Feasibility study of a total precipitable water IPDA lidar from a solar-powered stratospheric aircraft.

Repetitive, high spatial resolution measurements of water vapor are highly desirable for a range of critical applications, including quantitative forecasts of wildfire risk forecasting, extreme weather, drought implicated in mass refugee dislocation, and air quality. A point design for an integrated path differential absorption (IPDA) light detection and ranging (lidar) for column precipitable water vapor (PWV) intended for high-altitude long-endurance (HALE) uncrewed aerial systems (UASs) is described and analyzed. A novel, to the best of our knowledge, all-semiconductor source utilizing an intensity-modulated continuous wave approach to ranging is proposed, which facilitates reductions in weight, power, and size. Analytic and Monte Carlo calculations suggest that high spatial resolution (<10m) or high precision (<1%) may be obtained.

Aeroallergen Monitoring by the National Allergy Bureau: A Review of the Past and a Look Into the Future.

Monitoring aeroallergens has a long history within the American Academy of Allergy, Asthma & Immunology. The Aeroallergen Network of the National Allergy Bureau is composed mainly of members of the American Academy of Allergy, Asthma & Immunology, whose objectives are to enhance the knowledge of aerobiology and its relationship to allergy, increase the number of certified stations, maintain the standardization and quality of aerobiology data, improve the alert and forecast reporting system, and increase ties with other scientific entities inside and outside the United States. The public has a keen interest in pollen counts and pollen forecasts, as do many health professionals in the allergy community. In this review, we explore the past, present, and future of allergen monitoring with a focus on methods used for sampling, the training of those performing the analysis, and emerging technologies in the field. Although the development of automated samplers with machine intelligence offers great promise for meeting the goal of a fully automated system, there is still progress to be made regarding reliability and affordability.

Development of the Wheat Practical Haplotype Graph database as a resource for genotyping data storage and genotype imputation.

To improve the efficiency of high-density genotype data storage and imputation in bread wheat (Triticum aestivum L.), we applied the Practical Haplotype Graph (PHG) tool. The Wheat PHG database was built using whole-exome capture sequencing data from a diverse set of 65 wheat accessions. Population haplotypes were inferred for the reference genome intervals defined by the boundaries of the high-quality gene models. Missing genotypes in the inference panels, composed of wheat cultivars or recombinant inbred lines genotyped by exome capture, genotyping-by-sequencing (GBS), or whole-genome skim-seq sequencing approaches, were imputed using the Wheat PHG database. Though imputation accuracy varied depending on the method of sequencing and coverage depth, we found 92% imputation accuracy with 0.01× sequence coverage, which was slightly lower than the accuracy obtained using the 0.5× sequence coverage (96.6%). Compared to Beagle, on average, PHG imputation was ∼3.5% (P-value < 2 × 10-14) more accurate, and showed 27% higher accuracy at imputing a rare haplotype introgressed from a wild relative into wheat. We found reduced accuracy of imputation with independent 2× GBS data (88.6%), which increases to 89.2% with the inclusion of parental haplotypes in the database. The accuracy reduction with GBS is likely associated with the small overlap between GBS markers and the exome capture dataset, which was used for constructing PHG. The highest imputation accuracy was obtained with exome capture for the wheat D genome, which also showed the highest levels of linkage disequilibrium and proportion of identity-by-descent regions among accessions in the PHG database. We demonstrate that genetic mapping based on genotypes imputed using PHG identifies SNPs with a broader range of effect sizes that together explain a higher proportion of genetic variance for heading date and meiotic crossover rate compared to previous studies.

Preoperative Lateralization Modalities for Cushing Disease: Is Dynamic Magnetic Resonance Imaging or Cavernous Sinus Sampling More Predictive of Intraoperative Findings?

Objective To analyze whether cavernous sinus sampling (CSS) and dynamic magnetic resonance imaging (dMRI) are consistent with intraoperative findings in Cushing disease (CD) patients. Design Retrospective outcomes study. Setting Oregon Health & Science University; 2006 and 2013. Participants A total of 37 CD patients with preoperative dMRI and CSS to confirm central adrenocorticotropic hormone (ACTH) hypersecretion. Patients were 78% female; mean age was 41 years (at diagnosis), and all had a minimum of 6 months of follow-up. Main Outcome Measures Correlations among patient characteristics, dMRI measurements, CSS results, and intraoperative findings. Results All CSS indicated presence of CD. Eight of 37 patients had no identifiable tumor on dMRI. Three of 37 patients had no tumor at surgery. dMRI tumor size was inversely correlated with age (rs = - 0.4; p = 0.01) and directly correlated to intraoperative lateralization (rs = 0.3; p < 0.05). Preoperative dMRI was directly correlated to intraoperative lateralization (rs = 0.5; p < 0.002). CSS lateralization showed no correlation with intraoperative findings (rs = 0.145; p = 0.40) or lateralization observed on preoperative dMRI (rs = 0.17; p = 0.29). Postoperative remission rate was 68%. Conclusion dMRI localization was most consistent with intraoperative findings; CSS results were less reliable. Results suggest that small ACTH-secreting tumors continue to pose a challenge to reliable preoperative localization.

Perspectives of women about external breast prostheses.

