How Digital Technologies Enhance Telescopic and Conical Clinical Case Workflows.

Telescopic and conical dental solutions for tooth-borne, implant-borne, and combination tooth/implant-borne removable dental prosthetics have a long and rich history. Traditionally, these restorations have been based on analog techniques. The integration of digital technologies, however, has had a profound impact on these solutions in numerous ways, helping to facilitate efficient fabrication of many technical and clinical facets of these dental prosthetics. This article examines how digital technologies impact telescopic and conical clinical case workflows and technical protocols. It discusses such aspects as intraoral scanning, photogrammetry, primary and secondary telescopes and cones, tertiary structures, and temporary restorations.

From Nobeyama Radio Observatory to the international project ALMA -Evolution of millimeter and submillimeter wave astronomy in Japan.

The establishment of the Nobeyama Radio Observatory (NRO) in 1982 was an important event that greatly influenced the subsequent development of Japanese astronomy. The 45 m radio telescope and the Nobeyama Millimeter Array (NMA) pushed Japanese radio astronomy to the forefront of the world. As a plan beyond the Nobeyama telescopes, the Japanese radio astronomy community considered a large array to achieve unprecedented resolution at millimeter and submillimeter wavelengths under the project name of the Large Millimeter and Submillimeter Array (LMSA). After long and patient discussions and negotiations with the United States and Europe, the LMSA plan eventually led to the ALMA (Atacama Large Millimeter/submillimeter Array) as an international joint project, and the ALMA was inaugurated in 2013. This paper reviews the process from the establishment of the NRO to the realization of the ALMA, including planning of the LMSA, international negotiations, site survey, instrumental developments, and initial science results.

Detection system of the lobster eye telescope with large field of view.

The lobster eye telescope is promising for large-field x ray imaging in astronomy. The special structure of the lobster eye system makes the focal plane a sphere, resulting in detector defocus when the field is large. In this study, we established a model based on the principle of lobster eye imaging and simulated the imaging at different image distances. The results reveal the relationship between the defocus and position accuracy and angular resolution. To ensure the optical performance of the large field lobster eye telescope, we propose a detection system design method using multiple detectors stitched together to form a spherical-like surface and apply it to the development of the Einstein Probe/wide-field x ray telescope (EP/WXT) submodule. About 70% of the detection area is out of focus within 0.5 mm. The scanning image of the integrated WXT submodule shows good uniformity of the point spread function (PSF) for various incident angles, and the effect of defocus on imaging is acceptable.

Carbon dioxide detected around alien world for first time.

Webb telescope discovery offers clue to planet formation and promises insights on planetary habitability.

High-definition two-dimension video telescope operating monitor-assisted brain and spinal surgery in pediatrics: is it an acceptable substitute for microscopic surgery?

PURPOSE: Vision and ergonomics are crucial variables for successful outcomes during neurosurgery procedures. Two-dimension video telescope operating monitor (VITOM) exoscope has emerged as an alternative, which is cheaper than microscope. The aim of this study is to evaluate the clinical utility of 2D VITOM and to compare its merits and demerits with respect to microscope. METHODS: VITOM 2D (Karl Storz, Germany) was used in 9 cranial and 5 spinal pediatric cases. While KINEVO operative microscope (Carl Zeiss, Germany) was used in 12 cranial and 6 spinal pediatric patients. All surgeries were performed by single senior neurosurgeon. The author's experience and opinions, as well as qualitative data, were analyzed. A comparison was made on image quality, illumination, field of view, and magnification of the operative field and ergonomics. RESULTS: Seven out of 9 cranial pediatric cases were switched from VITOM 2D to operative microscope due to low-image definition in depth of cranial cavity. Poor visualization of bleeding source in surgical field was another major drawback. Two cranial cases in which exoscope were used exclusively, included superficial tumors. In all 5 spinal cases, VITOM 2D was successfully used without any major difficulty. The exoscope's advantages were observed in ergonomics and ease in switching to naked eyes, but the microscope's field of view, illumination, magnification, and user-friendliness was considered superior. CONCLUSION: 2D-VITOM is best suited for spinal and superficial cranial tumors. However, a lot of modifications are to be done especially in optics to become a substitute for operative microscope.

