were told to read for comprehension and for a probe recognition task in which the memory of the critical words was tested. In Experiment 1, when the probe words were tested immediately after the point of topic shift, we found shorter response times for the focused critical words than the unfocused ones regardless of topic manipulation. However, in Experiment 2, when the probe words were tested two sentences away from the point of topic shift, we found the facilitation effect of focus only in the topic-maintained discourses, but not in the topic-shifted discourses. This suggests that the facilitation effect of focus was not immediately suppressed at the point of topic shifting, but when additional information was added to the new topic. Our findings provide evidence for the dynamic interplay between global topic structure and local salience of information and have important implications on how activation of information fluctuates in mental representation. PMID:29276496

Intensification of the impact of high-intensity focused ultrasound (HIFU) with special spatiotemporal modulation

NASA Astrophysics Data System (ADS)

Gusev, V. A.; Rudenko, O. V.

2013-01-01

The principle of forming a special form of powerful acoustic signals is proposed, which makes it possible to ensure precise spatiotemporal beam focusing. The introduction of a transverse-coordinate-dependent local wave frequency is suggested, due to which the equality of the formation lengths of a discontinuity for all rays is achieved. This thereby ensures an increase in nonlinear absorption; as a result, the temperature and radiation action of focused ultrasound on the medium increase.

Time-dependent change of blood flow in the prostate treated with high-intensity focused ultrasound.

PubMed

Shoji, Sunao; Tonooka, Akiko; Hashimoto, Akio; Nakamoto, Masahiko; Tomonaga, Tetsuro; Nakano, Mayura; Sato, Haruhiro; Terachi, Toshiro; Koike, Junki; Uchida, Toyoaki

2014-09-01

Avascular areas on contrast-enhanced magnetic resonance imaging have been considered to be areas of localized prostate cancer successfully treated by high-intensity focused ultrasound. However, the optimal timing of magnetic resonance imaging has not been discussed. The thermal effect of high-intensity focused ultrasound is degraded by regional prostatic blood flow. Conversely, the mechanical effect of high-intensity focused ultrasound (cavitation) is not affected by blood flow, and can induce vessel damage. In this series, the longitudinal change of blood flow on contrast-enhanced magnetic resonance imaging was observed from postoperative day 1 to postoperative day 14 in 10 patients treated with high-intensity focused ultrasound. The median rates of increase in the non-enhanced volume of the whole gland, transition zone and peripheral zone from postoperative day 1 to postoperative day 14 were 36%, 39%, and 34%, respectively. In another pathological analysis of the prostate tissue of 17 patients immediately after high-intensity focused ultrasound without neoadjuvant hormonal therapy, we observed diffuse coagulative degeneration and partial non-coagulative prostate tissue around arteries with vascular endothelial cell detachment. These observations on contrast-enhanced magnetic resonance imaging support a time-dependent change of the blood flow in the prostate treated with high-intensity focused ultrasound. Additionally, our pathological findings support the longitudinal changes of these magnetic resonance imaging findings. Further large-scale studies will investigate the most appropriate timing of contrast-enhanced magnetic resonance imaging for evaluation of the effectiveness of high-intensity focused ultrasound for localized prostate cancer. © 2014 The Japanese Urological Association.

Are Public Health Organizations Tweeting to the Choir? Understanding Local Health Department Twitter Followership

PubMed Central

Choucair, Bechara; Maier, Ryan C; Jolani, Nina; Bernhardt, Jay M

2014-01-01

Background One of the essential services provided by the US local health departments is informing and educating constituents about health. Communication with constituents about public health issues and health risks is among the standards required of local health departments for accreditation. Past research found that only 61% of local health departments met standards for informing and educating constituents, suggesting a considerable gap between current practices and best practice. Objective Social media platforms, such as Twitter, may aid local health departments in informing and educating their constituents by reaching large numbers of people with real-time messages at relatively low cost. Little is known about the followers of local health departments on Twitter. The aim of this study was to examine characteristics of local health department Twitter followers and the relationship between local health department characteristics and follower characteristics. Methods In 2013, we collected (using NodeXL) and analyzed a sample of 4779 Twitter followers from 59 randomly selected local health departments in the United States with Twitter accounts. We coded each Twitter follower for type (individual, organization), location, health focus, and industry (eg, media, government). Local health department characteristics were adopted from the 2010 National Association of City and County Health Officials Profile Study data. Results Local health department Twitter accounts were followed by more organizations than individual users. Organizations tended to be health-focused, located outside the state from the local health department being followed, and from the education, government, and non-profit sectors. Individuals were likely to be local and not health-focused. Having a public information officer on staff, serving a larger population, and “tweeting” more frequently were associated with having a higher percentage of local followers. Conclusions Social media has the

Surgery in temporal lobe epilepsy patients without cranial MRI lateralization.

PubMed

Gomceli, Y B; Erdem, A; Bilir, E; Kutlu, G; Kurt, S; Erden, E; Karatas, A; Erbas, C; Serdaroglu, A

2006-03-01

High resolution MRI is very important in the evaluations of patients with intractable temporal lobe epilepsy in preoperative investigations. Morphologic abnormalities on cranial MRI usually indicate the epileptogenic focus. Intractable TLE patients who have normal cranial MRI or bilateral hippocampal atrophy may have a chance for surgery if a certain epileptogenic focus is determined. We evaluated the patients who were monitorized in Gazi University Medical Faculty Epilepsy Center from October 1997 to April 2004. Seventy three patients, who had a temporal epileptogenic focus, underwent anterior temporal lobectomy at Ankara University Medical Faculty Department of Neurosurgery. Twelve of them (16, 4%), did not have any localizing structural lesion on cranial MRI. Of the 12 patients examined 6 had normal findings and 6 had bilateral hippocampal atrophy. Of these 12 patients, 6 (50%) were women and 6 (50%) were men. The ages of patients ranged from 7 to 37 (mean: 24.5). Preoperatively long-term scalp video-EEG monitoring, cranial MRI, neuropsychological tests, and Wada test were applied in all patients. Five patients, whose investigations resulted in conflicting data, underwent invasive monitoring by the use of subdural strips. The seizure outcome of patients were classified according to Engel with postsurgical follow-up ranging from 11 to 52 (median: 35.7) months. Nine patients (75%) were classified into Engel's Class I and the other 3 patients (25%) were placed into Engel's Class II. One patient who was classified into Engel's Class II had additional psychiatric problems. The other patient had two different epileptogenic foci independent from each other in her ictal EEG. One of them localized in the right anterior temporal area, the other was in the right frontal lobe. She was classified in Engel's Class II and had no seizure originating from temporal epileptic focus, but few seizures originating from the frontal region continued after the surgery. In conclusion

Youth Employment: National Policy and Local Delivery in Three U.S. Settings.

ERIC Educational Resources Information Center

Elmore, Richard F.

Research on the local implementation of national policies offering youth employment focused on "high-risk" youth in Seattle, San Francisco, and Clark County, Washington. Data from structured interviews with young people, front-line workers, and local administrators were analyzed using "backward mapping" (going from behavior to…

Maxillary growth after maxillary protraction: Appliance in conjunction with presurgical orthopedics, gingivoperiosteoplasty, and Furlow palatoplasty for complete bilateral cleft lip and palate patients with protruded premaxilla.

PubMed

Kobayashi, Shinji; Hirakawa, Takashi; Fukawa, Toshihiko; Maegawa, Jiro

2015-06-01

In bilateral cleft lip and palate (BCLP) with premaxillary protrusion, a good outcome with adequate maxillary development is difficult to achieve. The purpose of this article is to evaluate the maxillary growth after using presurgical orthopedics (PSO), gingivoperiosteoplasty (GPP), Furlow palatoplasty, and maxillary protraction appliance (MPA) for BCLP with premaxillary protrusion. Seven patients with complete BCLP with premaxillary protrusion were treated by PSO, cheiloplasty, GPP, and Furlow palatoplasty. MPA was used as part of the protocol for 6 months to 1 year for postoperative retardation of maxillary growth cases. Maxillary growth was evaluated by cephalometric analysis at 4 and 10 years of age, and bone formation at the alveolar cleft was evaluated by computed tomography (CT) imaging at 5 years of age. At 4 years of age, three of seven patients had apparent retardation of maxillary growth. The maxillary growth at 10 years of age was equivalent to the average value of normal Japanese after using MPA in three cases. At 5 years of age, only two of seven patients showed sufficient bone formation at the alveolar cleft to avoid alveolar bone grafting (ABG). Subsequently, ABG was performed in five patients. Although three of seven patients had apparent crossbite at 4 years of age, the maxillary growth of all patients at 10 years of age was approximately equivalent to the average value of normal Japanese after using MPA. A treatment protocol based on PSO, GPP, Furlow palatoplasty, and MPA may be an option, but long-term growth is unknown. Copyright © 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Salvage of locally recurrent prostate cancer after definitive radiotherapy.

PubMed

Mendenhall, William M; Henderson, Randal H; Hoppe, Bradford S; Nichols, Romaine C; Mendenhall, Nancy P

2014-08-01

Although a significant proportion of patients with localized prostate cancer are cured after definitive radiotherapy, solitary local recurrence is observed in a subset of patients and poses a management challenge. Curative-intent treatment options include prostatectomy, reirradiation, cryotherapy, and high-intensity-focused ultrasound. Outcomes data after any of these options are relatively limited. The 5-year biochemical progression-free survival rate is approximately 50% after salvage prostatectomy. However, the morbidity rate of the procedure is significantly higher compared with that observed in previously untreated patients. The likelihood of cure after low dose rate brachytherapy is similar to that observed after salvage prostatectomy, and the morbidity, although significant is less. Although cryotherapy and high-intensity-focused ultrasound may be less morbid than a prostatectomy, the probability of cure is probably lower.

Difference in the Surgical Outcome of Unilateral Cleft Lip and Palate Patients with and without Pre-Alveolar Bone Graft Orthodontic Treatment

NASA Astrophysics Data System (ADS)

Chang, Chun-Shin; Wallace, Christopher Glenn; Hsiao, Yen-Chang; Chiu, Yu-Ting; Pai, Betty Chien-Jung; Chen, I.-Ju; Liao, Yu-Fang; Liou, Eric Jen-Wein; Chen, Philip Kuo-Ting; Chen, Jyh-Ping; Noordhoff, M. Samuel

2016-04-01

Presurgical orthodontic treatment before secondary alveolar bone grafting (SABG) is widely performed for cleft lip/palate patients. However, no randomized controlled trial has been published comparing SABG outcomes in patients with, and without, presurgical orthodontic treatment. This randomized, prospective, single-blinded trial was conducted between January 2012 and April 2015 to compare ABG volumes 6 months postoperatively between patients with and without presurgical orthodontic treatment. Twenty-four patients were enrolled and randomized and 22 patients completed follow-up. Patients who had presurgical orthodontics before SABG had significantly improved inclination (p < 0.001) and rotation (p < 0.001) of the central incisor adjacent to the defect, significantly improved ABG fill volume (0.81 ± 0.26 cm3 at 6 months compared to 0.59 ± 0.22 cm3 p < 0.05) and less residual alveolar bone defect (0.31 ± 0.08 cm3 at 6 months compared to s 0.55 ± 0.14 cm3 p < 0.001) compared to patients who did not have presurgical orthodontic treatment. In conclusion, orthodontic treatment combined with SABG results in superior bone volume when compared with conventional SABG alone.

High-intensity focused ultrasound (HIFU) in patients with solid malignancies: evaluation of feasibility, local tumour response and clinical results.

PubMed

Orgera, G; Monfardini, L; Della Vigna, P; Zhang, L; Bonomo, G; Arnone, P; Padrenostro, M; Orsi, F

2011-08-01

The purpose of this study was to evaluate the safety and efficacy of ultrasound-guided high-intensity focused ultrasound (USgHIFU) for ablation of solid tumours without damaging the surrounding structures. A specific written informed consent was obtained from every patient before treatment. From September 2008 to April 2009, 22 patients with 29 lesions were treated: nine patients with liver and/or soft-tissue metastases from colorectal carcinoma (CRC), six with pancreatic solid lesions, three with liver and/or bone metastases from breast cancer, one with osteosarcoma, one with muscle metastasis from lung cancer, one with iliac metastasis from multiple myeloma and one with abdominal liposarcoma. The mean diameter of tumours was 4.2 cm. All patients were evaluated 1 day, 1 month and 3 months after HIFU treatment by multidetector computed tomography (MDCT), positron-emission tomography (PET)-CT and clinical evaluation. The treatment time and adverse events were recorded. All patients had one treatment. Average treatment and sonication times were, respectively, 162.7 and 37.4 min. PET-CT or/and MDCT showed complete response in 11/13 liver metastases; all bone, soft-tissue and pancreatic lesions were palliated in symptoms, with complete response to PET-CT, MDCT or magnetic resonance imaging (MRI); the liposarcoma was almost completely ablated at MRI. Local oedema was observed in three patients. No other side effects were observed. All patients were discharged 1-3 days after treatment. According to our preliminary experience in a small number of patients, we conclude that HIFU ablation is a safe and feasible technique for locoregional treatment and is effective in pain control.

Prosumer-Citizenship and the Local: A Critical Case Study of Consumer Reviewing on Yelp.com

ERIC Educational Resources Information Center

Kuehn, Kathleen M.

2011-01-01

Over the past few years, content developers searching for new markets have found a potentially lucrative consumer base in local and location-based services as new media platforms have begun to "expand" their focus to hyper-local place-based communities. This shift to "local 2.0" has given birth to "local listing sites," an emerging social medium…

Magnetic compound refractive lens for focusing and polarizing cold neutron beams.

PubMed

Littrell, K C; te Velthuis, S G E; Felcher, G P; Park, S; Kirby, B J; Fitzsimmons, M R

2007-03-01

Biconcave cylindrical lenses are used to focus beams of x rays or neutrons using the refractive properties of matter. In the case of neutrons, the refractive properties of magnetic induction can similarly focus and simultaneously polarize the neutron beam without the concomitant attenuation of matter. This concept of a magnetic refractive lens was tested using a compound lens consisting of 99 pairs of cylindrical permanent magnets. The assembly successfully focused the intensity of a white beam of cold neutrons of one spin state at the detector, while defocusing the other. This experiment confirmed that a lens of this nature may boost the intensity locally by almost an order of magnitude and create a polarized beam. An estimate of the performance of a more practically dimensioned device suitable for incorporation in reflectometers and slit-geometry small angle scattering instruments is given.

The weak coherence account: detail-focused cognitive style in autism spectrum disorders.

PubMed

Happé, Francesca; Frith, Uta

2006-01-01

"Weak central coherence" refers to the detail-focused processing style proposed to characterise autism spectrum disorders (ASD). The original suggestion of a core deficit in central processing resulting in failure to extract global form/meaning, has been challenged in three ways. First, it may represent an outcome of superiority in local processing. Second, it may be a processing bias, rather than deficit. Third, weak coherence may occur alongside, rather than explain, deficits in social cognition. A review of over 50 empirical studies of coherence suggests robust findings of local bias in ASD, with mixed findings regarding weak global processing. Local bias appears not to be a mere side-effect of executive dysfunction, and may be independent of theory of mind deficits. Possible computational and neural models are discussed.

Directionality fields generated by a local Hilbert transform

NASA Astrophysics Data System (ADS)

Ahmed, W. W.; Herrero, R.; Botey, M.; Hayran, Z.; Kurt, H.; Staliunas, K.

2018-03-01

We propose an approach based on a local Hilbert transform to design non-Hermitian potentials generating arbitrary vector fields of directionality, p ⃗(r ⃗) , with desired shapes and topologies. We derive a local Hilbert transform to systematically build such potentials by modifying background potentials (being either regular or random, extended or localized). We explore particular directionality fields, for instance in the form of a focus to create sinks for probe fields (which could help to increase absorption at the sink), or to generate vortices in the probe fields. Physically, the proposed directionality fields provide a flexible mechanism for dynamical shaping and precise control over probe fields leading to novel effects in wave dynamics.

Bridge deficiency metric refinement : longer-term planning for state and locally-owned bridges.

DOT National Transportation Integrated Search

2010-06-01

The focus of this study was to devise a prioritization scheme for locally-owned bridges and to extend the planning time horizon for state-owned bridges. The inherent nature of the local and county structures prevents a direct application of the formu...

High-intensity focused ultrasound (HIFU) using Sonablate{trade mark, serif} devices for the treatment of localized prostate cancer: 13-year experience

NASA Astrophysics Data System (ADS)

Uchida, Toyoaki; Tomonaga, Tetsuro; Shoji, Sunao; Kim, Hakushi; Nagata, Yoshihiro

2012-11-01

To report on the long-term results of high-intensity focused ultrasound (HIFU) in the treatment of localized prostate cancer. Eight hundred and eighty-four men with prostate cancer treated with Sonablate® (SB) devices were included. All patients were followed for more than 2 years. The patients were divided into three groups: in the first group, 419 patients were treated with SB200/500 from 1999 to 2006; in the second group, 263 patients were treated with SB 500 ver. 4 from 2005 to 2009: in the third group, 202 patients were treated with SB 500 TCM from 2007 up to present. Biochemical failure was defined according to the Phoenix definition (PSA nadir + 2 ng/ml). The mean age, PSA, Gleason score, operation time, and follow-up period in each group were 68, 66 and 67 years, 11.2, 9.7 and 9.3 ng/ml, 6.2, 6.6 and 6.7, 167, 101 and 106 min, and 56, 48 and 36 months, respectively. The biochemical disease-free rate (bDFR) in each group at 5 years was, respectively, 54%, 61% and 84%, and was 50% at 10 years in the SB200/500 group (p<0.0001). The bDFR in patients in the low-, intermediate-, and high-risk groups in all patients at 10 years were 72% and 58%, 44%, respectively (p<0.0001). The BDFR in patients in the low-, intermediate-, and high-risk groups in the SB500 TCM group at 5 years were 97%, 83%, and 74% (p=0.0056). The negative prostate biopsy rates in 3 groups were 81%, 92% and 88%, respectively. As post HIFU complications, urethral stricture, acute epididymitis and urinary incontinence were noted in 18.0%, 6.2% and 1.9%, respectively. Rectourethral fistula was occurred in 0.6% in the first HIFU cases, Postoperative erectile dysfunction was noted in 27% of patients at 2 years after HIFU. HIFU therapy appears to be minimally invasive, efficacious, and safe for patients with localized prostate cancer. Technological advances as well as cultural and economic vectors have caused a shift from to minimally invasive techniques.

Cytological diagnosis of thyroid nodules in Hashimoto thyroiditis in elderly patients

PubMed Central

2013-01-01

Background Long standing Hashimoto Thyroiditis (HT) causes shrinking and atrophy of the thyroid, but may also lead to diffuse enlargement of the gland and/or formation of nodules. These nodules should be differentiated from papillary thyroid carcinoma (PTC) and primary thyroidal non-Hodgkin lymphoma (PTL), which are possible complications of HT, and require pre-surgical diagnoses and different treatments. This study focuses on the role of fine-needle cytology (FNC) in the clinical surveillance and pre-surgical diagnosis of HT with diffuse and nodular enlargement of the gland in elderly patients. Methods Thirty-four elderly patients (≥ 65 yrs) with HT and diffuse or nodular enlargement of the thyroid underwent ultrasound (US)-guided FNC. Smears were routinely stained and evaluated; additional passes were used for flow cytometry (FC) assessment of lymphoid infiltrate in 6 cases. Results The cytological diagnosis was HT in 12 cases with prevalence of Hurtle cells in 2 cases, PTC in 1 case and PTL in 2 cases. FC assessed the reactive, non-lymphomatous nature of the lymphoid infiltrate in 5 cases and demonstrated light chain restriction, hence the lymphomatous nature of the lymphoid infiltrate in 2 cases of PTL. Conclusions FNC plays a key role in the clinical surveillance and pre-surgical diagnosis of diffuse enlargement and nodular presentation of HT in elderly patients. FNC can correctly diagnose HT, PTC and PTL indicating the need for surgery and its extension in suspicious or neoplastic cases, leaving other cases to the medical treatment and clinical surveillance. PMID:24266923

Local gene transfection in the cochlea (Review).

PubMed

Xia, Li; Yin, Shankai

2013-07-01

There is much interest in the potential application of vector-induced gene therapeutic approaches to several forms of hearing disorders due to the poor efficacy of existing treatments. The cochlea is an ideal site for local gene transfection due to its anatomical encapsulation and fluid flow within its ducts. However, this requires the development of novel technologies in materials science and microbial supply vectors for target gene delivery. This review focuses on the introduction of various viral and non-viral vectors as well as injection approaches to transfecting cochlear cells in vivo. Finally, the perspective of local gene therapy was discussed. Therapeutic approaches using local gene transfection may provide a means of cochlear cell and tissue protection and treatment in cases of exogenous hearing loss and endogenous disorders.

Local Responses to National Policy: The Contrasting Experiences of Two Midlands Cities to the Academies Act 2010

ERIC Educational Resources Information Center

Smith, Penny; Abbott, Ian

2014-01-01

Drawing on data from a series of semi-structured interviews this article reports on findings from a research project focusing on the responses of two local authorities and their secondary schools to the Academies Act 2010. The article considers the background and the development of the education system in both localities. It goes on to focus on…

Measures against increased environmental radiation dose by the TEPCO Fukushima Dai-ichi NPP accident in some local governments in the Tokyo metropolitan area: focusing on examples of both Kashiwa and Nagareyama cities in Chiba prefecture.

