SWIVIT - Swiss video-intubation trial evaluating video-laryngoscopes in a simulated difficult airway scenario: study protocol for a multicenter prospective randomized controlled trial in Switzerland.

BACKGROUND: Video-laryngoscopes are marketed for intubation in difficult airway management. They provide a better view of the larynx and may facilitate tracheal intubation, but there is no adequately powered study comparing different types of video-laryngoscopes in a difficult airway scenario or in a simulated difficult airway situation. METHODS/DESIGN: The objective of this trial is to evaluate and to compare the clinical performance of three video-laryngoscopes with a guiding channel for intubation (Airtraq?, A. P. Advance?, King Vision?) and three video-laryngoscopes without an integrated tracheal tube guidance (C-MAC?, GlideScope?, McGrath?) in a simulated difficult airway situation in surgical patients. The working hypothesis is that each video-laryngoscope provides at least a 90% first intubation success rate (lower limit of the 95% confidence interval >0.9). It is a prospective, patient-blinded, multicenter, randomized controlled trial in 720 patients who are scheduled for elective surgery under general anesthesia, requiring tracheal intubation at one of the three participating hospitals. A difficult airway will be created using an extrication collar and taping the patients' head on the operating table to substantially reduce mouth opening and to minimize neck movement. Tracheal intubation will be performed with the help of one of the six devices according to randomization. Insertion success, time necessary for intubation, Cormack-Lehane grade and percentage of glottic opening (POGO) score at laryngoscopy, optimization maneuvers required to aid tracheal intubation, adverse events and technical problems will be recorded. Primary outcome is intubation success at first attempt. DISCUSSION: We will simulate the difficult airway and evaluate different video-laryngoscopes in this highly realistic and clinically challenging scenario, independently from manufacturers of the devices. Because of the sufficiently powered multicenter design this study will deliver important and cutting-edge results that will help clinicians decide which device to use for intubation of the expected and unexpected difficult airway. TRIAL REGISTRATION: NCT01692535.

Teaching Video NeuroImages: Micronystagmus of oculopalatal tremor.

Three months after brainstem hemorrhage, MRI revealed a hyperintense lesion of the left inferior olivary nucleus of a 45-year-old man (figure). The patient was completely asymptomatic, but exhibited oculopalatal tremor (OPT), rhythmic palatal oscillations, and small-amplitude vertical pendular nystagmus of the right eye, best visualized on fundus examination (see video).

Video Inspection of Highway Edgedrain Systems, HR-317, 1998

Minimizing infiltration of water in pavement structures has long been a priority of pavement designers. Incorporation of subsurface edgedrains is frequently an integral part of an pavement drainage system. In order for such a system to be effective however, it must be properly installed and maintained. With advances in video technology, inspection of edgedrain systems can now be conducted quite efficiently. This report documents the results of 287 video inspections of highway edgedrain systems in 29 states. These inspections were conducted to both demonstrate the capabilities of the technology as well as demonstrating some of the common problems associated with the performance of edgedrain systems. Findings indicated not only that the equipment was quite effective in identifying edgedrain performance concerns, but also how widespread the concerns of edgedrain performance are. Almost one third of the systems inspected had nonfunctional outlets, another third were either found to have non-functional mainlines or the mainlines could not be inspected due to physical obstructions. Only one third of the systems inspected were found to be performing as intended. Recommendations are provided for edgedrain design improvements to facilitate performance of the system and their inspections as well as recommendations to improve quality control during construction. Suggestions are also provided for maintenance procedures to address concerns identified in the inspection process. A Draft Guide Specification For Video Edgedrain Inspection and Acceptance is also provided as an Appendix.