Statistical analysis of a cluster-randomized clinical trial on adult general intensive care units in Brazil: TELE-critical care verSus usual Care On ICU PErformance (TELESCOPE) trial. / Plano de análise estatística de um ensaio clínico randomizado em cluster em unidades de terapia intensiva geral adulto no Brasil: TELE-critical care verSus usual Care On ICU PErformance (TELESCOPE).

OBJECTIVE: The TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE) trial aims to assess whether a complex telemedicine intervention in intensive care units, which focuses on daily multidisciplinary rounds performed by remote intensivists, will reduce intensive care unit length of stay compared to usual care. METHODS: The TELESCOPE trial is a national, multicenter, controlled, open label, cluster randomized trial. The study tests the effectiveness of daily multidisciplinary rounds conducted by an intensivist through telemedicine in Brazilian intensive care units. The protocol was approved by the local Research Ethics Committee of the coordinating study center and by the local Research Ethics Committee from each of the 30 intensive care units, following Brazilian legislation. The trial is registered with ClinicalTrials. gov (NCT03920501). The primary outcome is intensive care unit length of stay, which will be analyzed accounting for the baseline period and cluster structure of the data and adjusted by prespecified covariates. Secondary exploratory outcomes included intensive care unit performance classification, in-hospital mortality, incidence of nosocomial infections, ventilator-free days at 28 days, rate of patients receiving oral or enteral feeding, rate of patients under light sedation or alert and calm, and rate of patients under normoxemia. CONCLUSION: According to the trial's best practice, we report our statistical analysis prior to locking the database and beginning analyses. We anticipate that this reporting practice will prevent analysis bias and improve the interpretation of the reported results.ClinicalTrials.gov registration: NCT03920501.

OBJETIVO: O ensaio TELE-critical Care verSus usual Care On ICU PErformance (TELESCOPE) visa avaliar se uma intervenção complexa por telemedicina em unidades de terapia intensiva, que se concentra em rondas multidisciplinares diárias realizadas por intensivistas a distância, reduzirá o tempo de permanência na unidade de terapia intensiva em comparação com os cuidados habituais. MÉTODOS: O TELESCOPE é um ensaio nacional, multicêntrico, controlado, aberto, randomizado em cluster. O estudo testa a eficácia de rondas multidisciplinares diárias realizadas por um intensivista por meio de telemedicina em unidades de terapia intensiva brasileiras. O protocolo foi aprovado pelo Comitê de Ética em Pesquisa local do centro coordenador do estudo e pelo Comitê de Ética em Pesquisa local de cada uma das 30 unidades de terapia intensiva, de acordo com a legislação brasileira. O ensaio está registado no ClinicalTrials.gov (NCT03920501). O desfecho primário é o tempo de internação na unidade de terapia intensiva, que será analisado considerando o período basal e a estrutura dos dados em cluster, sendo ajustado por covariáveis predefinidas. Os desfechos exploratórios secundários incluem a classificação de desempenho da unidade de terapia intensiva, a mortalidade hospitalar, a incidência de infecções nosocomiais, o número de dias sem ventilação mecânica aos 28 dias, a taxa de pacientes que recebem alimentação oral ou enteral, a taxa de pacientes sob sedação leve ou em alerta e calmos e a taxa de pacientes sob normoxemia. CONCLUSÃO: De acordo com as melhores práticas do ensaio, divulgamos nossa análise estatística antes de bloquear a base de dados e iniciar as análises. Esperamos que essa prática de notificação evite o viés das análises e aprimore a interpretação dos resultados apresentados.Registro no ClinicalTrials.gov: NCT03920501.

Deep learning exoplanets detection by combining real and synthetic data.