PubMed

Iimoto, T; Fujii, H; Oda, S; Nakamura, T; Hayashi, R; Kuroda, R; Furusawa, M; Umekage, T; Ohkubo, Y

2012-11-01

The accident of the Fukushima Dai-ichi nuclear power plant of Tokyo Electric Power Cooperation (TEPCO) after the great east Japan earthquake (11 March 2011) elevated the background level of environmental radiation in Eastern Japan. Around the Tokyo metropolitan area, especially around Kashiwa and Nagareyama cities, the ambient dose equivalent rate has been significantly increased after the accident. Responding to strong requests from citizens, the local governments started to monitor the ambient dose equivalent rate precisely and officially, about 3 months after the accident had occurred. The two cities in cooperation with each other also organised a local forum supported by three radiation specialists. In this article, the activities of the local governments are introduced, with main focus on radiation monitoring and measurements. Topics are standardisation of environmental radiation measurements for ambient dose rate, dose mapping activity, investigation of foodstuff and drinking water, lending survey meters to citizens, etc. Based on the data and facts mainly gained by radiation monitoring, risk management and relating activity have been organised. 'Small consultation meetings in kindergartens', 'health consultation service for citizens', 'education meeting on radiation protection for teachers, medical staffs, local government staffs, and leaders of active volunteer parties' and 'decontamination activity', etc. are present key activities of the risk management and restoration around the Tokyo metropolitan area.

Focused-ion-beam induced interfacial intermixing of magnetic bilayers for nanoscale control of magnetic properties.

PubMed

Burn, D M; Hase, T P A; Atkinson, D

2014-06-11

Modification of the magnetic properties in a thin-film ferromagnetic/non-magnetic bilayer system by low-dose focused ion-beam (FIB) induced intermixing is demonstrated. The highly localized capability of FIB may be used to locally control magnetic behaviour at the nanoscale. The magnetic, electronic and structural properties of NiFe/Au bilayers were investigated as a function of the interfacial structure that was actively modified using focused Ga(+) ion irradiation. Experimental work used MOKE, SQUID, XMCD as well as magnetoresistance measurements to determine the magnetic behavior and grazing incidence x-ray reflectivity to elucidate the interfacial structure. Interfacial intermixing, induced by low-dose irradiation, is shown to lead to complex changes in the magnetic behavior that are associated with monotonic structural evolution of the interface. This behavior may be explained by changes in the local atomic environment within the interface region resulting in a combination of processes including the loss of moment on Ni and Fe, an induced moment on Au and modifications to the spin-orbit coupling between Au and NiFe.

Local agency pavement marking plan : final report, July 2010.

DOT National Transportation Integrated Search

2010-07-01

The proposed FHWA amendments to the MUTCD will change the way local agencies manage their pavement markings and places a : focus on pavement marking quality and management methods. This research effort demonstrates how a pavement marking maintenance ...

Goal specificity and knowledge acquisition in statistics problem solving: evidence for attentional focus.

PubMed

Trumpower, David L; Goldsmith, Timothy E; Guynn, Melissa J

2004-12-01

Solving training problems with nonspecific goals (NG; i.e., solving for all possible unknown values) often results in better transfer than solving training problems with standard goals (SG; i.e., solving for one particular unknown value). In this study, we evaluated an attentional focus explanation of the goal specificity effect. According to the attentional focus view, solving NG problems causes attention to be directed to local relations among successive problem states, whereas solving SG problems causes attention to be directed to relations between the various problem states and the goal state. Attention to the former is thought to enhance structural knowledge about the problem domain and thus promote transfer. Results supported this view because structurally different transfer problems were solved faster following NG training than following SG training. Moreover, structural knowledge representations revealed more links depicting local relations following NG training and more links to the training goal following SG training. As predicted, these effects were obtained only by domain novices.

Patterns in Students' Argumentation Confronted with a Risk-Focused Socio-Scientific Issue

ERIC Educational Resources Information Center

Kolsto, Stein Dankert

2006-01-01

This paper reports a qualitative study on students' informal reasoning on a controversial socio-scientific issue. Twenty-two students from four science classes in Norway were interviewed about the local construction of new power lines and the possible increased risk of childhood leukaemia. The focus in the study is on what arguments the students…

Near-infrared spectroscopic study and the Wada test for presurgical evaluation of expressive and receptive language functions in glioma patients: with a case report of dissociated language functions.

PubMed

Sato, Yosuke; Uzuka, Takeo; Aoki, Hiroshi; Natsumeda, Manabu; Oishi, Makoto; Fukuda, Masafumi; Fujii, Yukihiko

2012-02-29

Near-infrared spectroscopy (NIRS) has proven to be useful for the evaluation of language lateralization in healthy subjects, infants, and epileptic patients. This study for the first time investigated the expressive and receptive language functions separately, using NIRS in presurgical glioma patients. We also describe a special case with dissociated pattern of language functions. Ten glioma patients were examined. Using NIRS, the hemodynamic changes during a verb generation task or story listening task were measured in the cerebral hemisphere on either side covering the language areas. Following the NIRS study, the Wada test was performed in all the patients. The NIRS study revealed increases of oxyhemoglobin and decreases of deoxyhemoglobin in the language areas elicited by both tasks. In 9 patients, who were all right-handed, the expressive and receptive language functions were lateralized to the left hemisphere. The results of the NIRS study were completely consistent with those of the Wada test. In the remaining 1 patient with a right sided insular glioma, who was right-handed, the NIRS study revealed stronger activation of the right inferior frontal region during the verb generation task, and stronger activation of the left superior temporal region during the story listening task. This dissociated language function was validated by the Wada test and the postoperative neurological course. These results demonstrate that a NIRS study using our technique is extremely valuable for preoperative assessment of the language functions and exemplifies how a preoperative NIRS study can allow detection of unforeseen language lateralization. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Comparison of changes in the transverse dental axis between patients with skeletal Class III malocclusion and facial asymmetry treated by orthognathic surgery with and without presurgical orthodontic treatment.

PubMed

Song, Han-Sol; Choi, Sung-Hwan; Cha, Jung-Yul; Lee, Kee-Joon; Yu, Hyung-Seog

2017-07-01

To evaluate transverse skeletal and dental changes, including those in the buccolingual dental axis, between patients with skeletal Class III malocclusion and facial asymmetry after bilateral intraoral vertical ramus osteotomy with and without presurgical orthodontic treatment. This retrospective study included 29 patients with skeletal Class III malocclusion and facial asymmetry including menton deviation > 4 mm from the midsagittal plane. To evaluate changes in transverse skeletal and dental variables (i.e., buccolingual inclination of the upper and lower canines and first molars), the data for 16 patients who underwent conventional orthognathic surgery (CS) were compared with those for 13 patients who underwent preorthodontic orthognathic surgery (POGS), using three-dimensional computed tomography at initial examination, 1 month before surgery, and at 7 days and 1 year after surgery. The 1-year postsurgical examination revealed no significant changes in the postoperative transverse dental axis in the CS group. In the POGS group, the upper first molar inclined lingually on both sides (deviated side, -1.8° ± 2.8°, p = 0.044; nondeviated side, -3.7° ± 3.3°, p = 0.001) and the lower canine inclined lingually on the nondeviated side (4.0° ± 5.4°, p = 0.022) during postsurgical orthodontic treatment. There were no significant differences in the skeletal and dental variables between the two groups at 1 year after surgery. POGS may be a clinically acceptable alternative to CS as a treatment to achieve stable transverse axes of the dentition in both arches in patients with skeletal Class III malocclusion and facial asymmetry.

Peri-ictal water drinking and other ictal vegetative symptoms: Localizing and lateralizing the epileptogenic zone in temporal lobe epilepsy? Two case reports and review of the literature.

PubMed

Errguig, L; Lahjouji, F; Belaidi, H; Jiddane, M; Elkhamlichi, A; Dakka, T; Ouazzani, R

2013-11-01

Peri-ictal behavior disorders can be helpful in localizing and lateralizing seizure onset in partial epilepsies, especially those originating in the temporal lobe. In this paper, we present the case of two right-handed women aged 36 and 42 years who presented with partial seizures of mesial temporal type. Both of the patients had drug resistant epilepsy and undergone presurgical evaluation tests including brain magnetic resonance imaging, video-EEG monitoring and neuropsychological testing. The two patients had hippocampal sclerosis in the right temporal lobe and exhibited PIWD behavior concomitant with right temporal lobe discharges documented during video-EEG recordings. Anterior temporal lobectomy was performed in one case with an excellent outcome after surgery. The patient was free of seizures at 3 years follow-up. We reviewed other publications of peri-ictal autonomic symptoms considered to have a lateralizing significance, such as peri-ictal vomiting, urinary urge, ictal pilo-erection. Clinicians should search for these symptoms, even if not spontaneously reported by the patient, because they are often under-estimated, both by the patients themselves and by physicians. Additionally, patients with lateralizing auras during seizures have a significantly better outcome after epilepsy surgery than those without lateralizing features. Copyright © 2013. Published by Elsevier Masson SAS.

Reliability of MEG source imaging of anterior temporal spikes: analysis of an intracranially characterized spike focus.

PubMed

Wennberg, Richard; Cheyne, Douglas

2014-05-01

To assess the reliability of MEG source imaging (MSI) of anterior temporal spikes through detailed analysis of the localization and orientation of source solutions obtained for a large number of spikes that were separately confirmed by intracranial EEG to be focally generated within a single, well-characterized spike focus. MSI was performed on 64 identical right anterior temporal spikes from an anterolateral temporal neocortical spike focus. The effects of different volume conductors (sphere and realistic head model), removal of noise with low frequency filters (LFFs) and averaging multiple spikes were assessed in terms of the reliability of the source solutions. MSI of single spikes resulted in scattered dipole source solutions that showed reasonable reliability for localization at the lobar level, but only for solutions with a goodness-of-fit exceeding 80% using a LFF of 3 Hz. Reliability at a finer level of intralobar localization was limited. Spike averaging significantly improved the reliability of source solutions and averaging 8 or more spikes reduced dependency on goodness-of-fit and data filtering. MSI performed on topographically identical individual spikes from an intracranially defined classical anterior temporal lobe spike focus was limited by low reliability (i.e., scattered source solutions) in terms of fine, sublobar localization within the ipsilateral temporal lobe. Spike averaging significantly improved reliability. MSI performed on individual anterior temporal spikes is limited by low reliability. Reduction of background noise through spike averaging significantly improves the reliability of MSI solutions. Copyright © 2013 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

New approach for local cancer treatment using pulsed high-intensity focused ultrasound and phase-change nanodroplets.

PubMed

Ashida, Reiko; Kawabata, Ken-Ichi; Maruoka, Takashi; Asami, Rei; Yoshikawa, Hideki; Takakura, Rena; Ioka, Tatsuya; Katayama, Kazuhiro; Tanaka, Sachiko

2015-10-01

The aim of this study was to investigate the combination effects of pulsed HIFU (pHIFU) and phase-change nanodroplets (PCND) as a sensitizer on efficient induction of mechanical effects of pHIFU and chemically enhanced tumor growth inhibition for local anti-tumor therapy. Changes in growth of colon 26 tumor tissue inoculated onto CDF1 mice were evaluated by the following treatments. (1) pHIFU exposure (1.1 MHz, 3.2 kW/cm(2), 300 cycles, and 50 ms interval) for 60 s, (2) PCND (1 %) injection, (3) adriamycin (4 mg/kg) injection, (4) pHIFU exposure after PCND injection, and (5) pHIFU exposure after PCND + adriamycin injection simultaneously. Significant changes in tumor growth were observed in the group with combination of pHIFU and PCND, although single therapy did not show any significant difference. PCND enhanced mechanical tissue fractionation by pHIFU, which was detectable by Real-time tissue elastography. Moreover, the combination of pHIFU and PCND + Adriamycin suppressed the tumor growth for 2 weeks, and 3 of 4 mice did not show any sign of regrowth during the 30-day observation. The combination of pHIFU and PCND exerted a significant anti-tumor effect and may be a new candidate for treatment of locally advanced cancer.

Test performance and classification statistics for the Rey Auditory Verbal Learning Test in selected clinical samples.

PubMed

Schoenberg, Mike R; Dawson, Kyra A; Duff, Kevin; Patton, Doyle; Scott, James G; Adams, Russell L

2006-10-01

The Rey Auditory Verbal Learning Test [RAVLT; Rey, A. (1941). L'examen psychologique dans les cas d'encéphalopathie traumatique. Archives de Psychologie, 28, 21] is a commonly used neuropsychological measure that assesses verbal learning and memory. Normative data have been compiled [Schmidt, M. (1996). Rey Auditory and Verbal Learning Test: A handbook. Los Angeles, CA: Western Psychological Services]. When assessing an individual suspected of neurological dysfunction, useful comparisons include the extent that the patient deviates from healthy peers and also how closely the subject's performance matches those with known brain injury. This study provides the means and S.D.'s of 392 individuals with documented neurological dysfunction [closed head TBI (n=68), neoplasms (n=57), stroke (n=47), Dementia of the Alzheimer's type (n=158), and presurgical epilepsy left seizure focus (n=28), presurgical epilepsy right seizure focus (n=34)] and 122 patients with no known neurological dysfunction and psychiatric complaints. Patients were stratified into three age groups, 16-35, 36-59, and 60-88. Data were provided for trials I-V, List B, immediate recall, 30-min delayed recall, and recognition. Classification characteristics of the RAVLT using [Schmidt, M. (1996). Rey Auditory and Verbal Learning Test: A handbook. Los Angeles, CA: Western Psychological Services] meta-norms found the RAVLT to best distinguish patients suspected of Alzheimer's disease from the psychiatric comparison group.

A cross-cultural segmentation of western Balkan consumers: focus on preferences toward traditional fresh cow cheese.

PubMed

Giraud, Georges; Amblard, Corinne; Thiel, Elise; Zaouche-Laniau, Martine; Stojanović, Zaklina; Pohar, Jure; Butigan, Ružica; Cvetković, Miljan; Mugosa, Boban; Kendrovski, Vladimir; Mora, Cristina; Barjolle, Dominique

2013-11-01

Western Balkan countries (WBCs) have a long-standing culinary tradition. The promotion of traditional foods may be a tool for coping with modernisation trends in such transition economies. This paper explores consumer preferences toward food in this region, focusing on a traditional fresh cow cheese locally called 'Mladi Sir'. This product was quoted in all the preliminary focus groups as a common traditional product present in the six WBCs studied: Bosnia-Herzegovina, Croatia, Macedonia, Montenegro, Serbia and Slovenia. After a literature review investigating the concept of traditional food in WBCs and the implementation of focus groups, a survey including a conjoint analysis on preferences for fresh cow cheese was carried out in 2011 to collect data from 1200 respondents. Four clusters of consumers were identified: one focused more on the local origin; one oriented more toward the scale of production (on-farm and small dairy); the third favouring low prices and the fourth preferring high prices and industrial products. Policy makers and the supply chain could take these differences in consumer preferences regarding traditional food products into account in order to develop specific strategies. © 2013 Society of Chemical Industry.

Pre-seizure architecture of the local connections of the epileptic focus examined via graph-theory.

PubMed

Vecchio, Fabrizio; Miraglia, Francesca; Vollono, Catello; Fuggetta, Filomena; Bramanti, Placido; Cioni, Beatrice; Rossini, Paolo Maria

2016-10-01

Epilepsy is characterized by unpredictable and sudden paroxysmal neuronal firing occurrences and sometimes evolving in clinically evident seizure. To predict seizure event, small-world characteristic in nine minutes before seizure, divided in three 3-min periods (T0, T1, T2) were investigated. Intracerebral recordings were obtained from 10 patients with drug resistant focal epilepsy examined by means of stereotactically implanted electrodes; analysis was focused in a period of low spiking (Baseline) and during two seizures. Networks' architecture is undirected and weighted. Electrodes' contacts close to epileptic focus are the vertices, edges are weighted by mscohere (=magnitude squared coherence). Differences were observed between Baseline and T1 and between Baseline and T2 in theta band; and between Baseline and T1, Baseline and T2, and near-significant difference between T0 and T2 in Alpha 2 band. Moreover, an intra-band index was computed for small worldness as difference between Theta and Alpha 2. It was found a growing index trend from Baseline to T2. Cortical network features a specific pre-seizure architecture which could predict the incoming epileptic seizure. Through this study future researches could investigate brain connectivity modifications approximating a clinical seizure also in order to address a preventive therapy. Copyright © 2016 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Evaluation of the pain and local tenderness in bone metastasis treated with magnetic resonance-guided focused ultrasound surgery (MRgFUS)

NASA Astrophysics Data System (ADS)

Namba, Hirofumi; Kawasaki, Motohiro; Kato, Tomonari; Tani, Toshikazu; Ushida, Takahiro; Koizumi, Norihiro

2017-03-01

It has been reported that MRgFUS has pain palliative effects on the local pain in patients with bone metastasis. In general, a severity of pain has been evaluated using only subjective method with numerical rating scale (NRS) or visual analogue scale (VAS). It is important to evaluate local pain-palliative effects of MRgFUS treatment with objective and quantitative method. The aim of this study is to investigate changes in the severity of local pain of bone metastasis before and after MRgFUS treatments, measuring pressure pain threshold (PPT) using pressure algometer, and pain intensity using electrical stimulation device (the Pain Vision system) at most painful site of bone metastasis. We have conducted MRgFUS for pain palliation of bone metastasis for 8 patients, and evaluated the local tenderness quantitatively for 8 patients, and evaluated local pain intensity for 7 patients. Before the treatments, PPTs were 106.3kPa [40.0-431.5] at metastatic site and 344.8 kPa [206.0-667.0] at normal control site, which showed a significant difference. The PPTs at metastatic site shows a significant increase from 106.3 kPa [40.0-431.5] at the baseline to 270.5 kPa [93.5-533.5] at 3 months after the treatment. The NRS score shows a significant decrease from 6.0 [4-8] at baseline to 1 [0-3] at 3 months after the treatment. Similarly, the pain intensity shows a significant decrease 245 [96.3-888.7] at baseline to 55.9 [2.8-292] at 3 months after the treatment. The results of our study illustrate the pain-relieving effects of MRgFUS for the treatment of painful bone metastasis. PPT might be a useful parameter not only for assessing a treatment's effect, but also for the decision of the painful area to treat with MRgFUS. Pain Vision seems to be useful for quantitative and objective evaluation of local pain of painful bone metastasis.

Supporting tobacco control: stimulating local newspaper coverage with a technical assistance website for local coalitions.

PubMed

Buller, David B; Bettinghaus, Erwin P; Helme, Donald; Young, Walter F; Borland, Ron; Maloy, Julie A; Cutter, Gary R; Andersen, Peter A; Walther, Joseph B

2011-11-01

A large and growing literature confirms that well-designed web-based programs can be effective in preventing or treating several chronic diseases. This study examined how the Internet can deliver information and train community activists and specifically tested the effects of web-based technical assistance on local tobacco control coalitions' efforts to use media advocacy to advance their agendas. The authors compared a highly interactive, Enhanced website (intervention) to a noninteractive, Basic text-based website (comparison) in Colorado communities. A total of 24 tobacco control coalitions led by local county health departments and nursing services were enrolled in the project and randomly assigned to use either the intervention or comparison website. A total of 73 local daily and weekly newspapers were identified in the service areas of 23 of the 24 coalitions. A posttest assessment of newspaper coverage was conducted to locate all newspaper articles with tobacco control information published between January 1 and April 9, 2004, the last 3 months of the intervention. Although there was no evidence of a treatment effect on the frequency of newspaper articles on tobacco-related issues, there was, however, evidence that newspapers in counties where the coalition had access to the Enhanced website printed more stories focused on local/regional issues and more anti-tobacco local/regional stories than in the counties where coalitions had access to the Basic website. Coalitions can improve their influence on local media for community tobacco control when high-quality online technical assistance, training, and resources are available to them.

Rationalization of a nanoparticle-based nicotine nanovaccine as an effective next-generation nicotine vaccine: A focus on hapten localization.

PubMed

Zhao, Zongmin; Hu, Yun; Harmon, Theresa; Pentel, Paul; Ehrich, Marion; Zhang, Chenming

2017-09-01

A lipid-polymeric hybrid nanoparticle-based next-generation nicotine nanovaccine was rationalized in this study to combat nicotine addiction. A series of nanovaccines, which had nicotine-haptens localized on carrier protein (LPKN), nanoparticle surface (LPNK), or both (LPNKN), were designed to study the impact of hapten localization on their immunological efficacy. All three nanovaccines were efficiently taken up and processed by dendritic cells. LPNKN induced a significantly higher immunogenicity against nicotine and a significantly lower anti-carrier protein antibody level compared to LPKN and LPNK. Meanwhile, it was found that the anti-nicotine antibodies elicited by LPKN and LPNKN bind nicotine stronger than those elicited by LPKN, and LPNK and LPNKN resulted in a more balanced Th1-Th2 immunity than LPKN. Moreover, LPNKN exhibited the best ability to block nicotine from entering the brain of mice. Collectively, the results demonstrated that the immunological efficacy of the hybrid nanoparticle-based nicotine vaccine could be enhanced by modulating hapten localization, providing a promising strategy to combatting nicotine addiction. Copyright © 2017 Elsevier Ltd. All rights reserved.

Side Streets: A Local History Project for Colorado Teachers. Final Performance Report.

ERIC Educational Resources Information Center

Downey, Matthew T.; Metcalf, Fay D.

This description of a project to help secondary school social studies classroom teachers incorporate local history into the curriculum focuses on objectives, project development and activities, and outcome data. The specific intent of this project was to help classroom teachers in Colorado overcome some of the obstacles to the use of local history…

Innovative Interactive Visitor Experiences Focused on Climate Change

NASA Astrophysics Data System (ADS)

Lettvin, E. E.