Demonstration Project 85, Video Imagery Systems for Highway Applications, HR-1047, 1990

The report describes the state of the art video equipment used and experiences gained from the 6,800 mile field test. The first objective of this project was to determine if laser disc equipment could capture and store usable roadway images while operating in a mobile environment. The second objective was to evaluate methods of using optical disc storage and retrieval features to enhance highway planning and design function. Several highway departments have attempted to use video technology to replace the traditional 16 and 35 mm film format used in photologging. These attempts have met with limited success because of the distortion caused by video technology not being capable of dealing with highway speeds. The distortion has caused many highway signs to be unreadable and, therefore, clients have labeled the technology unusable. Two methods of using optical laser disc storage and retrieval have been successfully demonstrated by Wisconsin and Connecticut Departments of Transportation. Each method provides instantaneous retrieval and linking of images with other information. However, both methods gather the images using 35 mm film techniques. The 35 mm film image is then transferred to laser disc. Eliminating the film conversion to laser disc has potential for saving $4 to $5 per logging mile. In addition to a cost savings, the image would be available immediately as opposed to delays caused by film developing and transferring to laser disc. In June and November of 1986 Iowa DOT staff and cooperating equipment suppliers demonstrated the concept of direct image capture. The results from these tests were promising and an FHWA Demonstration program established. Since 1986 technology advancements have been incorporated into the design that further improve the image quality originally demonstrated.

Investigation of Video Crack and Patch Surveying for Pavement Management, MLR-92-01, 1992

The Iowa DOT has been using the AASHTO Present Serviceability Index (PSI) rating procedure since 1968 to rate the condition of pavement sections. A ride factor and a cracking and patching factor make up the PSI value. Crack and patch surveys have been done by sending crews out to measure and record the distress. Advances in video equipment and computers make it practical to videotape roads and do the crack and patch measurements in the office. The objective of the study was to determine the feasibility of converting the crack and patch survey operation to a video recording system with manual post processing. The summary and conclusions are as follows: Video crack and patch surveying is a feasible alternative to the current crack and patch procedure. The cost per mile should be about 25 percent less than the current procedure. More importantly, the risk of accidents is reduced by getting the people and vehicles off the roadway and shoulder. Another benefit is the elimination of the negative public perceptions of the survey crew on the shoulder.

Enhanced-reality video fluorescence: a real-time assessment of intestinal viability.

OBJECTIVE: Our aim was to evaluate a fluorescence-based enhanced-reality system to assess intestinal viability in a laparoscopic mesenteric ischemia model. MATERIALS AND METHODS: A small bowel loop was exposed, and 3 to 4 mesenteric vessels were clipped in 6 pigs. Indocyanine green (ICG) was administered intravenously 15 minutes later. The bowel was illuminated with an incoherent light source laparoscope (D-light-P, KarlStorz). The ICG fluorescence signal was analyzed with Ad Hoc imaging software (VR-RENDER), which provides a digital perfusion cartography that was superimposed to the intraoperative laparoscopic image [augmented reality (AR) synthesis]. Five regions of interest (ROIs) were marked under AR guidance (1, 2a-2b, 3a-3b corresponding to the ischemic, marginal, and vascularized zones, respectively). One hour later, capillary blood samples were obtained by puncturing the bowel serosa at the identified ROIs and lactates were measured using the EDGE analyzer. A surgical biopsy of each intestinal ROI was sent for mitochondrial respiratory rate assessment and for metabolites quantification. RESULTS: Mean capillary lactate levels were 3.98 (SD = 1.91) versus 1.05 (SD = 0.46) versus 0.74 (SD = 0.34) mmol/L at ROI 1 versus 2a-2b (P = 0.0001) versus 3a-3b (P = 0.0001), respectively. Mean maximal mitochondrial respiratory rate was 104.4 (±21.58) pmolO2/second/mg at the ROI 1 versus 191.1 ± 14.48 (2b, P = 0.03) versus 180.4 ± 16.71 (3a, P = 0.02) versus 199.2 ± 25.21 (3b, P = 0.02). Alanine, choline, ethanolamine, glucose, lactate, myoinositol, phosphocholine, sylloinositol, and valine showed statistically significant different concentrations between ischemic and nonischemic segments. CONCLUSIONS: Fluorescence-based AR may effectively detect the boundary between the ischemic and the vascularized zones in this experimental model.