As many as 90% of women who have undergone mastectomy or lumpectomy for breast cancer surgery will choose to wear a breast prosthesis. To date, there has been little systematic exploration of experiences and preferences related to wearing external breast prostheses, especially with new products. For this qualitative descriptive study, 24 women were interviewed regarding their perspectives about the conventional breast prosthesis and 19 about their perspectives regarding a newly available custom-designed breast prosthesis. Women spoke about difficulties obtaining information regarding available breast prostheses options; the awkwardness of being measured and fitted for a prosthesis, especially with seemingly untrained staff; challenges in wearing an external prosthesis; and how a prosthesis can foster increased confidence, enhanced body image and self-esteem, and a sense of normalcy. All recommended that women must make an individual decision about wearing a breast prosthesis and emphasized how important it is to have information about options early in the cancer journey. The study findings can guide oncology nurses in educating women about breast prostheses.

Waveform optimization for internal cardioversion of atrial fibrillation.

INTRODUCTION: A novel atrial defibrillator was developed at the Royal Victoria Hospital in collaboration with the Nanotechnology and Integrated Bio-Engineering Centre, University of Ulster. This device is powered by an external pulse of radiofrequency energy and designed to cardiovert using low-tilt monophasic waveform (LTMW) and low-tilt biphasic waveform (LTBW), 12 milliseconds pulse width. This study compared the safety and efficacy of LTMW with LTBW for transvenous cardioversion of atrial fibrillation (AF). METHODS: Patients were anticoagulated with warfarin to maintain International Normalized Ratio between 2 and 3 for 4 weeks prior cardioversion. Warfarin international normalized ratio level was maintained in between 2 and 3 for 4 weeks prior cardioversion. St Jude's defibrillating catheter was positioned in the distal coronary sinus and right atrium and connected to the defibrillator via a junction box. After a test shock using a dummy load, the patient was cardioverted in a step-up progression from 50 to 300 V. Shock success was defined as return of sinus rhythm for 30 seconds or more. If cardioversion was unsuccessful at peak voltage, the patient was crossed over to the other arm of the waveform type and cardioverted at peak voltage. RESULTS: Thirty patients were randomized equally to LTBW and LTMW (15 each). Seven out of 15 patients (46%) cardioverted to sinus rhythm with LTBW, and 1 (6%) of 15, with LTMW (P = .035). Including crossover patients, 14 patients (46%) converted to sinus rhythm. After crossover, 4 patients were cardioverted with LTBW and 2 with LTMW. Overall mean voltage, current, and energy used for cardioversion were 270.53 ± 35.96 V, 3.68 ± 0.80 A, and 9.12 ± 3.73 J, respectively, and intracardiac impedance was 70.82 ± 13.46 Ω. For patients who were successfully cardioverted, mean voltage, current, energy, and intracardiac impedance were 268.28 ± 42.41 V, 3.52 ± 0.63 A, 8.51 ± 3.16 J, and 73.92 ± 12.01 Ω. There were no major adverse complications during the study. Cardiac markers measured postcardioversion were unremarkable. CONCLUSION: Low-tilt biphasic waveform was more efficacious for low-energy transvenous cardioversion of AF. A significant proportion of patients were successfully cardioverted to sinus rhythm with low energy. Radiofrequency-powered defibrillation can be safely used for transvenous cardioversion of AF.

Making eco-friendly transportation safer: developing computer-based simulations to assess of the impacts of bicycle accident prevention interventions on healthcare utilization.

Computer-based modeling and simulations are becoming increasingly used for applications in health and safety. In this paper we describe a multi-phase project aimed at modeling bicycle accidents in Munster, Germany. The work involved a first phase of collecting empirical data on accident rates and severity. In the second phase a computer-based simulation model of bicycle accidents was created, using data from phase one to identify relevant parameters in the model. Finally, initial results from running the model are described that will be used to inform decision making regarding safety initiatives.

Sensitivity of high-resolution three-dimensional magnetic resonance angiography and three-dimensional spoiled-gradient recalled imaging in the prediction of neurovascular compression in patients with hemifacial spasm.

OBJECT: Hemifacial spasm is a clinical syndrome caused by vascular compression of the facial nerve in the cerebellopontine angle, which can be relieved by surgical intervention. Advances in medical imaging technology allow for direct visualization of the offending blood vessels in hemifacial spasm and similar conditions (such as trigeminal neuralgia). The utility of high resolution 3D MR angiography and 3D spoiled-gradient recalled (SPGR) imaging sequences for surgical decision-making in hemifacial spasm, as measured by sensitivity, specificity, and positive and negative predictive values, has not been previously determined. METHODS: A retrospective review was undertaken of 23 patients with hemifacial spasm who underwent operations between January 2001 and December 2006 at Oregon Health & Science University. All patients underwent preoperative high-resolution 3D MR angiography and 3D SPGR imaging. The sensitivity of the SPGR imaging/MR angiography interpretation of neurovascular compression (NVC) by both a neurosurgeon and 2 neuroradiologists was determined in relation to the presence of actual NVC during surgery. RESULTS: All patients were found to have NVC at surgery. After review by a neurosurgeon and 2 neuroradiologists, imaging data from 19 of the 23 patients were evaluated. The neurosurgeon's interpretation had a sensitivity of 79% and a positive predictive value (PPV) of 100%. The first neuroradiologist's interpretation had a sensitivity of 21% with a PPV of 100%. Further interpretation by a blinded second neuroradiologist with expertise in MR imaging of hemifacial spasm and trigeminal neuralgia was conducted, and sensitivity was 59% and PPV was 100%. Specificity was not determined because there were no true negative cases. The negative predictive value was 0% for both the neurosurgeon's and neuroradiologists' evaluations. CONCLUSIONS: Although high-resolution 3D MR angiography and 3D SPGR imaging was helpful in providing information about the anatomical relationship of cranial nerve VII and surrounding blood vessels, the authors determined that in the case of hemifacial spasm these types of imaging did not influence preoperative surgical decisionmaking.