2011-12-01

Pacific Science Center has adopted a multi-pronged approach to introduce visitors to the concepts of climate change and linkages to human behavior in an informal science education setting. We leverage key fixed exhibit assets derived from collaborations with NOAA: Science on a Sphere and an exhibit kiosk showcasing local CO2 measurements that are adjacent on our exhibit floor. NOAA PMEL Scientists deployed a sensor at the top of the Space Needle that measures variability in atmospheric CO2 over Seattle; the kiosk showcases these near-real-time, daily, weekly and monthly measurements as well as similar observations from a NOAA buoy near Aberdeen, Washington. Displays of these data enable visitors to see first-hand varying CO2 levels in urban and remote marine environments as well as seasonal cycling. It also reveals quantifiable increases in CO2 levels over a relatively short time (~5 years). Trained interpreters help visitors understand linkages between personal behavior and corresponding CO2 footprints. Interpreters discuss connections between local and regional CO2 measurements displayed on the kiosk, and global Sphere datasets including NOAA Carbon Tracker, changing arctic sea ice coverage and sea level rise projections. Portable Discovery Carts, consisting of props and interactive, hands-on activities provide a platform for facilitated interpretation on a series of topics. We have developed two climate focused carts: 'Sinks and Sources' that examines materials and activities that produce and absorb carbon, and 'Ocean Acidification' that shows how absorption of atmospheric CO2 is changing ocean composition and its habitability for marine life. These carts can be deployed anywhere on the exhibit floor but are primarily used adjacent to the Sphere and the kiosk, making it possible to have a range of conversations about global and local CO2 levels, linkages to individual and collective behaviour and associated implications. Additional collaborations with members of

Mobilizing and Managing Social Capital: On Roles and Responsibilities of Local Facilitators in Territorial Development

ERIC Educational Resources Information Center

Schermer, Markus; Kirchengast, Christoph; Petit, Sandrine; Magnani, Natalia; Mieville-Ott, Valerie

2010-01-01

The paper explores the difficulties and challenges in mobilizing and managing social capital in concrete local and territorial directed rural development project activities. The main focus is put on the roles of local facilitators working with farmers and other local stakeholders during project implementation. The EU 5th framework project IMALP…

Phase-transition oscillations induced by a strongly focused laser beam

NASA Astrophysics Data System (ADS)

Devailly, Clémence; Crauste-Thibierge, Caroline; Petrosyan, Artyom; Ciliberto, Sergio

2015-11-01

We report the observation of a surprising phenomenon consisting in a oscillating phase transition which appears in a binary mixture when this is enlightened by a strongly focused infrared laser beam. The mixture is poly-methyl-meth-acrylate (PMMA)-3-octanone, which has an upper critical solution temperature at Tc=306.6 K and volume fraction ϕc=12.8 % [Crauste et al., arXiv:1310.6720, 2013]. We describe the dynamical properties of the oscillations, which are produced by a competition between various effects: the local accumulation of PMMA produced by the laser beam, thermophoresis, and nonlinear diffusion. We show that the main properties of this kind of oscillations can be reproduced in the Landau theory for a binary mixture in which a local driving mechanism, simulating the laser beam, is introduced.

Climate and local abundance in freshwater fishes

PubMed Central

Knouft, Jason H.; Anthony, Melissa M.

2016-01-01

Identifying factors regulating variation in numbers of individuals among populations across a species' distribution is a fundamental goal in ecology. A common prediction, often referred to as the abundant-centre hypothesis, suggests that abundance is highest near the centre of a species' range. However, because of the primary focus on the geographical position of a population, this framework provides little insight into the environmental factors regulating local abundance. While range-wide variation in population abundance associated with environmental conditions has been investigated in terrestrial species, the relationship between climate and local abundance in freshwater taxa across species' distributions is not well understood. We used GIS-based temperature and precipitation data to determine the relationships between climatic conditions and range-wide variation in local abundance for 19 species of North American freshwater fishes. Climate predicted a portion of the variation in local abundance among populations for 18 species. In addition, the relationship between climatic conditions and local abundance varied among species, which is expected as lineages partition the environment across geographical space. The influence of local habitat quality on species persistence is well documented; however, our results also indicate the importance of climate in regulating population sizes across a species geographical range, even in aquatic taxa. PMID:27429769

Evolution of local facilitation in arid ecosystems.

PubMed

Kéfi, Sonia; van Baalen, Minus; Rietkerk, Max; Loreau, Michel

2008-07-01

In harsh environments, sessile organisms can make their habitat more hospitable by buffering environmental stress or increasing resource availability. Although the ecological significance of such local facilitation is widely established, the evolutionary aspects have been seldom investigated. Yet addressing the evolutionary aspects of local facilitation is important because theoretical studies show that systems with such positive interactions can exhibit alternative stable states and that such systems may suddenly become extinct when they evolve (evolutionary suicide). Arid ecosystems currently experience strong changes in climate and human pressures, but little is known about the effects of these changes on the selective pressures exerted on the vegetation. Here, we focus on the evolution of local facilitation in arid ecosystems, using a lattice-structured model explicitly considering local interactions among plants. We found that the evolution of local facilitation depends on the seed dispersal strategy. In systems characterized by short-distance seed dispersal, adaptation to a more stressful environment leads to high local facilitation, allowing the population to escape extinction. In contrast, systems characterized by long-distance seed dispersal become extinct under increased stress even when allowed to adapt. In this case, adaptation in response to climate change and human pressures could give the final push to the desertification of arid ecosystems.

Local electric field direct writing – Electron-beam lithography and mechanism

DOE PAGES

Jiang, Nan; Su, Dong; Spence, John C. H.

2017-08-24

Local electric field induced by a focused electron probe in silicate glass thin films is evaluated in this paper by the migration of cations. Extremely strong local electric fields can be obtained by the focused electron probe from a scanning transmission electron microscope. As a result, collective atomic displacements occur. This newly revised mechanism provides an efficient tool to write patterned nanostructures directly, and thus overcome the low efficiency of the conventional electron-beam lithography. Applying this technique to silicate glass thin films, as an example, a grid of rods of nanometer dimension can be efficiently produced by rapidly scanning amore » focused electron probe. This nanopatterning is achieved through swift phase separation in the sample, without any post-development processes. The controlled phase separation is induced by massive displacements of cations (glass modifiers) within the glass-former network, driven by the strong local electric fields. The electric field is induced by accumulated charge within the electron probed region, which is generated by the excitation of atomic electrons by the incident electron. Throughput is much improved compared to other scanning probe techniques. Finally, the half-pitch spatial resolution of nanostructure in this particular specimen is 2.5 nm.« less

Local electric field direct writing – Electron-beam lithography and mechanism

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

Jiang, Nan; Su, Dong; Spence, John C. H.

Local electric field induced by a focused electron probe in silicate glass thin films is evaluated in this paper by the migration of cations. Extremely strong local electric fields can be obtained by the focused electron probe from a scanning transmission electron microscope. As a result, collective atomic displacements occur. This newly revised mechanism provides an efficient tool to write patterned nanostructures directly, and thus overcome the low efficiency of the conventional electron-beam lithography. Applying this technique to silicate glass thin films, as an example, a grid of rods of nanometer dimension can be efficiently produced by rapidly scanning amore » focused electron probe. This nanopatterning is achieved through swift phase separation in the sample, without any post-development processes. The controlled phase separation is induced by massive displacements of cations (glass modifiers) within the glass-former network, driven by the strong local electric fields. The electric field is induced by accumulated charge within the electron probed region, which is generated by the excitation of atomic electrons by the incident electron. Throughput is much improved compared to other scanning probe techniques. Finally, the half-pitch spatial resolution of nanostructure in this particular specimen is 2.5 nm.« less

Localization of soft modes at the depinning transition

NASA Astrophysics Data System (ADS)

Cao, Xiangyu; Bouzat, Sebastian; Kolton, Alejandro B.; Rosso, Alberto

2018-02-01

We characterize the soft modes of the dynamical matrix at the depinning transition, and compare the matrix with the properties of the Anderson model (and long-range generalizations). The density of states at the edge of the spectrum displays a universal linear tail, different from the Lifshitz tails. The eigenvectors are instead very similar in the two matrix ensembles. We focus on the ground state (soft mode), which represents the epicenter of avalanche instabilities. We expect it to be localized in all finite dimensions, and make a clear connection between its localization length and the Larkin length of the depinning model. In the fully connected model, we show that the weak-strong pinning transition coincides with a peculiar localization transition of the ground state.

Discrete-Time Local Value Iteration Adaptive Dynamic Programming: Admissibility and Termination Analysis.

PubMed

Wei, Qinglai; Liu, Derong; Lin, Qiao

In this paper, a novel local value iteration adaptive dynamic programming (ADP) algorithm is developed to solve infinite horizon optimal control problems for discrete-time nonlinear systems. The focuses of this paper are to study admissibility properties and the termination criteria of discrete-time local value iteration ADP algorithms. In the discrete-time local value iteration ADP algorithm, the iterative value functions and the iterative control laws are both updated in a given subset of the state space in each iteration, instead of the whole state space. For the first time, admissibility properties of iterative control laws are analyzed for the local value iteration ADP algorithm. New termination criteria are established, which terminate the iterative local ADP algorithm with an admissible approximate optimal control law. Finally, simulation results are given to illustrate the performance of the developed algorithm.In this paper, a novel local value iteration adaptive dynamic programming (ADP) algorithm is developed to solve infinite horizon optimal control problems for discrete-time nonlinear systems. The focuses of this paper are to study admissibility properties and the termination criteria of discrete-time local value iteration ADP algorithms. In the discrete-time local value iteration ADP algorithm, the iterative value functions and the iterative control laws are both updated in a given subset of the state space in each iteration, instead of the whole state space. For the first time, admissibility properties of iterative control laws are analyzed for the local value iteration ADP algorithm. New termination criteria are established, which terminate the iterative local ADP algorithm with an admissible approximate optimal control law. Finally, simulation results are given to illustrate the performance of the developed algorithm.

Local Foods, Local Places

EPA Pesticide Factsheets

The Local Foods, Local Places technical assistance program protects human health and the environment, spurs revitalization, increases access to healthy foods, and creates economic opportunities by promoting local foods.

In vivo characterization of tissue thermal properties of the kidney during local hyperthermia induced by MR-guided high-intensity focused ultrasound.

PubMed

Cornelis, François; Grenier, Nicolas; Moonen, Chrit T; Quesson, Bruno

2011-08-01

The purpose of this study was to evaluate quantitatively in vivo the tissue thermal properties during high-intensity focused ultrasound (HIFU) heating. For this purpose, a total of 52 localized sonications were performed in the kidneys of six pigs with HIFU monitored in real time by volumetric MR thermometry. The kidney perfusion was modified by modulation of the flow in the aorta by insertion of an inflatable angioplasty balloon. The resulting temperature data were analyzed using the bio-heat transfer model in order to validate the model under in vivo conditions and to estimate quantitatively the absorption (α), thermal diffusivity (D) and perfusion (w(b)) of renal tissue. An excellent correspondence was observed between the bio-heat transfer model and the experimental data. The absorption and thermal diffusivity were independent of the flow, with mean values (± standard deviation) of 20.7 ± 5.1 mm(3) K J(-1) and 0.23 ± 0.11 mm(2) s(-1), respectively, whereas the perfusion decreased significantly by 84% (p < 0.01) with arterial flow (mean values of w(b) of 0.06 ± 0.02 and 0.008 ± 0.007 mL(-1) mL s(-1)), as predicted by the model. The quantitative analysis of the volumetric temperature distribution during nondestructive HIFU sonication allows the determination of the thermal parameters, and may therefore improve the quality of the planning of noninvasive therapy with MR-guided HIFU. Copyright © 2010 John Wiley & Sons, Ltd.

Local Control in Action: Learning from the CORE Districts' Focus on Measurement, Capacity Building, and Shared Accountability. Policy Brief 16-4

ERIC Educational Resources Information Center

Marsh, Julie; Bush-Mecenas, Susan; Hough, Heather

2016-01-01

California and the nation are at the crossroads of a major shift in school accountability policy. At the state level, California's Local Control and Accountability Plan (LCAP) encourages the use of multiple measures of school performance used locally to support continuous improvement and strategic resource allocation. Similarly, the federal Every…

Minding Our Own Business: Local Retail Establishments and the Future of Southern Civic Community

ERIC Educational Resources Information Center

Tolbert, Charles M., II

2005-01-01

The civic community perspective focuses on local social and economic institutions that buffer communities from external, often global forces. Important community organizations such as locally oriented business establishments, civic organizations, associations, and churches are emphasized. These critical entities are posited to benefit a…

Local Government Leadership Education: Measuring the Impact of Leadership Skill Development on Public Officials

ERIC Educational Resources Information Center

Davis, Gregory A.; Lucente, Joe

2012-01-01

Many Extension leadership development programs have been evaluated for effectiveness. Little literature exists focusing on the evaluation of leadership development programs involving elected and appointed local officials. This article describes an annual program involving elected and appointed local officials and shares quantitative and…

Endovascular treatment of head and neck arteriovenous malformations.

PubMed

Dmytriw, A A; Ter Brugge, K G; Krings, T; Agid, R

2014-03-01

Head and neck arteriovenous malformations (H&N AVM) are associated with considerable clinical and psychosocial burden and present a significant treatment challenge. We evaluated the presentation, response to treatment, and outcome of patients with H&N AVMs treated by endovascular means at our institution. Patients with H&N AVMs treated by endovascular means from 1984 to 2012 were evaluated retrospectively. These included AVMs involving the scalp, orbit, maxillofacial, and upper neck localizations. Patient's clinical files, radiological images, catheter angiograms, and surgical reports were reviewed. Eighty-nine patients with H&N AVMs (46 females, 43 males; 48 small, 41 large) received endovascular therapy. The goals of treatment were curative (n = 30), palliative (n = 34), or presurgical (n = 25). The total number of endovascular treatment sessions was 244 (average of 1.5 per patient). The goal of treatment was met in 92.1 % of cases. Eventual cure was achieved in 42 patients accounting for 58.4 % (52/89) of all patients who underwent treatment for any goal. Twenty-eight of these patients were cured by embolization alone (28/89, 31.4 %) of which 18 were single-hole AVFs. Twenty-four were cured by planned surgical excision after presurgical embolization (24/89, 27 %). Seven patients (7/89, 7.2 %) suffered transient and two (2/89, 2.2 %) permanent endovascular treatment complications. Endovascular treatment is effective for H&N AVMs and relatively safe. It is particularly effective for symptom palliation and presurgical aid. Embolization is curative mostly in small lesions and single-hole fistulas. In patients with large non-curable H&N AVMs, endovascular therapy is often the only palliative option.

Biodiversity conservation in local planning.

PubMed

Miller, James R; Groom, Martha; Hess, George R; Steelman, Toddi; Stokes, David L; Thompson, Jan; Bowman, Troy; Fricke, Laura; King, Brandon; Marquardt, Ryan

2009-02-01

Local land-use policy is increasingly being recognized as fundamental to biodiversity conservation in the United States. Many planners and conservation scientists have called for broader use of planning and regulatory tools to support the conservation of biodiversity at local scales. Yet little is known about the pervasiveness of these practices. We conducted an on-line survey of county, municipal, and tribal planning directors (n =116) in 3 geographic regions of the United States: metropolitan Seattle, Washington; metropolitan Des Moines, Iowa; and the Research Triangle, North Carolina. Our objectives were to gauge the extent to which local planning departments address biodiversity conservation and to identify factors that facilitate or hinder conservation actions in local planning. We found that biodiversity conservation was seldom a major consideration in these departments. Staff time was mainly devoted to development mandates and little time was spent on biodiversity conservation. Regulations requiring conservation actions that might benefit biodiversity were uncommon, with the exception of rules governing water quality in all 3 regions and the protection of threatened and endangered species in the Seattle region. Planning tools that could enhance habitat conservation were used infrequently. Collaboration across jurisdictions was widespread, but rarely focused on conservation. Departments with a conservation specialist on staff tended to be associated with higher levels of conservation actions. Jurisdictions in the Seattle region also reported higher levels of conservation action, largely driven by state and federal mandates. Increased funding was most frequently cited as a factor that would facilitate greater consideration of biodiversity in local planning. There are numerous opportunities for conservation biologists to play a role in improving conservation planning at local scales.

Performing Compliance: The Work of Local Policy Workers during the Implementation of National Health Promotion Guidelines

ERIC Educational Resources Information Center

Wimmelmann, Camila Lawaetz

2017-01-01

Guidelines are increasingly used to regulate how local authorities engage in practices. Focusing on the Danish national health promotion guidelines, this article reveals that the local policy workers did not implement the guidelines as proposed. Using a dramaturgical framework, it illustrates how the local policy workers front-staged some…

Zoomed MRI Guided by Combined EEG/MEG Source Analysis: A Multimodal Approach for Optimizing Presurgical Epilepsy Work-up and its Application in a Multi-focal Epilepsy Patient Case Study.

PubMed

Aydin, Ü; Rampp, S; Wollbrink, A; Kugel, H; Cho, J -H; Knösche, T R; Grova, C; Wellmer, J; Wolters, C H

2017-07-01

In recent years, the use of source analysis based on electroencephalography (EEG) and magnetoencephalography (MEG) has gained considerable attention in presurgical epilepsy diagnosis. However, in many cases the source analysis alone is not used to tailor surgery unless the findings are confirmed by lesions, such as, e.g., cortical malformations in MRI. For many patients, the histology of tissue resected from MRI negative epilepsy shows small lesions, which indicates the need for more sensitive MR sequences. In this paper, we describe a technique to maximize the synergy between combined EEG/MEG (EMEG) source analysis and high resolution MRI. The procedure has three main steps: (1) construction of a detailed and calibrated finite element head model that considers the variation of individual skull conductivities and white matter anisotropy, (2) EMEG source analysis performed on averaged interictal epileptic discharges (IED), (3) high resolution (0.5 mm) zoomed MR imaging, limited to small areas centered at the EMEG source locations. The proposed new diagnosis procedure was then applied in a particularly challenging case of an epilepsy patient: EMEG analysis at the peak of the IED coincided with a right frontal focal cortical dysplasia (FCD), which had been detected at standard 1 mm resolution MRI. Of higher interest, zoomed MR imaging (applying parallel transmission, 'ZOOMit') guided by EMEG at the spike onset revealed a second, fairly subtle, FCD in the left fronto-central region. The evaluation revealed that this second FCD, which had not been detectable with standard 1 mm resolution, was the trigger of the seizures.

Capacity-building activities for local leadership in Egypt from the local to the national and regional levels.

PubMed

El Sioufi, M

1996-03-01

In order to make the Sustainable Ismailia Project institutionally sustainable, the National Project Manager identified the need to build the capacity of local leadership. The Training Section, in UNCHS, proposed a capacity-building program designed to respond to this demand focusing on the skill-training and attitude formation needed for effective local leadership. The proposed program is adapted from the "Training for Elected Leadership" series widely tested and used in many regions. It combines direct training for local officials from villages in Ismailia, and indirect training for trainers from the Ministry of Local Administration (MLA). After the course, the MLA trainers would design a training program which they will implement nationally. The Minister for Local Administration decided to finance the translation and production of the manuals, while the Governor of Ismailia offered to cover the trainees' expenses. The UNCHS Training and Capacity-Building Section would provide technical guidance and coordinate and implement the program. Once the Arabic version of the training materials would be available, UNCHS would use it regionally to reach out to other Arab States. This example illustrates how concerned stakeholders cooperate to address capacity-building needs. The UNCHS Training Section assumes the role of facilitator and acts as a catalyst for the formulation of such activities. The feeling of ownership of the locally produced/adapted training materials enhances the propensity of their effective and extensive use. This approach has succeeded across regions, cultures, and languages with out-reaching multiplier effects. full text

Stability of Synchronization Clusters and Seizurability in Temporal Lobe Epilepsy

PubMed Central

Palmigiano, Agostina; Pastor, Jesús; García de Sola, Rafael; Ortega, Guillermo J.

2012-01-01

Purpose Identification of critical areas in presurgical evaluations of patients with temporal lobe epilepsy is the most important step prior to resection. According to the “epileptic focus model”, localization of seizure onset zones is the main task to be accomplished. Nevertheless, a significant minority of epileptic patients continue to experience seizures after surgery (even when the focus is correctly located), an observation that is difficult to explain under this approach. However, if attention is shifted from a specific cortical location toward the network properties themselves, then the epileptic network model does allow us to explain unsuccessful surgical outcomes. Methods The intraoperative electrocorticography records of 20 patients with temporal lobe epilepsy were analyzed in search of interictal synchronization clusters. Synchronization was analyzed, and the stability of highly synchronized areas was quantified. Surrogate data were constructed and used to statistically validate the results. Our results show the existence of highly localized and stable synchronization areas in both the lateral and the mesial areas of the temporal lobe ipsilateral to the clinical seizures. Synchronization areas seem to play a central role in the capacity of the epileptic network to generate clinical seizures. Resection of stable synchronization areas is associated with elimination of seizures; nonresection of synchronization clusters is associated with the persistence of seizures after surgery. Discussion We suggest that synchronization clusters and their stability play a central role in the epileptic network, favoring seizure onset and propagation. We further speculate that the stability distribution of these synchronization areas would differentiate normal from pathologic cases. PMID:22844524

Focused-ion-beam-inflicted surface amorphization and gallium implantation--new insights and removal by focused-electron-beam-induced etching.

PubMed

Roediger, P; Wanzenboeck, H D; Waid, S; Hochleitner, G; Bertagnolli, E

2011-06-10

Recently focused-electron-beam-induced etching of silicon using molecular chlorine (Cl(2)-FEBIE) has been developed as a reliable and reproducible process capable of damage-free, maskless and resistless removal of silicon. As any electron-beam-induced processing is considered non-destructive and implantation-free due to the absence of ion bombardment this approach is also a potential method for removing focused-ion-beam (FIB)-inflicted crystal damage and ion implantation. We show that Cl(2)-FEBIE is capable of removing FIB-induced amorphization and gallium ion implantation after processing of surfaces with a focused ion beam. TEM analysis proves that the method Cl(2)-FEBIE is non-destructive and therefore retains crystallinity. It is shown that Cl(2)-FEBIE of amorphous silicon when compared to crystalline silicon can be up to 25 times faster, depending on the degree of amorphization. Also, using this method it has become possible for the first time to directly investigate damage caused by FIB exposure in a top-down view utilizing a localized chemical reaction, i.e. without the need for TEM sample preparation. We show that gallium fluences above 4 × 10(15) cm(-2) result in altered material resulting from FIB-induced processes down to a depth of ∼ 250 nm. With increasing gallium fluences, due to a significant gallium concentration close beneath the surface, removal of the topmost layer by Cl(2)-FEBIE becomes difficult, indicating that gallium serves as an etch stop for Cl(2)-FEBIE.

