Evaluation of the Does Reduction Potential Using a Breast Positioning Technique for Organ-based Tube Current Modulated CT Examinations

Purpose: The purpose of this work was to investigate the breast dose saving potential of a breast positioning technique (BP) for thoracic CT examinations with organ-based tube current modulation (OTCM).

Methods: The study included 13 female patient models (XCAT, age range: 27-65 y.o., weight range: 52 to 105.8 kg). Each model was modified to simulate three breast sizes in standard supine geometry. The modeled breasts were further deformed, emulating a BP that would constrain the breasts within 120° anterior tube current (mA) reduction zone. The tube current value of the CT examination was modeled using an attenuation-based program, which reduces the radiation dose to 20% in the anterior region with a corresponding increase to the posterior region. A validated Monte Carlo program was used to estimate organ doses with a typical clinical system (SOMATOM Definition Flash, Siemens Healthcare). The simulated organ doses and organ doses normalized by CTDIvol were compared between attenuation-based tube current modulation (ATCM), OTCM, and OTCM with BP (OTCMBP).

Results: On average, compared to ATCM, OTCM reduced the breast dose by 19.3±4.5%, whereas OTCMBP reduced breast dose by 36.6±6.9% (an additional 21.3±7.3%). The dose saving of OTCMBP was more significant for larger breasts (on average 32, 38, and 44% reduction for 0.5, 1.5, and 2.5 kg breasts, respectively). Compared to ATCM, OTCMBP also reduced thymus and heart dose by 12.1 ± 6.3% and 13.1 ± 5.4%, respectively.

Conclusions: In thoracic CT examinations, OTCM with a breast positioning technique can markedly reduce unnecessary exposure to the radiosensitive organs in the anterior chest wall, specifically breast tissue. The breast dose reduction is more notable for women with larger breasts.

Systematic Molecular Phenotyping: A Path Toward Precision Emergency Medicine?

Precision medicine is an emerging approach to disease treatment and prevention that considers variability in patient genes, environment, and lifestyle. However, little has been written about how such research impacts emergency care. Recent advances in analytical techniques have made it possible to characterize patients in a more comprehensive and sophisticated fashion at the molecular level, promising highly individualized diagnosis and treatment. Among these techniques are various systematic molecular phenotyping analyses (e.g., genomics, transcriptomics, proteomics, and metabolomics). Although a number of emergency physicians use such techniques in their research, widespread discussion of these approaches has been lacking in the emergency care literature and many emergency physicians may be unfamiliar with them. In this article, we briefly review the underpinnings of such studies, note how they already impact acute care, discuss areas in which they might soon be applied, and identify challenges in translation to the emergency department (ED). While such techniques hold much promise, it is unclear whether the obstacles to translating their findings to the ED will be overcome in the near future. Such obstacles include validation, cost, turnaround time, user interface, decision support, standardization, and adoption by end-users.

Eyewitness Memory: Balancing the Accuracy, Precision, and Quantity of Information through Metacognitive Monitoring and Control

Historically, memory has been evaluated by examining how much is remembered, however a more recent conception of memory focuses on the accuracy of memories. When using this accuracy-oriented conception of memory, unlike with the quantity-oriented approach, memory does not always deteriorate over time. A possible explanation for this seemingly surprising finding lies in the metacognitive processes of monitoring and control. Use of these processes allows people to withhold responses of which they are unsure, or to adjust the precision of responses to a level that is broad enough to be correct. The ability to accurately report memories has implications for investigators who interview witnesses to crimes, and those who evaluate witness testimony. This research examined the amount of information provided, accuracy, and precision of responses provided during immediate and delayed interviews about a videotaped mock crime. The interview format was manipulated such that a single free narrative response was elicited, or a series of either yes/no or cued questions were asked. Instructions provided by the interviewer indicated to the participants that they should either stress being informative, or being accurate. The interviews were then transcribed and scored. Results indicate that accuracy rates remained stable and high after a one week delay. Compared to those interviewed immediately, after a delay participants provided less information and responses that were less precise. Participants in the free narrative condition were the most accurate. Participants in the cued questions condition provided the most precise responses. Participants in the yes/no questions condition were most likely to say “I don’t know”. The results indicate that people are able to monitor their memories and modify their reports to maintain high accuracy. When control over precision was not possible, such as in the yes/no condition, people said “I don’t know” to maintain accuracy. However when withholding responses and adjusting precision were both possible, people utilized both methods. It seems that concerns that memories reported after a long retention interval might be inaccurate are unfounded.

High volume fabrication of laser targets using MEMS techniques

The latest techniques for the fabrication of high power laser targets, using processes developed for the manufacture of Micro-Electro-Mechanical System (MEMS) devices are discussed. These laser targets are designed to meet the needs of the increased shot numbers that are available in the latest design of laser facilities. Traditionally laser targets have been fabricated using conventional machining or coarse etching processes and have been produced in quantities of 10s to low 100s. Such targets can be used for high complexity experiments such as Inertial Fusion Energy (IFE) studies and can have many complex components that need assembling and characterisation with high precision. Using the techniques that are common to MEMS devices and integrating these with an existing target fabrication capability we are able to manufacture and deliver targets to these systems. It also enables us to manufacture novel targets that have not been possible using other techniques. In addition, developments in the positioning systems that are required to deliver these targets to the laser focus are also required and a system to deliver the target to a focus of an F2 beam at 0.1Hz is discussed.