Using Digital Video Analysis to Monitor Driver Behavior at Intersections

Commercially available instruments for road-side data collection take highly limited measurements, require extensive manual input, or are too expensive for widespread use. However, inexpensive computer vision techniques for digital video analysis can be applied to automate the monitoring of driver, vehicle, and pedestrian behaviors. These techniques can measure safety-related variables that cannot be easily measured using existing sensors. The use of these techniques will lead to an improved understanding of the decisions made by drivers at intersections. These automated techniques allow the collection of large amounts of safety-related data in a relatively short amount of time. There is a need to develop an easily deployable system to utilize these new techniques. This project implemented and tested a digital video analysis system for use at intersections. A prototype video recording system was developed for field deployment. A computer interface was implemented and served to simplify and automate the data analysis and the data review process. Driver behavior was measured at urban and rural non-signalized intersections. Recorded digital video was analyzed and used to test the system.

Oscillations, phase-of-firing coding, and spike timing-dependent plasticity: an efficient learning scheme

Recent experiments have established that information can be encoded in the spike times of neurons relative to the phase of a background oscillation in the local field potential—a phenomenon referred to as “phase-of-firing coding” (PoFC). These firing phase preferences could result from combining an oscillation in the input current with a stimulus-dependent static component that would produce the variations in preferred phase, but it remains unclear whether these phases are an epiphenomenon or really affect neuronal interactions—only then could they have a functional role. Here we show that PoFC has a major impact on downstream learning and decoding with the now well established spike timing-dependent plasticity (STDP). To be precise, we demonstrate with simulations how a single neuron equipped with STDP robustly detects a pattern of input currents automatically encoded in the phases of a subset of its afferents, and repeating at random intervals. Remarkably, learning is possible even when only a small fraction of the afferents (~10%) exhibits PoFC. The ability of STDP to detect repeating patterns had been noted before in continuous activity, but it turns out that oscillations greatly facilitate learning. A benchmark with more conventional rate-based codes demonstrates the superiority of oscillations and PoFC for both STDP-based learning and the speed of decoding: the oscillation partially formats the input spike times, so that they mainly depend on the current input currents, and can be efficiently learned by STDP and then recognized in just one oscillation cycle. This suggests a major functional role for oscillatory brain activity that has been widely reported experimentally.

The long non-coding RNA NEAT1 is increased in IUGR placentas, leading to potential new hypotheses of IUGR origin/development.

INTRODUCTION: Intrauterine Growth Restriction (IUGR) is a multifactorial disease defined by an inability of the fetus to reach its growth potential. IUGR not only increases the risk of neonatal mortality/morbidity, but also the risk of metabolic syndrome during adulthood. Certain placental proteins have been shown to be implicated in IUGR development, such as proteins from the GH/IGF axis and angiogenesis/apoptosis processes. METHODS: Twelve patients with term IUGR pregnancy (birth weight < 10th percentile) and 12 CTRLs were included. mRNA was extracted from the fetal part of the placenta and submitted to a subtraction method (Clontech PCR-Select cDNA Subtraction). RESULTS: One candidate gene identified was the long non-coding RNA NEAT1 (nuclear paraspeckle assembly transcript 1). NEAT1 is the core component of a subnuclear structure called paraspeckle. This structure is responsible for the retention of hyperedited mRNAs in the nucleus. Overall, NEAT1 mRNA expression was 4.14 (±1.16)-fold increased in IUGR vs. CTRL placentas (P = 0.009). NEAT1 was exclusively localized in the nuclei of the villous trophoblasts and was expressed in more nuclei and with greater intensity in IUGR placentas than in CTRLs. PSPC1, one of the three main proteins of the paraspeckle, co-localized with NEAT1 in the villous trophoblasts. The expression of NEAT1_2 mRNA, the long isoform of NEAT1, was only modestly increased in IUGR vs. CTRL placentas. DISCUSSION/CONCLUSION: The increase in NEAT1 and its co-localization with PSPC1 suggests an increase in paraspeckles in IUGR villous trophoblasts. This could lead to an increased retention of important mRNAs in villous trophoblasts nuclei. Given that the villous trophoblasts are crucial for the barrier function of the placenta, this could in part explain placental dysfunction in idiopathic IUGR fetuses.