Temperature distributions in tissues during local hyperthermia by stationary or steered beams of unfocused or focused ultrasound.

PubMed Central

Lele, P. P.; Parker, K. J.

1982-01-01

Temperature distributions resulting from insonation with stationary or steered beams of unfocused or focused ultrasound were measured in tissue-equivalent phantom, beef muscle in vitro, dog muscle mass, and transplanted murine tumours in vivo. Arrays of 4 to 6 thermocouples stepped through the volume of interest under computer control were used to measure the steady-state temperatures at 600 to 800 locations in both in vitro and in vivo experiments. The results were confirmed in spontaneous tumours in dog patients using fewer multi-thermocouple probes. Plane wave ultrasound was found to result in spatially non-uniform hyperthermia even in superficial tumours. The region of maximum temperature rise was small in extent and was situated at a depth which varied in the different models from 0.5 to 1.0 cm. Neither its location nor its extent could be varied by spatial manipulations of the transducer or by changing the insonation parameters except the ultrasonic frequency. A second region of hyperthermia was produced at depth by reflective heating if an ultrasonically reflective target, such as bone or air-containing tissue, was located below the target tissue. On the other hand, using available steered, focused ultrasound techniques, tumours (whether situated superficially or at depth) could be heated to a uniform, controllable temperature without undesirable temperature elevation in surrounding normal tissues. The use of steered, focused ultrasound permits deposition of energy to be tailored to the specific needs of each individual tumour. The small size of the focal region enables heating of tumours even when located near ultrasound reflecting targets. PMID:6950746

Early FDG PET response assessment of preoperative radiochemotherapy in locally advanced rectal cancer: correlation with long-term outcome.

PubMed

Avallone, Antonio; Aloj, Luigi; Caracò, Corradina; Delrio, Paolo; Pecori, Biagio; Tatangelo, Fabiana; Scott, Nigel; Casaretti, Rossana; Di Gennaro, Francesca; Montano, Massimo; Silvestro, Lucrezia; Budillon, Alfredo; Lastoria, Secondo

2012-12-01

The aim of the present study is to prospectively evaluate the prognostic value of previously defined [(18)F]2-fluoro-2-deoxy-D-glucose positron emission tomography (FDG PET) criteria of early metabolic response in patients with locally advanced rectal cancer (LARC) after long-term follow-up. Forty-two patients with poor prognosis LARC underwent three biweekly courses of chemotherapy with oxaliplatin, raltitrexed and 5-fluorouracil modulated by levofolinic acid during pelvic radiotherapy. FDG PET studies were performed before and 12 days after the beginning of the chemoradiotherapy (CRT) treatment. Total mesorectal excision (TME) was carried out 8 weeks after completion of CRT. A previously identified cutoff value of ≥52 % reduction of the baseline mean FDG standardized uptake value (SUV(mean)) was applied to differentiate metabolic responders from non-responders and correlated to tumour regression grade (TRG) and survival. Twenty-two metabolic responders showed complete (TRG1) or subtotal tumour regression (TRG2) and demonstrated a statistically significantly higher 5-year relapse-free survival (RFS) compared with the 20 non-responders (86 vs 55 %, p = .014) who showed TRG3 and TRG4 pathologic responses. A multivariate analysis demonstrated that early ∆SUV(mean) was the only pre-surgical parameter correlated to the likelihood of recurrence (p = .05). This study is the first prospective long-term evaluation demonstrating that FDG PET is not only an early predictor of pathologic response but is also a valuable prognostic tool. Our results indicate the potential of FDG PET for optimizing multidisciplinary management of patients with LARC.

Jet Noise Source Localization Using Linear Phased Array

NASA Technical Reports Server (NTRS)

Agboola, Ferni A.; Bridges, James

2004-01-01

A study was conducted to further clarify the interpretation and application of linear phased array microphone results, for localizing aeroacoustics sources in aircraft exhaust jet. Two model engine nozzles were tested at varying power cycles with the array setup parallel to the jet axis. The array position was varied as well to determine best location for the array. The results showed that it is possible to resolve jet noise sources with bypass and other components separation. The results also showed that a focused near field image provides more realistic noise source localization at low to mid frequencies.

3D flow focusing for microfluidic flow cytometry with ultrasonics

NASA Astrophysics Data System (ADS)

Gnyawali, Vaskar; Strohm, Eric M.; Daghighi, Yasaman; van de Vondervoort, Mia; Kolios, Michael C.; Tsai, Scott S. H.

2015-11-01

We are developing a flow cytometer that detects unique acoustic signature waves generated from single cells due to interactions between the cells and ultrasound waves. The generated acoustic waves depend on the size and biomechanical properties of the cells and are sufficient for identifying cells in the medium. A microfluidic system capable of focusing cells through a 10 x 10 μm ultrasound beam cross section was developed to facilitate acoustic measurements of single cells. The cells are streamlined in a hydro-dynamically 3D focused flow in a 300 x 300 μm channel made using PDMS. 3D focusing is realized by lateral sheath flows and an inlet needle (inner diameter 100 μm). The accuracy of the 3D flow focusing is measured using a dye and detecting its localization using confocal microscopy. Each flowing cell would be probed by an ultrasound pulse, which has a center frequency of 375 MHz and bandwidth of 250 MHz. The same probe would also be used for recording the scattered waves from the cells, which would be processed to distinguish the physical and biomechanical characteristics of the cells, eventually identifying them. This technique has potential applications in detecting circulating tumor cells, blood cells and blood-related diseases.

Image- and model-based surgical planning in otolaryngology.

PubMed

Korves, B; Klimek, L; Klein, H M; Mösges, R

1995-10-01

Preoperative evaluation of any operating field is essential for the preparation of surgical procedures. The relationship between pathology and adjacent structures, and anatomically dangerous sites need to be analyzed for the determination of intraoperative action. For the simulation of surgery using three-dimensional imaging or individually manufactured plastic patient models, the authors have worked out different procedures. A total of 481 surgical interventions in the maxillofacial region, paranasal sinuses, orbit, and the anterior and middle skull base, in addition to neurotologic procedures were presurgically simulated using three-dimensional imaging and image manipulation. An intraoperative simulation device, part of the Aachen Computer-Assisted Surgery System, had been applied in 407 of these cases. In seven patients, stereolithography was used to create plastic patient models for the preparation of reconstructive surgery and prostheses fabrication. The disadvantages of this process include time and cost; however, the advantages included (1) a better understanding of the anatomic relationships, (2) the feasibility of presurgical simulation of the prevailing procedure, (3) an improved intraoperative localization accuracy, (4) prostheses fabrication in reconstructive procedures with an approach to more accuracy, (5) permanent recordings for future requirements or reconstructions, and (6) improved residency education.

Analysis of primary gingivoperiosteoplasty in alveolar cleft repair. Part I: Facial growth.

PubMed

Henkel, K O; Gundlach, K K

1997-10-01

The primary gingivoperiosteoplasty by Millard consists of presurgical active orthognathic treatment ('Latham device') of the alveolar margins at the age of 3 months and of surgical closure of the alveolar cleft with local gingivoperiosteal flaps at the age of 5 months. The aim of this investigation was to analyse the facial growth following this treatment. The following material was studied: lateral head X-rays and plaster casts from 146 patients with unilateral (UCLP) and bilateral (BCLP) clefts of lip and palate from birth to 16 years of age. Ninety-one of these patients formed the control group, who received neither gingivoperiosteoplasty nor pre-surgical active orthognathic treatment. The same surgeon and orthodontist treated all 146 patients. A three-dimensional growth disturbance after gingivoperiosteoplasty was observed: 42% patients with UCLP and 40% patients with BCLP had an 'open bite' following closure of the alveolar cleft (control group 5%/10%). The length of the upper jaw in patients who underwent gingivoperiosteoplasty was shorter than in the control group. The frequency of posterior cross bite was also higher in the gingivoperiosteoplasty group. These results demonstrate that treatment with a 'Latham device' disturbs facial growth. Therefore, this treatment should be abandoned.

Local immunological mechanisms of sublingual immunotherapy.

PubMed

Allam, Jean-Pierre; Novak, Natalija

2011-12-01

To summarize novel insights into the immunological mechanisms of sublingual immunotherapy (SLIT). Within the recent decades, several alternative noninvasive allergen application strategies have been investigated in allergen-specific immunotherapy (AIT), of which intra-oral allergen application to sublingual mucosa has been proven to be well tolerated and effective. To date, SLIT is widely accepted by most allergists as an alternative option to conventional subcutaneous immunotherapy (SCIT). Although detailed immunological mechanisms remain to be elucidated, much scientific effort has been made to shed some light on local and systemic immunological responses to SLIT in mice as well as humans. Only a few studies focused on the detailed mechanisms following allergen application to the oral mucosa as part of the sophisticated mucosal immunological network. Within this network, the pro-tolerogenic properties of local antigen-presenting cells (APCs) such as dendritic cells - which are able to enforce tolerogenic mechanisms and to induce T-cell immune responses - play a central role. Further on, basic research focused not only on the immune response in nasal and bronchial mucosa but also on the systemic T-cell immune response. Thus, much exiting data have been published providing a better understanding of immunological features of SLIT but far more investigations are necessary to uncover further exciting details on the key mechanisms of SLIT.

Ion focusing

DOEpatents

Cooks, Robert Graham; Baird, Zane; Peng, Wen-Ping

2015-11-10

The invention generally relates to apparatuses for focusing ions at or above ambient pressure and methods of use thereof. In certain embodiments, the invention provides an apparatus for focusing ions that includes an electrode having a cavity, at least one inlet within the electrode configured to operatively couple with an ionization source, such that discharge generated by the ionization source is injected into the cavity of the electrode, and an outlet. The cavity in the electrode is shaped such that upon application of voltage to the electrode, ions within the cavity are focused and directed to the outlet, which is positioned such that a proximal end of the outlet receives the focused ions and a distal end of the outlet is open to ambient pressure.

Ion focusing

DOEpatents

Cooks, Robert Graham; Baird, Zane; Peng, Wen-Ping

2017-01-17

The invention generally relates to apparatuses for focusing ions at or above ambient pressure and methods of use thereof. In certain embodiments, the invention provides an apparatus for focusing ions that includes an electrode having a cavity, at least one inlet within the electrode configured to operatively couple with an ionization source, such that discharge generated by the ionization source is injected into the cavity of the electrode, and an outlet. The cavity in the electrode is shaped such that upon application of voltage to the electrode, ions within the cavity are focused and directed to the outlet, which is positioned such that a proximal end of the outlet receives the focused ions and a distal end of the outlet is open to ambient pressure.

Focus Groups Help To Focus the Marketing Strategy.

ERIC Educational Resources Information Center

Ashar, Hanna; Lane, Maureen

1996-01-01

A university-based degree completion program for adults conducted focus group research to refine market positioning and promotion. Focus groups averaged five current students and recent graduates who reflected, demographically, the current student population. Results gave insight into reasons for selecting the university, aspects of the program…

'Gay times': identity, locality, memory, and the Brixton squats in 1970's London.

PubMed

Cook, Matt

2013-01-01

Through a thick description of a gay squatting community in south London in the 1970s, this piece explores the ways in which local histories complicate broader accounts of gay life, politics, and culture. Such a focus alerts us to the impact of personal encounters, of local politics, and material circumstances, of coincident local communities, of jobs (or the lack of them), and of major local events (like the Brixton riots of 1981). The local focus and the oral history sources also illuminate the complex ways in which unspoken and often unconscious imperatives associated with ethnicity, class, and the familial, social, and cultural contexts of our upbringings are played out under new and changing circumstances. Taking this approach fractures homogenizing assumptions about gay identity and community--even of a self-identified gay community like this squatting collective. It can also decentre sexuality as a primary category of identity and analysis as other factors come into sharper focus and shed light on the ebb and flow of identification and on the ways in which broader histories are woven into everyday lives. The piece thus considers different scales of analysis, the limits of identification, the inclusions and exclusions enacted when communities come together and identities coalesce, the continuities and discontinuities between broader and counter cultures (especially in relation to ideas and lived experiences of home), and the way memories of the squats and of the 1970s are modulated by subsequent national and gay politics, by AIDS, and by a profound sense of loss.

Cable Television In Metro Denver. Background and Policy Issues For Local Decision-Making.

ERIC Educational Resources Information Center

Bortz, Paul I.; Gilmore, John S.

A general introduction to cable television (CATV) in the metropolitan Denver area, with a focus on policy issues for local decision-making, is provided. The overview is based upon a literature review, information presented at conferences, local surveys of CATV, interviews with people involved with CATV, and on-going research conducted by the…

Aid conditionalities, international Good Manufacturing Practice standards and local production rights: a case study of local production in Nepal.

PubMed

Brhlikova, Petra; Harper, Ian; Subedi, Madhusudan; Bhattarai, Samita; Rawal, Nabin; Pollock, Allyson M

2015-06-14

Local pharmaceutical production has been endorsed by the WHO as a means of addressing health priorities of developing countries. However, local producers of essential medicines must comply with international pharmaceutical standards in order to be eligible to compete in donor tenders. These standards determine production rights for on-patent and off-patent medicines, and guide international procurement of medicines. We reviewed the literature on the impact of Good Manufacturing Practice (GMP) on local production; a gap analysis from the literature review indicated a need for further research. Over sixty interviews were conducted with people involved in the Nepali pharmaceutical production and distribution chain from 2006 to 2009 on the GMP areas of relevance: regulatory capacity, staffing, funding and training, resourcing of GMP, inspectors' interpretation of the rules and compliance. Although Nepal producers have increased their overall share of the domestic market, only the public manufacturer, Royal Drugs, focuses on medicines for public health programmes; private producers engage mainly in brand competition for private markets, not essential medicines. Nepali regulators and producers state that implementation of GMP standards is hindered by low regulatory capacity, insufficient training of staff in the industry, financial constraints and lack of investment for upgrading capital. The transition period to mandatory compliance with WHO GMP rules is lengthy. Less than half of private producers had WHO GMP in 2013. Producers are not directly affected by international harmonisation of standards as they do not export medicines and the Nepali regulator does not enforce the WHO standards strictly. Without an international GMP certificate they cannot tender for donor dependent health programmes. In Nepal, local private manufacturers focus mainly on brand competition for private consumption not essential medicines, the government preferentially procures essential

From local development policies to strategic planning-Assessing continuity in institutional coalitions.

PubMed

Mazzeo Rinaldi, Francesco

2016-06-01

In the last two decades, EU policies have had a fundamental role in orienting regional/local development. The objective of this work is set in this context as it intends to analyze the local development programs activated in Sicily in the last three programming periods. The main aim is to explore whether the EU partnership principle influenced cooperation among local actors, assessing the continuity of local institutional coalition in managing different local development programs within the regional development policy system. We focus, in particular, on Strategic Plans (SP) promoted in Sicily in the transition phase between the 2000-2006 and the 2007-2013 periods. Copyright © 2016 Elsevier Ltd. All rights reserved.

Coign of Vantage and Action: Considering California's Local Accountability and School Finance Plans for English Learners

ERIC Educational Resources Information Center

Vasquez Heilig, Julian; Romero, Lisa S.; Hopkins, Megan

2017-01-01

Local control has been a bedrock principle of public schooling in America since its inception. In 2013, the California Legislature codified a new local accountability approach for school finance. An important component of the new California Local Control Funding Formula (LCFF) approach is a focus on English learners (ELs). The law mandates that…

Management of localized and locally advanced renal tumors. A contemporary review of current treatment options.

PubMed

Brookman-May, S; Langenhuijsen, J F; Volpe, A; Minervini, A; Joniau, S; Salagierski, M; Roscigno, M; Akdogan, B; Vandromme, A; Rodriguez-Faba, O; Marszalek, M

2013-06-01

About 70% of patients with renal cell carcinoma present with localized or locally advanced disease at primary diagnosis. Whereas these patients are potentially curable by surgical treatment alone, a further 20% to 30% of patients are diagnosed with primary metastatic disease. Although over the past years medical treatment for metastatic patients has nearly completely changed from immunotherapy to effective treatment with targeted agents, metastatic disease still represents a disease status which is not curable. Also in patients with metastatic disease, surgical treatment of the primary tumor plays an important role, since local tumor related complications can be avoided or minimized by surgery. Furthermore, also improvement of overall survival has been proven for surgery in metastatic patients when combined with cytokine treatment. Hence, surgical combined with systemic treatment as a multi-modal, adjuvant, and neo-adjuvant treatment is also required in patients with advanced or metastatic disease. A growing number of elderly and comorbid patients are currently diagnosed with small renal masses, which has led to increased attention paid to alternative ablative treatment modalities as well as active surveillance strategies, which are applied in order to avoid unnecessary overtreatment in these patients. Since surgical treatment also might enhance the risk of chronic kidney disease with consecutive cardiac disorders as well as reduced overall survival, ablative techniques and active surveillance are increasingly applied. In this review article we focus on current surgical and none-surgical treatment options for the management of patients with localized, locally advanced, and metastatic renal cell carcinoma.

Photoacoustic micro-imaging of focused ultrasound induced blood-brain-barrier opening in a rat model

NASA Astrophysics Data System (ADS)

Wang, Po-Hsun; Hsu, Po-Hung; Liu, Hao-Li; Wang, Churng-Ren Chris; Li, Meng-Lin

2010-02-01

Blood brain barrier (BBB) prevents most of the drug from transmitting into the brain tissue and decreases the treatment performance for brain disease. One of the methods to overcome the difficulty of drug delivery is to locally increase the permeability of BBB with high-intensity focused ultrasound. In this study, we have investigated the feasibility of photoacoustic microscopy of focused-ultrasound induced BBB opening in a rat model in vivo with gold nanorods (AuNRs) as a contrast agent. This study takes advantage of the strong near-infrared absorption of AuNRs and their extravasation tendency from BBB opening foci due to their nano-scale size. Before the experiments, craniotomy was performed on rats to provide a path for focused ultrasound beam. Localized BBB opening at the depth of about 3 mm from left cortex of rat brains was achieved by delivering 1.5 MHz focused ultrasound energy into brain tissue in the presence of microbubbles. PEGylated AuNRs with a peak optical absorption at ~800 nm were then intravenously administered. Pre-scan prior to BBB disruption and AuNR injection was taken to mark the signal background. After injection, the distribution of AuNRs in rat brains was monitored up to 2 hours. Experimental results show that imaging AuNRs reveals BBB disruption area in left brains while there are no changes observed in the right brains. From our results, photoacoustic imaging plus AuNRs shows the promise as a novel monitoring strategy in identifying the location and variation of focused-ultrasound BBB-opening in a rat model.

A new local-global approach for classification.

PubMed

Peres, R T; Pedreira, C E

2010-09-01

In this paper, we propose a new local-global pattern classification scheme that combines supervised and unsupervised approaches, taking advantage of both, local and global environments. We understand as global methods the ones concerned with the aim of constructing a model for the whole problem space using the totality of the available observations. Local methods focus into sub regions of the space, possibly using an appropriately selected subset of the sample. In the proposed method, the sample is first divided in local cells by using a Vector Quantization unsupervised algorithm, the LBG (Linde-Buzo-Gray). In a second stage, the generated assemblage of much easier problems is locally solved with a scheme inspired by Bayes' rule. Four classification methods were implemented for comparison purposes with the proposed scheme: Learning Vector Quantization (LVQ); Feedforward Neural Networks; Support Vector Machine (SVM) and k-Nearest Neighbors. These four methods and the proposed scheme were implemented in eleven datasets, two controlled experiments, plus nine public available datasets from the UCI repository. The proposed method has shown a quite competitive performance when compared to these classical and largely used classifiers. Our method is simple concerning understanding and implementation and is based on very intuitive concepts. Copyright 2010 Elsevier Ltd. All rights reserved.

Ophthalmic preservatives: focus on polyquaternium-1.

PubMed

Rolando, Maurizio; Crider, Julie Y; Kahook, Malik Y

2011-11-01

Ophthalmic preservatives, such as polyquaternium-1 (PQ-1), are critical for the inhibition of growth of microbial contaminants in multi-dose bottles of topical medications. These antimicrobial agents must have a high efficacy against pathogenic organisms, while maintaining a favorable tolerability and safety profile. This review focuses on the ophthalmic preservative PQ-1. For comparison purposes, the most commonly used preservative, benzalkonium chloride (BAK), is also discussed. This survey focuses primarily on data collected during the past 10 years. Effective drug delivery requires more than just an active ingredient that achieves its desired biological effect on end-target tissues. In addition, drugs must be stable in the containers that they are stored in, and must possess minimal undesired local and systemic side effects that can cause patients to decrease their adherence. In addressing these concerns, specifically in topical ophthalmic drops, one must take into account the active ingredients, vehicle components and preservatives. Medications with fewer adverse effects may lead to enhanced adherence to therapy; therefore, the induction of such adverse outcomes must be considered by physicians when treating patients with chronic ocular disease. Although BAK will continue to be used in ophthalmic medications, due to its familiarity and compatibility with a broad range of topical ocular formulations, PQ-1 is certainly a viable alternative in the preservative formulary armamentarium.

Focusing on reproductive health for adolescents.