Shooting for the Moon or Flying Too Near the Sun? Crossing the Value Rubicon in Precision Cancer Care

In his last two State of the Union addresses, President Barack Obama has focused on the need to deliver innovative solutions to improve human health, through the Precision Medicine Initiative in 2015 and the recently announced Cancer Moonshot in 2016. Precision cancer care has delivered clear patient benefit, but even for high-impact medicines such as imatinib mesylate (Glivec) in chronic myeloid leukaemia, the excitement at the success of this practice-changing clinical intervention has been somewhat tempered by the escalating price of this 'poster child' for precision cancer medicine (PCM). Recent studies on the costs of cancer drugs have revealed significant price differentials, which are a major causative factor behind disparities in the access to new generations of immunological and molecularly targeted agents. In this perspective, we will discuss the benefits of PCM to modern cancer control, but also emphasise how increasing costs are rendering the current approaches to integrating the paradigm of PCM unsustainable. Despite the ever increasing pressure on cancer and health care budgets, innovation will and must continue. Value-based frameworks offer one of the most rational approaches for policymakers committed to improving cancer outcomes through a public health approach.

Temporal aggregation of migration counts can improve accuracy and precision of trends

Temporal replicate counts are often aggregated to improve model fit by reducing zero-inflation and count variability, and in the case of migration counts collected hourly throughout a migration, allows one to ignore nonindependence. However, aggregation can represent a loss of potentially useful information on the hourly or seasonal distribution of counts, which might impact our ability to estimate reliable trends. We simulated 20-year hourly raptor migration count datasets with known rate of change to test the effect of aggregating hourly counts to daily or annual totals on our ability to recover known trend. We simulated data for three types of species, to test whether results varied with species abundance or migration strategy: a commonly detected species, e.g., Northern Harrier, Circus cyaneus; a rarely detected species, e.g., Peregrine Falcon, Falco peregrinus; and a species typically counted in large aggregations with overdispersed counts, e.g., Broad-winged Hawk, Buteo platypterus. We compared accuracy and precision of estimated trends across species and count types (hourly/daily/annual) using hierarchical models that assumed a Poisson, negative binomial (NB) or zero-inflated negative binomial (ZINB) count distribution. We found little benefit of modeling zero-inflation or of modeling the hourly distribution of migration counts. For the rare species, trends analyzed using daily totals and an NB or ZINB data distribution resulted in a higher probability of detecting an accurate and precise trend. In contrast, trends of the common and overdispersed species benefited from aggregation to annual totals, and for the overdispersed species in particular, trends estimating using annual totals were more precise, and resulted in lower probabilities of estimating a trend (1) in the wrong direction, or (2) with credible intervals that excluded the true trend, as compared with hourly and daily counts.

New mechanical samples positioning system for irradiations on a radial channel at nuclear research reactor in a full-power continuous operation

FAPESP:97/5550

Monitoring sandy shores morphologies by DGPS: a practical tool to generate digital elevation models

The highly dynamic nature of some sandy shores with continuous morphological changes require the development of efficient and accurate methodological strategies for coastal hazard assessment and morphodynamic characterisation. During the past decades, the general methodological approach for the establishment of coastal monitoring programmes was based on photogrammetry or classical geodetic techniques. With the advent of new geodetic techniques, space-based and airborne-based, new methodologies were introduced in coastal monitoring programmes. This paper describes the development of a monitoring prototype that is based on the use of global positioning system (GPS). The prototype has a GPS multiantenna mounted on a fast surveying platform, a land vehicle appropriate for driving in the sand (four-wheel quad). This system was conceived to perform a network of shore profiles in sandy shores stretches (subaerial beach) that extend for several kilometres from which high-precision digital elevation models can be generated. An analysis of the accuracy and precision of some differential GPS kinematic methodologies is presented. The development of an adequate survey methodology is the first step in morphodynamic shore characterisation or in coastal hazard assessment. The sample method and the computational interpolation procedures are important steps for producing reliable three-dimensional surface maps that are real as possible. The quality of several interpolation methods used to generate grids was tested in areas where there were data gaps. The results obtained allow us to conclude that with the developed survey methodology, it is possible to Survey sandy shores stretches, under spatial scales of kilometers, with a vertical accuracy of greater than 0.10 m in the final digital elevation models.

Automated Collection of Sign Inventory Information by Integrating Global Positioning System (GPS) with Videologging Data Collection Activities, 1995

Advances in communication, navigation and imaging technologies are expected to fundamentally change methods currently used to collect data. Electronic data interchange strategies will also minimize data handling and automatically update files at the point of capture. This report summarizes the outcome of using a multi-camera platform as a method to collect roadway inventory data. It defines basic system requirements as expressed by users, who applied these techniques and examines how the application of the technology met those needs. A sign inventory case study was used to determine the advantages of creating and maintaining the database and provides the capability to monitor performance criteria for a Safety Management System. The project identified at least 75 percent of the data elements needed for a sign inventory can be gathered by viewing a high resolution image.

Positioning Australia’s contemporary health and physical education curriculum to address poor physical activity participation rates by adolescent girls

Swath bathymetry using phase difference: Theoretical analysis of acoustical measurement precision

The phase difference principle is widely applied nowadays to sonar systems used for sea floor bathymetry, The apparent angle of a target point is obtained from the phase difference measured between two close receiving arrays. Here we study the influence of the phase difference estimation errors caused by the physical structure of the backscattered signals. It is shown that, under certain current conditions, beyond the commonly considered effects of additive external noise and baseline decorrelation, the processing may be affected by the shifting footprint effect: this is due to the fact that the two interferometer receivers get simultaneous echo contributions coming from slightly shifted seabed parts, which results in a degradation of the signal coherence and, hence, of the phase difference measurement. This geometrical effect is described analytically and checked with numerical simulations, both for square- and sine-shaped signal envelopes. Its relative influence depends on the geometrical configuration and receiver spacing; it may be prevalent in practical cases associated with bathymetric sonars. The cases of square and smooth signal envelopes are both considered. The measurements close to nadir, which are known to be especially difficult with interferometry systems, are addressed in particular.