Prospective randomized trial of EUS versus ERCP-guided common bile duct stone removal: an interim report (with video)

Background: EUS is being increasingly utilized for the diagnosis of choledocholithiasis and microlithiasis, especially in patients with biliary colic. Simultaneously, there is also a rising interest in the use of EUS for therapeutic interventions. Objectives: Our goal was to assess the effectiveness of EUS-directed common bile duct (CBD) stone removal to compare its safety and effectiveness with ERCP-directed intervention. Design: interim results of a prospective, randomized, single-center blinded clinical trial. Setting: A single tertiary care referral center. Patients: Fifty-two patients with uncomplicated CBD stones were prospectively randomized to CBD cannulation and stone removal under EUS or ERCP guidance. Main Outcome Measurements and Interventions: Primary outcome measure was the rate of successful cannulation of the CBD. Secondary Outcome measures included Successful removal of stones and overall complication rates. Results: CBD cannulation followed by stone extraction was successful in 23 of 26 patients (88.5%) in the EUS group (1) versus 25 of 26 patients (96.2%) in the ERCP group (11) (95% CI, -27.65%, 9.88%). Overall, there were 3 complications in the EUS group and 4 complications in the ERCP group. Limitation: The current study is an interim report from a single center report and performed by a single operator. Conclusions: Our preliminary analysis indicates that Outcomes following EUS-guided CBD stone retrieval are equivalent to those following ERCP EUS-related adverse events are similar to those following ERCP. ERCP and EUS-guided stone retrieval appears to be equally effective for therapeutic interventions of the bile duct. Additional studies are required to validate these preliminary results and to determine predictors of success of EUS-guided stone removal. (Gastrointest Endosc 2009;69:238-43.)

Origin of 10(15)-10(16) G magnetic fields in the central engine of gamma ray bursts

Various authors have suggested that the gamma-ray burst (GRB) central engine is a rapidly rotating, strongly magnetized, (similar to 10(15)-10(16) G) compact object. The strong magnetic field can accelerate and collimate the relativistic flow and the rotation of the compact object can be the energy source of the GRB. The major problem in this scenario is the difficulty of finding an astrophysical mechanism for obtaining such intense fields. Whereas, in principle, a neutron star could maintain such strong fields, it is difficult to justify a scenario for their creation. If the compact object is a black hole, the problem is more difficult since, according to general relativity it has ""no hair"" (i.e., no magnetic field). Schuster, Blackett, Pauli, and others have suggested that a rotating neutral body can create a magnetic field by non-minimal gravitational-electromagnetic coupling (NMGEC). The Schuster-Blackett form of NMGEC was obtained from the Mikhail and Wanas`s tetrad theory of gravitation (MW). We call the general theory NMGEC-MW. We investigate here the possible origin of the intense magnetic fields similar to 10(15)-10(16) G in GRBs by NMGEC-MW. Whereas these fields are difficult to explain astrophysically, we find that they are easily explained by NMGEC-MW. It not only explains the origin of the similar to 10(15)-10(16) G fields when the compact object is a neutron star, but also when it is a black hole.

An enhanced content selection mechanism for personalization of video news programmes

In this paper, we propose a content selection framework that improves the users` experience when they are enriching or authoring pieces of news. This framework combines a variety of techniques to retrieve semantically related videos, based on a set of criteria which are specified automatically depending on the media`s constraints. The combination of different content selection mechanisms can improve the quality of the retrieved scenes, because each technique`s limitations are minimized by other techniques` strengths. We present an evaluation based on a number of experiments, which show that the retrieved results are better when all criteria are used at time.

On modeling and evaluating multicomputer transcoding architectures for live-video streams

The pervasive and ubiquitous computing has motivated researches on multimedia adaptation which aims at matching the video quality to the user needs and device restrictions. This technique has a high computational cost which needs to be studied and estimated when designing architectures and applications. This paper presents an analytical model to quantify these video transcoding costs in a hardware independent way. The model was used to analyze the impact of transcoding delays in end-to-end live-video transmissions over LANs, MANs and WANs. Experiments confirm that the proposed model helps to define the best transcoding architecture for different scenarios.

Watch-and-Comment as a Paradigm toward Ubiquitous Interactive Video Editing

The literature reports research efforts allowing the editing of interactive TV multimedia documents by end-users. In this article we propose complementary contributions relative to end-user generated interactive video, video tagging, and collaboration. In earlier work we proposed the watch-and-comment (WaC) paradigm as the seamless capture of an individual`s comments so that corresponding annotated interactive videos be automatically generated. As a proof of concept, we implemented a prototype application, the WACTOOL, that supports the capture of digital ink and voice comments over individual frames and segments of the video, producing a declarative document that specifies both: different media stream structure and synchronization. In this article, we extend the WaC paradigm in two ways. First, user-video interactions are associated with edit commands and digital ink operations. Second, focusing on collaboration and distribution issues, we employ annotations as simple containers for context information by using them as tags in order to organize, store and distribute information in a P2P-based multimedia capture platform. We highlight the design principles of the watch-and-comment paradigm, and demonstrate related results including the current version of the WACTOOL and its architecture. We also illustrate how an interactive video produced by the WACTOOL can be rendered in an interactive video environment, the Ginga-NCL player, and include results from a preliminary evaluation.

The game of contacts: Estimating the social visibility of groups

Estimating the sizes of hard-to-count populations is a challenging and important problem that occurs frequently in social science, public health, and public policy. This problem is particularly pressing in HIV/AIDS research because estimates of the sizes of the most at-risk populations-illicit drug users, men who have sex with men, and sex workers-are needed for designing, evaluating, and funding programs to curb the spread of the disease. A promising new approach in this area is the network scale-up method, which uses information about the personal networks of respondents to make population size estimates. However, if the target population has low social visibility, as is likely to be the case in HIV/AIDS research, scale-up estimates will be too low. In this paper we develop a game-like activity that we call the game of contacts in order to estimate the social visibility of groups, and report results from a study of heavy drug users in Curitiba, Brazil (n = 294). The game produced estimates of social visibility that were consistent with qualitative expectations but of surprising magnitude. Further, a number of checks suggest that the data are high-quality. While motivated by the specific problem of population size estimation, our method could be used by researchers more broadly and adds to long-standing efforts to combine the richness of social network analysis with the power and scale of sample surveys. (C) 2010 Elsevier B.V. All rights reserved.

A game theoretical approach to the evolution of structured communication codes

Structured meaning-signal mappings, i.e., mappings that preserve neighborhood relationships by associating similar signals with similar meanings, are advantageous in an environment where signals are corrupted by noise and sub-optimal meaning inferences are rewarded as well. The evolution of these mappings, however, cannot be explained within a traditional language evolutionary game scenario in which individuals meet randomly because the evolutionary dynamics is trapped in local maxima that do not reflect the structure of the meaning and signal spaces. Here we use a simple game theoretical model to show analytically that when individuals adopting the same communication code meet more frequently than individuals using different codes-a result of the spatial organization of the population-then advantageous linguistic innovations can spread and take over the population. In addition, we report results of simulations in which an individual can communicate only with its K nearest neighbors and show that the probability that the lineage of a mutant that uses a more efficient communication code becomes fixed decreases exponentially with increasing K. These findings support the mother tongue hypothesis that human language evolved as a communication system used among kin, especially between mothers and offspring.