PubMed

1995-06-01

JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents.

Importance of U.S. 395 Corridor For Local and Regional Commerce in South Central Washington

DOT National Transportation Integrated Search

1995-04-01

This study examined the importance of the U.S. 395 corridor area for local and regional commerce. The analysis focuses on the use and importance of the highway system for local and regional commerce. However, it is recognized that the highway system ...

Disentangling Stability, Variability and Adaptability in Human Performance: Focus on the Interplay between Local Variance and Serial Correlation

ERIC Educational Resources Information Center

Torre, Kjerstin; Balasubramaniam, Ramesh

2011-01-01

We address the complex relationship between the stability, variability, and adaptability of psychological systems by decomposing the global variance of serial performance into two independent parts: the local variance (LV) and the serial correlation structure. For two time series with equal LV, the presence of persistent long-range correlations…

Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology.

PubMed

Szaflarski, Jerzy P; Gloss, David; Binder, Jeffrey R; Gaillard, William D; Golby, Alexandra J; Holland, Scott K; Ojemann, Jeffrey; Spencer, David C; Swanson, Sara J; French, Jacqueline A; Theodore, William H

2017-01-24

To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes. An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded. The use of fMRI may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE; Level C), temporal epilepsy in general (Level C), or extratemporal epilepsy (Level C). For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient (Level U). fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection (Level C). The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE (Level C) but is of unclear utility in other epilepsy types (Level U). fMRI of verbal memory or language encoding should be considered for predicting verbal memory outcome (Level B). fMRI using nonverbal memory encoding may be considered for predicting visuospatial memory outcomes (Level C). Presurgical fMRI could be an adequate alternative to IAP memory testing for predicting verbal memory outcome (Level C). Clinicians should carefully advise patients of the risks and benefits of fMRI vs IAP during discussions concerning choice of specific modality in each case. © 2017 American Academy of Neurology.

Advances in local ablation of malignant liver lesions

PubMed Central

Eisele, Robert M

2016-01-01

Local ablation of liver tumors matured during the recent years and is now proven to be an effective tool in the treatment of malignant liver lesions. Advances focus on the improvement of local tumor control by technical innovations, individual selection of imaging modalities, more accurate needle placement and the free choice of access to the liver. Considering data found in the current literature for conventional local ablative treatment strategies, virtually no single technology is able to demonstrate an unequivocal superiority. Hints at better performance of microwave compared to radiofrequency ablation regarding local tumor control, duration of the procedure and potentially achievable larger size of ablation areas favour the comparably more recent treatment modality; image fusion enables more patients to undergo ultrasound guided local ablation; magnetic resonance guidance may improve primary success rates in selected patients; navigation and robotics accelerate the needle placement and reduces deviation of needle positions; laparoscopic thermoablation results in larger ablation areas and therefore hypothetically better local tumor control under acceptable complication rates, but seems to be limited to patients with no, mild or moderate adhesions following earlier surgical procedures. Apart from that, most techniques appear technically feasible, albeit demanding. Which technology will in the long run become accepted, is subject to future work. PMID:27099433

Developing Small Firms in Local Communities. Circular CRD-24.

ERIC Educational Resources Information Center

Strawn, Harry B.

Focusing on small, independent businesses, this primer answers questions relating to starting and operating a new firm and how local development organizations can help in the process. The general pattern of the company forming process (displacement, disposition to act, credibility, and availability of resources) is discussed. Success factors for…

Post-filamentation high-intensive light channels formation upon ultrashort laser pulses self-focusing in air

NASA Astrophysics Data System (ADS)

Geints, Yu. E.; Ionin, A. A.; Mokrousova, D. V.; Seleznev, L. V.; Sinitsyn, D. V.; Sunchugasheva, E. S.; Zemlyanov, A. A.

2017-01-01

Experimental and theoretical study of the post-filamentation stage of focused high-power Ti:Sa laser pulses in air is presented. Angular divergence of the laser beam, as well as angular and spatial characteristics of specific spatially localized light structures, the post-filament channels (PFCs), under different initial focusing conditions and laser beam energy are investigated. We show that PFC angular divergence is always less than that of the whole laser beam and tends to decrease with laser pulse energy increase and beam focal length elongation.

Classification of EEG abnormalities in partial epilepsy with simultaneous EEG-fMRI recordings.

PubMed

Pedreira, C; Vaudano, A E; Thornton, R C; Chaudhary, U J; Vulliemoz, S; Laufs, H; Rodionov, R; Carmichael, D W; Lhatoo, S D; Guye, M; Quian Quiroga, R; Lemieux, L

2014-10-01

Scalp EEG recordings and the classification of interictal epileptiform discharges (IED) in patients with epilepsy provide valuable information about the epileptogenic network, particularly by defining the boundaries of the "irritative zone" (IZ), and hence are helpful during pre-surgical evaluation of patients with severe refractory epilepsies. The current detection and classification of epileptiform signals essentially rely on expert observers. This is a very time-consuming procedure, which also leads to inter-observer variability. Here, we propose a novel approach to automatically classify epileptic activity and show how this method provides critical and reliable information related to the IZ localization beyond the one provided by previous approaches. We applied Wave_clus, an automatic spike sorting algorithm, for the classification of IED visually identified from pre-surgical simultaneous Electroencephalogram-functional Magnetic Resonance Imagining (EEG-fMRI) recordings in 8 patients affected by refractory partial epilepsy candidate for surgery. For each patient, two fMRI analyses were performed: one based on the visual classification and one based on the algorithmic sorting. This novel approach successfully identified a total of 29 IED classes (compared to 26 for visual identification). The general concordance between methods was good, providing a full match of EEG patterns in 2 cases, additional EEG information in 2 other cases and, in general, covering EEG patterns of the same areas as expert classification in 7 of the 8 cases. Most notably, evaluation of the method with EEG-fMRI data analysis showed hemodynamic maps related to the majority of IED classes representing improved performance than the visual IED classification-based analysis (72% versus 50%). Furthermore, the IED-related BOLD changes revealed by using the algorithm were localized within the presumed IZ for a larger number of IED classes (9) in a greater number of patients than the expert

Health plan competition in local markets.

PubMed

Grossman, J M

2000-04-01

To examine the structure of local health insurance markets and the strategies health plans were using to respond to competitive pressures in local markets in 1996/1997. Community Tracking Study site visits conducted between May 1996 and April 1997 in 12 U.S. markets selected to be nationally representative. In each site, 36 to 60 interviews on local health system change were conducted with healthcare industry informants representing health plans, providers, and purchasers. Relevant data for this article were abstracted from standardized protocols administered to multiple respondents in each site. Although the competitive threat from national plans was pervasive, local plans in most sites continued to retain strong, often dominant, positions in historically concentrated markets. In all sites, in response to purchaser pressures for stable premiums and provider choice, and the threat of entry and to plans were using three strategies to increase market share and market power: (1) consolidation/geographic expansion, (2) price competition, and (3) product line/segment diversification that focused on broad networks and open-access products. In most markets, in response to the demand for provider choice, the trend was away from ownership and exclusive arrangements with providers. Although local plans were moving to become full-service regional players, there was uncertainty about the abilities of all plans to sustain growth strategies at the expense of margins and organizational stability, and to effectively manage care with broad networks.

The Information Technology Workforce Crisis: Planning for the Next Environment. NYSFIRM Government Information Focus.

ERIC Educational Resources Information Center

Maxwell, Terrence A.

Attention has been focused on critical shortages of information technology professionals. These shortages have begun to affect the ability of state and local governments to perform core operations, meet new agency program needs and support the development of new enterprise-wide capacities. The shortages are not expected to disappear any time soon.…

Elasticity mapping of tissue mimicking phantoms by remote palpation with a focused ultrasound beam and intensity autocorrelation measurements

NASA Astrophysics Data System (ADS)

Usha Devi, C.; Bharat Chandran, R. S.; Vasu, R. M.; Sood, A. K.

2007-05-01

We use a focused ultrasound beam to load a region of interest (ROI) in a tissue-mimicking phantom and read out the vibration amplitude of phantom particles from the modulation depth in the intensity autocorrelation of a coherent light beam that intercepted the ROI. The modulation depth, which is also affected by the local light absorption coefficient, which is employed in ultrasound assisted optical tomography, to read out absorption coefficient is greatly influenced by the vibration amplitude, depends to a great extend on local elasticity. We scan a plane in an elastography phantom with an inhomogeneous inclusion, in elasticity with the focused ultrasound and from the measured modulation depth variation create a qualitative map of the elasticity variation in the interrogated plane.

Nonlinear focusing of ultrasonic waves by an axisymmetric diffraction grating embedded in water

NASA Astrophysics Data System (ADS)

Jiménez, N.; Romero-García, V.; Picó, R.; Garcia-Raffi, L. M.; Staliunas, K.

2015-11-01

We report the nonlinear focusing of ultrasonic waves by an axisymmetric diffraction grating immersed in water. In the linear regime, the system presents high focal gain (32 dB), with a narrow beam-width and intense side lobes as it is common in focusing by Fresnel-like lenses. Activating the nonlinearity of the host medium by using high amplitude incident waves, the focusing properties of the lens dramatically change. Theoretical predictions show that the focal gain of the system extraordinary increases in the strongly nonlinear regime (Mach number of 6.1 × 10-4). Particularly, the harmonic generation is locally activated at the focal spot, and the second harmonic beam is characterized by strongly reduced side-lobes and an excellent beam profile as experiments show in agreement with theory. The results can motivate applications in medical therapy or second harmonic imaging.

Asynchrony among local communities stabilises ecosystem function of metacommunities.

PubMed

Wilcox, Kevin R; Tredennick, Andrew T; Koerner, Sally E; Grman, Emily; Hallett, Lauren M; Avolio, Meghan L; La Pierre, Kimberly J; Houseman, Gregory R; Isbell, Forest; Johnson, David Samuel; Alatalo, Juha M; Baldwin, Andrew H; Bork, Edward W; Boughton, Elizabeth H; Bowman, William D; Britton, Andrea J; Cahill, James F; Collins, Scott L; Du, Guozhen; Eskelinen, Anu; Gough, Laura; Jentsch, Anke; Kern, Christel; Klanderud, Kari; Knapp, Alan K; Kreyling, Juergen; Luo, Yiqi; McLaren, Jennie R; Megonigal, Patrick; Onipchenko, Vladimir; Prevéy, Janet; Price, Jodi N; Robinson, Clare H; Sala, Osvaldo E; Smith, Melinda D; Soudzilovskaia, Nadejda A; Souza, Lara; Tilman, David; White, Shannon R; Xu, Zhuwen; Yahdjian, Laura; Yu, Qiang; Zhang, Pengfei; Zhang, Yunhai

2017-12-01

Temporal stability of ecosystem functioning increases the predictability and reliability of ecosystem services, and understanding the drivers of stability across spatial scales is important for land management and policy decisions. We used species-level abundance data from 62 plant communities across five continents to assess mechanisms of temporal stability across spatial scales. We assessed how asynchrony (i.e. different units responding dissimilarly through time) of species and local communities stabilised metacommunity ecosystem function. Asynchrony of species increased stability of local communities, and asynchrony among local communities enhanced metacommunity stability by a wide range of magnitudes (1-315%); this range was positively correlated with the size of the metacommunity. Additionally, asynchronous responses among local communities were linked with species' populations fluctuating asynchronously across space, perhaps stemming from physical and/or competitive differences among local communities. Accordingly, we suggest spatial heterogeneity should be a major focus for maintaining the stability of ecosystem services at larger spatial scales. © 2017 The Authors. Ecology Letters published by CNRS and John Wiley & Sons Ltd.

Local perturbations perturb—exponentially-locally

NASA Astrophysics Data System (ADS)

De Roeck, W.; Schütz, M.

2015-06-01

We elaborate on the principle that for gapped quantum spin systems with local interaction, "local perturbations [in the Hamiltonian] perturb locally [the groundstate]." This principle was established by Bachmann et al. [Commun. Math. Phys. 309, 835-871 (2012)], relying on the "spectral flow technique" or "quasi-adiabatic continuation" [M. B. Hastings, Phys. Rev. B 69, 104431 (2004)] to obtain locality estimates with sub-exponential decay in the distance to the spatial support of the perturbation. We use ideas of Hamza et al. [J. Math. Phys. 50, 095213 (2009)] to obtain similarly a transformation between gapped eigenvectors and their perturbations that is local with exponential decay. This allows to improve locality bounds on the effect of perturbations on the low lying states in certain gapped models with a unique "bulk ground state" or "topological quantum order." We also give some estimate on the exponential decay of correlations in models with impurities where some relevant correlations decay faster than one would naively infer from the global gap of the system, as one also expects in disordered systems with a localized groundstate.

EDITORIAL: Focus on Plasmonics FOCUS ON PLASMONICS

NASA Astrophysics Data System (ADS)

Bozhevolnyi, Sergey; García-Vidal, Francisco

2008-10-01

Plasmonics is an emerging field in optics dealing with the so-called surface plasmons whose extraordinary properties are being both analyzed from a fundamental point of view and exploited for numerous technological applications. Surface plasmons associated with surface electron density oscillations decorating metal-dielectric interfaces were discovered by Rufus Ritchie in the 1950s. Since the seventies, the subwavelength confinement of electromagnetic fields as well as their enhancement inherent to the surface plasmon excitation has been widely used for spectroscopic purposes. Recent advances in nano-fabrication, characterization and modelling techniques have allowed unique properties of these surface electromagnetic modes to be explored with respect to subwavelength field localization and waveguiding, opening the path to truly nanoscale plasmonic optical devices. This area of investigation also has interesting links with research on photonic band gap materials and the field of optical metamaterials. Nowadays, plasmonics can be seen as a mature interdisciplinary area of research in which scientists coming from different backgrounds (chemistry, physics, optics and engineering) strive to discover and exploit new and exciting phenomena associated with surface plasmons. The already made and forthcoming discoveries will have impacts in many fields of science and technology, including not only photonics and materials science but also computation, biology and medicine, among others. This focus issue of New Journal of Physics is intended to cover all the aforementioned capabilities of surface plasmons by presenting a current overview of state-of-the-art advances achieved by the leading groups in this field of research. The below list of articles represents the first contributions to the collection and further additions will appear soon. Focus on Plasmonics Contents Nanoantenna array-induced fluorescence enhancement and reduced lifetimes Reuben M Bakker, Vladimir P Drachev

Percolation of localized attack on complex networks

NASA Astrophysics Data System (ADS)

Shao, Shuai; Huang, Xuqing; Stanley, H. Eugene; Havlin, Shlomo

2015-02-01

The robustness of complex networks against node failure and malicious attack has been of interest for decades, while most of the research has focused on random attack or hub-targeted attack. In many real-world scenarios, however, attacks are neither random nor hub-targeted, but localized, where a group of neighboring nodes in a network are attacked and fail. In this paper we develop a percolation framework to analytically and numerically study the robustness of complex networks against such localized attack. In particular, we investigate this robustness in Erdős-Rényi networks, random-regular networks, and scale-free networks. Our results provide insight into how to better protect networks, enhance cybersecurity, and facilitate the design of more robust infrastructures.

Sediment redistribution and grainsize effects on 230Th-normalized mass accumulation rates and focusing factors in the Panama Basin

NASA Astrophysics Data System (ADS)

Loveley, Matthew R.; Marcantonio, Franco; Lyle, Mitchell; Ibrahim, Rami; Hertzberg, Jennifer E.; Schmidt, Matthew W.

2017-12-01

Here, we examine how redistribution of differing grain sizes by sediment focusing processes in Panama Basin sediments affects the use of 230Th as a constant-flux proxy. We study representative sediments of Holocene and Last Glacial Maximum (LGM) time slices from four sediment cores from two different localities close to the ridges that bound the Panama Basin. Each locality contains paired sites that are seismically interpreted to have undergone extremes in sediment redistribution, i.e., focused versus winnowed sites. Both Holocene and LGM samples from sites where winnowing has occurred contain significant amounts (up to 50%) of the 230Th within the >63 μm grain size fraction, which makes up 40-70% of the bulk sediment analyzed. For sites where focusing has occurred, Holocene and LGM samples contain the greatest amounts of 230Th (up to 49%) in the finest grain-sized fraction (<4 μm), which makes up 26-40% of the bulk sediment analyzed. There are slight underestimations of 230Th-derived mass accumulation rates (MARs) and overestimations of 230Th-derived focusing factors at focused sites, while the opposite is true for winnowed sites. Corrections made using a model by Kretschmer et al. (2010) suggest a maximum change of about 30% in 230Th-derived MARs and focusing factors at focused sites, except for our most focused site which requires an approximate 70% correction in one sample. Our 230Th-corrected 232Th flux results suggest that the boundary between hemipelagically- and pelagically-derived sediments falls between 350 and 600 km from the continental margin.

5D-Tracking of a nanorod in a focused laser beam--a theoretical concept.

PubMed

Griesshammer, Markus; Rohrbach, Alexander

2014-03-10

Back-focal plane (BFP) interferometry is a very fast and precise method to track the 3D position of a sphere within a focused laser beam using a simple quadrant photo diode (QPD). Here we present a concept of how to track and recover the 5D state of a cylindrical nanorod (3D position and 2 tilt angles) in a laser focus by analyzing the interference of unscattered light and light scattered at the cylinder. The analytical theoretical approach is based on Rayleigh-Gans scattering together with a local field approximation for an infinitely thin cylinder. The approximated BFP intensities compare well with those from a more rigorous numerical approach. It turns out that a displacement of the cylinder results in a modulation of the BFP intensity pattern, whereas a tilt of the cylinder results in a shift of this pattern. We therefore propose the concept of a local QPD in the BFP of a detection lens, where the QPD center is shifted by the angular coordinates of the cylinder tilt.

76 FR 43119 - Medical Devices; General and Plastic Surgery Devices; Classification of the Focused Ultrasound...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-07-20

... and it is identified as a device using focused ultrasound to produce localized, mechanical motion... labeling includes warnings related to patient reaction in terms of pain and information to user in terms of observable skin reactions that are known to be precursors to the potential thermal adverse effects...

Energy localization and frequency analysis in the locust ear.

PubMed

Malkin, Robert; McDonagh, Thomas R; Mhatre, Natasha; Scott, Thomas S; Robert, Daniel

2014-01-06

Animal ears are exquisitely adapted to capture sound energy and perform signal analysis. Studying the ear of the locust, we show how frequency signal analysis can be performed solely by using the structural features of the tympanum. Incident sound waves generate mechanical vibrational waves that travel across the tympanum. These waves shoal in a tsunami-like fashion, resulting in energy localization that focuses vibrations onto the mechanosensory neurons in a frequency-dependent manner. Using finite element analysis, we demonstrate that two mechanical properties of the locust tympanum, distributed thickness and tension, are necessary and sufficient to generate frequency-dependent energy localization.

Intratumoral and Intertumoral Genomic Heterogeneity of Multifocal Localized Prostate Cancer Impacts Molecular Classifications and Genomic Prognosticators

PubMed Central

Wei, Lei; Wang, Jianmin; Lampert, Erika; Schlanger, Simon; DePriest, Adam D.; Hu, Qiang; Gomez, Eduardo Cortes; Murakam, Mitsuko; Glenn, Sean T.; Conroy, Jeffrey; Morrison, Carl; Azabdaftari, Gissou; Mohler, James L.; Liu, Song; Heemers, Hannelore V.

2018-01-01

Background Next-generation sequencing is revealing genomic heterogeneity in localized prostate cancer (CaP). Incomplete sampling of CaP multiclonality has limited the implications for molecular subtyping, stratification, and systemic treatment. Objective To determine the impact of genomic and transcriptomic diversity within and among intraprostatic CaP foci on CaP molecular taxonomy, predictors of progression, and actionable therapeutic targets. Design, setting, and participants Four consecutive patients with clinically localized National Comprehensive Cancer Network intermediate- or high-risk CaP who did not receive neoadjuvant therapy underwent radical prostatectomy at Roswell Park Cancer Institute in June–July 2014. Presurgical information on CaP content and a customized tissue procurement procedure were used to isolate nonmicroscopic and noncontiguous CaP foci in radical prostatectomy specimens. Three cores were obtained from the index lesion and one core from smaller lesions. RNA and DNA were extracted simultaneously from 26 cores with ≥90% CaP content and analyzed using whole-exome sequencing, single-nucleotide polymorphism arrays, and RNA sequencing. Outcome measurements and statistical analysis Somatic mutations, copy number alternations, gene expression, gene fusions, and phylogeny were defined. The impact of genomic alterations on CaP molecular classification, gene sets measured in Oncotype DX, Prolaris, and Decipher assays, and androgen receptor activity among CaP cores was determined. Results and limitations There was considerable variability in genomic alterations among CaP cores, and between RNA- and DNA-based platforms. Heterogeneity was found in molecular grouping of individual CaP foci and the activity of gene sets underlying the assays for risk stratification and androgen receptor activity, and was validated in independent genomic data sets. Determination of the implications for clinical decision-making requires follow-up studies. Conclusions

Many-Body Localization and Thermalization in Quantum Statistical Mechanics

NASA Astrophysics Data System (ADS)

Nandkishore, Rahul; Huse, David A.

2015-03-01

We review some recent developments in the statistical mechanics of isolated quantum systems. We provide a brief introduction to quantum thermalization, paying particular attention to the eigenstate thermalization hypothesis (ETH) and the resulting single-eigenstate statistical mechanics. We then focus on a class of systems that fail to quantum thermalize and whose eigenstates violate the ETH: These are the many-body Anderson-localized systems; their long-time properties are not captured by the conventional ensembles of quantum statistical mechanics. These systems can forever locally remember information about their local initial conditions and are thus of interest for possibilities of storing quantum information. We discuss key features of many-body localization (MBL) and review a phenomenology of the MBL phase. Single-eigenstate statistical mechanics within the MBL phase reveal dynamically stable ordered phases, and phase transitions among them, that are invisible to equilibrium statistical mechanics and can occur at high energy and low spatial dimensionality, where equilibrium ordering is forbidden.