Block structured dynamics and neuronal coding

When certain control parameters of nervous cell models are varied, complex bifurcation structures develop in which the dynamical behaviors available appear classified in blocks, according to criteria of dynamical likelihood. This block structured dynamics may be a clue to understand how activated neurons encode information by firing spike trains of their action potentials.

Hybrid turbo FEC/ARQ systems and distributed space-time coding for cooperative transmission

Cooperative transmission can be seen as a "virtual" MIMO system, where themultiple transmit antennas are in fact implemented distributed by the antennas both at the source and the relay terminal. Depending on the system design, diversity/multiplexing gainsare achievable. This design involves the definition of the type of retransmission (incrementalredundancy, repetition coding), the design of the distributed space-time codes, the errorcorrecting scheme, the operation of the relay (decode&forward or amplify&forward) and thenumber of antennas at each terminal. Proposed schemes are evaluated in different conditionsin combination with forward error correcting codes (FEC), both for linear and near-optimum(sphere decoder) receivers, for its possible implementation in downlink high speed packetservices of cellular networks. Results show the benefits of coded cooperation over directtransmission in terms of increased throughput. It is shown that multiplexing gains areobserved even if the mobile station features a single antenna, provided that cell wide reuse of the relay radio resource is possible.

Genome-wide profiling of the cardiac transcriptome after myocardial infarction identifies novel heart-specific long non-coding RNAs.

AIM: Heart disease is recognized as a consequence of dysregulation of cardiac gene regulatory networks. Previously, unappreciated components of such networks are the long non-coding RNAs (lncRNAs). Their roles in the heart remain to be elucidated. Thus, this study aimed to systematically characterize the cardiac long non-coding transcriptome post-myocardial infarction and to elucidate their potential roles in cardiac homoeostasis. METHODS AND RESULTS: We annotated the mouse transcriptome after myocardial infarction via RNA sequencing and ab initio transcript reconstruction, and integrated genome-wide approaches to associate specific lncRNAs with developmental processes and physiological parameters. Expression of specific lncRNAs strongly correlated with defined parameters of cardiac dimensions and function. Using chromatin maps to infer lncRNA function, we identified many with potential roles in cardiogenesis and pathological remodelling. The vast majority was associated with active cardiac-specific enhancers. Importantly, oligonucleotide-mediated knockdown implicated novel lncRNAs in controlling expression of key regulatory proteins involved in cardiogenesis. Finally, we identified hundreds of human orthologues and demonstrate that particular candidates were differentially modulated in human heart disease. CONCLUSION: These findings reveal hundreds of novel heart-specific lncRNAs with unique regulatory and functional characteristics relevant to maladaptive remodelling, cardiac function and possibly cardiac regeneration. This new class of molecules represents potential therapeutic targets for cardiac disease. Furthermore, their exquisite correlation with cardiac physiology renders them attractive candidate biomarkers to be used in the clinic.

Tissue-Specific Evolution of Protein Coding Genes in Human and Mouse.

Protein-coding genes evolve at different rates, and the influence of different parameters, from gene size to expression level, has been extensively studied. While in yeast gene expression level is the major causal factor of gene evolutionary rate, the situation is more complex in animals. Here we investigate these relations further, especially taking in account gene expression in different organs as well as indirect correlations between parameters. We used RNA-seq data from two large datasets, covering 22 mouse tissues and 27 human tissues. Over all tissues, evolutionary rate only correlates weakly with levels and breadth of expression. The strongest explanatory factors of purifying selection are GC content, expression in many developmental stages, and expression in brain tissues. While the main component of evolutionary rate is purifying selection, we also find tissue-specific patterns for sites under neutral evolution and for positive selection. We observe fast evolution of genes expressed in testis, but also in other tissues, notably liver, which are explained by weak purifying selection rather than by positive selection.