Scientists and astronomers have attached great importance to the task of discovering new exoplanets, even more so if they are in the habitable zone. To date, more than 4300 exoplanets have been confirmed by NASA, using various discovery techniques, including planetary transits, in addition to the use of various databases provided by space and ground-based telescopes. This article proposes the development of a deep learning system for detecting planetary transits in Kepler Telescope light curves. The approach is based on related work from the literature and enhanced to validation with real light curves. A CNN classification model is trained from a mixture of real and synthetic data. The model is then validated only with unknown real data. The best ratio of synthetic data is determined by the performance of an optimisation technique and a sensitivity analysis. The precision, accuracy and true positive rate of the best model obtained are determined and compared with other similar works. The results demonstrate that the use of synthetic data on the training stage can improve the transit detection performance on real light curves.

A New Intraocular Telescopic Device for Age-Related Macular Degeneration.

Age-related macular degeneration is the third leading cause of blindness worldwide after cataracts and glaucoma. We described our recent surgical experience in managing the smaller-incision, new-generation, implantable, miniature telescope that has been designed to enlarge retinal images of the central visual field implanted monocularly in the capsular bag after lens extraction.

Clinical Report: Experiences of a Driver with Vision Impairment when Using a Tesla Car.

SIGNIFICANCE: Assisted and autonomous driving technologies may be a new paradigm shift for the driving rehabilitation field to enable less restricted driving, increase driving confidence, and maintain driving safety for drivers with vision impairment. PURPOSE: This study aimed to document how a driver with vision impairment uses assistance and automation systems in a Tesla car based on real-world experiences of using these technologies. METHODS: A 53-year-old man with Stargardt disease and 20/182 visual acuity self-explored the use of driver assistance technologies, which resulted in purchasing a Tesla Model Y with the full self-driving package in 2020. Two semistructured interviews were administered to quantify the driver's driving habits, adaptive strategies, use of the assisted and semiautonomous driving features in the Tesla car, and use of his bioptic telescope. RESULTS: When driving a Tesla car, the patient developed new driving strategies by codriving with different assisted and semiautonomous functions (e.g., Traffic-Aware Cruise Control, Traffic Light and Stop Sign Control, Autopilot) in different road environments. He shifted his main task from active driving to supervising the car automation systems in most driving situations. He also integrated a new use of his bioptic telescope to support him with monitoring the road environment before granting permission to the automated systems for car maneuver changes. The patient reported that driving confidence greatly increased and that he is able to drive more often and in situations that he would otherwise avoid because of difficulties related to his vision. CONCLUSIONS: This clinical report demonstrates how assisted and semiautonomous driving systems in a Tesla car were used to support daily driving by a driver with vision impairment. Codriving with these systems allows him to confidently drive more often and to avoid less situations than he used to.

A novel range telescope concept for proton CT.

Proton beam therapy can potentially offer improved treatment for cancers of the head and neck and in paediatric patients. There has been a sharp uptake of proton beam therapy in recent years as improved delivery techniques and patient benefits are observed. However, treatments are currently planned using conventional x-ray CT images due to the absence of devices able to perform high quality proton computed tomography (pCT) under realistic clinical conditions. A new plastic-scintillator-based range telescope concept, named ASTRA, is proposed here to measure the proton's energy loss in a pCT system. Simulations conducted using GEANT4 yield an expected energy resolution of 0.7%. If calorimetric information is used the energy resolution could be further improved to about 0.5%. In addition, the ability of ASTRA to track multiple protons simultaneously is presented. Due to its fast components, ASTRA is expected to reach unprecedented data collection rates, similar to 108protons/s. The performance of ASTRA has also been tested by simulating the imaging of phantoms. The results show excellent image contrast and relative stopping power reconstruction.

Oxygen use in Atacama large millimeter and submillimeter (ALMA) arrays in Chajnantor valley at 5050 m / Uso de oxígeno en Atacama large millimeter and submillimeter (ALMA) en el valle de Chajnantor a 5050 m