Collaborations between the State and Local Colleges: Sleeping with the Enemy?

ERIC Educational Resources Information Center

Brand, Elizabeth Cox

2014-01-01

This chapter describes the characteristics of successful partnerships between a state-level department and local community colleges. Particular focus is paid to the lack of mandated collaboration between the entities and the elements necessary for motivation and sustainability.

Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy.

PubMed

Keefe, John R; Solomonov, Nili; Derubeis, Robert J; Phillips, Alexander C; Busch, Fredric N; Barber, Jacques P; Chambless, Dianne L; Milrod, Barbara L

2018-04-18

This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.

Barriers to adopting and implementing local-level tobacco control policies.

PubMed

Satterlund, Travis D; Cassady, Diana; Treiber, Jeanette; Lemp, Cathy

2011-08-01

Although California communities have been relatively successful in adopting and implementing a wide range of local tobacco control policies, the process has not been without its setbacks and barriers. Little is known about local policy adoption, and this paper examines these processes related to adopting and implementing outdoor smoke-free policies, focusing on the major barriers faced by local-level tobacco control organizations in this process. Ninety-six projects funded by the California Tobacco Control Program submitted final evaluation reports pertaining to an outdoor smoking objective, and the reports from these projects were analyzed. The barriers were grouped in three primary areas: politically polarizing barriers, organizational barriers, and local political orientation. The barriers identified in this study underscore the need for an organized action plan in adopting local tobacco policy. The authors also suggest potential strategies to offset the barriers, including: (1) having a "champion" who helps to carry an objective forward; (2) tapping into a pool of youth volunteers; (3) collecting and using local data as a persuasive tool; (4) educating the community in smoke-free policy efforts; (5) working strategically within the local political climate; and (6) demonstrating to policymakers the constituent support for proposed policy.

CRISPR-FOCUS: A web server for designing focused CRISPR screening experiments.

PubMed

Cao, Qingyi; Ma, Jian; Chen, Chen-Hao; Xu, Han; Chen, Zhi; Li, Wei; Liu, X Shirley

2017-01-01

The recently developed CRISPR screen technology, based on the CRISPR/Cas9 genome editing system, enables genome-wide interrogation of gene functions in an efficient and cost-effective manner. Although many computational algorithms and web servers have been developed to design single-guide RNAs (sgRNAs) with high specificity and efficiency, algorithms specifically designed for conducting CRISPR screens are still lacking. Here we present CRISPR-FOCUS, a web-based platform to search and prioritize sgRNAs for CRISPR screen experiments. With official gene symbols or RefSeq IDs as the only mandatory input, CRISPR-FOCUS filters and prioritizes sgRNAs based on multiple criteria, including efficiency, specificity, sequence conservation, isoform structure, as well as genomic variations including Single Nucleotide Polymorphisms and cancer somatic mutations. CRISPR-FOCUS also provides pre-defined positive and negative control sgRNAs, as well as other necessary sequences in the construct (e.g., U6 promoters to drive sgRNA transcription and RNA scaffolds of the CRISPR/Cas9). These features allow users to synthesize oligonucleotides directly based on the output of CRISPR-FOCUS. Overall, CRISPR-FOCUS provides a rational and high-throughput approach for sgRNA library design that enables users to efficiently conduct a focused screen experiment targeting up to thousands of genes. (CRISPR-FOCUS is freely available at http://cistrome.org/crispr-focus/).

MRI-Guided Focused Ultrasound Surgery

PubMed Central

Jolesz, Ferenc A.

2014-01-01

MRI-guided focused ultrasound (MRgFUS) surgery is a noninvasive thermal ablation method that uses magnetic resonance imaging (MRI) for target definition, treatment planning, and closed-loop control of energy deposition. Integrating FUS and MRI as a therapy delivery system allows us to localize, target, and monitor in real time, and thus to ablate targeted tissue without damaging normal structures. This precision makes MRgFUS an attractive alternative to surgical resection or radiation therapy of benign and malignant tumors. Already approved for the treatment of uterine fibroids, MRgFUS is in ongoing clinical trials for the treatment of breast, liver, prostate, and brain cancer and for the palliation of pain in bone metastasis. In addition to thermal ablation, FUS, with or without the use of microbubbles, can temporarily change vascular or cell membrane permeability and release or activate various compounds for targeted drug delivery or gene therapy. A disruptive technology, MRgFUS provides new therapeutic approaches and may cause major changes in patient management and several medical disciplines. PMID:19630579

Thailand Momentum on Policy and Practice in Local Legislation on Dengue Vector Control

PubMed Central

Bhumiratana, Adisak; Intarapuk, Apiradee; Chujun, Suriyo; Kaewwaen, Wuthichai; Sorosjinda-Nunthawarasilp, Prapa; Koyadun, Surachart

2014-01-01

Over a past decade, an administrative decentralization model, adopted for local administration development in Thailand, is replacing the prior centralized (top-down) command system. The change offers challenges to local governmental agencies and other public health agencies at all the ministerial, regional, and provincial levels. A public health regulatory and legislative framework for dengue vector control by local governmental agencies is a national topic of interest because dengue control program has been integrated into healthcare services at the provincial level and also has been given priority in health plans of local governmental agencies. The enabling environments of local administrations are unique, so this critical review focuses on the authority of local governmental agencies responsible for disease prevention and control and on the functioning of local legislation with respect to dengue vector control and practices. PMID:24799896

Visual attention spreads broadly but selects information locally.

PubMed

Shioiri, Satoshi; Honjyo, Hajime; Kashiwase, Yoshiyuki; Matsumiya, Kazumichi; Kuriki, Ichiro

2016-10-19

Visual attention spreads over a range around the focus as the spotlight metaphor describes. Spatial spread of attentional enhancement and local selection/inhibition are crucial factors determining the profile of the spatial attention. Enhancement and ignorance/suppression are opposite effects of attention, and appeared to be mutually exclusive. Yet, no unified view of the factors has been provided despite their necessity for understanding the functions of spatial attention. This report provides electroencephalographic and behavioral evidence for the attentional spread at an early stage and selection/inhibition at a later stage of visual processing. Steady state visual evoked potential showed broad spatial tuning whereas the P3 component of the event related potential showed local selection or inhibition of the adjacent areas. Based on these results, we propose a two-stage model of spatial attention with broad spread at an early stage and local selection at a later stage.

Learning intervention-induced deformations for non-rigid MR-CT registration and electrode localization in epilepsy patients

PubMed Central

Onofrey, John A.; Staib, Lawrence H.; Papademetris, Xenophon

2015-01-01

This paper describes a framework for learning a statistical model of non-rigid deformations induced by interventional procedures. We make use of this learned model to perform constrained non-rigid registration of pre-procedural and post-procedural imaging. We demonstrate results applying this framework to non-rigidly register post-surgical computed tomography (CT) brain images to pre-surgical magnetic resonance images (MRIs) of epilepsy patients who had intra-cranial electroencephalography electrodes surgically implanted. Deformations caused by this surgical procedure, imaging artifacts caused by the electrodes, and the use of multi-modal imaging data make non-rigid registration challenging. Our results show that the use of our proposed framework to constrain the non-rigid registration process results in significantly improved and more robust registration performance compared to using standard rigid and non-rigid registration methods. PMID:26900569

P300 Source Localization Contrasts in Body-Focused Repetitive Behaviors and Tic Disorders

PubMed Central

Sauvé, Geneviève; O’Connor, Kieron P.; Blanchet, Pierre J.

2017-01-01

Tic disorders (TD) and body-focused repetitive behaviors (BFRB) have similar phenotypes that can be challenging to distinguish in clinical settings. Both disorders show high rates of comorbid psychiatric conditions, dysfunctional basal ganglia activity, atypical cortical functioning in the prefrontal and motor cortical regions, and cognitive deficits. Clinicians frequently confound the two disorders and it is important to find reliable objective methods to discriminate TD and BFRB. Neuropsychological tests and event-related potential (ERP) studies have yielded inconsistent results regarding a possible context updating deficit in TD and BFRB patients. However, most previous studies did not control for the presence of comorbid psychiatric condition and medication status, which might have confounded the findings reported to date. Hence, we aimed to investigate the psychophysiology of working memory using ERP in carefully screened TD and BFRB patients excluding those with psychiatric comorbidity and those taking psychoactive medication. The current study compared 12 TD patients, 12 BRFB patients, and 15 healthy control participants using a motor oddball task (button press). The P300 component was analyzed as an index of working memory functioning. Results showed that BFRB patients had decreased P300 oddball effect amplitudes over the right hemisphere compared to the TD and control groups. Clinical groups presented different scalp distributions compared to controls, which could represent a potential endophenotype candidate of BFRB and TD. PMID:28671557

Focusators for laser-branding

NASA Astrophysics Data System (ADS)

Doskolovich, L. L.; Kazanskiy, N. L.; Kharitonov, S. I.; Uspleniev, G. V.

A new method is investigated for synthesis of computer-generated optical elements: focusators that are able to focus the radial-symmetrical laser beam into complex focal contours, in particular into alphanumeric symbols. The method is based on decomposition of the focal contour into segments of straight lines and semi-circles, following corresponding spacing out of the focusator on elementary segments (concentric rings or sectors) and solution of the inverse task of focusing from focusator segments into corresponding elements of the focal contour. The results of numerical computing of the field from synthesized focusators into the letters are presented. The theoretical efficiency of the focusators discussed is no less than 85%. The amplitude masks and the results of operational studies of synthesized focusators are presented.

The acute toxicity of local anesthetics.

PubMed

Mather, Laurence E

2010-11-01

Systemic toxicity, usually from overdose or intravascular dose, is feared because it mainly affects the heart and brain, and may be acutely life-threatening. Pharmacological studies of local anesthetic toxicity have largely been reviewed primarily relating to the evaluation of ropivacaine and levobupivacaine during the past decade. This review/opinion focuses more on the principles and concepts underlying the main models used, from chemical pharmacological and pharmacokinetic perspectives. Research models required to produce pivotal toxicity data are discussed. The potencies for neural blockade and systemic toxicity are associated across virtually all models, with some deviations through molecular stereochemistry. These models show that all local anesthetics can produce direct cardiovascular system toxicity and CNS excitotoxicity that may further affect the cardiovascular system response. Whereas the longer-acting local anesthetics are more likely to cause cardiac death by malignant arrhythmias, the shorter-acting agents are more likely to cause cardiac contraction failure. In most models, equi-anesthetic doses of ropivacaine and levobupivacaine are less likely to produce serious toxicity than bupivacaine. Of the various models, this reviewer favors a whole-body large animal preparation because of the comprehensive data collection possible. The conscious sheep preparation has contributed more than any other, and may be regarded as the de facto 'standard' experimental model for concurrent study of local anesthetic toxicity ± pharmacokinetics, using experimental designs that can reproduce the toxicity seen in clinical accidents.

Local classifier weighting by quadratic programming.

PubMed

Cevikalp, Hakan; Polikar, Robi

2008-10-01

It has been widely accepted that the classification accuracy can be improved by combining outputs of multiple classifiers. However, how to combine multiple classifiers with various (potentially conflicting) decisions is still an open problem. A rich collection of classifier combination procedures -- many of which are heuristic in nature -- have been developed for this goal. In this brief, we describe a dynamic approach to combine classifiers that have expertise in different regions of the input space. To this end, we use local classifier accuracy estimates to weight classifier outputs. Specifically, we estimate local recognition accuracies of classifiers near a query sample by utilizing its nearest neighbors, and then use these estimates to find the best weights of classifiers to label the query. The problem is formulated as a convex quadratic optimization problem, which returns optimal nonnegative classifier weights with respect to the chosen objective function, and the weights ensure that locally most accurate classifiers are weighted more heavily for labeling the query sample. Experimental results on several data sets indicate that the proposed weighting scheme outperforms other popular classifier combination schemes, particularly on problems with complex decision boundaries. Hence, the results indicate that local classification-accuracy-based combination techniques are well suited for decision making when the classifiers are trained by focusing on different regions of the input space.

Localised drug release using MRI-controlled focused ultrasound hyperthermia.

PubMed

Staruch, Robert; Chopra, Rajiv; Hynynen, Kullervo

2011-01-01

Thermosensitive liposomes provide a mechanism for triggering the local release of anticancer drugs, but this technology requires precise temperature control in targeted regions with minimal heating of surrounding tissue. The objective of this study was to evaluate the feasibility of using MRI-controlled focused ultrasound (FUS) and thermosensitive liposomes to achieve thermally mediated localised drug delivery in vivo. Results are reported from ten rabbits, where a FUS beam was scanned in a circular trajectory to heat 10-15 mm diameter regions in normal thigh to 43°C for 20-30 min. MRI thermometry was used for closed-loop feedback control to achieve temporally and spatially uniform heating. Lyso-thermosensitive liposomal doxorubicin was infused intravenously during hyperthermia. Unabsorbed liposomes were flushed from the vasculature by saline perfusion 2 h later, and tissue samples were harvested from heated and unheated thigh regions. The fluorescence intensity of the homogenised samples was used to calculate the concentration of doxorubicin in tissue. Closed-loop control of FUS heating using MRI thermometry achieved temperature distributions with mean, T90 and T10 of 42.9°C, 41.0°C and 44.8°C, respectively, over a period of 20 min. Doxorubicin concentrations were significantly higher in tissues sampled from heated than unheated regions of normal thigh muscle (8.3 versus 0.5 ng/mg, mean per-animal difference = 7.8 ng/mg, P < 0.05, Wilcoxon matched pairs signed rank test). The results show the potential of MRI-controlled focused ultrasound hyperthermia for enhanced local drug delivery with temperature-sensitive drug carriers.

Age-Related Change in Shifting Attention between Global and Local Levels of Hierarchical Stimuli

ERIC Educational Resources Information Center

Huizinga, Mariette; Burack, Jacob A.; Van der Molen, Maurits W.

2010-01-01

The focus of this study was the developmental pattern of the ability to shift attention between global and local levels of hierarchical stimuli. Children aged 7 years and 11 years and 21-year-old adults were administered a task (two experiments) that allowed for the examination of 1) the direction of attention to global or local stimulus levels;…

Salvage therapy for locally recurrent prostate cancer after radiation.

PubMed

Marcus, David M; Canter, Daniel J; Jani, Ashesh B; Dobbs, Ryan W; Schuster, David M; Carthon, Bradley C; Rossi, Peter J

2012-12-01

External beam radiotherapy (EBRT) is widely utilized as primary therapy for clinically localized prostate cancer. For patients who develop locally recurrent disease after EBRT, local salvage therapy may be indicated. The primary modalities for local salvage treatment in this setting include radical prostatectomy, cryotherapy, and brachytherapy. To date, there is little data describing outcomes and toxicity associated with each of these salvage modalities. A review of the literature was performed to identify studies of local salvage therapy for patients who had failed primary EBRT for localized prostate cancer. We focused on prospective trials and multi-institutional retrospective series in order to identify the highest level of evidence describing these therapies. The majority of reports describing the use of local salvage treatment for recurrent prostate cancer after EBRT are single-institution, retrospective reports, although small prospective studies are available for salvage cryotherapy and salvage brachytherapy. Clinical outcomes and toxicity for each modality vary widely across studies, which is likely due to the heterogeneity of patient populations, treatment techniques, and definitions of failure. In general, most studies demonstrate that local salvage therapy after EBRT may provide long-term local control in appropriately selected patients, although toxicity is often significant. As there are no randomized trials comparing salvage treatment modalities for localized prostate cancer recurrence after EBRT, the selection of a local treatment modality should be made on a patient-by-patient basis, with careful consideration of each patient's disease characteristics and tolerance for the risks of treatment. Additional data, ideally from prospective randomized trials, is needed to guide decision making for patients with local recurrence after EBRT failure.

Constrained spectral clustering under a local proximity structure assumption

NASA Technical Reports Server (NTRS)

Wagstaff, Kiri; Xu, Qianjun; des Jardins, Marie

2005-01-01

This work focuses on incorporating pairwise constraints into a spectral clustering algorithm. A new constrained spectral clustering method is proposed, as well as an active constraint acquisition technique and a heuristic for parameter selection. We demonstrate that our constrained spectral clustering method, CSC, works well when the data exhibits what we term local proximity structure.

Impact of Physical Educators on Local School Wellness Policies

ERIC Educational Resources Information Center

Buns, Matthew T.; Thomas, Katherine T.

2015-01-01

The Child Nutrition and WIC Reauthorization Act of 2004 required school district officials to approve a local school wellness policy by July 2006, making this the first federal legislation requiring school district officials to establish a goal for physical activity and that could focus on physical education. The purpose of this study was to…

Chinese cultural dimensions of death, dying, and bereavement: focus group findings.

PubMed

Yick, Alice G; Gupta, Rashmi

2002-01-01

The purpose of this qualitative study is to describe Chinese immigrants and Chinese Americans' attitudes and practices about death, dying, and bereavement. To this end, three focus groups were conducted with social work graduate students, pastors and religious leaders, and service providers working in the Chinese American community in New York City. The United States is becoming increasingly multicultural, and Chinese Americans are the most rapidly growing Asian American group. Findings from this study revealed that many Chinese attitudes and practices about death and dying are rooted in Asian cultural values such as filial piety, centrality of the family, and emphasis of hierarchy. In addition, strains of Confucianism, Buddhism, Taoism, and local folklore are embedded in these death attitudes and practices. Based on themes extrapolated from the focus groups, recommendations are delineated for service providers in order to implement culturally-sensitive bereavement practices.

Urinary urge seizure semiology localization by intracranial monitoring.

PubMed

Rengarajan, Ronak; Shamim, Sadat

2018-01-01

Seizures may present with many different symptom complexes. Seizure semiologies have localization value when contemplating surgical therapies. Epilepsy presenting as a desire to micturate is exceedingly rare, with only a handful of published cases. We present a patient who had initially unexplained childhood urinary urge that progressed into lapses of memory and confusion that was eventually diagnosed as epilepsy in adulthood. Due to refractoriness to medical management, our patient's epileptic focus was localized through both noninvasive and invasive subdural electrode arrays to the nondominant medial temporal lobe and successfully treated with an amygdalohippocampectomy. Only one other case of ictal urinary urgency seizures has been recorded with intracranial electroencephalogram monitoring in the literature.

Urinary urge seizure semiology localization by intracranial monitoring

PubMed Central

Rengarajan, Ronak; Shamim, Sadat

2018-01-01

ABSTRACT Seizures may present with many different symptom complexes. Seizure semiologies have localization value when contemplating surgical therapies. Epilepsy presenting as a desire to micturate is exceedingly rare, with only a handful of published cases. We present a patient who had initially unexplained childhood urinary urge that progressed into lapses of memory and confusion that was eventually diagnosed as epilepsy in adulthood. Due to refractoriness to medical management, our patient's epileptic focus was localized through both noninvasive and invasive subdural electrode arrays to the nondominant medial temporal lobe and successfully treated with an amygdalohippocampectomy. Only one other case of ictal urinary urgency seizures has been recorded with intracranial electroencephalogram monitoring in the literature. PMID:29686574

Health plan competition in local markets.

PubMed Central

Grossman, J M

2000-01-01

OBJECTIVE: To examine the structure of local health insurance markets and the strategies health plans were using to respond to competitive pressures in local markets in 1996/1997. DATA SOURCES/STUDY SETTING: Community Tracking Study site visits conducted between May 1996 and April 1997 in 12 U.S. markets selected to be nationally representative. STUDY DESIGN: In each site, 36 to 60 interviews on local health system change were conducted with healthcare industry informants representing health plans, providers, and purchasers. DATA COLLECTION/EXTRACTION METHOD: Relevant data for this article were abstracted from standardized protocols administered to multiple respondents in each site. PRINCIPAL FINDINGS: Although the competitive threat from national plans was pervasive, local plans in most sites continued to retain strong, often dominant, positions in historically concentrated markets. In all sites, in response to purchaser pressures for stable premiums and provider choice, and the threat of entry and to plans were using three strategies to increase market share and market power: (1) consolidation/geographic expansion, (2) price competition, and (3) product line/segment diversification that focused on broad networks and open-access products. In most markets, in response to the demand for provider choice, the trend was away from ownership and exclusive arrangements with providers. CONCLUSIONS: Although local plans were moving to become full-service regional players, there was uncertainty about the abilities of all plans to sustain growth strategies at the expense of margins and organizational stability, and to effectively manage care with broad networks. PMID:10778822

Probing the photoresponse of individual Nb2O5 nanowires with global and localized laser beam irradiation.

PubMed

Tamang, Rajesh; Varghese, Binni; Mhaisalkar, Subodh G; Tok, Eng Soon; Sow, Chorng Haur

2011-03-18

Photoresponse of isolated Nb(2)O(5) nanowires (NW) padded with platinum (Pt) at both ends were studied with global irradiation by a laser beam and localized irradiation using a focused laser beam. Global laser irradiation on individual NW in ambient and vacuum conditions revealed photocurrent contributions with different time characteristics (rapid and slowly varying components) arising from defect level excitations, thermal heating effect, surface states and NW-Pt contacts. With a spot size of < 1 µm, localized irradiation highlighted the fact that the measured photocurrent in this single NW device (with and without applied bias) depended sensitively on the photoresponse at the NW-Pt contacts. At applied bias, unidirectional photocurrent was observed and higher photocurrent was achieved with localized laser irradiation at reverse-biased NW-Pt contacts. At zero bias, the opposite polarity of photocurrents was detected when the two NW-Pt contacts were subjected to focused laser beam irradiation. A reduced Schottky barrier/width resulting from an increase in charge carriers and thermoelectric effects arising from the localized thermal heating due to focused laser beam irradiation were proposed as the mechanisms dictating the photocurrent at the NW-Pt interface. Comparison of photocurrents generated upon global and localized laser irradiation showed that the main contribution to the photocurrent was largely due to the photoresponse of the NW-Pt contacts.

A Tikhonov Regularization Scheme for Focus Rotations with Focused Ultrasound Phased Arrays

PubMed Central

Hughes, Alec; Hynynen, Kullervo

2016-01-01

Phased arrays have a wide range of applications in focused ultrasound therapy. By using an array of individually-driven transducer elements, it is possible to steer a focus through space electronically and compensate for acoustically heterogeneous media with phase delays. In this paper, the concept of focusing an ultrasound phased array is expanded to include a method to control the orientation of the focus using a Tikhonov regularization scheme. It is then shown that the Tikhonov regularization parameter used to solve the ill-posed focus rotation problem plays an important role in the balance between quality focusing and array efficiency. Finally, the technique is applied to the synthesis of multiple foci, showing that this method allows for multiple independent spatial rotations. PMID:27913323

A Tikhonov Regularization Scheme for Focus Rotations With Focused Ultrasound-Phased Arrays.

PubMed

Hughes, Alec; Hynynen, Kullervo

2016-12-01

Phased arrays have a wide range of applications in focused ultrasound therapy. By using an array of individually driven transducer elements, it is possible to steer a focus through space electronically and compensate for acoustically heterogeneous media with phase delays. In this paper, the concept of focusing an ultrasound-phased array is expanded to include a method to control the orientation of the focus using a Tikhonov regularization scheme. It is then shown that the Tikhonov regularization parameter used to solve the ill-posed focus rotation problem plays an important role in the balance between quality focusing and array efficiency. Finally, the technique is applied to the synthesis of multiple foci, showing that this method allows for multiple independent spatial rotations.

Focus Group Evaluation of Customized Family Health History Education Materials in a North Carolina Community

ERIC Educational Resources Information Center

Powell, Karen; Edelson, Vaughn; O'Leary, James; Christianson, Carol; Henrich, Vincent

2011-01-01

The "Does It Run In The Family?" booklets provide educational materials about family health history (FHH) and basic genetics to readers of all levels and are customizable for local communities. Purpose: The booklets were customized and provided to focus groups to evaluate their usefulness in conveying health information at a low reading…

Local Studies and Larger Issues: The Case of Sara Bagby.

ERIC Educational Resources Information Center

Luckett, Judith

2002-01-01

Explains that students can study local events within a larger context that clarifies larger events or issues. Focuses on the 1861 case of Sara Lucy Bagby (Cleveland, Ohio), an escaped slave, to illuminate aspects of gender, racial relations, politics, and the origins of the U.S. Civil War. (CMK)

Planar-focusing cathodes.

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

Lewellen, J. W.; Noonan, J.; Accelerator Systems Division

2005-01-01

Conventional {pi}-mode rf photoinjectors typically use magnetic solenoids for emittance compensation. This provides independent focusing strength but can complicate rf power feed placement, introduce asymmetries (due to coil crossovers), and greatly increase the cost of the photoinjector. Cathode-region focusing can also provide for a form of emittance compensation. Typically this method strongly couples focusing strength to the field gradient on the cathode, however, and usually requires altering the longitudinal position of the cathode to change the focusing. We propose a new method for achieving cathode-region variable-strength focusing for emittance compensation. The new method reduces the coupling to the gradient onmore » the cathode and does not require a change in the longitudinal position of the cathode. Expected performance for an S-band system is similar to conventional solenoid-based designs. This paper presents the results of rf cavity and beam dynamics simulations of the new design. We have proposed a method for performing emittance compensation using a cathode-region focusing scheme. This technique allows the focusing strength to be adjusted somewhat independently of the on-axis field strength. Beam dynamics calculations indicate performance should be comparable to presently in-use emittance compensation schemes, with a simpler configuration and fewer possibilities for emittance degradation due to the focusing optics. There are several potential difficulties with this approach, including cathode material selection, cathode heating, and peak fields in the gun. We hope to begin experimenting with a cathode of this type in the near future, and several possibilities exist for reducing the peak gradients to more acceptable levels.« less

An Empirical Study of the Transmission Power Setting for Bluetooth-Based Indoor Localization Mechanisms

PubMed Central

Castillo-Cara, Manuel; Lovón-Melgarejo, Jesús; Bravo-Rocca, Gusseppe; Orozco-Barbosa, Luis; García-Varea, Ismael

2017-01-01

Nowadays, there is a great interest in developing accurate wireless indoor localization mechanisms enabling the implementation of many consumer-oriented services. Among the many proposals, wireless indoor localization mechanisms based on the Received Signal Strength Indication (RSSI) are being widely explored. Most studies have focused on the evaluation of the capabilities of different mobile device brands and wireless network technologies. Furthermore, different parameters and algorithms have been proposed as a means of improving the accuracy of wireless-based localization mechanisms. In this paper, we focus on the tuning of the RSSI fingerprint to be used in the implementation of a Bluetooth Low Energy 4.0 (BLE4.0) Bluetooth localization mechanism. Following a holistic approach, we start by assessing the capabilities of two Bluetooth sensor/receiver devices. We then evaluate the relevance of the RSSI fingerprint reported by each BLE4.0 beacon operating at various transmission power levels using feature selection techniques. Based on our findings, we use two classification algorithms in order to improve the setting of the transmission power levels of each of the BLE4.0 beacons. Our main findings show that our proposal can greatly improve the localization accuracy by setting a custom transmission power level for each BLE4.0 beacon. PMID:28590413

An Empirical Study of the Transmission Power Setting for Bluetooth-Based Indoor Localization Mechanisms.

PubMed

Castillo-Cara, Manuel; Lovón-Melgarejo, Jesús; Bravo-Rocca, Gusseppe; Orozco-Barbosa, Luis; García-Varea, Ismael

2017-06-07

Nowadays, there is a great interest in developing accurate wireless indoor localization mechanisms enabling the implementation of many consumer-oriented services. Among the many proposals, wireless indoor localization mechanisms based on the Received Signal Strength Indication (RSSI) are being widely explored. Most studies have focused on the evaluation of the capabilities of different mobile device brands and wireless network technologies. Furthermore, different parameters and algorithms have been proposed as a means of improving the accuracy of wireless-based localization mechanisms. In this paper, we focus on the tuning of the RSSI fingerprint to be used in the implementation of a Bluetooth Low Energy 4.0 (BLE4.0) Bluetooth localization mechanism. Following a holistic approach, we start by assessing the capabilities of two Bluetooth sensor/receiver devices. We then evaluate the relevance of the RSSI fingerprint reported by each BLE4.0 beacon operating at various transmission power levels using feature selection techniques. Based on our findings, we use two classification algorithms in order to improve the setting of the transmission power levels of each of the BLE4.0 beacons. Our main findings show that our proposal can greatly improve the localization accuracy by setting a custom transmission power level for each BLE4.0 beacon.

Local Foods, Local Places Summary Reports

EPA Pesticide Factsheets

These reports summarize community projects done with Local Foods, Local Places assistance, including farmers markets, cooperatives, community gardens, and other food-related enterprises that can boost local economies and drive revitalization.

Local Kernel for Brains Classification in Schizophrenia

NASA Astrophysics Data System (ADS)

Castellani, U.; Rossato, E.; Murino, V.; Bellani, M.; Rambaldelli, G.; Tansella, M.; Brambilla, P.

In this paper a novel framework for brain classification is proposed in the context of mental health research. A learning by example method is introduced by combining local measurements with non linear Support Vector Machine. Instead of considering a voxel-by-voxel comparison between patients and controls, we focus on landmark points which are characterized by local region descriptors, namely Scale Invariance Feature Transform (SIFT). Then, matching is obtained by introducing the local kernel for which the samples are represented by unordered set of features. Moreover, a new weighting approach is proposed to take into account the discriminative relevance of the detected groups of features. Experiments have been performed including a set of 54 patients with schizophrenia and 54 normal controls on which region of interest (ROI) have been manually traced by experts. Preliminary results on Dorso-lateral PreFrontal Cortex (DLPFC) region are promising since up to 75% of successful classification rate has been obtained with this technique and the performance has improved up to 85% when the subjects have been stratified by sex.

Financing State and Local Government: Future Challenges and Opportunities.

ERIC Educational Resources Information Center

Wildasin, David E.; Childress, Michael T.; Hackbart, Merl; Lynch, Lawrence K.; Martie, Charles W.

This report focuses on state and local taxation in the state of Kentucky. It looks into what "the ideal" tax system looks like and how Kentucky's system compares, whether the current system will provide adequate revenue for the long-term, whether the tax system is efficient, how fair and equitable the tax system is, and whether the state…

Jails and Local Justice System Reform: Overview and Recommendations

ERIC Educational Resources Information Center

Copp, Jennifer E.; Bales, William D.

2018-01-01

Over the past three decades, the number of people housed in local jails has more than tripled. Yet when it comes to reforming the nation's incarceration policies, write Jennifer Copp and William Bales, researchers, policymakers, and the public alike have focused almost exclusively on state and federal prisons. If you took a snapshot on a single…

Qualitative Assessment of a Novel Efficacy-Focused Training Intervention for Public Health Workers in Disaster Recovery.

PubMed

Tower, Craig; Altman, Brian A; Strauss-Riggs, Kandra; Iversen, Annelise; Garrity, Stephanie; Thompson, Carol B; Walsh, Lauren; Rutkow, Lainie; Schor, Kenneth; Barnett, Daniel J

2016-08-01

We trained local public health workers on disaster recovery roles and responsibilities by using a novel curriculum based on a threat and efficacy framework and a training-of-trainers approach. This study used qualitative data to assess changes in perceptions of efficacy toward Hurricane Sandy recovery and willingness to participate in future disaster recoveries. Purposive and snowball sampling were used to select trainers and trainees from participating local public health departments in jurisdictions impacted by Hurricane Sandy in October 2012. Two focus groups totaling 29 local public health workers were held in April and May of 2015. Focus group participants discussed the content and quality of the curriculum, training logistics, and their willingness to engage in future disaster recovery efforts. The training curriculum improved participants' understanding of and confidence in their disaster recovery work and related roles within their agencies (self-efficacy); increased their individual- and agency-level sense of role-importance in disaster recovery (response-efficacy); and enhanced their sense of their agencies' effective functioning in disaster recovery. Participants suggested further training customization and inclusion of other recovery agencies. Threat- and efficacy-based disaster recovery trainings show potential to increase public health workers' sense of efficacy and willingness to participate in recovery efforts. (Disaster Med Public Health Preparedness. 2016;10:615-622).

Local spatio-temporal analysis in vision systems

NASA Astrophysics Data System (ADS)

Geisler, Wilson S.; Bovik, Alan; Cormack, Lawrence; Ghosh, Joydeep; Gildeen, David

1994-07-01

The aims of this project are the following: (1) develop a physiologically and psychophysically based model of low-level human visual processing (a key component of which are local frequency coding mechanisms); (2) develop image models and image-processing methods based upon local frequency coding; (3) develop algorithms for performing certain complex visual tasks based upon local frequency representations, (4) develop models of human performance in certain complex tasks based upon our understanding of low-level processing; and (5) develop a computational testbed for implementing, evaluating and visualizing the proposed models and algorithms, using a massively parallel computer. Progress has been substantial on all aims. The highlights include the following: (1) completion of a number of psychophysical and physiological experiments revealing new, systematic and exciting properties of the primate (human and monkey) visual system; (2) further development of image models that can accurately represent the local frequency structure in complex images; (3) near completion in the construction of the Texas Active Vision Testbed; (4) development and testing of several new computer vision algorithms dealing with shape-from-texture, shape-from-stereo, and depth-from-focus; (5) implementation and evaluation of several new models of human visual performance; and (6) evaluation, purchase and installation of a MasPar parallel computer.

Local divergence and curvature divergence in first order optics

NASA Astrophysics Data System (ADS)

Mafusire, Cosmas; Krüger, Tjaart P. J.

2018-06-01

The far-field divergence of a light beam propagating through a first order optical system is presented as a square root of the sum of the squares of the local divergence and the curvature divergence. The local divergence is defined as the ratio of the beam parameter product to the beam width whilst the curvature divergence is a ratio of the space-angular moment also to the beam width. It is established that the beam’s focusing parameter can be defined as a ratio of the local divergence to the curvature divergence. The relationships between the two divergences and other second moment-based beam parameters are presented. Their various mathematical properties are presented such as their evolution through first order systems. The efficacy of the model in the analysis of high power continuous wave laser-based welding systems is briefly discussed.

Broadband Focusing Acoustic Lens Based on Fractal Metamaterials

PubMed Central

Song, Gang Yong; Huang, Bei; Dong, Hui Yuan; Cheng, Qiang; Cui, Tie Jun

2016-01-01

Acoustic metamaterials are artificial structures which can manipulate sound waves through their unconventional effective properties. Different from the locally resonant elements proposed in earlier studies, we propose an alternate route to realize acoustic metamaterials with both low loss and large refractive indices. We describe a new kind of acoustic metamaterial element with the fractal geometry. Due to the self-similar properties of the proposed structure, broadband acoustic responses may arise within a broad frequency range, making it a good candidate for a number of applications, such as super-resolution imaging and acoustic tunneling. A flat acoustic lens is designed and experimentally verified using this approach, showing excellent focusing abilities from 2 kHz and 5 kHz in the measured results. PMID:27782216

Experimental detection and focusing in shallow water by decomposition of the time reversal operator.

PubMed

Prada, Claire; de Rosny, Julien; Clorennec, Dominique; Minonzio, Jean-Gabriel; Aubry, Alexandre; Fink, Mathias; Berniere, Lothar; Billand, Philippe; Hibral, Sidonie; Folegot, Thomas

2007-08-01

A rigid 24-element source-receiver array in the 10-15 kHz frequency band, connected to a programmable electronic system, was deployed in the Bay of Brest during spring 2005. In this 10- to 18-m-deep environment, backscattered data from submerged targets were recorded. Successful detection and focusing experiments in very shallow water using the decomposition of the time reversal operator (DORT method) are shown. The ability of the DORT method to separate the echo of a target from reverberation as well as the echo from two different targets at 250 m is shown. An example of active focusing within the waveguide using the first invariant of the time reversal operator is presented, showing the enhanced focusing capability. Furthermore, the localization of the scatterers in the water column is obtained using a range-dependent acoustic model.

Depicting surgical anatomy of the porta hepatis in living donor liver transplantation.

PubMed

Kelly, Paul; Fung, Albert; Qu, Joy; Greig, Paul; Tait, Gordon; Jenkinson, Jodie; McGilvray, Ian; Agur, Anne

2017-01-01

Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs. Reconstructions of the biliary system were modeled from intraoperative cholangiograms. The distribution of the donor portal veins, hepatic arteries and bile ducts was defined from the porta hepatis intrahepatically to the point of surgical division. Each step of the surgery was enhanced with 3D animation to provide sequential and seamless visualization from pre-surgical planning to outcome. Use of visualization techniques such as transparency and overlays allows viewers not only to see the operative field, but also the origin and course of segmental branches and their spatial relationships. This novel educational approach enables integrating case-based operative footage with advanced editing techniques for visualizing not only the surgical procedure, but also complex anatomy such as vascular and biliary structures. The surgical team has found this approach to be beneficial for preoperative planning and clinical teaching, especially for complex cases. Each animation-enhanced video case is posted to the open-access Toronto Video Atlas of Surgery (TVASurg), an education resource with a global clinical and patient user base. The novel educational system described in this paper enables integrating operative footage with 3D animation and cinematic editing techniques for seamless sequential organization from pre-surgical planning to outcome.

Depicting surgical anatomy of the porta hepatis in living donor liver transplantation

PubMed Central

Fung, Albert; Qu, Joy; Greig, Paul; Tait, Gordon; Jenkinson, Jodie; McGilvray, Ian; Agur, Anne

2017-01-01

Visualizing the complex anatomy of vascular and biliary structures of the liver on a case-by-case basis has been challenging. A living donor liver transplant (LDLT) right hepatectomy case, with focus on the porta hepatis, was used to demonstrate an innovative method to visualize anatomy with the purpose of refining preoperative planning and teaching of complex surgical procedures. The production of an animation-enhanced video consisted of many stages including the integration of pre-surgical planning; case-specific footage and 3D models of the liver and associated vasculature, reconstructed from contrast-enhanced CTs. Reconstructions of the biliary system were modeled from intraoperative cholangiograms. The distribution of the donor portal veins, hepatic arteries and bile ducts was defined from the porta hepatis intrahepatically to the point of surgical division. Each step of the surgery was enhanced with 3D animation to provide sequential and seamless visualization from pre-surgical planning to outcome. Use of visualization techniques such as transparency and overlays allows viewers not only to see the operative field, but also the origin and course of segmental branches and their spatial relationships. This novel educational approach enables integrating case-based operative footage with advanced editing techniques for visualizing not only the surgical procedure, but also complex anatomy such as vascular and biliary structures. The surgical team has found this approach to be beneficial for preoperative planning and clinical teaching, especially for complex cases. Each animation-enhanced video case is posted to the open-access Toronto Video Atlas of Surgery (TVASurg), an education resource with a global clinical and patient user base. The novel educational system described in this paper enables integrating operative footage with 3D animation and cinematic editing techniques for seamless sequential organization from pre-surgical planning to outcome. PMID:29078606

Compressed learning and its applications to subcellular localization.

PubMed

Zheng, Zhong-Long; Guo, Li; Jia, Jiong; Xie, Chen-Mao; Zeng, Wen-Cai; Yang, Jie

2011-09-01

One of the main challenges faced by biological applications is to predict protein subcellular localization in automatic fashion accurately. To achieve this in these applications, a wide variety of machine learning methods have been proposed in recent years. Most of them focus on finding the optimal classification scheme and less of them take the simplifying the complexity of biological systems into account. Traditionally, such bio-data are analyzed by first performing a feature selection before classification. Motivated by CS (Compressed Sensing) theory, we propose the methodology which performs compressed learning with a sparseness criterion such that feature selection and dimension reduction are merged into one analysis. The proposed methodology decreases the complexity of biological system, while increases protein subcellular localization accuracy. Experimental results are quite encouraging, indicating that the aforementioned sparse methods are quite promising in dealing with complicated biological problems, such as predicting the subcellular localization of Gram-negative bacterial proteins.

Magnetic resonance guided focused ultrasound surgery (MRgFUS) of bone metastases: From primary pain palliation to local tumor control

NASA Astrophysics Data System (ADS)

Napoli, A.; Leonardi, A.; Andrani, F.; Boni, F.; Anzidei, M.; Catalano, C.

2017-03-01

Purpose: To evaluate the clinical performance of MRgFUS in primary pain palliation of painful bone metastases and in local tumor control. Materials and Methods: We enrolled 26 consecutive patients (female/male 12/14; age: 64.7±7.5yrs) with painful bone metastases. Before and 3 months after MRgFUS treatment pain severity and pain interference scores were assessed according to Brief Pain Inventory-Quality of Life (BPI-QoL) criteria and patients underwent both CT and MRI. Local tumor control was evaluated according to lesion size, density and perfusion at CT, dynamic contrast enhancement at MRI (Discovery 750HD, GE; Gd-Bopta, Bracco) and metabolic activity at PET or scintigraphy. Patients were classified as responders or non-responders. Results: No treatment-related adverse events were recorded during the study. As statistically significant difference between baseline and follow-up values for both pain severity and pain interference scores was observed (p<0.05). Increased bone density was observed in 9/26 (34.6%) patients. Non-Perfused Volume values ranged between 20% and 92%. There was no difference in NPV values between responders and non-responders (46.7±24.2% [25 - 90 %] vs. 45±24.9% [20 - 93 %]; p=0.7). In 6 patients (5 prostate and 1 breast primary cancer) there was nearly absence of metabolic activity after treatment (mean SUV=1.2). Conclusion: MRgFUS can be safely and effectively used as the primary treatment for pain palliation in patients with painful bone metastases; moreover our experience demonstrated also a potential role for the MRgFUS in local tumor control.

Arc Fault Detection & Localization by Electromagnetic-Acoustic Remote Sensing

NASA Astrophysics Data System (ADS)

Vasile, C.; Ioana, C.

2017-05-01

Electrical arc faults that occur in photovoltaic systems represent a danger due to their economic impact on production and distribution. In this paper we propose a complete system, with focus on the methodology, that enables the detection and localization of the arc fault, by the use of an electromagnetic-acoustic sensing system. By exploiting the multiple emissions of the arc fault, in conjunction with a real-time detection signal processing method, we ensure accurate detection and localization. In its final form, this present work will present in greater detail the complete system, the methods employed, results and performance, alongside further works that will be carried on.

Evolutionary-inspired probabilistic search for enhancing sampling of local minima in the protein energy surface

PubMed Central

2012-01-01

Background Despite computational challenges, elucidating conformations that a protein system assumes under physiologic conditions for the purpose of biological activity is a central problem in computational structural biology. While these conformations are associated with low energies in the energy surface that underlies the protein conformational space, few existing conformational search algorithms focus on explicitly sampling low-energy local minima in the protein energy surface. Methods This work proposes a novel probabilistic search framework, PLOW, that explicitly samples low-energy local minima in the protein energy surface. The framework combines algorithmic ingredients from evolutionary computation and computational structural biology to effectively explore the subspace of local minima. A greedy local search maps a conformation sampled in conformational space to a nearby local minimum. A perturbation move jumps out of a local minimum to obtain a new starting conformation for the greedy local search. The process repeats in an iterative fashion, resulting in a trajectory-based exploration of the subspace of local minima. Results and conclusions The analysis of PLOW's performance shows that, by navigating only the subspace of local minima, PLOW is able to sample conformations near a protein's native structure, either more effectively or as well as state-of-the-art methods that focus on reproducing the native structure for a protein system. Analysis of the actual subspace of local minima shows that PLOW samples this subspace more effectively that a naive sampling approach. Additional theoretical analysis reveals that the perturbation function employed by PLOW is key to its ability to sample a diverse set of low-energy conformations. This analysis also suggests directions for further research and novel applications for the proposed framework. PMID:22759582

Transportation research synthesis : effects of major traffic generators on local highway systems.