The Chilean workforce has over 200,000 people that are intermittently exposed to altitudes over 4000 m. In 2012, the Ministry of Health provided a technical guide for high altitude workers that included a series of actions to mitigate the effects of hypoxia. Previous studies have shown the positive effect of oxygen enrichment at high altitudes. The Atacama Large Millimeter / submillimeter Arrays (ALMA) radiotelescope operate at 5,050 m (Array Operation Site, AOS) and is the only place in the world where Pressure Swing Adsorption (PSA) and Liquid Oxygen technologies have been installed at a large scale. Here we discuss our experience using oxygen supplementation at ALMA, to prevent the malaise and/or risks associated with exposure at 5,050 m. Antenna operators experienced chronic intermittent hypobaric hypoxia (CIHH, shiftwork 8 days HA*6 days rest SL) over 4 years. Studies to define normal O2 saturation values were performed in OSF and AOS by continuous recording during the shift. The outcomes showed no differences between production procedures (PSA or Liquid oxygen) in regulating oxygen availability at AOS facilities. As a result, big-scale installations have difficulties reaching the appropriate oxygen concentration due to leaks in high mobility areas. In addition, the PSA plant requires adequation and maintenance to operate at a very high altitude.

La fuerza laboral chilena cuenta con más de 200.000 personas que están expuestas intermitentemente a altitudes superiores a los 4000 m. En 2012, el Ministerio de Salud entregó una guía técnica para trabajadores de altura que incluía una serie de acciones para mitigar los efectos de la hipoxia. Estudios anteriores han demostrado el efecto positivo del enriquecimiento de oxígeno en altitudes elevadas. El radiotelescopio Atacama Large Millimeter/submillimeter Arrays (ALMA) opera a 5.050 m (Array Operation Site, AOS) y es el único lugar en el mundo donde se han instalado tecnologías de adsorción por cambio de presión (PSA) y oxígeno líquido a gran escala. Aquí discutimos nuestra experiencia usando suplementos de oxígeno en ALMA, para prevenir el malestar y/o los riesgos asociados con la exposición a 5.050 m. Los operadores de antena experimentaron hipoxia hipobárica intermitente crónica (CIHH, trabajo por turnos 8 días HA*6 días descanso SL) durante 4 años. Se realizaron estudios para definir valores normales de saturación de O2 en OSF y AOS mediante registro continuo durante el turno. Los resultados no mostraron diferencias entre los procedimientos de producción (PSA u oxígeno líquido) en la regulación de la disponibilidad de oxígeno en las instalaciones de AOS. Como resultado, las instalaciones a gran escala tienen dificultades para alcanzar la concentración de oxígeno adecuada debido a fugas en áreas de alta movilidad. Además, la planta de PSA requiere de adecuación y mantenimiento para operar a gran altura.

Vision, Driving Exposure, and Collisions in Bioptic Drivers.

SIGNIFICANCE: Lack of knowledge regarding the mileage driven by drivers with low vision who use bioptic telescopes could obscure the relationship between vision and road safety. This study provides data suggesting that worse vision is correlated with less mileage driven but more collisions per mile in bioptic drivers. PURPOSE: The purpose of this study was to determine whether vision or demographic factors predict mileage driven in bioptic drivers and per-mile motor vehicle collision rate and also to compare the collision rate of bioptic drivers with previous estimates for the general population. METHODS: Driver data were collected retrospectively from clinic records. Collision data were collected from the Ohio Bureau of Motor Vehicles database. Subjects were also asked to estimate their yearly mileage. Regression models were used to investigate relationships between vision and collision rates. RESULTS: Seventy-three licensed Ohio bioptic drivers (36 male) were included. Mean ± standard deviation age was 51 ± 16 years. Mean logMAR visual acuity was 0.67 (approximately 20/100). Mean log contrast sensitivity was 1.57. Mean reported annual mileage was 9746. Age, sex, and previous (nonbioptic) driving experience were not associated with mileage. LogMAR visual acuity was inversely related to mileage (P = .02), and contrast sensitivity (P = .01) and horizontal visual field (P = .02) were directly associated with mileage. Visual acuity (P = .02) and visual field (P = .005), but not contrast sensitivity (P = .19), were associated with number of collisions. CONCLUSIONS: Visual acuity, visual field, and contrast sensitivity were associated with driving exposure in bioptic drivers (with drivers with poorer vision reporting lower annual mileage), and poorer visual acuity and visual field were associated with more collisions. The per-mile collision rate for bioptic drivers was within the range of that previously reported for fully sighted drivers, although higher than would be expected for fully sighted drivers of similar age distribution.