DOT National Transportation Integrated Search

2010-01-01

The Minnesota Department of Transportation initiated a study focused on the effects of major traffic generators on : local highway systems. Minnesota State University and SRF Consulting Group, Inc. will conduct a major research : study on the topic. ...

Infrastructure Analysis Tools: A Focus on Cash Flow Analysis (Presentation)

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

Melaina, M.; Penev, M.

2012-09-01

NREL has developed and maintains a variety of infrastructure analysis models for the U.S. Department of Energy. Business case analysis has recently been added to this tool set. This presentation focuses on cash flow analysis. Cash flows depend upon infrastructure costs, optimized spatially and temporally, and assumptions about financing and revenue. NREL has incorporated detailed metrics on financing and incentives into the models. Next steps in modeling include continuing to collect feedback on regional/local infrastructure development activities and 'roadmap' dynamics, and incorporating consumer preference assumptions on infrastructure to provide direct feedback between vehicles and station rollout.

The California Cauldron: Immigration and the Fortunes of Local Communities.

ERIC Educational Resources Information Center

Clark, William A. V.

Since 1965, changes in the immigration law have altered the influx from abroad and transformed the nation, especially California. This book examines the fundamental transformation of the state's population, focusing on local outcomes in California communities. Chapters 1 and 2 discuss social and economic causes of immigration, types of migrants,…

Locally Dependent Latent Trait Model and the Dutch Identity Revisited.

ERIC Educational Resources Information Center

Ip, Edward H.

2002-01-01

Proposes a class of locally dependent latent trait models for responses to psychological and educational tests. Focuses on models based on a family of conditional distributions, or kernel, that describes joint multiple item responses as a function of student latent trait, not assuming conditional independence. Also proposes an EM algorithm for…

Ambient Noise Correlation Amplitudes and Local Site Response

NASA Astrophysics Data System (ADS)

Bowden, D. C.; Tsai, V. C.; Lin, F. C.

2014-12-01

We investigate amplitudes from ambient noise cross correlations in a spatially dense array. Our study of wave propagation effects and ambient noise is focused on the Long Beach Array, with more than 5000 single component geophones in an area of about 100 square kilometers, providing high resolution imaging of shallow crustal features. The method allows for observations of ground properties like site response and attenuation, which can well supplement traditional velocity models and simulations for seismic hazard. Traditional ambient noise cross correlations have proven to be an effective means of measuring velocity information about surface waves, but the amplitudes of such signals in traditional processing are often distorted. We discuss a method of signal processing which preserves relative amplitudes of signals within an array, and the subsequent processing to track wave motion across the array. Previous work showed promising correlation to known local structure, but did not represent a thorough application of tomographic methods. Now we extend the methodology to more robustly consider wavefront focusing and defocusing, interference with higher modes, and discuss the differing effects of local site response, attenuation, and scattering. Application of Helmholtz tomography and determination of local site amplification has previously been demonstrated using earthquake data on the continental scale with USArray, but the exploitation of the ambient noise field is required both for the higher frequencies needed by seismic hazard studies and for the short deployment time of a Long Beach scale array. We outline both the successes and shortcomings of the methodology, and show how it can be extended for use on future arrays.

Comparison of Travel-Time and Amplitude Measurements for Deep-Focusing Time-Distance Helioseismology

NASA Astrophysics Data System (ADS)

Pourabdian, Majid; Fournier, Damien; Gizon, Laurent

2018-04-01

The purpose of deep-focusing time-distance helioseismology is to construct seismic measurements that have a high sensitivity to the physical conditions at a desired target point in the solar interior. With this technique, pairs of points on the solar surface are chosen such that acoustic ray paths intersect at this target (focus) point. Considering acoustic waves in a homogeneous medium, we compare travel-time and amplitude measurements extracted from the deep-focusing cross-covariance functions. Using a single-scattering approximation, we find that the spatial sensitivity of deep-focusing travel times to sound-speed perturbations is zero at the target location and maximum in a surrounding shell. This is unlike the deep-focusing amplitude measurements, which have maximum sensitivity at the target point. We compare the signal-to-noise ratio for travel-time and amplitude measurements for different types of sound-speed perturbations, under the assumption that noise is solely due to the random excitation of the waves. We find that, for highly localized perturbations in sound speed, the signal-to-noise ratio is higher for amplitude measurements than for travel-time measurements. We conclude that amplitude measurements are a useful complement to travel-time measurements in time-distance helioseismology.

Dynamics of laser-driven proton beam focusing and transport into solid density matter

NASA Astrophysics Data System (ADS)

Kim, J.; McGuffey, C.; Beg, F.; Wei, M.; Mariscal, D.; Chen, S.; Fuchs, J.

2016-10-01

Isochoric heating and local energy deposition capabilities make intense proton beams appealing for studying high energy density physics and the Fast Ignition of inertial confinement fusion. To study proton beam focusing that results in high beam density, experiments have been conducted using different target geometries irradiated by a kilojoule, 10 ps pulse of the OMEGA EP laser. The beam focus was measured by imaging beam-induced Cu K-alpha emission on a Cu foil that was positioned at a fixed distance. Compared to a free target, structured targets having shapes of wedge and cone show a brighter and narrower K-alpha radiation emission spot on a Cu foil indicating higher beam focusability. Experimentally observed images with proton radiography demonstrate the existence of transverse fields on the structures. Full-scale simulations including the contribution of a long pulse duration of the laser confirm that such fields can be caused by hot electrons moving through the structures. The simulated fields are strong enough to reflect the diverging main proton beam and pinch a transverse probe beam. Detailed simulation results including the beam focusing and transport of the focused intense proton beam in Cu foil will be presented. This work was supported by the National Laser User Facility Program through Award DE-NA0002034.

Local-Level Prognostics Health Management Systems Framework for Passive AdvSMR Components. Interim Report

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

Ramuhalli, Pradeep; Roy, Surajit; Hirt, Evelyn H.

2014-09-12

This report describes research results to date in support of the integration and demonstration of diagnostics technologies for prototypical AdvSMR passive components (to establish condition indices for monitoring) with model-based prognostics methods. The focus of the PHM methodology and algorithm development in this study is at the localized scale. Multiple localized measurements of material condition (using advanced nondestructive measurement methods), along with available measurements of the stressor environment, enhance the performance of localized diagnostics and prognostics of passive AdvSMR components and systems.

Local Laplacian Coding From Theoretical Analysis of Local Coding Schemes for Locally Linear Classification.

PubMed

Pang, Junbiao; Qin, Lei; Zhang, Chunjie; Zhang, Weigang; Huang, Qingming; Yin, Baocai

2015-12-01

Local coordinate coding (LCC) is a framework to approximate a Lipschitz smooth function by combining linear functions into a nonlinear one. For locally linear classification, LCC requires a coding scheme that heavily determines the nonlinear approximation ability, posing two main challenges: 1) the locality making faraway anchors have smaller influences on current data and 2) the flexibility balancing well between the reconstruction of current data and the locality. In this paper, we address the problem from the theoretical analysis of the simplest local coding schemes, i.e., local Gaussian coding and local student coding, and propose local Laplacian coding (LPC) to achieve the locality and the flexibility. We apply LPC into locally linear classifiers to solve diverse classification tasks. The comparable or exceeded performances of state-of-the-art methods demonstrate the effectiveness of the proposed method.

Improving Localization Accuracy: Successive Measurements Error Modeling

PubMed Central

Abu Ali, Najah; Abu-Elkheir, Mervat

2015-01-01

Vehicle self-localization is an essential requirement for many of the safety applications envisioned for vehicular networks. The mathematical models used in current vehicular localization schemes focus on modeling the localization error itself, and overlook the potential correlation between successive localization measurement errors. In this paper, we first investigate the existence of correlation between successive positioning measurements, and then incorporate this correlation into the modeling positioning error. We use the Yule Walker equations to determine the degree of correlation between a vehicle’s future position and its past positions, and then propose a p-order Gauss–Markov model to predict the future position of a vehicle from its past p positions. We investigate the existence of correlation for two datasets representing the mobility traces of two vehicles over a period of time. We prove the existence of correlation between successive measurements in the two datasets, and show that the time correlation between measurements can have a value up to four minutes. Through simulations, we validate the robustness of our model and show that it is possible to use the first-order Gauss–Markov model, which has the least complexity, and still maintain an accurate estimation of a vehicle’s future location over time using only its current position. Our model can assist in providing better modeling of positioning errors and can be used as a prediction tool to improve the performance of classical localization algorithms such as the Kalman filter. PMID:26140345

Electroencephalography in Mesial Temporal Lobe Epilepsy: A Review

PubMed Central

Javidan, Manouchehr

2012-01-01

Electroencephalography (EEG) has an important role in the diagnosis and classification of epilepsy. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. In temporal lobe epilepsy (TLE) seizures could originate in the medial or lateral neocortical temporal region, and many of these patients are refractory to medical treatment. However, majority of patients have had excellent results after surgery and this often relies on the EEG and magnetic resonance imaging (MRI) data in presurgical evaluation. If the scalp EEG data is insufficient or discordant, invasive EEG recording with placement of intracranial electrodes could identify the seizure focus prior to surgery. This paper highlights the general information regarding the use of EEG in epilepsy, EEG patterns resembling epileptiform discharges, and the interictal, ictal and postictal findings in mesial temporal lobe epilepsy using scalp and intracranial recordings prior to surgery. The utility of the automated seizure detection and computerized mathematical models for increasing yield of non-invasive localization is discussed. This paper also describes the sensitivity, specificity, and predictive value of EEG for seizure recurrence after withdrawal of medications following seizure freedom with medical and surgical therapy. PMID:22957235

Assessment of hemispheric dominance for receptive language in pediatric patients under sedation using magnetoencephalography.

PubMed

Rezaie, Roozbeh; Narayana, Shalini; Schiller, Katherine; Birg, Liliya; Wheless, James W; Boop, Frederick A; Papanicolaou, Andrew C

2014-01-01

Non-invasive assessment of hemispheric dominance for receptive language using magnetoencephalography (MEG) is now a well-established procedure used across several epilepsy centers in the context of pre-surgical evaluation of children and adults while awake, alert and attentive. However, the utility of MEG for the same purpose, in cases of sedated patients, is contested. Establishment of the efficiency of MEG is especially important in the case of children who, for a number of reasons, must be assessed under sedation. Here we explored the efficacy of MEG language mapping under sedation through retrospective review of 95 consecutive pediatric patients, who underwent our receptive language test as part of routine clinical evaluation. Localization of receptive language cortex and subsequent determination of laterality was successfully completed in 78% (n = 36) and 55% (n = 27) of non-sedated and sedated patients, respectively. Moreover, the proportion of patients deemed left hemisphere dominant for receptive language did not differ between non-sedated and sedated patients, exceeding 90% in both groups. Considering the challenges associated with assessing brain function in pediatric patients, the success of passive MEG in the context of the cases reviewed in this study support the utility of this method in pre-surgical receptive language mapping.

Assessment of hemispheric dominance for receptive language in pediatric patients under sedation using magnetoencephalography

PubMed Central

Rezaie, Roozbeh; Narayana, Shalini; Schiller, Katherine; Birg, Liliya; Wheless, James W.; Boop, Frederick A.; Papanicolaou, Andrew C.

2014-01-01

Non-invasive assessment of hemispheric dominance for receptive language using magnetoencephalography (MEG) is now a well-established procedure used across several epilepsy centers in the context of pre-surgical evaluation of children and adults while awake, alert and attentive. However, the utility of MEG for the same purpose, in cases of sedated patients, is contested. Establishment of the efficiency of MEG is especially important in the case of children who, for a number of reasons, must be assessed under sedation. Here we explored the efficacy of MEG language mapping under sedation through retrospective review of 95 consecutive pediatric patients, who underwent our receptive language test as part of routine clinical evaluation. Localization of receptive language cortex and subsequent determination of laterality was successfully completed in 78% (n = 36) and 55% (n = 27) of non-sedated and sedated patients, respectively. Moreover, the proportion of patients deemed left hemisphere dominant for receptive language did not differ between non-sedated and sedated patients, exceeding 90% in both groups. Considering the challenges associated with assessing brain function in pediatric patients, the success of passive MEG in the context of the cases reviewed in this study support the utility of this method in pre-surgical receptive language mapping. PMID:25191260

High-resolution EEG (HR-EEG) and magnetoencephalography (MEG).

PubMed

Gavaret, M; Maillard, L; Jung, J

2015-03-01

High-resolution EEG (HR-EEG) and magnetoencephalography (MEG) allow the recording of spontaneous or evoked electromagnetic brain activity with excellent temporal resolution. Data must be recorded with high temporal resolution (sampling rate) and high spatial resolution (number of channels). Data analyses are based on several steps with selection of electromagnetic signals, elaboration of a head model and use of algorithms in order to solve the inverse problem. Due to considerable technical advances in spatial resolution, these tools now represent real methods of ElectroMagnetic Source Imaging. HR-EEG and MEG constitute non-invasive and complementary examinations, characterized by distinct sensitivities according to the location and orientation of intracerebral generators. In the presurgical assessment of drug-resistant partial epilepsies, HR-EEG and MEG can characterize and localize interictal activities and thus the irritative zone. HR-EEG and MEG often yield significant additional data that are complementary to other presurgical investigations and particularly relevant in MRI-negative cases. Currently, the determination of the epileptogenic zone and functional brain mapping remain rather less well-validated indications. In France, in 2014, HR-EEG is now part of standard clinical investigation of epilepsy, while MEG remains a research technique. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Clinical Resting-state fMRI in the Preoperative Setting

PubMed Central

Lee, Megan H.; Miller-Thomas, Michelle M.; Benzinger, Tammie L.; Marcus, Daniel S.; Hacker, Carl D.; Leuthardt, Eric C.; Shimony, Joshua S.

2017-01-01

The purpose of this manuscript is to provide an introduction to resting-state functional magnetic resonance imaging (RS-fMRI) and to review the current application of this new and powerful technique in the preoperative setting using our institute’s extensive experience. RS-fMRI has provided important insights into brain physiology and is an increasingly important tool in the clinical setting. As opposed to task-based functional MRI wherein the subject performs a task while being scanned, RS-fMRI evaluates low-frequency fluctuations in the blood oxygen level dependent (BOLD) signal while the subject is at rest. Multiple resting state networks (RSNs) have been identified, including the somatosensory, language, and visual networks, which are of primary importance for presurgical planning. Over the past 4 years, we have performed over 300 RS-fMRI examinations in the clinical setting and these have been used to localize eloquent somatosensory and language cortices before brain tumor resection. RS-fMRI is particularly useful in this setting for patients who are unable to cooperate with the task-based paradigm, such as young children or those who are sedated, paretic, or aphasic. Although RS-fMRI is still investigational, our experience indicates that this method is ready for clinical application in the presurgical setting. PMID:26848556

Open database of epileptic EEG with MRI and postoperational assessment of foci--a real world verification for the EEG inverse solutions.

PubMed

Zwoliński, Piotr; Roszkowski, Marcin; Zygierewicz, Jaroslaw; Haufe, Stefan; Nolte, Guido; Durka, Piotr J

2010-12-01

This paper introduces a freely accessible database http://eeg.pl/epi , containing 23 datasets from patients diagnosed with and operated on for drug-resistant epilepsy. This was collected as part of the clinical routine at the Warsaw Memorial Child Hospital. Each record contains (1) pre-surgical electroencephalography (EEG) recording (10-20 system) with inter-ictal discharges marked separately by an expert, (2) a full set of magnetic resonance imaging (MRI) scans for calculations of the realistic forward models, (3) structural placement of the epileptogenic zone, recognized by electrocorticography (ECoG) and post-surgical results, plotted on pre-surgical MRI scans in transverse, sagittal and coronal projections, (4) brief clinical description of each case. The main goal of this project is evaluation of possible improvements of localization of epileptic foci from the surface EEG recordings. These datasets offer a unique possibility for evaluating different EEG inverse solutions. We present preliminary results from a subset of these cases, including comparison of different schemes for the EEG inverse solution and preprocessing. We report also a finding which relates to the selective parametrization of single waveforms by multivariate matching pursuit, which is used in the preprocessing for the inverse solutions. It seems to offer a possibility of tracing the spatial evolution of seizures in time.

Determining the Interstellar Wind Longitudinal Inflow Evolution Using Pickup Ions in the Helium Focusing Cone

NASA Astrophysics Data System (ADS)

Spitzer, S. A.; Gilbert, J. A.; Lepri, S. T.

2017-12-01

We propose to determine the longitudinal inflow direction of the local interstellar medium through the Heliosphere. This longitudinal inflow direction directly correlates to the longitudinal direction of the helium focusing cone with respect to the Sun. We can calculate this direction by finding the He+ pickup ion density peak as mass spectrometers such as ACE/SWICS, Wind/STICS, and Helios/Micrometeoroid Detector and Analyzer pass through the focusing cone. Mapping from the location of this density peak to the Sun, around which the helium is focused, will directly yield the desired longitudinal direction. We will find this direction for each year since the first measurements in the 1970s through the present and thereby analyze its evolution over time. This poster outlines our proposed method and initial results.

Emotional state and local versus global spatial memory.

PubMed

Brunyé, Tad T; Mahoney, Caroline R; Augustyn, Jason S; Taylor, Holly A

2009-02-01

The present work investigated the effects of participant emotional state on global versus local memory for map-based information. Participants were placed into one of four emotion induction groups, crossing high and low arousal with positive and negative valence, or a control group. They then studied a university campus map and completed two memory tests, free recall and spatial statement verification. Converging evidence from these two tasks demonstrated that arousal amplifies symbolic distance effects and leads to a globally-focused spatial mental representation, partially at the expense of local knowledge. These results were found for both positively- and negatively-valenced affective states. The present study is the first investigation of emotional effects on spatial memory, and has implications for theories of emotion and spatial cognition.

Lecture-Room Interference Demo Using a Glass Plate and a Laser Beam Focused on It

ERIC Educational Resources Information Center

Ageev, Leonid A.; Yegorenkov, Vladimir D.

2010-01-01

We describe a simple case of non-localized interference produced with a glass plate and a laser beam focused on it. The proposed setup for observing interference is compact when semiconductor lasers are employed, and it is well suited for demonstration and comparison of interference in reflected and transmitted light in a large lecture-room. This…

[Pre-verbality in focusing and the need for self check. An attempt at "focusing check"].

PubMed

Masui, T; Ikemi, A; Murayama, S

1983-06-01

Though the Focusing process is not entirely non-verbal, in Focusing, careful attention is paid by the Focuser and the Listener to the pre-verbal experiential process. In other words, Focusing involves attending to the felt sense that is not easily expressed in words immediately. Hence, during the process of learning to Focus, the Focusing teacher attempts to communicate the experiences of Focusing to the student which are not easily done by words. Due to such difficulties, the Focusing student may (and quite frequently does) mistake the experiential process in Focusing with other processes. Often, the felt sense can be confused with other phenomena such as "autogenic discharge". Also the Focuser may not stay with the felt sense and drift into "free association" or frequently, certain processes in "meditation" can be confused with Focusing. Therefore, there is a need for a "check" by which the Focusing student can confirm the Focusing experience for himself. For the Focusing student, such a "check" serves not only to confirm the Focusing process, but also an aid to learning Focusing. We will report here a "Focusing Check" which we developed by translating Eugene Gendlin's "Focusing Check" and making several modifications in it so that it will be more understandable to the Japanese. Along with the "Focusing Check" we developed, the authors discuss the need for such a check.

A long arm for ultrasound: a combined robotic focused ultrasound setup for magnetic resonance-guided focused ultrasound surgery.

PubMed

Krafft, Axel J; Jenne, Jürgen W; Maier, Florian; Stafford, R Jason; Huber, Peter E; Semmler, Wolfhard; Bock, Michael

2010-05-01

Focused ultrasound surgery (FUS) is a highly precise noninvasive procedure to ablate pathogenic tissue. FUS therapy is often combined with magnetic resonance (MR) imaging as MR imaging offers excellent target identification and allows for continuous monitoring of FUS induced temperature changes. As the dimensions of the ultrasound (US) focus are typically much smaller than the targeted volume, multiple sonications and focus repositioning are interleaved to scan the focus over the target volume. Focal scanning can be achieved electronically by using phased-array US transducers or mechanically by using dedicated mechanical actuators. In this study, the authors propose and evaluate the precision of a combined robotic FUS setup to overcome some of the limitations of the existing MRgFUS systems. Such systems are typically integrated into the patient table of the MR scanner and thus only provide an application of the US wave within a limited spatial range from below the patient. The fully MR-compatible robotic assistance system InnoMotion (InnoMedic GmbH, Herxheim, Germany) was originally designed for MR-guided interventions with needles. It offers five pneumatically driven degrees of freedom and can be moved over a wide range within the bore of the magnet. In this work, the robotic system was combined with a fixed-focus US transducer (frequency: 1.7 MHz; focal length: 68 mm, and numerical aperture: 0.44) that was integrated into a dedicated, in-house developed treatment unit for FUS application. A series of MR-guided focal scanning procedures was performed in a polyacrylamide-egg white gel phantom to assess the positioning accuracy of the combined FUS setup. In animal experiments with a 3-month-old domestic pig, the system's potential and suitability for MRgFUS was tested. In phantom experiments, a total targeting precision of about 3 mm was found, which is comparable to that of the existing MRgFUS systems. Focus positioning could be performed within a few seconds